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• W4381194241 abstract "Breastfeeding MedicineVol. 18, No. 6 President's ColumnFree AccessBreastfeeding Medicine Across the GlobeAnn KellamsAnn Kellams—Ann Kellams, MD, FABM, IBCLC, FAAP, President, Academy of Breastfeeding MedicineSearch for more papers by this authorPublished Online:15 Jun 2023https://doi.org/10.1089/bfm.2023.29245.alkAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail I recently had the distinct honor and pleasure of attending and delivering a welcome address at the 8th Academy of Breastfeeding Medicine (ABM) and European Association of Breastfeeding Medicine (EABM) in the spectacular city of Split, Croatia. With >250 registrants, the conference hosted experts in the field from ∼40 different countries. We were all treated to an exhibition of traditional Croatian dancing and singing, complete with traditional attire and a conference filled with colleagues from all over the world who “get it” when it comes to breastfeeding, lactation, human milk, and new families.I thought I could share with you some of my many takeaways from the meeting: 1.All great breastfeeding medicine efforts have a hero or a champion—someone who is passionate, well versed, and inspires others to join with them. So, for those of you out there who are meeting road blocks, keep going. Your work matters!2.Perseverance is another commonality in these efforts. We are individuals and nonprofit organizations up against the corporate, commercialization of infant feeding and political policies, and forces that are well funded, and not completely beneficent. We must keep swimming upstream and partnering to ensure that mothers and new families maintain their right to make health decisions for themselves and their children free of commercial influence, misinformation, and manipulation.3.There are still so many gaps in knowledge and a lack of research about all things breastfeeding and lactation. Although the science has come a long way, and although we could argue why there are these deficits in information (think anything women's health versus the erectile dysfunction drug industry, for example), the bottom line is that we need to be setting the research agenda, advocating for and seeking funding, and using our clinical knowledge to inform studies and advance the field. Who can you partner with in the biostatistics, epidemiology, or translational research realms?4.COVID-19 had a huge impact on breastfeeding support, and not just for those who tested positive and/or were exposed. We lost some ground with hospital practices including the ten steps and outpatient support, and we and those we care for are still being impacted by the consequences.5.We still need to be incorporating the realities of the “risks of not breastfeeding” into our daily discourse and be particularly careful when we speak publicly and when we publish. Breastfeeding is the physiological norm, and anything other than breastfeeding needs to prove that it is not harmful and does not increase risks to health–and not the other way around. That is very different than saying there are “benefits” to breastfeeding.6.Breastfeeding is a team sport! I was so delighted to meet and talk with physical therapists, pharmacists, trainees, International Board Certified Lactation Consultants's, and nurses who were all at the conference to learn together how we can do better in the medical care of breastfeeding dyads.7.There is a difference between thinking of the infant “sucking” the milk out of the breast and what really happens, which is an elegant dance in which the breastfeeding person's body ejects the milk upon the onset of effective signaling from the baby, and then the baby “drinks” the milk. (This is a Jack Newman-ism that particularly resonates!) There are many implications here, for example, sucking milk out sounds like it might hurt, and drinking sounds more benign as it should be. Sucking per se is not the main mechanism for milk removal versus what a breast pump does. In fact, hand expression may be closer to what a baby's mouth actually does. And on and on.8.We still have more to learn about mastitis, but what we do know and believe is more similar among the various schools of thought and expert opinions on the subject than they are different. Here are some places where there is agreement related to the mastitis spectrum: Not every inflamed breast is infected and needs antibiotics. Some inflamed breasts—for example, with fever/aches/chills, severe pain, red streaks, and not improving after supportive management for inflammation—really do—and you have got to get a good history and do a thorough physical evaluation to determine which inflamed breast is which and what the best management steps will be. Abscesses need to be drained, but not all fluid collections are abscesses.Not all countries see a lot of oversupply, but those that have a large number of people pumping and returning to work early do, and this is likely a risk factor for mastitis. Better with the inflamed breast and the normal breast to remove only so much milk as the baby needs rather than continually producing more. It is ok to keep feeding the baby if you have mastitis, or an abscess, or are being treated for either. You cannot squeeze out or “massage out” a “plug” and in fact, vigorous attempts to do so can make matters worse.9.No matter where we live, we still have a long way to go to educate doctors and other health care professionals about the importance, management, and support of breastfeeding.10.The ten steps work, and we should be doing everything we can in the neonatal intensive care settings as well. The first 1,000 minutes, hours, and days truly matter!The above bullets will hopefully give you a flavor of the types of enlightening and informative presentations and discussions that occurred over the course of the 3-day meeting. It was an honor to hear from experts from WHO, International Baby Foods Action Network, ABM, EABM, and various other local, regional, and international colleagues all with a common purpose of promoting the health of mothers, infants, and new families. Many thanks go out to Irena Zakarija-Grkovik, the EABM, and the conference scientific and planning committees for putting on such an enjoyable, successful, informative, and seamless event. It made me proud to be a part of this great organization and this community of caring professionals.FiguresReferencesRelatedDetails Volume 18Issue 6Jun 2023 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:Ann Kellams.Breastfeeding Medicine Across the Globe.Breastfeeding Medicine.Jun 2023.500-501.http://doi.org/10.1089/bfm.2023.29245.alkPublished in Volume: 18 Issue 6: June 15, 2023PDF download" @default.
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