Dr. MILK: Support Program for Physician Mothers

Dr. MILK^® (Mothers Interested in Lactation Knowledge) is an online and in-person support network to help physician mothers achieve their personal breastfeeding goals. Physician mothers have been defined as a high-risk breastfeeding group^1–7 because of their unique barriers to achieving breastfeeding goals in addition to the common barriers shared with all work-outside-the-home mothers (Table 1). This group is particularly prone to early weaning, and many have called for research and support to improve outcomes. When a physician mother reaches her breastfeeding goals, she is more likely to hold positive knowledge and attitudes toward breastfeeding in her medical practice.^8–12 Although positive breastfeeding experiences by physician mothers will enhance their ability to counsel their own patients and peer network, universal physician education in breastfeeding competencies remains critical to providing accurate and reliable medical expertise.^13,14

The Dr. MILK group was started in 2009 in Phoenix, AZ, as an informal gathering at a hospital over the lunch hour for pumping physician mothers. The group has since expanded to meet monthly at four hospitals in the Greater Phoenix area, and there are Dr. MILK chapters at Tulane University in New Orleans, LA, and at a private hospital in Dallas, TX. These meetings offer physician mothers an opportunity to ask questions about all aspects of breastfeeding, offer and receive advice on motherhood and childrearing, and provide logistical information on pumping in hospitals, balancing competing demands for time, and overcoming challenges specific to physician mothers at all levels of training.

In addition to monthly meetings, Dr. MILK has a growing online presence, reflecting the need for social media in order to connect with physician mothers in the demographic age group of 20–40 years.^15,16 The Web site (www.drmilk.org) provides a way for people to join the group, provides useful links to other resources, and includes a free downloadable booklet made from member experiences. Our private Facebook group page offers our members a forum to ask questions and receive tips and insight from almost 200 active users. This page is closely monitored to ensure that it is accessible only to physicians and for accuracy of medical information, allowing Dr. MILK members to freely communicate and share experiences with each other. Dr. MILK also maintains a Twitter account (@DoctorDrMILK) as an additional means to connect, providing physician mothers several ways to support and network with each other.

The Dr. MILK group has limited its membership in response to potential implications for doctor–patient relationships in an open meeting that includes non-physician attendees. We include medical students, residents, and attending physicians in all medical specialties in all types of practices. It is clear that peer counseling is an effective tool in the support and maintenance of breastfeeding to 1 year of age and beyond. ¹⁷ It is within this protected environment that physician mothers give each other encouragement, validation, medical advice, and time-saving tips to achieve breastfeeding goals (Table 2). This private but open exchange of information is critical to the success of the group, with implicit understanding that among our peers, we create a safe environment in which we can discuss highly sensitive topics. Each physician brings knowledge and understanding of the challenges and barriers specific to her work environment, from surgeons to primary care physicians, from night shift inpatient practice to private outpatient practice.

The key components to starting a Dr. MILK chapter at a hospital or residency program include (Table 3): a group leader, mentors, mentees (pregnant or nursing/pumping), and an International Board Certified Lactation Consultant. Promotion of the group should involve women in medicine groups, graduate medical education office or medical school office (if applicable), physician newsletters, word of mouth, and e-mail.

The Academy of Breastfeeding Medicine supports investment in physician mothers as a high-risk population, in order to help them reach their breastfeeding goals.^1,11,18 This small but critical population is generally highly motivated and willing to engage. In fact, many Dr. MILK members go on to study more in-depth medical knowledge in breastfeeding medicine and become passionate advocates for breastfeeding in their hospitals and practices. The Dr. MILK clubs are simple to arrange and provide unique peer counseling to overcome long-standing barriers to breastfeeding success. Hospitals and offices of graduate medical education across the country are natural resources to help create similar groups. With education and support, physician mothers can receive the tools they need to improve breastfeeding attitudes and outcomes.