Breastfeeding Medicine Blog

ABM’s First Australia/ New Zealand Regional Conference

The inaugural ABM Australia/New Zealand Regional Conference was held  at the Gold Coast, Queensland, Australia on July 20-21 2018 with over 85 registrants from Australia, New Zealand, Malaysia, Indonesia and Taiwan.

The conference was preceded by a one day workshop “Breastfeeding Essentials for Medical Practitioners” which is a Australian/NZ version of the ABM ‘What every physician need to know about breastfeeding’ course, modified to meet the needs of Australian and New Zealand doctors.  In Australia and New Zealand, most breastfeeding medicine is provided by general practitioners (family physicians) who care for the mother-baby dyad routinely in the postpartum period.  Australian research in 2009, indicated only 23% of general practice registrars felt confident that their breastfeeding knowledge was adequate, with common sources of information being undergraduate teaching, post graduate teaching, general practice and personal experience. (1)  Our aim was to present a breastfeeding conference organised by doctors, for doctors, with clinically relevant and evidence based presentations.

There is a disappointing lack of routine data collection around breastfeeding in Australia; however in 2010 (2) around 96% of women initiated breastfeeding, with a rapid drop in the early months with 39% of women exclusively breastfeeding at 4 months (2). Data from 2007 (3) indicated only 28% of babies continued to be breastfed at 12 months of age. The Australian government has a paid parental scheme where mothers who earn less than AU$150,000 per annum are entitled to 18 weeks paid leave at the national minimum wage. Some employers also provide additional paid parental leave. All mothers are entitled to take up to 12 months maternity leave in total (paid and unpaid) and have their jobs protected under legislation. A similar scheme operates in New Zealand, with 18 weeks government paid parental leave,  increasing to 26 weeks in 2020.

Anecdotal evidence from female medical practitioners indicates that there are numerous barriers in the workplace that contribute to medical practitioners ceasing breastfeeding earlier than desired. This includes limited access to paid parental leave and part time work options on return to work as well as pressure to return to work to meet postgraduate training pathway commitments.  In addition, Australian and New Zealand medical women continue to describe workplace cultures that are not conducive to breastfeeding or adequate expression of breastmilk to maintain adequate milk supply. Female medical practitioners in specialist training continue to experience difficulties with gaining recognition of the need for facilities for breastfeeding and milk expression during examinations, and frequently are made to feel that their breastfeeding infants are not welcome at professional conferences and meetings.

As medical professionals who are aware of the importance of human milk for optimum growth and development, we need to support our own colleagues to breastfeed to term, so that we as a profession can lead the way in increasing breastfeeding rates across both our countries. As an organising committee we felt it was essential that we celebrate and welcome our breastfeeding colleagues.  Many families accompanied registrants to the conference and mums and babies were made welcome in our main room with space at the rear and couches provided.  We also had a room adjacent with couches, playmats and live audio and visual feed for parents who preferred to move out of the main room.  This proved very popular – see photos below! Several registrants responded to our request for volunteers to doula other registrant mums with babies, and we had great feedback from conference attendees and on social media.  Dr Alison Soerensen, a recently fellowed general practitioner from Western Australia, was our after dinner speaker and spoke passionately about her personal battle for adequate arrangements for breastfeeding candidates during general practice fellowship exams.

We welcomed ABM Board member and Treasurer Dr Sarah Reece-Stremtan who spoke about anaesthesia and analgesia in breastfeeding women and also non pharmacological pain relief in infants. Other highlights from the program included ENT Surgeon (and ex-Olympic Rowing medallist) Dr Nikki Mills who presented fascinating results of her PhD in functional anatomy of the tongue and its role in infant suck, swallow and breathing. Obstetric physician Professor Leonie Callaway discussed breastfeeding and the diabetic mother, and Dr Susan Jordan, previously a GP and now an epidemiologist, discussed breastfeeding and gynaecological cancers. Dr Treasure McGuire, a pharmacist with a special interest in breastfeeding and women’s health discussed breastfeeding and psychoactive medications as part of a symposium on mental health and breastfeeding. Dr Gillian Opie, Neonatologist, and Dr Sharon Perrella RN/RM IBCLC and post doctoral fellow from the Hartmann Lactation Research Group in Perth presented about the challenges of the late preterm infant transitioning to feeding at the breast.  We also presented a symposium on tongue tie featuring Dr Nikki Mills, Dr Sharon Perrella and Dr Yvonne Le Fort, a general practitioner, IBCLC  and ABM Board member from New Zealand, which was very well received.

We received great feedback from attendees both informally and via the post conference evaluation and plans are already afoot for another ABM Australia/New Zealand regional conference in the not-to-distant future.

Dr. Marnie Rowan is a family physician and IBCLC at Elizabeth Clinic and medical officer at the Department of Psychological Medicine, King Edward Memorial Hospital, Women and Newborn Health Service in Perth, Western Australia.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.


  1. Brodribb W, Fallon A, Jackson C, Hegney D. Breastfeeding knowledge – the experiences of Australian general practice registrars. Australian family physician. 2009;38(1-2):26-29.

2.  Australian Institute of Health and Welfare 2011. 2010 Australian National Infant Feeding Survey: indicator results. Canberra: AIHW.


The well-being of mothers and children is not a tradeable commodity

Breastfeeding is the foundation of public health and economic development. All major medical organizations recommend 6 months of exclusive breastfeeding, followed by continued breastfeeding through the first one to two years of life and beyond.

Evidence continues to mount that disrupting optimal breastfeeding contributes to disease burden and premature death for women and children. Globally, optimal breastfeeding would prevent 823,000 child deaths each year. In the US, enabling optimal breastfeeding would prevent 721 child deaths and 2619 maternal deaths each year, as well as 600,000 ear infections, 2.6 million gastrointestinal illnesses, 5,000 cases of maternal breast cancer and more than 8,000 heart attacks.

Optimal infant feeding is also essential for economic development. Being breastfed is associated with a 3 to 4 point increase in IQ, leading to better school performance and workplace productivity. As stated by the World Bank’s Keith Hansen, “If breastfeeding did not already exist, someone who invented it today would deserve a dual Nobel Prize in medicine and economics.”

Breastfeeding is vital and essential to protect the world’s children, the most vulnerable who cannot speak for themselves.  Given the essential role of breastfeeding in global health and wellbeing, it is imperative that every nation supports policies and programs that enable women and children to breastfeed. It is therefore deeply troubling that the United States delegation to the World Health Assembly actively undermined efforts to enable optimal breastfeeding, as reported by the New York Times.

Contrary to assertions by U.S. officials, the World Health Assembly resolution did not attempt to restrict access to infant formula; rather, the resolution called for enforcement of the International Code of Marketing of Breastmilk Substitutes.  Marketing of artificial breastmilk substitutes is a major deterrent to optimal infant feeding. The $70 billion baby food industry has long engaged in a global effort to replace breastfeeding with commercial formulas, to the detriment of global maternal and child health.

In settings where clean water is not available, infant formula is a major cause of death from diarrheal disease. These acute risks of formula-feeding become relevant in high income countries during natural disasters, or when the water supply is contaminated with heavy metals. Moreover, aggressive marketing efforts to replace breastfeeding with infant formula expose both mothers and children to morbidity and mortality.

When mother’s own milk is not available, the preferred alternative for infant feeding is donor human milk. Human milk is tailored to the physiology of human infants. Artificial breast milk substitutes should be considered the last resort.

Poverty or malnutrition is not an indication for formula feeding; rather, social policies that separate mothers from children precipitate formula feeding and worsen poverty and malnutrition. The United States is the only high income country without any provision for paid parental leave; consequently, 23% of employed women return to the workforce within 10 days of birth. The appalling absence of social policies to enable women to nurture their children undermines breastfeeding and perpetuates poverty and malnutrition.

Breastfeeding and breast milk are life sustaining, unique human physiologic events that cannot and should not compete with or have an equal with other commodities or corporate profits.  Maternal and child health is not a trade issue.

The Academy of Breastfeeding Medicine calls upon legislators and policy makers to:

1) Recognize that enabling mothers to breastfeed is fundamental to human health and must be foundational to all national and global policy;

2) Support enforcement of the WHO Code of Marketing of Breastmilk Substitutes and subsequent WHA resolutions;

3) Enact paid family and medical leave, consistent with the International Labour Organization’s standards on maternity protection;

4) Ensure that social policies and programs enable every mother to nurture her child and engage in optimal infant and young child feeding.


Every time a baby goes to breast, the $70 billion baby food industry loses a sale

On Sunday, the most shared story in the New York Times was about breastfeeding – specifically, about how the US government threatened multiple countries with trade sanctions and withdrawal of military support if they backed a resolution calling for more support for breastfeeding mothers and their babies.

According to the Times:

American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.

Why would the US government stand in the way of global breastfeeding advocacy? There are a number of theories – but my money is on the $70 billion baby food industry – upon whom the US dairy industry relies to convert massive milk surpluses into profitable products. In a face-off between a powerful industry lobby and global maternal and child health, the powerful industry carried the day.

This is the critical take-home message for anyone who cares about the health of moms and babies: When it comes to global infant and young child feeding, industry profits take precedence over public health.

The underlying issue is that we have a massive milk oversupply problem in the US. American milk consumption has plummeted, from 290 pounds per capita in 1950 to just 45 pounds per capita in 2014. Unloading all that milk has been a long-term project for the dairy industry. For example, with support from the Department of Agriculture, the National Dairy Board has worked tirelessly to inject cheese into every element of the American diet, tripling consumption between 1970 and 2007. In 2002, the USDA partnered with Pizza Hut to promote the “Summer of Cheese,” increasing cheese consumption by 102 million pounds.

Despite these efforts (and the associated obesity epidemic), we still have too much milk. In 2016, the Wall Street Journal reported that America’s dairy farmers dumped 43 million gallons of excess milk. When there’s not a market for fresh milk, it’s stored in other forms. Last week, it was reported that US cheese reserves are at their highest in a century, with 1.39 billion pounds in warehouses. As the director of market intelligence at the American Farm Bureau Federation told the Washington Post, “We’re producing more milk. It’s inevitable. That milk needs to get turned into something storable.”

What’s the fastest growing “something storable” in 2018? Baby formula – and in particular, a product called toddler milk. This product has been dubbed “The Hello Kitty of Packaged Food” for its runaway success in Asian markets. According to the European Food Safety Authority, these products offer no additional value to a balanced diet, and many are sweetened with sugar or corn syrup, potentially contributing to the global obesity epidemic. Toddler milk sales are expected to grow by 20% in developed countries from 2015 to 2020; in 2014, these milks comprised 39% of the baby milk retail market worldwide.

The World Health Assembly has identified marketing of toddler milks as potentially detrimental to child health, and has called for restrictions on inappropriate promotion. To address these issues, the WHO convened NetCode, the Network for Global Monitoring and Support for Implementation of the International Code of Marketing of Breast-milk Substitutes and Subsequent relevant World Health Assembly Resolutions. All but one reference to the WHO Code was stripped from the WHA resolution that ultimately passed in May. Protecting toddler milk as a dumping ground for excess milk was likely a primary motivation for the US take-no-prisoners attack on global breastfeeding.

The formula industry has long recognized that rising breastfeeding rates are a threat their financial bottom line. In his Q1 2016 earnings call with shareholders, Mead Johnson CEO Peter Kasper Jakobsen said:

The start to the year in our U.S. business was affected by market share losses from the highs we saw in the middle of 2015. On a positive note, we believe the strengthening labor market and workforce participation rates have caused a rise in breastfeeding rates to level off over the last four months or so. [italics added]

For the dairy and infant formula industries, it’s all about market share. Every time a baby goes to breast, the $70 billion baby food industry loses a sale.

The United States’ opposition to the WHA breastfeeding resolution is appalling. And it is also in line with decades of US policies that have prioritized corporate profit over public health. At least it’s clear, in this moment, exactly what we are up against.

Alison Stuebe, MD, MSc, is a maternal-fetal medicine physician and president-elect of the Academy of Breastfeeding Medicine. You can follow her on Twitter at @astuebe. This blog post is adapted from a presentation at the Breatfeeding Advocacy Collective meeting in Toronto, Canada, May 9, 2018.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.



Separation of children and infants from parents – breastfeeding implications

June 21, 2018 – The Academy of Breastfeeding Medicine, an international physician’s organization, condemns policies that result in the separation of parents from their children.

As the UN High Commissioner of Human Rights has established, “Children have the right to life, survival and development and to the highest attainable standard of health, of which breastfeeding must be considered an integral component.” Mothers similarly have the right to nurture their children: “Restriction of women’s autonomy in making decisions about their own lives leads to violation of women’s rights to health and, infringes women’s dignity and bodily integrity.”

“Separating children from their parents results in toxic stress that impacts breastfeeding and health for a lifetime,” said Timothy Tobolic MD, President of the Academy of Breastfeeding Medicine. “Furthermore, separating a mother from her breastfeeding child violates the human rights of both mother and child.”

Separation of the breastfeeding mother-baby pair further confers risk of acute illness for mother and child. Breastfeeding women who are separated from their infants and unable to drain their breasts will become engorged and are at risk for mastitis and breast abscesses. Unrelieved engorgement will precipitate involution and loss of milk supply.

Infants who are not breastfed face increased risks of ear infections, gastroenteritis and pneumonia. Separation of any infant from their mother also has untold emotional harms on those children. These risks are magnified if they are housed in facilities where proper preparation of formula or washing bottles and teats is not available.

Indeed, in emergency settings, such as refugee camps for migrant populations fleeing oppression, the first principal of the 2017 Operational Guidance for Infant and Young Child Feeding in Emergencies is the protection, promotion and support of breastfeeding. Separating a mother from her breastfed child violates this first principal.

ABM recommends reuniting infants and children with there parents without delay. When mother and child are reunited, the Academy of Breastfeeding Medicine and IYCFE guidelines recommend individual-level assessment by a qualified health or nutrition professional trained in breastfeeding and infant feeding issues. The mother-child pair will need sustained support to reestablish lactation, with access to an appropriate breast milk substitute until the mother’s milk supply is reestablished or until at least six months of age and beyond.

“We agree with President Trump’s executive order to stop the separation of infants and children from their parents.” said Dr. Tobolic. “Families belong together and breastfeeding must be supported for the health of the children.”

Breastfeeding, advocacy and women’s rights

In June 2015, I heard a fantastic talk by Keith Hansen, Vice President for Human Development at the World BankGroup, at the Academy of Breastfeeding Medicine summit. Hansen spoke eloquently about the importance of breastfeeding for both global health and economic development; he said, “If breastfeeding did not already exist, someone who invented it today would deserve a dual Nobel Prize in medicine and economics.”

I’d brought my teenage son with me to Washington, and when we met up for lunch, I shared Hansen’s quote. He responded, “If breastfeeding were invented today, there would be an outrage, because of feminism.”

It took me a few seconds to fully process this response, as I began to consider the implications of a newly-discovered practice that would require one half of the population to engage in thousands of hours of unpaid work, at all hours of the day and night, for the greater good. There would, indeed, be an outrage.

This disconnect between praise of breastfeeding and practicality of women’s lives is pervasive, and it is reflected in health promotion strategies. Posters list the ingredients of human milk vs. formula, celebrating the product of breast milk without acknowledging the process of breastfeeding.

Breastmilk is described as nature’s “most specific personalized medicine,” rather than celebrating breastfeeding as personalized nurturing. Even our public health goals aim to “increase the proportion of infants who are breastfed,” absenting the mother doing the breastfeeding from consideration. As a physician scientist, I know how easy it is to become fascinated by the science of human milk and the intricacies of oligosaccharides and the gut microbiome – but speaking of “milk as medicine” suggests a resource to be extracted from a passive mother, without regard to her bodily integrity or autonomy. As Benoit, Goldberg and Campbell-Yeo have written:

By placing breastfeeding focus on the biomedical and nutritional benefits of breastmilk, as opposed to maternal experience associated with nursing her infant, health care providers are perpetuating the patriarchal conceptualization of the ‘good mother’ as one who is defined as selflessly giving by nursing her child while asking for nothing in return.

Our excitement over the constituents of human milk reflects the reductionism of modern scientific research, in which the whole can best be understood by breaking it into its parts. And yet, doing so undermines the fundamental nurturing relationship between parent and child; as Van Esterik and O’Connor write in their critically important book, The Dance of Nurture, “Nurture is a relationship not a thing, and relationships cannot be reduced to their parts.”

Our focus on human milk constituents further fails to consider a growing body of evidence linking breastfeeding duration with maternal health. In reproductive physiology, lactation follows pregnancy, and when breastfeeding is disrupted, chronic disease burden for women increases. In observational studies that adjust for multiple confounders, shorter breastfeeding durations are associated with higher maternal risk of breast cancer, ovarian cancer, diabetes, hypertension and cardiovascular disease. Indeed, a recent cost analysis found that the health burden of suboptimal breastfeeding is far greater for mothers than for children. Policies that disrupt breastfeeding impair a woman’s lifelong health.

Given its importance in reproductive physiology and women’s health, breastfeeding is a woman’s reproductive right.  However, Judith Galtry notes that the Convention on the Elimination of Discrimination against Women (CEDAW) barely mentions breastfeeding. The absence of breastfeeding from the human rights discourse when CEDAW was written in the 1970s may reflect the influence of Western feminists who were focused on liberating women from responsibility for child-rearing. In this context, breastfeeding was a chain to be broken, rather than a right to be protected. As Galtry writes, “It did not always occur to policymakers and legislators that many women did not actually have the right to breastfeed.” This focus on “my right to not breastfeed” continues to dominate discussions among professional women in high-income countries, at the expense of recognizing that economic constraints prevent many marginalized women from breastfeeding, regardless of their personal preferences.

Framing breastfeeding as a woman’s right encourages us to address the relative costs and benefits of breastfeeding for each mother and baby. Tully and Ball note that a woman’s investment in sustained breastfeeding reflects tradeoffs, and lowering the personal cost of breastfeeding would support longer durations:

Van Esterik summarizes the need to address the costs to mothers in a 1981 essay on breastfeeding and women’s work:

Breastfeeding may be viewed by some feminists as the epitome of nurturant behavior – restrictive and unappealing, constraining an emancipated woman from employment possibilities. For these women, biologically determined functions may be devalued and, whenever possible, replaced by technological innovations such as bottlefeeding. A more radical feminist might argue instead for a restructuring of society to support women in their productive and reproductive lives.

What if we leveraged the importance of breastfeeding to restructure our society around each woman’s human right to nurture her children as she desires?

As defined by the Officer of the High Commissioner on Human Rights, “Human rights entail both rights and obligations. States assume obligations and duties under international law to respect, to protect and to fulfil human rights.” If breastfeeding is a woman’s right, then it is not sufficient to urge women to breastfeed – we must enact policies that respect, protect and fulfill that right. A human rights framework recognizes that breastfeeding is not a one-woman job – multiple social structures are essential to enable a woman to exercise her human right to nurture her child as she desires.  To that end, the Global Breastfeeding Collective has identified seven key strategies to enable mothers to achieve their infant feeding goals, including funding for breastfeeding support, implementing the WHO Code of Marketing, enacting paid family leave, implementing evidence-based maternity care, improving access to skilled support, strengthening links between health facilities and communities, and strengthening monitoring of processes and outcomes.

The collective has tracked country-level adherence to these recommendations with a Country Scorecard; to date, no country provides the minimum standard for support. Consider paid family leave: the standard for the Score Card is compliance with International Labor Organization conventions for at least 18 weeks of maternity leave and guarantees continuation of previous earnings paid out of compulsory social insurance or public funds. Slightly more than 10% of countries meet this standard; 90% of countries fail to address this fundamental barrier to a woman’s right to nurture her child.

Lack of paid leave is particularly egregious in the United States, where 23% of employed women return to paid work within 10 days of birth. Moreover, in 8 US states, single parent head-of-households with a newborn are not exempt from welfare work requirements. Women living in poverty are effectively punished for nurturing their children. As Burtle and Bezruchka have written:

The lack of policies substantially benefitting early life in the United States constitutes a grave social injustice: those who are already most disadvantaged in our society bear the greatest burden.

Given what we know about the importance of the first months of life for the health and wellbeing of mothers and infants, why haven’t we taken the necessary steps? In The Dance of Nurture, Van Esterik and O’Connor offer an explanation:

…we have not done the things that we need to do to support breastfeeding because these things conflict with deregulated capitalism and complacent consumerism.

Where to, then, from here? Do we conclude that modernity is inimical to breastfeeding, and rely on formula companies to provide “liberation in a can”? Or do we challenge societal structures that do not permit women to use their breasts and their brains at the same time? Feminist scholar Bernice Hausman writes:

Feminists …should be fighting for the right to breastfeed without social censure, loss of economic livelihood, or limitations on women’s freedom…Changing the bottle-feeding culture that we live in is a political enterprise than cannot be accomplished simply by advertising risks to replacement feeding or heralding the medicinal qualities of breast milk.

These are not new challenges, and these are not new ideas. In 1976, when I was 3 years old, Elisabet Helsing wrote:

In a world in which a female labour force is participating more and more, the peculiarities of this labour force have to be borne in mind. Until now, pregnancy and lactation have been strictly private enterprises, and society has not had to bother about how to cater to the newborn–that has always been regarded as the task of a woman… How can society adjust, so that she can remain useful to the society and simultaneously take the necessary care of her offspring?

Real liberation for women would not require us to choose between our professional and reproductive work. The current system incurs costs that reverberate across society by disrupting women’s participation in the paid work force. Indeed, a recent International Labor Organization / Gallup report found that balance between work and family is the number one challenge facing working women worldwide. Moreover, the report notes, “An ILO survey of 1,300 private-sector companies in 39 developing countries confirmed that family responsibilities borne by women was ranked as the No. 1 barrier to women’s leadership.” When societal constraints exclude women from participating in paid work, we all lose. As Gallup CEO Jim Clifton writes:

Our research also concludes that women have every bit as much game-changing talent as entrepreneurs and “builders” as do men. The problem is, millions of potential star women leaders are on the sidelines, and this isn’t good for organizations, societies or countries. Failing to maximize women’s talent to lead, manage and build stunts global economic growth and fails humankind.

It’s time for a feminist outage that demands we restructure society to support women and men in their productive and reproductive lives. As Van Esterik wrote in 1994:

By enabling women to breastfeed we address women’s rights since the improvement of women’s social and economic status is necessary for supporting breastfeeding. Any violation of women’s right to breastfeed is a violation of women’s human rights.

Alison Stuebe, MD, MSc, is a maternal-fetal medicine physician and president-elect of the Academy of Breastfeeding Medicine. You can follow her on Twitter at @astuebe. This blog post is adapted from a presentation at the Breatfeeding Advocacy Collective meeting in Toronto, Canada, May 9, 2018.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.










Maternal Mental Health is a public health priority due to its impact on both maternal and child health

May 2nd is World Maternal Mental Health Day.  Here in my home state of Virginia, The Governor and General Assembly, back in 2015, declared May as Maternal Mental Health Month in the Commonwealth.  The Blue Dot Project has defined this year’s Maternal Mental Health Week (#MMHweek) as removing the stigma of perinatal mood and anxiety disorders. Women (and men) all across the world are posting their stories (with a pastel blue dot) are not only posting about the trials and tribulations of parenting, but showing the face of postpartum anxiety and depression.  #noshame #realparenting

As I was surfing social media early this morning, I saw a post about maternal mental health where a women posted a picture of her feeding her child with a bottle. She told her story about the guilt she felt (and still feels) about now being able to breastfeed her child and how that exacerbated her depression.  What followed were comments by other moms, how they too felt when their ‘body didn’t work’ and they were unable to breastfeed their child.  Many of these women commented on how they felt shame giving their child a bottle in public.

As a pediatrician with an interest breastfeeding medicine and postpartum mood and anxiety disorders (PMAD), I am faced with this question frequently. Although we screen in our pediatric health system for PMAD, many women still do not get the help they need. While there is a paucity of resources in some areas, many women are still afraid to get the help they need.  When I speak on this topic, I often am approached and/or contacted by women, mothers who know they need help but are too afraid because they are breastfeeding.  One particular mother, a woman who worked in the healthcare field, knew that she needed to see a therapist, but told me ‘breastfeeding is the one thing I can control, and I don’t want to stop if I need medication.’ My friend and I, a perinatal psychiatrist, held conferences, spoke at Grand Rounds, met with OB and Psych departments, and realized how much misinformation was out there. Many physicians told mothers to stop breastfeeding before they could restart their medications (often SSRIs).

Luckily, this is changing. Now what I see is that mothers often take themselves off their medications during pregnancy for 1) fear of harming the fetus and 2) they won’t be able to breastfeed.  The Academy of Breastfeeding Medicine (ABM) has written a protocol so that all health professionals can have access to evidence-based medicine when treating PMAD in breastfeeding mothers.

As a pediatrician, I am also in the position of supporting moms who decide to stop breastfeeding.  If breastfeeding is worsening her ability to sleep, increasing her anxiety, and generally making mom’s mental health worse, as pediatricians, when we see the baby (and mom!) so frequently in those first few months, I can (and I have!) tell mom it’s okay to stop and/or limit breastfeeding. There is no shame in giving the baby formula; the mom has to do what is going to help her get better.  Many times, that helps. Sometimes it doesn’t. This is a decision that she must make. However, for many moms, receiving that validation that they can’t or don’t want to breastfeed is a relief for them, and hopefully minimizes their guilt. What we can do is to empower our mothers so they know they are doing what’s best for their baby…while also taking care of themselves. Happy Mommy=Happy Baby.

Natasha K. Sriraman is a general pediatrician and an associate professor of Pediatrics at Children’s Hospital of The King’s Daughters/Eastern Virginia Medical School in Norfolk, VA.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.