Recognizing Physicians with Breastfeeding Expertise

It takes a village to raise a child, and probably just as many people to support, encourage, and assist a woman to reach her breastfeeding goals. Community and family are vitally important in nurturing the breastfeeding relationship, while health professionals often influence health service policy that impacts on breastfeeding success. Health professionals also provide assistance and expertise to groups and individual women and families about how to breastfeed and to overcome breastfeeding difficulties as they arise. As well as assisting women to breastfeeding in general, physicians have a unique niche in the breastfeeding support “village,” using their medical skills, knowledge, and expertise to assist women with more complex breastfeeding problems and when the woman or her infant also has concurrent medical issues. Unfortunately, not all physicians have the expertise or the desire to assist in this manner.

The amount of information and skills medical students learn about breastfeeding within medical curricula varies considerably from university to university, let alone from country to country. Similarly, the teaching and experiences gained during subsequent training are not consistent and are often determined by the expertise and interest of more senior clinicians, hospital policies, and other issues unique to individual hospitals. Some physicians develop an interest in breastfeeding and human lactation early in their medical career and seek out experiences that expand their knowledge and skill base. Others find that they need more knowledge when faced with difficult clinical cases or discover that their work place expects them to manage more problematic breastfeeding situations. Sometimes physicians become more involved in the field following personal breastfeeding experiences with their own children.

Regardless, mothers as well as other health professionals often have difficulty identifying those physicians who are proficient in this specialty area. One of the Academy of Breastfeeding Medicine's (ABM's) main aims is to educate physicians about breastfeeding and human lactation worldwide. Although the formal establishment of a Breastfeeding Medicine specialty would be ideal, many hurdles must be overcome first. Discussions about developing a certification process for physicians with breastfeeding expertise are ongoing. Structured Fellowships in breastfeeding and human lactation have been established in several locations, and work is continuing to define an ideal fellowship program.

ABM has developed a process to recognize physicians who have additional training, experience, and knowledge in the clinical, research, academic, or public policy areas of breastfeeding medicine. Physicians can become Fellows of the ABM and use the designation FABM. A Fellow of the Academy must be a licensed (or registered, depending on the country's requirements) physician of any specialty, have been a member of ABM for at least 5 years, have advanced knowledge and skills in the fields of breastfeeding and human lactation, and demonstrate ongoing specialized professional activities related to clinical expertise, research, or teaching experience and/or significant advocacy efforts in the field of breastfeeding medicine.

Applicants are required to have attended three or more ABM Annual or Regional Meetings and provide information about their clinical activities (including administrative activities in a clinical setting), educational activities (including lectures to trainees and curriculum or program development), advocacy or policy-making activities, and research-related activities (including peer-reviewed publications and book chapters) in the previous 10 years. Some physicians will have significantly more experience with clinical activities than research activities, whereas others may focus on advocacy or education. It is the overall total contribution and experience that are important.

In addition to the information described above, applicants are also required to submit two letters of recommendation, one from an active ABM member and one from an ABM Fellow, addressing their breastfeeding medicine background and expertise and their commitment to ABM. New Fellows are recognized at the Annual Meeting each year.

To maintain Fellowship status, Fellows are required to reapply every 10 years, detailing their clinical, educational, advocacy/policy, and research activities since they became a Fellow, their ABM membership for at least 7 of the previous 10 years, and attendance at two Annual or Regional Meetings.

At present there are nearly 100 ABM Fellows from many parts of the world. The FABM designation enables the identification of physicians who have breastfeeding expertise. This can only be a good thing for mothers and health professionals alike.

If you are an ABM member and think you meet the requirements, go to the ABM Web site (www.bfmed.org/Membership/AboutFABM.aspx) and investigate the application process. The submission date for pre-applications is usually the end of March each year.