Educational Objectives and Skills for the Physician with Respect to Breastfeeding, Revised 2018

Abstract

The Academy of Breastfeeding Medicine is a worldwide organization of physicians dedicated to the promotion, protection and support of breastfeeding and human lactation. Our mission is to unite into one association members of the various medical specialties with this common purpose .

Introduction

THE SCIENCE OF BREASTFEEDING and human lactation requires that physicians from many different specialties have a collaborative forum to promote progress in physician education. To optimize breastfeeding practices globally, physicians must incorporate the attitudes and skills needed to practice evidence-based breastfeeding medicine. The study of breastfeeding and human lactation is not currently recognized as a medical subspecialty, so the maintenance of a multispecialty organization dedicated to physician education and expansion of knowledge in this field has been vital.

Background

The numerous benefits of breastfeeding for mothers and children have been well documented. Physicians (medical doctors) play a key role in supporting breastfeeding, and they interact with women, children, and families throughout the life span. To advocate for breastfeeding, educate families about breastfeeding, and provide optimal clinical management of breastfeeding, these physicians must be educated about and skilled in breastfeeding establishment, maintenance, and support, as well as how to diagnose and treat breastfeeding complications. Lack of sufficient education to provide breastfeeding support and guidance by physicians has been well documented in the medical literature.

The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) “Ten Steps to Successful Breastfeeding,” (Ten Steps), revised in 2018, called for all health care staff to have sufficient knowledge, competence, and skills to support breastfeeding. The Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding identified four key goals in breastfeeding support: establishing national committees for oversight, ensuring maternity facilities practice the Ten Steps, enforcing the International Code of Marketing of Breast-milk Substitutes, and enacting legislation that protects the breastfeeding rights of working women. Where national committees exist, many have an objective to educate all health care providers regarding appropriate breastfeeding and lactation support (e.g., the Australian National Breastfeeding Strategy, the German Breastfeeding Committee, Breastfeeding Promotion Network of India, Kenya’s National Infant and Young Child Feeding Committee, and the United States Breastfeeding Committee, ). The United States Breastfeeding Committee published “Core Competencies in Breastfeeding Care and Services for All Health Professionals.”

The Academy of Breastfeeding Medicine was founded to promote physician education and has a central goal to develop and disseminate the standard for physician education around breastfeeding and human lactation. Guidance for the integration of breastfeeding medicine throughout the undergraduate, graduate, and postgraduate medical education of physicians is provided in this statement. While this guidance may be applicable to other health care disciplines, the competencies are aimed at physicians specifically. ABM protocols are useful in teaching evidence-based practices throughout the medical education continuum. ABM recognizes that terminology used to describe levels of medical education in various medical education systems around the globe differs. In this statement, the term “undergraduate medical education” is used to describe education received before obtaining a medical doctor degree; “graduate medical education” refers to clinical education received after the medical degree has been conferred and before the independent practice of medicine (i.e., doctors training during residency and/or fellowship); and “postgraduate education” refers to continuing medical education (CME) and maintenance of certification activities completed during ongoing professional development and/or as a requirement to maintain licensure/registration after the training phases have been completed.

Guidelines