What One Doctor Says About Breastfeeding Training in the United States

May 10, 2010 • 9:39 am

So, why are mothers and babies having such a hard time with breastfeeding?  I just received a link to this blog which I thought was very interesting.  In the blog, this doctor admits she really knew nothing about breastfeeding until she took a special course on breastfeeding.  Is she unusual?  I don’t think so.

When I think about all of the things a doctor would need to know about a baby, about their normal development, what is abnormal and needs further investigation, it is overwhelming.  So, it is not shocking that they might not be aware of the latest scientific research on breastfeeding.  It is shocking to find they have had such a lack of basic training to begin with from their university.

So, is it the doctor’s fault?  In general, I really don’t think so.  I genuinely feel doctors have the baby’s best interests at heart.  It is really our culture’s lack of valuing normal human infant feeding, i.e., breastfeeding, to the degree that a university that offers a program on medicine that does not have any information about the feeding practices of the species that they are studying, human mammals.  Mammals, get it?  This refers to our ability to make milk from our mammary glands.  This is how our species is designed to feed their babies.  Again, not to blame the university, it is our culture.

If your doctor does not know the answers to breastfeeding questions, what should they do?  In the Ann Arbor area, we tend to have great doctors who seem to know what they  know.  In the above mentioned blog, the doctor reports that on their first day of medical school, the dean told them, “Fifty percent of what we are teaching you is wrong, we just don’t know which fifty percent”.

If your doctor hears a click in your newborn’s hip at one of the first exams, they have to worry about hip dysplasia.  Do they take care of it right then and there in the office?  No, they refer the baby to a pediatric bone specialist.  So, perhaps it is right when a doctor has an infant feeding question that they are not sure about, that they refer to an IBCLC.  Many of the clients that I see have been referred to me by their doctors.

As an International Board Certified Lactation Consultant (IBCLC), breastfeeding is my area of specialty.  Having studies breastfeeding intently for the past 14 years, I am still shocked at what I don’t know.  There is so much to learn in this small, but very important, specialty.  Because I am the Professional Development Director of the United States Lactation Consultant Association, I have access to many of the founders and leaders in our field that can help me when I am not sure how to proceed.  Maybe we need to know when to ask for help?

There are many MDs who are working hard to try and make up for this basic lack of training in the medical profession.  Dr. Nancy Wight, a California Neonatologist, has been doing her darnedest to help MDs learn about breastfeeding.  She teaches seminars, lectures, does grand rounds at hospitals, and publishes research findings.    She is helping other doctors learn what they were not exposed to in their formal education.  Good job, Dr. Wight!

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Breastfeeding Rates in the US

May 5, 2010 • 9:49 am

What has gone so wrong with breastfeeding in our country?  The United States lags behind most nations around the world in our breastfeeding initiation rates.  However, more importantly perhaps, is how short our breastfeeding duration rates are.  The majority of US mothers are all for giving breastfeeding a shot.  The percentage of mothers who “ever breastfeed” after birth is between 48.3% in Mississippi and 92.8% in Utah.  These numbers are based upon the CDC’s breastfeeding report card from 2008 which shows all of our states and what rates were reported.   If you check out the report card yourself, you can see our Southern states are having the hardest time.  If you go East, North, West, out to Hawaii, up to Alaska, they are doing better.  But by the time the baby has reached three months of age, all of these rates have plummeted dramatically!   Mississippi is down to 16.8% of moms who are still breastfeeding exclusively at 3 months and even Utah, our leader in breastfeeding, is down to 50.8%!  We are losing about one half of our breastfeeding families in the first three months.  By one year, only 8.13% of babies in Mississippi are breastfeeding and in Utah, 33.9%.  How are we doing in Michigan?  Not so well.  Our initiation rate is 64.8%, 23.5% are exclusively breastfeeding at three months, and only 14.4% at one year.  It seems as though breastfeeding is failing in the US.  The American Academy of Pediatrics recommends that mothers breastfeed exclusively for the first six months of their baby’s lives.  “Exclusively” means nothing but mom’s milk.  They then recommend that babies are breastfed for at least one year (my italics).   This means one year is the minimum that our United States Pediatricians feel babies need to be fed their mother’s milk.  WHO (World Health Organization) recommends human babies are fed their mother’s milk for at least two years!  Again, we are lucky here if we get a few months of breastfeeding in.  All this being said, I really don’t think this is the mother’s, the baby’s, the partner’s fault.  Also, any amount of breast milk a baby receives is a tremendous health benefit, even if it is only for one day.

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Hello world!

April 1, 2010 • 9:36 am

My blog…What to say?  First of all, a disclaimer.  This blog is not to be used in place of medical advice from your health care practitioner.  I will try and be clear about what is my opinion and what is based upon medical research.  I am hoping to have many links to articles for you.  OK?  Now that that is clear, let’s continue!
While I know many, many things about breastfeeding, sometimes I feel I have far more questions then answers.  I want to use this forum to share the things that I am wondering about, musing about, questioning in my profession.  Sometimes there will be a “right” answer to some of my thoughts.  But I am hoping this will be more of a place to think deeply about practices and beliefs that we may not know what is “right”.   I don’t want this to be a place where people get mad at me.  I want to provoke thought, not anger!

Wish me luck!
Barbara

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Why do I have a job?

February 16, 2010 • 9:37 pm

One of the things I think about a lot is why do I have a job?  If breastfeeding is so natural, why do people need me to help them get started with breastfeeding or continue when their babies are older.  There are many reasons for this in my opinion.  (Remember, this is where I get to just say what I think!  I may be right or wrong.  If there is research to back things up, I’ll share that too when I can.)
I one of the biggest reasons I believe I need to do this work, that there is a lactation profession, (IBCLC is the name for this.  If you are paying someone to help with lactation, they need this credential!  See my “Breastfeeding Consults” page for my rant on this.) is that I am now the holder of what use to be our collective knowledge concerning breastfeeding.

I think back when we were an exclusive breastfeeding society, our daughters grew up assimilating their own breastfeeding experiences through sight, sounds, touch, smell.  If they then had a breastfeeding issue as a mother, they would just ask every other mother she would see about her concern and someone would have her answer.  We don’t have that now.  How many of us come from breastfeeding families?  Not that many.

More on that later.  So, I, now through my own breastfeeding experiences, my extensive studies of breastfeeding, my collaboration with the best lactation consultants in the United States, these have all brought me to a place where I know more about breastfeeding then the great majority of the population.  And I still don’t know so much.  My leading lactation ladies, that’s what I call them, have been in this business for 30-50 years!  I at, 14 + years, am still collecting experience and knowledge.  Also, I will never be done learning.  There will always be new research about breastfeeding, new mothers and babiess to learn from.   I am honored that you may need me.  I also wish there will come a day that no one will.

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