Abstract
I was introduced to breastfeeding in 1980 during medical school by Dr. G. de Jonge, Professor of Pediatrics at the Free University of Amsterdam. He asked breastfeeding mothers to attend our classes with their babies and to tell about their breastfeeding experience. He explained the basics of breastfeeding, and in this way, he put breastfeeding on the medical curriculum. The knowledge of the value of breastfeeding for babies, families, and society was shaped by his experience as a pediatrician working in Indonesia. 1 He also started breastfeeding research in the Netherlands (Terneuzen cohort) and stimulated his students as both a tutor and mentor to conduct research in this field.
However, in the year 1980, breastfeeding was generally not a topic of interest for physicians. Wasn’t it the role of nurses or midwives to give breastfeeding support? There was hardly any scientific research in this area either. A PubMed Search for 1980 revealed only 368 results on scientific articles with topics related to breastfeeding, and very few of these articles addressed the role of a physician in support of breastfeeding. On the contrary, most physicians, often influenced by a very effective marketing of the formula industry, frequently and openly distributed free breastmilk substitutes without medical reasons.
Fast forward, in 2023, more than 40 years later, PubMed yields 4151 results for publications on breastfeeding. And the combination key words “Breastfeeding/Physician” alone yield 131 results, highlighting, that the medical world is finally taking breastfeeding medicine more seriously. In addition, numerous recent studies have documented the strong association of breastfeeding as an important tool to reduce mortality and morbidity. Therefore, it is imperative that a core responsibility of physicians must be to support and preserve breastfeeding wherever and whenever possible.
Unfortunately, this responsibility is not being integrated in the education of the medical profession. The basic education of physicians about breastfeeding is still not a universal part of medical curricula. Most medical students and even gynecological, pediatric, or family physician residents do not have basic knowledge of Breastfeeding Medicine, and the absence of any attention to this topic in many universities and medical schools suggests that this topic is not relevant for physicians. Establishing breastfeeding as a subspecialty with relevance to many of the main medical specialties would emphasize the value of a basic understanding of Breastfeeding Medicine for all (future) physicians.
Further steps in this direction already have been made. In 2022, the North American Board of Breastfeeding and Lactation Medicine was founded, as a “certifying body for the standard in physician training, knowledge, skills and certification in Breastfeeding and Lactation Medicine for Canada and the USA.” 2 Founded by physicians, among whom was Anne Eglash, who is also the Founder of ABM and several other ABM members, such as BOD members Karen Bodnar and Rima Strassman Toland, this certifying body emphasizes the need for education on breastfeeding of the physician. It also highlights the importance of specialized care by Breastfeeding Medicine specialists in addition to the goal of attaining more general knowledge of breastfeeding by all physicians.
This Breastfeeding and Lactation Medicine specialization provides the in-depth education and clinical training that is necessary to understand a wide range of breastfeeding problems and to be able to give medical advice and therapy guided by scientific protocols and statements. A specialist is also able to ask questions and collaborate in further research, which in turn will bring a broader development of the field. These specialists will also be qualified to teach (future) colleagues in Breastfeeding Medicine.
For all physicians, both the physician who needs the basic understanding of breastfeeding and lactation, and the physician who provides specialized care for mother–infant dyads with more complicated presentation and can be defined as a Breastfeeding Medicine specialist, the Academy of Breastfeeding Medicine wants to be a resource. The upcoming conference will give all physicians in both categories a wealth of information and a platform to discuss clinical problems around breastfeeding. It will provide them also with an important network of colleagues to collaborate, to exchange information, and to encourage each other. And it will be a gathering of persons who shaped the specialty of breastfeeding medicine in the past and will shape this specialty in the future.
It is thanks to the giants in the field that we have made this progress, and at the upcoming Annual Meeting of the Academy of Breastfeeding Medicine, we will celebrate the contribution of so many early advocates, especially Dr. Ruth Lawrence, whose 100th birthday was celebrated earlier this year. In the early years, she published the first edition of her book “Breastfeeding, a guide for the medical profession,” 3 making it very clear that physicians do have an important role to play in Breastfeeding Medicine. Dr. Lawrence has been a role model for the medical community as a breastfeeding medicine specialist in doing research and publishing articles on this topic, in taking clinical care of breastfeeding dyads, in writing breastfeeding policies for the medical profession and in influencing public health systems to support breastfeeding, In doing this, she and other early leaders have been leading us in the way to a viable medical subspecialty.
I invite all physicians and health care workers join us in Schaumburg for the 29th Annual International Meeting on November 14–17, 2024, to learn about breastfeeding, to share their knowledge, to connect with participants from many countries to exchange research and experience, and to celebrate with us not only the lifetime achievement of Dr. Ruth Lawrence but also of all the ones who have given breastfeeding the place in the medical world it deserves as a major contributor to health and well-being on its way to a medical specialism.