We have heaps and heaps of evidence to show the importance of human milk, breastfeeding and support for breastfeeding families yet, the United States lags pitifully behind in providing proper support to ensure the mother-baby dyad can breastfeed successfully. Bringing light to this deficit, Anne Eglash, MD, IBCLC, FABM, founder of the non-profit The Milk Mob, poses this question: Can you identify any other health behavior besides breastfeeding that the majority of mothers and babies are engaged in for which medical professionals are not educated?
In the U.S., an impressive 80 percent of mother-baby dyads leave the hospital breastfeeding; still, very few outpatient medical care providers and staff are equipped with evidence-based education and training that support healthy infant feeding.
When medical care providers lack the tools to support breastfeeding, families often seek lactation care outside of their pediatrician, OB or family physician which “…places the United States population at risk for racial and ethnic disparity in breastfeeding support since families with more resources will have a greater chance of accessing lactation care in their communities.” [https://themilkmob.org/breastfeeding-friendly-medical-systems/]
Dr. Eglash founded The Milk Mob in 2014 with the mission to optimize support for breastfeeding families in the outpatient sector by building Breastfeeding Friendly Medical Systems and Communities through education and collaboration.
Training breastfeeding champions
The organization offers the Outpatient Breastfeeding Champion Training, a basic, clinically-focused, 16 hour course for medical or community breastfeeding supporters. To date, the organization has trained about 1,000 Breastfeeding Champions.
Dr. Eglash has found that staff working in the front lines have great interest in learning the skills to help breastfeeding dyads.
The Milk Mob is currently working to train WIC staff as Breastfeeding Champions in five Midwest states. In an effort to disseminate the training, the Outpatient Breastfeeding Champion Training functions with an Instruct the Instructor model. Participants complete the initial training, then complete an instructor’s course, so that they are equipped to teach small groups in their own communities. This approach cultivates culturally-appropriate and relevant instruction.
Through The Milk Mob, Dr. Eglash provides a variety of continuing education including The Breastfeeding Medicine Podcast, The Clinical Question of the Week, and breastfeeding handouts so Champions can stay up to date with current policies and new research. Dr. Eglash says that the outpatient breastfeeding program has been a stepping stone to The Lactation Counselor Training Course for many of its participants.
Educating providers
The Milk Mob offers separate breastfeeding education modules for healthcare providers: a one- day primary care breastfeeding medicine basics training and a three-day advanced breastfeeding medicine training.
Interestingly, the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Obstetrics and Gynecology (ACOG) all have formal statements advising breastfeeding education during specialty training.
“But the staff of the medical schools and residencies don’t have the education to provide the comprehensive education,” Dr. Eglash explains.
A host of problems succeeds. For one, when a medical student or resident learns about lactation and breastfeeding support from someone other than a physician, the education is out of context; that is, they do not learn how to incorporate breastfeeding support into their care, Dr. Eglash explains. With this approach, students and residents get the illusion that lactation is not something they need to learn, she continues. Further, lactation professionals and physicians have different scopes of practice.
When physicians do provide lactation training, the education reflects what they’ve learned about breastfeeding: the information is often inaccurate and the message about the importance of breastfeeding is diluted.
“[Students] are learning from someone who may not value breastfeeding because that instructor was never showed the value of breastfeeding,” Dr. Eglash adds.
Fortunately, as a clinical professor, Dr. Eglash witnesses residents’ enthusiasm to learn about breastfeeding. Many of them are having children of their own and are influenced by their own birth and breastfeeding experiences. At this pivotal point, Dr. Eglash says that the future will depend on making sure we have the means to educate medical students and residents, so that when they begin to practice, they will be able to “hit the ground running.”
The Milk Mob recently released the 6th edition of The Little Green Book of Breastfeeding Management for Physicians and Other Healthcare Providers, a pocket-sized reference manual for the most commonly asked questions that breastfeeding families have throughout the course of lactation.
Encouraging community collaboration
The mother-baby dyad requires support prenatally, immediately postpartum, in the outpatient sector and as they integrate into the community as a new couplet. Establishing a continuum of breastfeeding support throughout this journey is another component of the Breastfeeding Friendly Medical System.
A unique example is that of the collaboration between the Aurora WIC program in Milwaukee, Wis. and Aurora Sinai Medical Center. In fact, the WIC office is housed inside of the hospital. This setup facilitates daily communication and consistent messaging between staff and accessibility for families.
Facilitating conversations
The Milk Mob will host its first Art & Science of Breastfeeding Conference on May 12, 2017.
The conference attempts to connect bench scientists and clinicians, coupling “both the art of infant feeding with new and emerging scientific explanations of clinical phenomena that we observe when working with breastfeeding dyads.” [https://themilkmob.org/art-science-2017/]
“If we could start having more conversations between the bench and clinical science folks, we will move along further in what we are doing,” Dr. Eglash says.
Visit The Milk Mob here.
Register for the conference here.