Behavioral Safe Sleep Training (BeSST) teaches caregivers how to arrange infant sleeping spaces

Whereas bedsharing was once denounced entirely, it is becoming increasingly recognized as a behavior that many parents will engage in, especially when breastfeeding. So, health advocates are shifting focus to how to do so safely. For some examples see ABM, NCEMCH, and NAPPSS-IIN.

Image courtesy of the Safe to Sleep® campaign, for educational purposes only; Eunice Kennedy Shriver National Institute of Child Health and Human Development, http://www.nichd.nih.gov/sids; Safe to Sleep® is a registered trademark of the U.S. Department of Health and Human Services.

The CDC reports that there are about 3,400 sleep-related deaths among babies in the US each year. 

Jason C. Vladescu, Ph.D., BCBA-D, NCSP, LBA(NY) is a professor in the Department of Applied Behavior Analysis and Clinical Supervisor at the Center for Autism and Applied Behavior Analysis at Caldwell University, and he and his colleagues developed the Behavioral Safe Sleep Training (BeSST)—a practice-based approach—to teach caregivers to arrange the infant sleeping area. The BeSST team consists of researchers from three Mid-Atlantic Universities and has reached about 60 caregivers in Philadelphia since 2019.

Infant feeding is not a primary focus of their training, but Vladescu explains, “We recognize that this is an area that is not unrelated to safe infant sleep in that feeding of human milk (note here I intentionally didn’t specify breastfeeding, as work here has not always distinguished between feeding at the breast vs. expressed human milk) is recommended by the American Academy of Pediatrics (AAP) as it has been associated with a reduced risk of sudden infant death syndrome (SIDS).”   

He goes on to explain that BeSST training was designed to align with APP infant sleep environment recommendations: policy statement and  technical report.

The recommendation “includes supine positioning; use of a firm, noninclined sleep surface; room sharing without bed sharing; and avoidance of soft bedding and overheating.” 

Vladescu comments, “This recommendation is made because there is five times greater risk for infant death when bedsharing. The hope is that by room sharing (rather than bedsharing), caregivers can still feed and comfort their infant with relative ease, without increasing the risk of sleep-related death. By addressing the AAP recommendations in our work, we provide caregivers with information and training, as well as rationales for the recommendations provided in the training, with the end goal of minimizing risk and working to ensure caregiver needs and those of their infant are met.” 

The AAP recommendations differ from approaches like those of Durham University and the greater UK which acknowledges the reality that many babies will be in bed with parents and is against the ‘just say no’ approach, as Healthy Children Project’s Karin Cadwell points out. 

Currently, the BeSST team is deploying their training in a maternal residential substance use treatment program. 

“This is particularly exciting work given the emerging evidence that infants born to mothers with opioid use disorder are at increased risk of sleep-related deaths,” Vladescu begins.  “Some of the variables at play for this population of infants are unique (for example, healthcare personnel may utilize practices that do not align with the AAP recommendations to improve neonatal opioid withdrawal symptoms, which caregivers may imitate outside of the hospital). Such unique variables need to be considered when developing interventions to promote safe infant sleep with this population. In the context of this work,

we will be evaluating an initial attempt to evaluate the influence of a contingency management program based on caregiver responding across the night.” 

At the moment, the BeSST program is available in Philadelphia, Pa. through partnerships with community health centers, but Vladescu says he hopes by developing a network of partnerships with colleagues and professionals, they can increase the scale of their work. 

You can reach out to Vladescu directly at JVladescu@caldwell.edu  for more information or to engage with their programming. 

Check out these recent publications for more on the topic

Full spectrum doula facilitates multilateral programming to support BIPOC breastfeeding

When Meah El, SFW, TCP, CBE, a Full-Spectrum Doula, Education Specialist, Doula Team Leader and Cribs for Kids Coordinator at The Foundation for Delaware County, was just eight years old, she landed her first job. On summer trips to New England, El would help her aunt in her in-home daycare.  When her aunt gave birth to a premature baby in her late forties, El was the only one her aunt trusted in helping out with the baby.

“I always say that my career found me,” El reflects.

She stayed on this early education career path, later working with Maternity Care Coalition as an Early Head Start advocate. Through this work, she became trained as the first doula at their site.

“I loved it ever since,” she says. “Birth work is the crème de la crème.”

El remembers one of her first clients, a 15-year-old mother, and struggles to put into words just how amazing it felt to help a birthing mother.

To enhance her ability to support lactating and breastfeeding clients, El took a breastfeeding course with Nikki Lee  and now, she is one of the latest recipients to earn the Accessing the Milky Way scholarship which covers the Lactation Counselor Training Course (LCTC). A colleague of hers is also working through the LCTC, so they have scheduled a weekly meet up to review the course material together.

El is dedicated to helping BIPOC families reach their breastfeeding goals and dedicated to improving overall health within BIPOC communities through healthy infant feeding.

While Chester and Delaware counties have relatively high breastfeeding initiation rates, the overall infant feeding culture “hushes” breastfeeding, and BIPOC families are up against barriers to breastfeeding like lack of education, familial support, and skilled lactation care, as El explains.

During Black Breastfeeding Week (BBW) 2023, El facilitated a celebration complete with henna artists, reiki sessions, infant foot massage, aromatouch hand massages for parents, brunch and a breastfeeding photo shoot. El will curate the images from the photo shoot into an art installation during next year’s BBW celebration.

Moreover, El is working to establish a lactation cafe, a peer breastfeeding support group run by breastfeeding champions in the community, and mini trainings for staff at The Foundation.

Logo by Meah El

In order to combat breastfeeding misinformation on social media, El will create social media “shorts” with practical breastfeeding information that will be disseminated through the organizations channels. El is also in the process of working with the Pennsylvania Chapter of the American Academy of Pediatrics (AAP) to recognize breastfeeding-friendly businesses.

All of these efforts are part of El’s goal to create a supportive environment around breastfeeding.

“If there’s no community support and no support at home, [the system] is built to fail,” El begins. “I want everyone to win.”

El encourages Our Milky Way readers to share their breastfeeding photos on social media and tag #delcobreastfeeds in order to normalize breastfeeding. She also reminds readers to explore the multitude of programs available at The Foundation for Delaware County. You can contact El directly for direction.

Human milk banks around the world

Of all the known approaches to saving infant lives, human milk has the greatest potential impact on child survival. (PATH) When direct breastfeeding or mother’s expressed milk is not available, donor human milk is the next best option.

Photo by Samer Daboul

As such, the 2018 WHO/UNICEF implementation guidance on the Baby-friendly Hospital Initiative stated that “Infants who cannot be fed their mother’s own milk, or who need to be supplemented, especially low-birthweight infants, including those with very low birth weight and other vulnerable infants, should be fed donor human milk.” The American Academy of Pediatrics, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition, and other national and global policy groups also call for use of donor human milk as the feeding of choice, if mother’s own milk is insufficient, unavailable or contraindicated. (WHO)

Now, WHO is in the process of developing guidelines on donor human milk banking.

The ISRHML Trainee Interest Group recently presented A Global View of Human Milk Banking with Kimberly Mansen (PATH), Dr. Victoria Nakibuuka (Nsambya Hospital), Debbie Stone (Rogers Hixon Ontario Human Milk Bank), and Dr. Maryanne Perrin (The University of North Carolina Greensboro) which brought to light several, wonderful resources and is the inspiration for  this week’s post.

Let’s take a look at some human milk banks around the world.

This tableau map depicts publicly known human milk banks. If you know of a milk bank that is not shown on the map, you can fill out this form and/or email kamundson@path.org or humanmilkbankmap@gmail.com.

Brazil 

Donor milk banking thrives in countries such as Brazil, where there has been a concerted effort at the Health Ministry level to incorporate milk banks into health policy. (Arnold, 2006)

 

Uganda

In commemoration of World Prematurity Day, Uganda introduced its first human milk bank at Nsambya Hospital on the 26th of November 2021 at Pope Square. [More here.]

 

Canada 

The Rogers Hixon Ontario Human Milk Bank in Ontario has dispensed over 1 million ounces of human milk. The Rogers Hixon Ontario Human Milk Bank is a non-profit organization and a joint initiative of Mount Sinai Hospital, The Hospital for Sick Children (SickKids) and Sunnybrook Health Sciences Centre. It is a member of the Human Milk Banking Association of North America.

 

Ukraine 

The first and currently only Ukrainian Human Milk Bank was established in Kiev at the Perinatal Centre where approximately 80 percent of all premature babies in the city are born.

 

South Africa

The South African Breastmilk Reserve (SABR) has set up a total of 44 in-hospital human milk banks in public and private hospitals across South Africa.

 

Vietnam

The first human milk bank in Vietnam was officially opened on February 17, 2017, at the Danang Hospital for Women and Children. This facility is supported by the Vietnam Ministry of Health and the Danang Provincial Department of Health, and is the first human milk bank in Vietnam to be operated within the public health system and to international standards. (PATH)

Take a virtual tour of the bank here.

Also consult:

Physicians as breastfeeding supporters

Photo retrieved from: https://tobacco.stanford.edu/cigarette/img0079/

“More doctors smoke camels than any other cigarette,” claims the ad from 1950. Today, it’s preposterous to imagine that any physician would align themselves with the tobacco industry. Starting  in the 1920s and continuing well into the 1950s though, tobacco companies used doctors to help them sell their products. Stanford’s Research into the Impact of Tobacco Advertising has a collection of over 1,000 advertisements that feature doctors endorsing tobacco products. 

In an eerie parallel, WHO’s February 2022 report, How the marketing of formula milk influences our decisions on infant feeding, states that “Recommendations from health professionals are a key channel of formula milk marketing. Health professionals spoke of receiving commissions from sales, funding for research, promotional gifts, samples of infant and specialized formula milk products, or invitations to seminars, conferences and events.” (p. 7) 

Last week, Nikki Lee, RN, BSN, MS, Mother of 2, IBCLC,RLC, CCE, CIMI, CST (cert.appl.), ANLC, RYT500 and I shared our reflection on the forces that shape physicians’ personal infant feeding experiences. In this second installment, we explore how physicians as professionals can support breastfeeding despite being targeted by the breastmilk substitute (BMS) industry and despite generally being woefully equipped with proper lactation education, training and counseling skills. These predicaments can lead physicians to “explicitly or inadvertently, introduce doubts around the ability of women to breastfeed and the value and quality of their breast milk.” (WHO, p. 12) 

 

Pervasive industry influence for generations

Because “health professionals are among the most respected and trusted members of society…[their] advice…is highly influential for pregnant women and parents of infants and young children, including around infant feeding decisions.”  Formula milk companies exploit this relationship of trust. (WHO, p. 12)

Source: United States Breastfeeding Committee

BMS representatives target physicians “with a range of incentives, including funding for research, commissions from sales, ambassadorial roles, merchandise, gifts and all expenses paid promotional trips.” (WHO, p.13) 

The psychology behind gift-giving, both big and small is that “ it imposes…a sense of indebtedness…. The…rule of reciprocity imposes…an obligation to repay for favors, gifts and invitations…” (Katz 2003) Instead of supporting infant feeding purely through a health and wellness lens, physicians feel obliged to a company muddying their relationships with their patients. 

Interestingly, most physicians feel immune to marketing’s influence, despite clear evidence to the contrary, Frederick S. Sierles, MD lays out in The Gift-Giving Influence

Curious consumers can search their doctors’ names through ProPublica’s Dollars for Docs project to learn about gifts they have accepted. 

 

Mechanical culture 

Our culture fails to acknowledge the mother baby unit as a dyad, and this influences the way physicians can support breastfeeding too.

Source: United States Breastfeeding Committee (USBC)

“We are never taught, in our fragmented system, that the mother and baby are a unit,” Lee reiterates. “OB/GYN/midwife sees mama; peds sees babies. There are even different places for them in the hospital: nursery, postpartum unit. What a struggle we had with the BFHI to keep mother and baby together.” 

[As a side, Attorney Leah Margulies recently shared in Protecting Breastfeeding in the United States: Time for Action on The Code that formula companies provide architectural designs to maternity care facilities in a deliberate attempt to separate dyads.] 

The Alliance for Innovation on Maternal Health’s (AIM) Patient Safety Bundles offer models for how health professionals can use task force approaches that break down silos of care and open channels of communication. The strategies used in these bundles aim to ultimately shift from fractured care to continuity of care where the dyad is protected.  

We must also consider how physicians are compensated for their work. In the current U.S. healthcare system, physicians find themselves paid in Relative Value Units (RVUs), which bluntly put, is a pretty mechanical way to value providing care to other humans, as we mentioned in our first installment. In short, the more RVUs a physician racks up, the more they’re paid. Breastfeeding counseling takes time.

 

Inadequate education 

How are physicians to spend time with their patients, educating and supporting breastfeeding when they’ve had little to no breastfeeding education invested in them? Dr. Nigel Campbell Rollins pointed out in WHO’s How the marketing of formula milk influences our decisions on infant feeding webinar that faculty in medical schools themselves sometimes believe that formula products are inevitable or necessary. 

A cross-sectional study in the UK suggests that UK medical schools are not adequately preparing students to support breastfeeding patients.  

Source: United States Breastfeeding Committee

Samantha A Chuisano and  Olivia S Anderson’s findings in Assessing Application-Based Breastfeeding Education for Physicians and Nurses: A Scoping Review “… align with existing literature in finding a dearth of high-quality studies assessing breastfeeding education among physicians and nurses. The variability in teaching and evaluation methods indicates a lack of standardization in breastfeeding education between institutions.”

Elizabeth Esselmont and colleagues’ piece Residents’ breastfeeding knowledge, comfort, practices, and perceptions: results of the Breastfeeding Resident Education Study (BRESt) concludes: “Pediatric residents in Canada recognize that they play an important role in supporting breastfeeding. Most residents lack the knowledge and training to manage breastfeeding difficulties but are motivated to learn more about breastfeeding. Pediatric program directors recognize the lack of breastfeeding education.” 

 

A collection of physicians’ stories 

Often, it is a physician’s own struggle to breastfeed that seems to spur advocacy and change. Our Milky Way’s repository includes a breadth of physicians’ stories of personal struggles that have inspired them to become breastfeeding champions for their patients and communities. 

Source: United States Breastfeeding Committee (Photo by Sara D. Davis)

Some of those stories are linked below: 

Sarah Jacobitz-Kizzier, MD, MS, in Resident physician advances breastfeeding support,  shares that her lactation education in medical school included a one hour lecture about the anatomy of the breast and a brief discussion in physiology about lactogenesis.

“There was no training about [breastfeeding] technique, no discussion about common problems before discharge, no training about clinical problems as far as in the first few months postpartum…when to introduce complementary food,” she continues.

Physician calls for peer breastfeeding support features the work of Colette Wiseman, MD, CLC. 

In Breastfeeding in the healthiest county in Virginia, Janine A. Rethy, MD, MPH, FAAP, FABM, IBCLC, a general pediatrician in Loudoun County, Va. describes her dedication to improving breastfeeding outcomes. In it, she shares a resource she and her colleagues created –the Breastfeeding Support Implementation Guide for the Outpatient Setting which includes information on how to bill insurance for lactation services.

Skin to skin in the OR showcases Rebecca Rudesill’s, MD, CLC quest for more breastfeeding education. 

Kristina Lehman’s, MD, CLC work is featured in Internist looks to augment breastfeeding education

James Thomas Dean III, DO and Assistant Professor of Pediatrics at the University of Texas San Antonio Dr. Perla N. Soni, MD share their perspectives in Lack of breastfeeding education in med school harms families

Alison Stuebe, MD, MSc tackles big topics in OB/GYN sheds light on breastfeeding culture.

We are honored to have been able to feature the work of the late Audrey Naylor in Commendable contributions to the field of lactation. ​​With a lifetime interest in illness prevention, Naylor said she was quickly convinced of the power of breastfeeding after only attending a few hours of a breastfeeding seminar in 1976.

“Neither medical school nor pediatric residency taught me anything about breastfeeding,” Naylor said.  

Elizabeth Sahlie’s, MD, FAAP and Jesanna Cooper’s, MD work is featured in Birmingham Mother-to-mother support helps moms reach feeding goals. Cooper says that before she became a mother, she had no idea that her medical training and education had been so lacking.

“It is easy to become frustrated with nurses and physicians who – often inadvertently sabotage breastfeeding mothers and babies, but I also sympathize,” she explains. “We are in a position where we are supposed to have answers, but no one has taught us the skills necessary to provide those answers.”

Other stories and models for care 

Lori Feldman-Winter’s, et al  Residency curriculum improves breastfeeding care showed that “a targeted breastfeeding curriculum for residents in pediatrics, family medicine, and obstetrics and gynecology improves knowledge, practice patterns, and confidence in breastfeeding management in residents and increases exclusive breastfeeding in their patients. Implementation of this curriculum may similarly benefit other institutions.

 As part of their work to build a cohort of breastfeeding-friendly pediatricians, the Georgia Chapter of the American Academy of Pediatrics and the Georgia Breastfeeding Coalition launched a “Breastfeeding-Friendly Pediatrician Interest Form.” Georgia pediatricians who are interested in becoming certified as a “Breastfeeding-Friendly Pediatrician” are invited to fill out the form.

 

Further reading and resources

Physicians, Formula Companies, and Advertising: A Historical Perspective

Inspire Health, CHAMPS,  and the University of Mississippi Medical Center’s Breastfeeding, Human Medicine,  Interprofessional Education training   

CDC Physician Breastfeeding Education  

What Every Physician Needs to Know About Breastfeeding from the W.K. Kellogg Foundation

The Institute for the Advancement of Breastfeeding & Lactation Education (IABLE) is a nonprofit membership organization whose mission is to optimize the promotion and support of breastfeeding for families in the outpatient sector. IABLE is dedicated to building Breastfeeding Knowledgeable Medical Systems and Communities. 

Academy of Breastfeeding Medicine (ABM) Breastfeeding-friendly Physicians protocol 

 

Physician group position papers and recommendations on breastfeeding 

American Academy of Pediatrics (AAP)

American Academy of Family Physicians (AAFP)

The American College of Obstetrics and Gynecology (ACOG) 

Physicians as parents: How can one pour from an empty cup?

A medical student once told Nikki Lee, RN, BSN, MS, Mother of 2, IBCLC,RLC, CCE, CIMI, CST (cert.appl.), ANLC, RYT500  about an obstetrician who loved to pump while she was catching babies because she collected more milk than usual. Lee theorizes that perhaps it was due to the high levels of oxytocin in the atmosphere during childbirth. 

It’s a fascinating concept, and quite unusual considering physicians often find themselves in a terrible paradox. As Lee puts it, they are supposed to take care of everybody else, and no one takes care of them. They’re expected to be experts on everything;  as childbirth educators and lactation care providers, we often disclaim “this information is not meant as a substitute for medical advice.”

In this two-part series, Lee and I set out to explore the forces that surround infant feeding, ones that physicians must muscle through as parents themselves and as professionals. We explore emerging themes inspired by the article Medical training taught this Philadelphia doctor about breast feeding. But the real lessons came from her twins. In Part One, we offer thoughts on physicians functioning as parents themselves. Part Two covers physicians as professionals trying to support breastfeeding most often with inadequate education and training.

Source: United States Breastfeeding Committee

With insufficient support in their personal infant feeding goals, physicians’ struggles sometimes seem to spur advocacy and a “do-better-for-my patients” attitude. Just the same, these experiences can lead individuals to harbor resentment, despair, resignation and defeat, and might unintentionally influence the breastfeeding support they are able to offer their patients. 

When physicians’ basic needs aren’t met, we can’t expect them to meet the needs of their patients. How can one pour from an empty cup?  Kathleen Kendall Tackett offers Burnout, Compassion Fatigue, and Self Care for Members of the Perinatal Team which presents insights on the effects of little institutional support and specific strategies for integrating self-care into care for others. 

Self-care is sustainable only when everyone can do it. 

Before physicians are done with their decade or more of training, they are challenged by inadequate support in their efforts to feed their own children. 

“In a survey of 412 medical trainees with children, more than 80% of women reported feeling stressed about breastfeeding, and one-third did not meet their breastfeeding goal,” Gaelen Dwyer points out in Pumping up support: Making breastfeeding easier for med students

What’s more, a  recent research letter, American Board of Medical Specialties Board Examination Lactation Accommodation, evaluates the American Board of Medical Specialties (ABMS) member boards’ lactation-specific board examination accommodation policies highlighting that a minority of female physicians (42%) achieve the recommendation that infants receive mother’s milk at least until age one. 

Source: United States Breastfeeding Committee

“Board examinations are a key aspect of medical training,” the authors begin. “With up to 22% of female trainees delivering a child during postgraduate training, and nearly 59, 000 female physicians in residency and fellowship in the US, there is a large group potentially affected by board examination lactation accommodations.”

About a decade ago, ​​in a landmark case that has implications for all testing organizations in Massachusetts, a unanimous Massachusetts Supreme Judicial Court ruled that breastfeeding mothers are entitled to special accommodations to allow them sufficient time to pump milk during lengthy testing for medical licensure. [https://www.wbur.org/news/2012/04/13/breastfeeding-doctor-ruling ] 

The elephant in the room is the issue of parental leave. Honestly, it’s hard to stomach that we are still arguing that there are medical and psychosocial benefits of protected parental leave for both parents and children. The U.S. is the only Organisation for Economic Co-operation and Development (OECD) member country—and one of only six countries in the world—without a national paid parental leave policy. The U.S. is also one of the few high-income countries without a national family caregiving or medical leave policy. [https://bipartisanpolicy.org/explainer/paid-family-leave-across-oecd-countries/

Women don’t breastfeed; societies do. The societal burden on the mother is magnified when the mother is a physician and is compelled to take care of everyone else, with no support for their own breastfeeding. Breastfeeding is blamed for being difficult, instead of us all getting furious that we don’t have paid maternity leave.

In the current U.S. healthcare system, physicians find themselves paid in Relative Value Units (RVUs), which bluntly put, is a pretty mechanical way to value providing care to other humans. In short, the more RVUs a physician racks up, the more they’re paid. Often that leaves lactating physicians forgoing pumping to spend more time with patients. The Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act would close the loopholes that force physicians to choose income or feeding their babies. The PUMP Act advanced out of the Senate HELP Committee with unanimous bipartisan support in May 2021 and then passed with significant bipartisan support (267-149) in the House last October. Despite this strong bipartisan support, the bill has languished in the Senate for almost a year. Get updates on progress here

In February 2021, the American Academy of Pediatrics (AAP) issued a policy statement on Parental Leave for Residents and Pediatric Training Programs.

Source: United States Breastfeeding Committee

The policy reports that the Institutional Requirements of the Accreditation Council for Graduate Medical Education require training programs to provide written policies regarding leaves of absence, including parental leave, and these policies must comply with current legislation such as the Family Medical Leave Act (FMLA), but that the length of leave has considerable variability among residency programs. The statement outlines the challenges of parental leave policies in training programs and gives recommendations to protect trainees and their families. One challenge is that education calendars are set long before a person enters a medical program, but labor, delivery, and the establishment of breastfeeding don’t fit into a predetermined calendar. 

Despite this dismal landscape, the medical world is changing and there are stories and models to celebrate. 

Catherine Wagner, a cardiothoracic surgery resident at Michigan Medicine, managed to breastfeed and pump for a year during her residency with a network of support. 

A committee at the University of Michigan is calling on pediatricians to support their fellow physicians.  Pediatricians Advocating Breastfeeding: Let’s Start with Supporting our Fellow Pediatricians First describes the efforts to support lactation within the department. The committee collected university policies, state and federal laws, identified the needs of breastfeeding mothers and then created a policy to support lactating individuals as well as a handout to help supervisors and colleagues support lactating women in the healthcare setting. (Supplemental material; available at www.jpeds.com).

Got Milk? Design and Implementation of a Lactation Support Program for Surgeons describes an initiative where “Multiple faculty members offered to offload resident workload before starting cases to provide time for a lactating resident to express milk… The University of Wisconsin adopted a ‘cross-cover’ model encouraging lactating residents to have other residents assist in the operating room during non-critical portions of the case if the primary operating resident needed to express milk that has been very well received and easily implemented.”

Source: United States Breastfeeding Committee

There’s attention being paid to lactation accommodation information in urology residency programs too. 

In this study, “Of 145 urology residency programs, 72.4% included information about lactation accommodations anywhere on the institution’s website.” The authors conclude that “efforts to recruit and retain female urologists should include making [lactation accommodation]  information more easily accessible.”

Authors Annery G Garcia-Marcinkiewicz and Sarah S Titler call on  anesthesiology as a workforce and specialty, to support the unique need of lactating and breastfeeding anesthesiologists in Lactation and Anesthesiology

This study offers the first comprehensive scoping review of the literature on breastfeeding policies pertaining to surgical residents in Canada.

The authors write: “…We aim to use these data to advocate for breast feeding for surgical resident physicians through the creation and improvement of current breastfeeding policies as applicable. This work aims to help change surgical culture to be more inclusive, which is vital in creating a breast feeding-friendly environment. This would include leadership endorsement of the policy, a culture shift (for example, no repercussions to resident for coming back on a modified schedule or taking breaks for expressing milk), visible educational notices throughout the workplace (ie, ‘breast feeding-friendly workplace’ notices, common in Canadian public settings), and creation of a network of ‘new moms’ within the surgical resident programme to ensure there is support and mentorship for new moms returning back to work. ”

While we wait for policies to catch up to the needs of lactating physicians, wearable pumps are helping them reach their infant feeding goals.  The Impact of Wearable Breast Pumps on Physicians’ Breastfeeding Experience and Success found that “those who had used a wearable pump reported statistically significant shorter lactation breaks (p < 0.00001) and were more likely to be able to provide breast milk to their infants for their entire intended duration (p = 0.005) compared to the traditional pump group.” 

The support network Dr. MILK (Mothers Interested in Lactation Knowledge) has been successful at helping physicians mothers reach their infant feeding goals. 

Where else are you seeing physician parents being supported in their infant feeding journeys? Email us at info@ourmilkyway.org