A Testimony to Dr. Ruth A. Lawrence: An Elegant Revolutionary

It is nearly impossible to write a testimony for Dr. Ruth A. Lawrence as one doesn’t know where to start. But if there is one feature of Ruth’s professional career to highlight, it is her status in leading and guiding a true revolution in infant care and thus leading to a major improvement in the wellbeing and health of mothers, infants, and children worldwide.

One cannot emphasize enough Ruth’s truly revolutionary activities and accomplishments. Her vision and understanding of the health benefits of breastfeeding and the feeding of human milk was beyond simply considering it a matter of nutrition. Her understanding that human lactation is a complex biological process, that it has broad ecological, cultural, and even political consequences, and that it should be conceptualized as a basic academic discipline was truly unique. As such, the subject of “Breastfeeding,” in her mind and belief, had to become an integral part of medical education and practice. Most importantly, in turn, she cajoled, persuaded, and demanded that her medical colleagues acknowledge that the clinical support and supervision of breastfeeding had to be accepted as the prime responsibility of the medical profession and not be left in the hands of nonprofessional lay volunteers.

I trained in the late 1960s—both as a pediatrician and as a neonatologist, in an era where breastfeeding was at best ignored, when the biological process of lactation and the uniqueness of human milk was of interest only to a few nonmedical basic scientists and nutritionists. Advocacy and support of breastfeeding was primarily a mission of lay volunteers and devotees, who by and large were without any formal scientific training, medical experiences or authority. One must remember that these lay lactation “counselors,” as dedicated and supportive as they were, could not order laboratory tests or prescribe medications, let alone comprehensively evaluate the medical status of the mother and/or the breastfeeding infant. In reality, physicians then, out of a combination of ignorance, indifference, and other priorities, simply remained all too often uninvolved in managing breastfeeding or “solved” every problem by recommending that the mother stop breastfeeding and for the mothers to provide the infant with latest branded formula.

The title of Ruth’s monumental textbook: BREASTFEEDNG: A Guide for the Medical Profession, first published in 1980(!) reflected the conceptual and logistical revolution she led, that is, defining Breastfeeding Medicine in all aspects as a scientific discipline with its own body of knowledge and as a medical subspecialty with a defined medical curriculum. In addition, the textbook (now in its 9th Edition) provided evidenced-based clinical management recommendations equipping physicians with the information they needed to accept the responsibility for providing care and support for mothers and infants. Yes, until that point of time, the care of the breastfeeding mother–infant dyad was, simply, not considered, functionally or practically, a medical professional responsibility.

No less significant was Ruth’s conviction that there needs to be a formal organization of physicians whose professional focus and activity would be the care of the breastfeeding maternal–infant dyad. Thus, in 1995, she led a critical mass of 12 physicians in establishing the Academy of Breastfeeding Medicine. No less important was her founding in 2006 and serving as Editor-in-Chief of this medical journal, Breastfeeding Medicine, so as to give a publishing home to peer-reviewed evidence-based scientific studies on the qualities and advantages of mother’s milk, guidelines as to proven breastfeeding support programs, and documentation of the short- and long-term health benefits to the mother and child.

The buzzword today in academic circles is “translational medicine” defined as a discipline that aims to improve the health of individuals and communities by “translating” research findings into diagnostic tools, therapeutic medicines and procedures, and health care policies. Decades before this term became popular, it was Ruth who pioneered this approach as she almost singlehandedly collated, translated, and synthesized data from basic science researchers and from the practical experience of clinicians and integrated these data into the newly defined academic discipline of Breastfeeding Medicine. Today, the fact that our medical professional colleagues have accepted this concept and have internalized this obligation to treat the practice of breastfeeding with the respect and seriousness due to any other medical specialty is testimony to Dr Lawrence’s revolutionary success. Simply put, she changed our approach to the practices of infant feeding and thus to the ultimate benefit of improved health of both the mother and infant worldwide.

Generations of mothers and infants will be eternally grateful to her for what was truly for her a holy undertaking. Those of us who know Ruth personally have always realized that the driving forces that all but guaranteed her accomplishments were not only her capacity to convey her knowledge with conviction and respect for others, her always elegant demeanor, her intellectual honesty and indefatigable industrious commitment to excellence, but also her deep abiding faith in what was clearly a religious-driven mission.

As King Solomon in his wisdom stated in the book of Proverbs (Chapter 21, verse 29–31).

Thus, let us all join in and praise the work of Dr. Ruth Lawrence and may she continue to go from strength to strength.