I am not a physician and do not know the structure of the ABM. Certainly, I understand the intention to elevate breastfeeding as an imperative among your peers and to educate them as effectively as possible. I understand the intention to support parents by ensuring that those peds who do not have an interest in breastfeeding can be pointed in the direction of accurate information that might keep a family breastfeeding under adverse circumstances. That is all significant work and clearly sends an important message to both your peers and the community at large.
Still, it occurs to me that breastfeeding is the professional role of the IBCLC, some of whom happen to also be physicians. Is it presumed that only an IBCLC who is a medical doctor would have anything to contribute to the policies developed by the ABM? Are there not areas where others might have important expertise to offer, expertise that you do not have?
Tongue-tie is a perfect example. Collectively the IATP represents the world's experts on TT, yet IATP has not been contacted as an organization to consult on policy, nor are dentists who have more collective expertise in treating tongue-tie effectively than anyone else allowed to be members. One of the wonderful things about IATP is that we listen and learn equally from one another. There is no sense that the physician opinion will be the default in IATP. Breastfeeding is not a medical problem, so how is it that a medicalized approach to every concern becomes the default?
I love the work that I do with families, but every day I question how medicalized this profession has become and whether I can continue to believe in it. I think the expectation that every breastfeeding issue needs a medical solution is a very dangerous one. I am extremely effective in working with my clients, yet I have not had to refer a mother for abx in about a decade. It seems to me that the ABM protocol on mastitis is going to influence decision-making in a very harmful way. How can the members of the organization be so unconcerned with gut function as to presume that abx should be the first line of defense simply because a mother has these symptoms? It this not a case of "if all you have is a hammer, then everything is a nail"? It is so damaging and unecessary. Are the members of the ABM not aware of the research linking abx exposure to obesity? Collectively, researchers and physicians alike bemoan the overuse of abx, but where are the policies that address those very real concerns? IMO, the mastitis protocol rests on a foundation that does a grave disservice to all involved. I have something I tell my families when they are inclined to rush to a bottle for reasons that do not support such use. I tell them, "When you are about to reach for a bottle, do what you would do if you did not have one". I urge the ABM to demedicalize breastfeeding and step far away from the box in developing protocols that protect the human microbiome. In doing this you would be pioneers and everyone else will one day be rushing out of desperation to follow in your footsteps.
Jennifer Tow, IBCLC, USA & France
Intuitive Parenting Network, LLC
Date: Sun, 20 Jul 2014 15:41:29 -0400
From: Lee Galasso <[log in to unmask]>
Subject: Re: ABM mastitis protocol
Jane (and previously Gail Hertz, MD) - I understand the purpose of the
organization and applaud it; but if IBCLC icons who are NOT physicians were
included on the ABM Board, the lack of information that Jennifer Tow alluded to
could be avoided. The ABM could also avoid any slight misinformation with the
input of IBCLC icons on the board. Would that create a problem for the ABM?
IMO, it is an idea that could help all concerned.
Warmest regards,
Lee Galasso, MS, LLLL, IBCLC, RLC
Lactation Specialist, Lactation Center of Westchester/Putnam; Westchester County
in NYS, USA
“Children Are Born with the Need to Breastfeed”
***********************
Formula feeding is the longest-lasting uncontrolled experiment in the history of
medicine.
~~ Frank Oski, MD; Chair, Department of Pediatrics, Johns Hopkins University,
1985-1996
-----Original Message-----
Date: Wed, 16 Jul 2014 14:55:30 -0500
From: <mailto:[log in to unmask]> [log in to unmask]
Subject: Re: ABM mastitis protocol
The whole purpose of ABM is to have [help?] educate and support physicians
interested in breastfeeding. We have ILCA and many physicians are IBCLC's as
well. I don't blame them for NOT having non-MD's on their board.
-----Original Message-----
From: Lactation Information and Discussion [ <mailto:[log in to unmask]>
mailto:[log in to unmask]] On Behalf Of Lee Galasso
Sent: Monday, July 14, 2014 3:25 PM
Subject: ABM mastitis protocol
Jennifer - Regarding your below message, I am not surprised that you noted: "It
could not have been more medicalized." Years ago, I wrote on LACTNET that I
wished the Academy of Breastfeeding Medicine (ABM) would change its name to use
the word SCIENCE instead of MEDICINE. There is no such thing as breastfeeding
medicine, as far as I'm concerned...and I am very uncomfortable with the way
breastfeeding is being medicalized. One of the former Presidents of ABM was
quick to treat mastitis with antibiotics instead of first rooting out the cause
of the mastitis and resolving it with better breastfeeding management.
The responses to my posts were scarce and negative. So breastfeeding is
medicalized by ABM and its board of physicians; the ABM board does not include
IBCLC icons who are not medical doctors.
Warmest regards,
Lee Galasso, MS, LLLL, IBCLC, RLC
Lactation Specialist, Lactation Center of Westchester/Putnam Westchester County
in NYS, USA “Children Are Born with the Need to Breastfeed”
***********************
Formula feeding is the longest-lasting uncontrolled experiment in the history of
medicine.
~~ Frank Oski, MD; Chair, Department of Pediatrics, Johns Hopkins University,
1985-1996
-----------------------------
Date: Mon, 7 Jul 2014 02:48:44 -0400
From: "Jennifer Tow, IBCLC" < <mailto:[log in to unmask]> [log in to unmask]>
Subject: ABM mastitis protocol
How unfortunate that the ABM did not think to include TT as a consideration in
its newest mastitis protocol. I think I see more mastitis due to ties than
anything else other than maternal diet. Just as disturbing for me is the
complete lack of concern for the integrity of the gut and global protocols that
do not rush to medicate women for mastitis--this is so easily managed w.o meds
--I would guess 95% of the time. Nothing in the protocol is reflective of
anything I see in my practice. This is such a disappointment. It could not have
been more medicalized.
<http://online.liebertpub.com/doi/full/10.1089/bfm.2014.9984>
http://online.liebertpub.com/doi/full/10.1089/bfm.2014.9984
Jennifer Tow, IBCLC, USA & France
Intuitive Parenting Network, LLC
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