Breastfeeding Medicine

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How a Surgeon Ended up in ABM

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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.

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Written by sntierney

October 16, 2012 at 7:55 am

La dolce vita of breastfeeding in Trieste

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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.

Written by elienrouw

July 15, 2012 at 11:02 am

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

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Yesterday was the first day of the 4th 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.

Written by kmarinellimd

May 20, 2012 at 5:08 pm

Spread the ABM Holiday Cheer!

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Warmest Holiday Wishes

to Mothers and Babies Worldwide

Written by bfmed

December 7, 2011 at 12:05 pm

Posted in Members