I’m grateful for a community of physicians who care deeply about breastfeeding

Last week, more than 400 health professionals gathered in San Francisco for the Academy of Breastfeeding Medicine’s 23^rdInternational Conference. The conference drew participants from 25 counties and 41 US states, including 259 physicians from medical specialties ranging from neonatology to breast surgery.

Members of Dr. Milk at ABM 2018

We kicked off with two pre-conference courses, “What every physician needs to know about breastfeeding (WEPNTK)” and “What every physician needs to know about breastfeeding II.” WEPNTK covers the anatomy and physiology of breastfeeding that many of us missed in medical school. WEPNTK II covered more advanced clinical issues, like maternal risk factors for low milk supply, management of tongue tie, therapeutic ultrasound for mastitis, and postpartum depression.

ABM is unlike any other medical conference that I attend because the audience spans multiple medical specialties and brings together clinicians from around the world. The conference committee faces the daunting task of selecting speakers that address the interests of both subspecialists and general practitioners across the translational continuum from basic science to public policy. And as an international conference, our speakers are selected to include perspectives on breastfeeding policy and public health from around the globe.

On finding #MyPeopleABM: Physicians share what ABM means to them

Jennifer Caplan, MD, FAAP, IBCLC
North Scottsdale Pediatric Associates, AZ USA
I joined ABM after going to an AAP conference in 2008 with my nursing baby. At the conference, I ended up spending almost the entire time with the Section on Breastfeeding because my baby was not interested in staying with my husband—so I brought her with me. And I felt more comfortable hanging out with the breastfeeding crowd. I ended up riding in an elevator with some of the organizers and one of the women told me I should join ABM.

I had been so energized by the discussions at that conference—learning how to do frenotomies, hearing about the “Ban the Bag” efforts in Massachusetts, finding out about Baby Friendly Hospitals for the first time. So, I joined ABM and attended my first conference in 2009.

Being at an ABM conference is amazing. I’m really not a conference person—networking does not come easily to me, I don’t really like the marketing/advertising hall, but I do love learning about new things. ABM is the only conference I really enjoy going to. I always come away from the conference with at least a dozen new ways to practice and a new energy to spread my knowledge to others. And I love the people I meet at ABM conferences—so many perspectives, so many different ways they express their passion for supporting the mother-baby dyad. After another couple conferences, I had been convinced to become a lactation consultant.

I usually make it to the ABM conference, but even in years where I don’t go, I still get a lot out of my membership. I probably use the protocols more than anything else—always the most up to date, comprehensive source on breastfeeding topics. I enjoy seeing the new research coming out in the journals. And just knowing I’m a part of an amazing group that is a political force for advancing breastfeeding and advocating for women is important to me.

ABM Gold Member Profile: Touraj Shafai, MD, PhD, FAAP, FABM

ABM: Why did you become a member of ABM?

Touraj Shafai, MD, PhD, FAAP, FABM Medical Director, Inland Empire Children’s Medical Group and BF Clinic

Shafai: To improve my knowledge about benefits of breastfeeding to both mother and baby and to society.

ABM: What is ABM‘s greatest strength?

Shafai: As an organization ABM has the greatest collection of knowledge than any other organization.

ABM: What inspires you to promote, protect and support breastfeeding?

Shafai:  To educate moms regarding the benefits of breastfeeding so our newborns can achieve their fullest potential.

ABM: What advice can you offer to physicians who are interested in learning more about breastfeeding?

Shafai: To become a member of the ABM and attend the Annual Meetings of the Academy.

ABM: What accomplishment are you most proud of in your career?

Shafai: To receive a PhD in biochemistry following my MD degree which provided me with critical thinking and gave me the tools in research and improving patient care.

ABM: What is a current challenge for you in your work?

Shafai: To get rid of some of the hospital policies such as the old hypoglycemia and jaundice policies that are obstacles to breastfeeding.

ABM: What can ABM offer physicians worldwide?

Shafai: Many pediatric residents and medical students express a desire to learn more about breastfeeding. Unfortunately this is not available in their training programs. We should be able to fill this gap and provide them with the information that they need.

Thank you, Dr. Shafai.  We look forward to featuring additional Lifetime and Gold Members on the ABM Blog each month.

Join us at the 19th Annual International Meeting to be held November 13-16, 2014 in Cleveland, OH, USA.

ABM Gold Member Profile: Anne M. Montgomery, MD, FABM

Anne Montgomery, MD, FABM
Associate Director
Family Medicine Residency
Eisenhower Medical Center

ABM: Why did you become a member of ABM?

Montgomery: I was very involved in breastfeeding support and wanted to be part of a group of similar physicians.

ABM: What is ABM‘s greatest strength?

Montgomery: The diversity and expertise of our members.

ABM: What inspires you to promote, protect and support breastfeeding?

Montgomery:  Like many people, I was a “mainstream breastfeeding supporter” til I had my son; breastfeeding him exclusively for 5.5 months then continuing for 4.5 years “radicalized” me. I recognized that not not everyone had the tenacity/stubbornness to overcome all the barriers. As a physician to mothers and babies, it was part of my responsibility to be sure that all babies had the opportunity to be breastfed and that all mothers were supported in their feeding choices.

ABM: What advice can you offer to physicians who are interested in learning more about breastfeeding?

Montgomery: Join ABM! Don’t be afraid to attend courses aimed at nurses and lactation consultants if that is all that is available in your area.

ABM: What accomplishment are you most proud of in your career?

Montgomery: I achieved full professor academic rank in my late 40’s and have taught many residents and students about family medicine including breastfeeding.

ABM: What is a current challenge for you in your work?

Montgomery: Starting a new job soon, I don’t know what to expect yet! A brand new family medicine residency program should be interesting.

ABM: What can ABM offer physicians worldwide?

Montgomery: A chance to network with other like-minded physicians, good breastfeeding education, and support for their work assisting mothers and babies.

Thank you, Dr. Montgomery.  We look forward to featuring additional Lifetime and Gold Members on the ABM Blog each month.

Join us at the 18th Annual International Meeting to be held November 21-24, 2013 in Philadelphia.

ABM Gold Member Profile: Lori Feldman-Winter, MD, MPH, FABM

Lori Feldman-Winter, MD, MPH, FABM
Professor of Pediatrics
Children’s Regional Hospital at Cooper, Cooper Medical School of Rowan University

ABM: Why did you become a member of ABM?

Feldman-Winter: I wanted opportunities to network with colleagues that had a shared interest and learn from others work.

ABM: What is ABM‘s greatest strength?

Feldman-Winter: The members are definitely what makes this organization special. Each member makes their own unique contributions and we all learn from each other.

ABM: What inspires you to promote, protect and support breastfeeding?

Feldman-Winter:  For too many years breastfeeding fell outside the realm of mainstream medicine and physicians were unprepared to support mothers decisions to breastfeed. Through organizations such as ABM physicians are much more knowledgeable and skillful in their support, but we still have a long way to go!

ABM: What advice can you offer to physicians who are interested in learning more about breastfeeding?

Feldman-Winter: First take courses, especially those geared for physicians such as the WEPNTKAB course. Then join organizations such as the ABM to gain a better understanding of the field from the physicians’ perspective. Then get involved, there are so many opportunities to make a real difference.

ABM: What accomplishment are you most proud of in your career?

Feldman-Winter: I have dedicated a large part of my career in breastfeeding medicine to physician education. Being part of the inaugural group of FABM’s is one of the highlights of my career.

ABM: What is a current challenge for you in your work?

Feldman-Winter: In my current work as a consultant to NICHQ Best Fed Beginnings Project, my biggest challenge is to convince physicians all over the country that they need to make changes, including getting the required education, to help their hospitals achieve Baby-Friendly designation. The resistance to change is sometimes overwhelming. Somehow we need to convince all physicians to acknowledge that we all have much to learn about breastfeeding, and that it is a vital component of healthcare.

ABM: What can ABM offer physicians worldwide?

Feldman-Winter: The clinical protocols are helpful to set a global agenda for optimal evidence based care.

Thank you, Dr. Feldman-Winter.  We look forward to featuring additional Lifetime and Gold Members on the ABM Blog each week.

Join us at the 18th Annual International Meeting to be held November 21-24, 2013 in Philadelphia.

ABM Lifetime Member Profile: Nancy E. Wight, MD, IBCLC, FABM, FAAP

Nancy E. Wight, MD, IBCLC, FABM, FAAP, San Diego Neonatology, Inc. Medical Director, Sharp HealthCare Lactation Services

ABM: Why did you become a member of ABM?

Wight: I was inspired by the quality and vision of the founding members and wanted to be a part of the journey.

ABM: What is ABM‘s greatest strength?

Wight: It’s members and all they do in so many arenas (clinical care, research, teaching, mentoring, health planning, etc. etc.)!

ABM: What inspires you to promote, protect and support breastfeeding?

Wight:  As a physician, I care about the health of my community in all its forms and breastfeeding is the best health insurance.

ABM: What advice can you offer to physicians who are interested in learning more about breastfeeding?

Wight: Join ABM, join ILCA, join your local breastfeeding coalition. Find a breastfeeding ‘champion’ in your area to act as a mentor for you.

ABM: What accomplishment are you most proud of in your career?

Wight: I am most proud of the fact that as a clinician and educator I have influenced others to follow in my footsteps and EXCEED my accomplishments.

ABM: What is a current challenge for you in your work?

Wight: Keeping up with the incredible increase in human lactation research and literature over the last 10 years while working full-time (including nights!) as an ‘elder’ clinical neonatologist.

ABM: What can ABM offer physicians worldwide?

Wight: A vast wealth of peer knowledge and support.

Thank you, Dr. Wight.  We look forward to featuring additional Lifetime and Gold Members on the ABM Blog each week.

Join us at the 18th Annual International Meeting to be held November 21-24, 2013 in Philadelphia.

ABM Gold Member Profile: Featuring Paula K. Schreck, MD

ABM: Why did you become a member of ABM?

Paula K. Schreck, MD
Breastfeeding Coordinator
St. John Providence Health System

Schreck: I became a member of ABM as I first began building my career in Breastfeeding Medicine. The promise of fellowship with other like-minded MD’s was compelling as was the access to up-to-date science and information.

ABM: What is ABM‘s greatest strength?

Schreck: ABM’s greatest strength is its membership.

ABM: What inspires you to promote, protect and support breastfeeding?

Schreck:  The palpable difference in the health of the breastfeeding mother and baby dyad motivates and inspires me in my work.

ABM: What advice can you offer to physicians who are interested in learning more about breastfeeding?

Schreck: Start by attending an ABM Annual Meeting.

ABM: What accomplishment are you most proud of in your career?

Schreck: My greatest accomplishment is the creation of my outpatient breastfeeding clinic. Its success has brought breastfeeding into the spotlight in my hospital system.

ABM: What is a current challenge for you in your work?

Schreck: Taking four hospitals through Baby-Friendly at the same time.

ABM: What can ABM offer physicians worldwide?

Schreck: Inspiration, information, and fellowship.

Thank you, Dr. Schreck.  We look forward to featuring additional Lifetime and Gold Members on the ABM Blog each week.

Join us at the 18th Annual International Meeting to be held November 21-24, 2013 in Philadelphia.

How a Surgeon Ended up in ABM

Surgeons are often Type A personalities, the ones who sit in the front of the class, who volunteer for everything, who stay scrubbed in the OR all day with appendicitis and do a post-op check before checking themselves into the emergency department (yes, that was me.) As such, surgeons are often dismissive of the subspecialty of breast surgery. The surgeries are not as complex as cardiac bypass surgery or Whipple procedures for pancreatic cancer. In fact, it’s often a rotation for interns. I was a Type A personality. I had no plans to do breast surgery.

Then, a funny thing happened. I had my first son during residency. Planned with military precision, of course, to coincide with the beginning of my designated research years, as I had hoped to squeeze another baby in there somewhere. After his birth, I would breastfeed, because that is what Type A mothers do these days. It’s the best! Of course, I would do the best! However, like many mothers out there, we had an incredibly rocky start. Poor latch with inadequate weight gain. Triple feeding with pumped milk. Cracked nipples leading to mastitis. As a Type A person, I threw myself into research in an effort to solve the problems. Not just the many, many baby books out there, but Medline searches on breastfeeding management. I learned more than I ever had in my surgery textbooks about the breast, the physiology of lactation that is both incredibly simple and enormously complex, and most importantly, miraculous. I was reminded constantly in my reading of the importance of preserving this ability to breastfeed my son, for his and my health, and how challenging that could be.

La dolce vita of breastfeeding in Trieste

La dolce vita in Trieste…

The conference is over, the bills are paid, but it still resounds in my memory: the 4th ABM European Regional Meeting for Physicians, held on 19th-20th of May in Trieste, Italy.

The meeting was organized by a team of BURLO Trieste under the leadership of Adriano Cattaneo and myself. The main organizer was the Academy of Breastfeeding Medicine and cosponsor was Burlo Trieste, who supported us wholeheartedly.

It is not easy to communicate with people who come from all over the world. Only 14 attendees were participating in their native language, English. All others were expressing themselves in (for them) foreign languages. But that didn’t matter. There was a wish to understand each other. As Dr. Adriano Cattaneo put it at the beginning of the conference: No more discrimination: 98 participants from 29 countries, speaking many, many languages, were interacting, were becoming friends and were planning for future collaboration and mutual support. And many ABM members met each other, sometimes for the first time, sometimes it was a happy “nice to see you again” after former meetings in Göppingen, Vienna and Torun.

In general the meeting took place in a very good atmosphere with very lively discussions, both in the sessions and during the breaks and dinner. The only real problem was that there was much too little time for discussion during the sessions. The lectures were excellently received and many participants reported afterwards, that they were inspired by the event.

I want to share with you some of the feedback that was given to this conference:
– “Excellent preparations, excellent that topics like BN and peristaltic were discussed in a differentiated way, very good that each level of English is accepted; this allows really international participation. Lots of impulses, lots of missing puzzle pieces!
– “It was my first ABM Meeting and I enjoyed it very much. Trieste is a nice place for such a congress. Listening to people from different countries and talking to them is very inspiring! Thank you!

A highlight of the conference was a small bus trip on the end of the first day to a central church in Trieste with a wonderful view on the city and the Adriatic Sea. Afterwards the busses took all participants to a restaurant near Miramar directly on the seashore, where there was much time to speak about experiences and to enjoy the evening. A real dolce vita in Trieste, with discussions, but also with warmth and laughter, with tumbling of ideas and exchange of opinions.

Because of the conference, some European collaboration projects have started, most notably a project under the leadership of Dr. Pat Hoddinott on an RCT of proactive telephone support for parents of premature babies (FEST). As a result of the conference many participants asked if it is possible to have a European Regional Meeting in their country. We have offers from Romania (Bucharest), Croatia (Split), Spain (Barcelona), Slovakia (Bratislava), the Netherlands (Amsterdam) and Denmark (Copenhagen – in connection with the next European conference of lactation consultants). So we can at least organize 5 or 6 further regional meetings!

And being a breastfeeding conference, it is only appropriate to mention, that this meeting was very nourishing for all of us. The meeting inspires us to continue to work for the best of children and their mothers – and fathers – around the world.

Elien Rouw, MD, FABM, is a member of the board of directors of the Academy of Breastfeeding Medicine.

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

Buongiorno from the 4th ABM European Regional Meeting for Physicians in Trieste Italy!

Yesterday was the first day of the 4^th ABM European Regional Meeting for Physicians in beautiful Trieste Italy.  As this is very close to the childhood home of my grandfather, I feel like I have come home.  The city itself is a beautiful Italian city perched on the edge of the sparkling blue Adriatic Sea.  Arriving by car from Germany two days ago, the vistas from high above the city out over the sea were breath-taking.

The meeting started off with an informal “pizza party” of sorts at a lovely restaurant nearby the hotels on the canal and close to the sea Friday night.  The multinational attendance was immediately evident by the accents and languages one heard.

We began bright and early Saturday morning on a gorgeous sunny day.  There are 100 attendees from 29  countries and 6 countinents—a mini United Nations!    OK—really 5 continents, but one attendee originally was from Australia and another works part-time in Australia, so I think that counts for 6 continents!!  Elien Rouw (Germany) and Adriano Cattaneo (Italy) opened the program as the conference organizers.  The first plenary session was a fascinating look at “The mechanics of breastfeeding revised” by Michael Woolridge (UK).  The next session was a roundtable discussion, “Ensuring effective feeds: biological nurturing, learning how a baby latches on, or both?”  It was lead by presentations by Christina Smillie (US), M. Ersilia Armeni (Italy) and Kathleen Marinelli (US), and engendered lively discussion from the attendees!

In the afternoon, we focused on Baby-Friendly worldwide.  Maria Bettinelli (Italy) spoke of “Breastfeeding and continuum of care throughout the life cycle: a framework for action in the Baby Friendly Initiative.”  We learned not only of Baby-Friendly in the hospital, but of the Italian Baby-Friendly Community program.  This was followed by the second Round Table, this one on “Experiences and Challenges in countries implementing the Baby-Friendly Initiative.  Our speakers to inform this session were Martha Muresan (Romania), Irena Zakarija-Grkovic (Croatia), and Carol Williams (UK).  The last plenary presentation of the day was “Baby-Friendly Initiative: beyond information towards relational approaches with women” by Fiona Dykes (UK).  This thought-provoking discussion was followed by two platform abstract presentations—Maria Astengo (Italy)”Breastfeeding Promotion and Support in Public Health Services: Experiences of a Local Health Agency” and Beatriz Flores (Spain) Why Does Spain have so Few BFHI Hospitals?”

There were also many posters on display from all over the world on many different topics in breastfeeding.  Seeing the ideas out there and the work that is being done, and the animation of colleagues interacting over this work, was very exciting indeed!

At the end of the day, we all met by the waterfront and took a bus tour of part of the city.  We had the opportunity to see the main Piazza, Roman ruins, different beautiful parts of the city, the Church of San  Giusto with its beautiful paintings of the breastfeeding Madonna, not to mention the added bonus of the vistas of the sea and the city from that height.  Then the buses took us to a seaside restaurant for a traditional Italian multicourse dinner, with nothing but good food, great Italian wine and time to network and talk with colleagues and new friends.  It was a lovely somewhat magical evening for all.

On Day 2, we began with a presentation that got the audience as worried as the speaker—”The inter-relationships between pregnancy, obesity and breastfeeding” by Kathleen Marinelli (US).  The figures are staggering and very frightening.  This was followed by a fascinating Roundtable: “Continuing breastfeeding and the timing and introduction of complementary foods” by Adriano Cattaneo (Italy), Carol Williams (UK) and Maria Teresa Hernandez-Aguilar (Spain).  We may sound different to one another, dress differently, but we certainly all face the same issues.  Pat Hoddinott (UK) gave a stimulating discussion of her research on “Family perspectives on breastfeeding—what would make a difference?”  This was followed by the last presentation of the conference, “The social impact of breastfeeding” by Anne Marie Oudesluys-Murphy (Netherlands).

The sessions were wonderful, informative, and lively at discussion time.  Breaks and lunch—well, let’s talk food first.  Can’t top freshly made espresso or cappuccino instead of just an urn of old cooling coffee in my book!  And trying to be “good” I had to avoid the Italian pastries (sigh).  Prosciutto, cheese, bread, pasta and couscous salads for lunch…doesn’t get much better—except that it was all served on a sunny rooftop terrace overlooking the city.  How to make it better—many physicians with many accents all talking with one another.  And I kept hearing snatches of conversation with words like “collaboration”, “share our research protocol”, “compare how we do it with how you are doing it”, “interested in looking at this with me”?   Isn’t this what ABM is all about??  Our Mission Statement:”The Academy of Breastfeeding Medicine is a worldwide organization of physicians dedicated to the promotion, protection and support of breastfeeding and human lactation.  Its mission is to unite into one association members of the various medical specialties with this common purpose.”  Our Vision Statement: ABM is an independent self-sustaining multi-specialty international physician-to-physician organization that promotes breastfeeding education, knowledge, attitudes and skills for physicians, worldwide.  These discussions certainly support out Mission and our Vision!  I learned we share many of the same issues, and we can certainly learn innovation from one another.  This IS an international meeting in the best sense of the world.  Elien is to be praised for her hard work and persistence in starting and continuing these meetings.  I for one, am very impressed and am looking forward to future meetings with great expectation!  A number of members have offered to host the next meeting in their countries after attending this meeting.  Our Strategic plan has us holding the annual meeting outside North America by 2015.  I would posit that with the attendance the European meetings have drawn, and the success they have attained, we could be considering holding the 2015 meeting in Europe.  Elien—what do you think??!!

Kathleen Marinelli MD, IBCLC, FABM is a neonatologist a Board member of the Academy of Breastfeeding Medicine, and Chair of the ABM Protocol Committee.

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