Where are they now? Catching up with Lucy Ellen Towbin, LCSW

Towbin admires her grandchild in this recent photo.

Many of Lucy Ellen Towbin’s, LCSW endeavors are defined by nourishment. By the time she was two, Towbin was producing art and as she has continued to make multimedia art into her 70s, she nourishes her Self. As the eldest of four children, Towbin helped provide for her
younger siblings in their childhood. In her 30s, as a new mother,  she nourished her children.  As a social worker and lactation care provider, she supported other dyads in their infant feeding efforts. Later, Towbin started a business (which has since been sold) that offers clean, dehydrated parrot pellets, so that she and other parrot-owners could escape reliance on industry-produced pet food which usually contains additives and food coloring that parrots are particularly sensitive to.

During the first wave of the COVID-19 pandemic, Towbin retired from the
Arkansas Health Department, and while she no longer holds her IBCLC
credential, she continues to assist new mothers informally. Towbin now
practices as a part-time therapist for a psychotherapy clinic in
Arkansas.

The last time Towbin graced Our Milky Way was back in 2017 when we
featured the breastfeeding art contest she facilitated through the
Arkansas Breastfeeding Coalition.

We’re pleased to have chatted with Towbin as part of our Where are they
now? series. Responses have been edited for brevity.

 

Towbin poses with Ruth Lawrence roughly a decade ago.

How did you become interested in maternal child health? 

The first job I had at the Department of Health was as the refugee health program coordinator. We worked with mostly refugees from Southeast Asia.  I was really interested in and intrigued  by the difference in how
they were taking care of their children. They slept with their babies, which I’m sure plenty of people in the U.S. still did quietly, but back then, no one was talking about it.
During a panel discussion we once held, a speaker from Laos shared
that his six children born in Laos were breastfed, and the five children
born in the States were bottle-fed. This is when I really became
interested in the cultural aspects that affect infant feeding, and I started
to try to figure out what was going on.

Is there a current trend, project or organization that excites you?

I’m really not that up-to-date about trends in lactation, but what does
excite me are the portable pumps that working moms can wear. A close
friend of my daughter’s is a nurse practitioner and she showed me her
pump that she wears under her white jacket as she walks around seeing
patients. It makes almost no noise and it’s amazing because you don’t
even know that it’s under there. That would’ve been so incredible for me
to have as a working breastfeeding mom.

When I was working outside of the home, it was really difficult; even La
Leche League wasn’t very supportive of working moms at the time. With
my first child, I had a manual pump and my own office, but the pump was
miserable.  It hurt and wasn’t that effective. With my second child, I
stayed home longer with him and then he wouldn’t take a bottle, so I
didn’t do that much pumping. When I went back to work, my mother took
care of him and she lived close to where I was working, so I would nurse
him before work, and then drive back and forth to her house to feed him
about every two hours. It was a lot of back and forth.

What is the most significant change you’ve noticed within maternal child
health?

I have a very small sample size to talk about significant changes. All I
know is from my daughter and her friends. I’ve noticed that there seems
to be less unmedicated births happening in the hospital. I know there are
still a lot of people choosing home birth. But of those having babies in
the hospital, I haven’t heard about anyone doing what I did and having
mine in the hospital, but with no pain medicine or IV or anything.   I was
lucky to find the physicians that I did who went along with my wishes.  I
would expect there would be more supportive physicians now and instead, I don’t hear about any. I do want to reiterate that my observations are based on just a small group.

What is your best piece of advice for the next generation of lactation
care providers?

The most helpful lesson combines my training as both a therapist and
lactation consultant. New mothers need so much emotional support.
They don’t need people to take care of the baby. Bringing food and running errands for them is helpful. But I think what gets overlooked is
how much they need to be told that they’re going to make it, that they will
survive this early period of no sleep, and not knowing if they are doing a
good job. They need reassurance that this difficult time is normal and
they need to be told they will get through this.

My best piece of advice for the next generation is to take a holistic
approach, don’t just emphasize the physical exam. Equally important is
how much sleep the mother is getting,  what she is eating, if she is
getting exercise, if she has family and friends supporting her, if she has a
plan for if she’s going to be working outside of the home. It’s important to
equip new moms with coping strategies like easy breathing exercises or
something when she is feeling stressed that are doable in short time
frames and at home.

Where do you envision yourself in the next decade?

Asking someone my age where I see myself in the next ten years is
basically just hoping I’m still healthy and active! I do all the right things
and have good genes, so I’m on the pathway to that, but you never
know. Appreciate good health and youthful energy if you still have it.

Where are they now? Lessons from ruins with Carin Richter RN, MSN, APN-BC, IBCLC, CCBE

Photo by Aykut Eke on Unsplash

The peafowl is a bird known for attracting attention. Whether flaunting their colorful, unfurled plumage or delivering a resounding cry, peafowl are undoubtedly expressive, insistent creatures.

Occasionally, when Healthy Children Project’s Carin Richter, RN, MSN, APN-BC, IBCLC, CCBE hosts Lactation Counselor Training Course (LCTC) competencies from her Florida home, a curious peacock will poke its head into the frame of the video call demanding attention from her and the participants. 

“The big inquisitive bird insists on being part of the session on breastfeeding!” Richter exclaims.  

Since we featured her last, Richter has fully retired from her responsibilities at St. Anthony’s Medical Center in Rockford, Ill. and now helps facilitate the online LCTC once a week.

Our Milky Way caught up with Richter this winter as part of our Where are they now? series. 

Now 70 years old, Richter shares with a stirring of anger, worry and dismay in her tone: “Women’s health… We are in crisis mode. I’m personally struggling with any kind of optimism.”

She cites a few culprits: a political climate that tolerates division and disrespect, the marginalization of maternal child health issues, and the stripping of rights as marked by the reversal of Roe v. Wade. 

From these ruins, Richter has constructed several lessons. For one, she implores us to become politically involved. 

“Keep women’s issues right smack dab in the conversation,” she advises. “Look around. Search out areas where you can sit at that decision making table.” 

Political involvement, Richter suggests, can come in the form of participating on a shared governance board, community advisory boards, church councils, and rotary clubs. Engagement doesn’t need to look like shaking hands with the mayor. 

She continues, “My friends always say, ‘Oh Carin, you never have one conversation without the word breast coming through.’ We need to live that! Because if we don’t we’re going to lose what we have.”

Photo by Nicole Arango Lang on Unsplash

In other words, be a peafowl. Demand attention. 

Richter lays out what happens when we don’t. 

During her nursing career, Richter and her colleagues’ involvement with the Baby-Friendly Hospital Initiative (BFHI) eventually gave rise to seven hospitals in her area being designated by 2013. As of 2022, only one of those hospitals had retained their designation. 

“Because there was no one sitting at the decision making table speaking for the initiative,  administration lost sight of it and breastfeeding took a back seat or perhaps didn’t have a seat at all,” Richter reflects. “No one spoke of keeping breastfeeding issues in the forefront. It’s an experience that brings me to tears.”

Another insight she’s gained is the difficulty in beginning and sustaining a community-based lactation business. She watched friends with solid business plans, well-researched proposals, and passionate ambitions to help dyads get crushed by lack of insurance reimbursement, lack of mentorship and lack of collaboration.

“We need a lot of work on that front,” Richter comments. 

She suggests a reimagination of the way lactation services are viewed where insurances and companies recognize the importance of breastfeeding and elevate lactation support to a professional state. 

For instance, while working at the hospital, Richter brainstormed ways to give value to and justify the services of in-house lactation care providers. She found that postpartum breastfeeding support offered in-hospital  resulted in a marked increase in patient satisfaction scores. A creative solution suggested that  initial lactation and breast care be embedded in the room rate available for all patients, not billed as a separate line item, allowing for a higher reimbursement rate, Richter explains.  

Photo by Hannah Barata: https://www.pexels.com/photo/woman-having-skin-to-skin-contact-with-her-newborn-baby-19782322/

After retirement from the clinical setting, Richter cared for her aging parents. She says she felt the pinch many women of today experience as they juggle personal, familial and work responsibilities.

As she lived the struggle to find workable solutions for the care of her elder parents, she says she was surprised to find that barriers were similar to those she encountered while working for change in the community surrounding breastfeeding. For both, breastfeeding and elder care, resources are often limited, frequently expensive, and often inaccessible or unavailable.

Her focus now has broadened from maternal child health advocacy to the broader realm of family care issues. She finds herself
advocating for maternal child health and family care issues like pay equity and affordable child care.

“The struggle continues across the continuum, in arenas frequently dominated by women who bear the majority of responsibility,” Richter reflects. 

Despite a sometimes discouraging climate, Richter says she sees “little bright spots” here and there. 

“Not a week goes by that I don’t have a [medical professional] seeking lactation credentialing… I am thrilled with this,” she begins.  The practitioners seeking lactation credentials are not only specializing in women’s health; instead they’re an interdisciplinary group of folks, a sign that breastfeeding and lactation care is breaking free from siloed confines.  

“This is what keeps me excited,” Richter says. “More knowledgeable, eager voices speaking for mothers and babies.” 

Looking back, Richter remembers when it caused a fight to require lactation credentialing for OB nurses. 

“We got so much backlash not only from administration but from OB nurses themselves,”  Richter recounts. “Some OB nurses took no ownership of lactation. ‘That’s the lactation counselors’ job,’ they would claim.”

In this culture, Richter pointed out that trauma nurses are required to be trauma certified, oncology nurses  are required to be oncology certified; why were OB nurses not required to be certified in lactation when it’s such a large portion of their work?

“It was a bit of an eye opener,” Richter says. 

Retrieved from ALPP. Used with permission.

Now almost all hospital OB nurses need to be certified within the first one to two years of hire, and Richter says she’s encouraged by the ever-increasing number of OB nurses she speaks with weekly who are seeking breastfeeding certification and are supported by their department managers.

As for physicians certified in lactation, an already developed template existed. The state of Illinois had issued a Perinatal state wide initiative to mandate that all anesthesiologists caring  for pregnant patients were to be certified in Neonatal Resuscitation Program (NRP). All obstetricians soon followed. Richter says her wish would be that the template could extend to mandating lactation credentials to all professionals caring for pregnant and breastfeeding families.

Another bright spot Richter’s noticed are the larger, private sector industry and private employers in the Midwest offering adequate workplace lactation accommodations and services  that go beyond what is mandated by law. 

Moreover, Richter continues to be  impressed by the work that the United States Breastfeeding Committee (USBC) is doing, namely increasing momentum for workplace protections across the nation.

Though she adds, “The spirit is really strong, but the body is really weak. Getting the body to make the decisions and the policies is difficult.” 

Retrieved from ALPP. Used with permission.

Yet another area of encouragement is the inroad made into the recognition of perinatal mood disorders (PMD). Acknowledging that there is always room for improvement, Richter extols the improvements in detection, treatment and the lightened stigma around PMDs.  

Richter shares on a final note that while maternal child health issues have been largely well promoted and mostly supported in the last decade, she hopes to see more emphasis and energy put into the protection leg of the triad. That will require involvement in the work of policy change at the institution, community, state and national level. Policy development and change is the first stepping stone, she advises. 

“Do not be afraid of policies, because policies have power,” Richter states.  “Get involved and find your place at the decision making table.That’s your homework assignment for the year!” 



Infusing work-life balance in medicine: reflections from Katrina B. Mitchell, MD, IBCLC, PMH-C, FACS

— “…Breastfeeding isn’t about ‘success’ or ‘goals’ — it’s a human experience.” —
Mitchell’s son captures her on the job. Used with permission: https://www.instagram.com/p/CuN_G35Rc0h/

Katrina B. Mitchell, MD, IBCLC, PMH-C, FACS, a breast surgeon, lactation consultant, and perinatal mental health provider in Santa Barbara, Cali., went back to work at five weeks postpartum.

“Looking back…I have no idea how I did this,” she reflects.  “I know this is still far better than migrant workers on the central coast of California, who may not even have a week to recover.”

In part, Dr. Mitchell recognizes the support she received from a pediatrician; he counseled her on bed sharing during the time she was breastfeeding as a single parent in surgical training.

“This literally saved mine and my son’s physical and emotional health (as well as allowed me to exclusively breastfeed for six months and then onward for years),” Dr. Mitchell explains. “Sure, it was still terrible to have to pump milk in a bathroom by the OR and lug my pump all over the hospital, but I really believe I stayed on a postpartum high because I got to sleep and nurse my baby at night when I got home.”

She continues: “[Bedsharing] saved every possible complication we could have experienced with me being back at work operating 14 plus hours a day at that point in time…. I am forever grateful to this pediatrician…”

Dr. Mitchell captured these early experiences in a book she wrote for her son about being a surgeon mom.

In her practice today, Dr. Mitchell tells her patients who are going back to work that the ounces in a bottle during the day are not nearly as important as feeding baby at the breast when the dyad is together and feeding overnight on cue.

“Safe bedsharing is what facilitates this and results in continuation of breastfeeding far longer than separate surface bedsharing, sleep training, and feeding a pump rather than the baby,” she explains.

In particular, physicians have long struggled with “pouring from an empty cup” alongside being influenced by insidious industry tactics, mechanical culture and inadequate education. Nikki Lee and I wrote about these forces in Physicians as parents: How can one pour from an empty cup? and Physicians as breastfeeding supporters.

In New study calls for greater access, equity for breastfeeding surgeons author Hilary Brown reports on “A new vanguard of physicians… determined to make the field more hospitable to working mothers by establishing dedicated pumping spaces and allotting time for pumping without fear of retribution or punishment.”

Brown goes on, “… No one should be denied professional opportunities just for choosing to have a work-life balance. For too long, surgeons were lauded for not having families, or prioritizing their work over a personal life. To be a martyr to the field was considered the highest level of dedication. But ultimately, such devotion has proven to be a detriment. Excellent patient care, London-Bounds says, starts with self-care.”

Dr. Mitchell acknowledges that “..the surgical world is becoming more attune to this topic.”

In 2020, the Association of Women in Surgery released a position statement on supporting physicians and trainees who are breastfeeding.

In regard to lactation accommodations in the workplace though, Dr. Mitchell says she often thinks of something Kimberly Seals Allers pointed out many years ago when she said something along the lines of: “We are a pump nation — we shouldn’t be celebrating being gifted a pump from our medical insurance.  We should be demanding adequate paid maternity leave.”

“Accommodations should really be focusing on this governmental-level change,” Dr. Mitchell elucidates.  “Not only is it the right thing to do for human beings, but it reflects one of the fundamental principles of economics 101:  opportunity cost.  You lose some productivity up front by giving mom a longer maternity leave, but you exponentially recoup this cost when moms breastfeed rather than wean and have good mental and physical health when they return to work.”

In this landscape without paid leave, there can be a layer of tension that brews between colleagues.

“A  lot of the hostility towards lactation and lactating patients does stem from physician personal experience with lactation (which was unfortunately largely negative in the past, and can persist today no matter what accommodations we provide),” Dr. Mitchell begins.

“And these negative experiences are a direct result of the medical patriarchy, which provides little to no education on the breast and lactation in medical school, residency, or fellowship training.  Because of this, just like all other patients, physicians themselves are at risk for not receiving appropriate evidence-based support and education surrounding lactation and breastfeeding.”

She continues, “As we all know, the postpartum time period is one of great vulnerability, and a person’s experience with breastfeeding can play a central role in how they navigate early motherhood.”

Juxtaposing the way that we look at lactation and breast cancer care, Dr. Mitchell says that we would never tolerate breast cancer care as being reflective of personal experience, but this often happens with lactation.

“With breastfeeding, there’s the dismissive comments of ‘oh, it didn’t work for me, so it’s fine it doesn’t work for you.’  We would never say ‘that chemotherapy didn’t work for me, so it’s ok if it doesn’t work for you,’” she explains.

Clear to recognize that this is not the fault of the individual, Dr. Mitchell says it’s instead a reaction to “the fact that the patriarchy didn’t support them, either.”

And so, to influence real change, we have to start at a systems level in medical education, she says.

Training needs to include education about things like safe bedsharing, how formula feeding and breastfeeding are vastly different in terms of volume and infant behavior (e.g. the normal distraction of a breastfed infant at four months old versus a bottle fed infant taking a bottle on schedule), Dr. Mitchell explains.

“…This should be standard education for all of us.”

Physicians from less traditional backgrounds have great power to drive change too, Dr. Mitchell suggests, sharing her personal experience:  “I am the only person in my generation on one side of my family to go to college, much less medical school.  Three quarters of medical school matriculants come from the top two household-income quintiles — I was not one of them.  Since I was a teenager, I worked my way through school.  I had a liberal arts background and undergraduate degree, and I think all of this made me see things from a different perspective than other medical students and physicians.  I was also lucky that my mom pushed back against the tide of formula feeding in the late 1970s, and I was a breastfeed infant myself because of this.”

In a powerful Instagram post, a photo snapped by her seven-year-old son is captioned “I love this moment because it’s the ultimate rebellion against corporate medicine. No one can take away the power of human connection.”

The post is commentary on a simpler, more connected way of caring for patients.

“Instead of a patient having to login to the EMR or deal with a centralized scheduling call center to make an appointment, [the post] reflected the way we used to care for people in medicine and what I try to preserve as much as possible:  a patient needing help, contacting me directly on a weekend, us all going in with casual clothes and me just doing my job as a doctor,” Dr. Mitchell explains. “ No electronic medical record, no ‘15 minutes with each patient’ corporate mandates, no ‘you can’t do this or that’ by the administration.”

Ironically, Dr. Mitchell continues, she’s noticed that corporate medicine has made certain aspects of lactation accommodations better.

“The one positive aspect …is oversight and standardization and human resource departments,” she says.   “If there’s a law for accommodations, there is someone enforcing them (along with all the other not-so-helpful ‘enforcements’ like clicking through countless screens in the EMR simply to write a quick note on a patient).”

During the 2020 COVID-19 pandemic, Dr. Mitchell created the Physician Guide to Breastfeeding, a hub where she’s committed to sharing openly and advocating for improvements in broader maternal child health education. You can explore her collection here.

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)