Abstract
On August 15th, 2024, one of the Founders of Academy of Breastfeeding Medicine, Dr. Ruth A. Lawrence, celebrates her 100th birthday, and we as members of the Academy sincerely congratulate her with this milestone! We are grateful for Dr. Ruth Lawrence, for all that she has achieved in the many, many years of her life, and we are proud that she has been our Founder and leader, serving as President of our organization, as Board member, as Chief Editor of our Journal, Breastfeeding Medicine, as a pioneer in the field of Breastfeeding Medicine, as author of the foundational book, “Breastfeeding, a Guide for the Medical Profession,” and as an inspiring role model in Breastfeeding Medicine for so many physicians worldwide.
So often she has been the first: the first woman to graduate from Yale residency and the first woman to be hired as medical faculty at the University of Rochester. She was the first who advised the public directly on poisoning as the first Director of the Poisoning Center of Rochester University. At Rochester University, she also founded the Breastfeeding and Lactation Study Center in 1985, making breastfeeding medicine an academic field.
So much has changed in this century for our society. Dr. Ruth Lawrence describes in her interview with Dr. Lori Feldman-Winter for the oral history project of the American Academy of Pediatrics, 1 that at the time she was a child and lost her father, there was no social safety net whatsoever, and her mother was responsible for taking care of four children on her own. Dr. Lawrence had to contribute to the family income early on. When she started medical school, at one of the hospitals she was sent to there were no places for female students to stay. And females were often not accepted as residents in surgical disciplines.
So much has changed in this century in Pediatrics. When Dr. Ruth Lawrence started, babies were not ventilated. Together with her husband, Dr. Bob Lawrence, an anesthesiologist, and other anesthesiologists, she put the first premature infant on a ventilator. 2 At the beginning of her career there were no IV fluids for newborns, because the needles were too big. Yale was the only residency in the country, where it was an obligation for the residents to spend time in the nursery.
And yet, the basic skills for pediatricians stay the same. As Dr. Ruth Lawrence expressed, “I think, if they go into pediatrics, it doesn’t matter how complicated and intense their skills are, they have that compassion and that ability to connect with the child.” 1 And elsewhere she added: “The science will come and go, but the best doctors understand people…they imbue trust and hope in people and provide comfort when needed.” 3 Pediatricians should see a child within 7 days after discharge, Dr. Lawrence suggested, and this still applies. And the basics of breastfeeding medicine stay the same: the physiology of the female and infant body, breastfeeding and human nutrition, the biochemistry of human milk that contributes to the health and development of newborns, babies, and toddlers.
This basis, the physiology of breastfeeding and human lactation, has guided Dr. Lawrence throughout her career, in her numerous activities and in her numerous achievements in breastfeeding medicine. She worked at the first of its kind rooming-in unit in the United States developed by Dr. Edie Jackson at Yale, Dr. Jackson introduced this concept long before the Baby-Friendly Hospital Initiative was founded. Dr. Jackson had studied in Vienna, and there she was inspired by the work on psychoanalysis by Dr. Anna Freud, highlighting the importance of not separating mothers and their infants—a physiological concept of taking care of newborns. 1
Dr. Lawrence had personal experience with breastfeeding her own nine children, and she shared her knowledge on breastfeeding with friends who were struggling and asking her questions. Professionally she was asked to lead the preterm nursery at Rochester, where nutrition was a major aspect of her work, and through all these activities the basis of her extraordinary career in Breastfeeding medicine was laid. Her experiences led to the medical textbook that was published first at the end of 1979 and is now already in its 9th edition, acknowledged as a wonderful guide in Breastfeeding for generations of physicians.
Dr. Lawrence was a Founder of both the Academy of Breastfeeding Medicine and of the United States Breastfeeding Committee. 1 Always searching for connections to enhance breastfeeding, she established a relationship with the Surgeon General Dr. C. Everett Koop, which led to the first Surgeon General’s Workshop on Breastfeeding at Rochester University after which event the Breastfeeding and Lactation Study Center was founded, thus giving academic structure and support to the field 2 Together with Dr. Cynthia Howard and the former Executive Director of the Academy of Breastfeeding Medicine, Dr. Karla Rubinger, she organized 10 breastfeeding summits, bringing together physicians, politicians and other participants from society with interest in breastfeeding and nutrition.
And Dr. Lawrence is a teacher. At how many conferences and summits and meetings was she an invited speaker, traveling around the world? Many of us remember her in this way: lecturing at the Annual International Conference of the Academy of Breastfeeding Medicine, introducing other speakers at this conference, and asking questions when others presented their scientific work, which was always very precise, very clear, and to the point. With her lectures, with her stimulating questions, with the discussions she started, she encouraged many of us to think further, to delve deeper into the wonderful field of breastfeeding medicine. She was always the impeccably dressed, most elegant physician at our conferences.
Dr. Ruth Lawrence can look back at a life well lived, still living in Rochester, surrounded by her many children, grandchildren and greatgrandchildren. One of her successors at Rochester University, Dr. Casey Rosen-Carol, described it so well, when she wrote “she has touched countless lives with individualized support for breastfeeding, teaching and advocacy” (personal communication). For this contribution and for all that she has given us in the Academy of Breastfeeding Medicine and in personal encounters and support we want to thank Dr. Lawrence and wish her all the best. She has not only made a difference in the lives of so many medical professionals, but also a difference to an untold number of babies and mothers who have been supported in their breastfeeding journeys.