A doctor friend once said to me “Of course I support breastfeeding. But I am not like THOSE people.” THOSE people being the in-your-face ‘advocates’ who raise hell over something as ‘harmless’ as a bottle of formula. The ones so uncivilized that they feed babies with a cup. Who bare their breasts in public, pickett in front of Congress, pick fights with their physicians. At one point in time, I may have shared the same sentiment.
I am the 2nd of 7 formula-fed children. I grew up in a home where bottled milk was the norm, and in a society that wasn’t any different. The first time I ever saw human milk from human breasts was when I was about 7. Our new cook had apprently just had a baby, and was squeezing milk from her breasts into a drinking glass to relieve her discomfort. To my young eyes it seemed just a little freaky.
Fast-forward 14 years later: I graduated from ‘the best medical school in the country’. I had devoted many sleepless nights to reading endless amounts of text. I had numerous hours of assisting surgeries and attending to patients under my belt. I also had about a full hour’s worth of breastfeeding education in a lecture hall.
I decided to become a Pediatrician. I love children, and realized I had a knack for understanding them. I moved to New York, where I learned a lot about primary care and keeping children healthy. And despite the rigorous training in almost everything else, I learned very little about breastfeeding.
I got married during my residency and at the end of my third year, gave birth to my first child. Like many doctors, I assumed I knew everything there was to know (I was a Pediatrician after all, had attended many a delivery, and cared for many newborns). So after several hours of active labor and almost an hour of pushing, I delivered an 8 lb 13 oz baby boy. The nurse put him in my arms and after I marveled at how beautiful he was, I thought, “Huh. What do I do now?”
I knew “breast is best” but at that moment I realized that was all I knew. I had never truly watched anyone breastfeed before. I had been too busy attending to more urgent and life-threatening matters. So I held my son close and prayed that he would know what to do. He latched on, but I saw and felt nothing. I wondered if this was how things were supposed to be.
Lucky for me, I gave birth in a wonderful baby-friendly hospital in New York, the same place that had agreed to take me on as a Fellow in Neonatology. They had regular breastfeeding classes for new moms on the maternity floor, and had 2 in-house lactation consultants doing rounds. It was because of all this that I discovered the true magic in one human body’s ability to fully nourish another.
The first weeks with my son were not easy. I had delayed lactogenesis and my son became very jaundiced and dehydrated. I was also due to start fellowship training 2 weeks after I had given birth. It was all a recipe for breastfeeding disaster. And yet by some miracle, we both survived.
I showed up to my first day at work when my Son was 13 days old. I was in a Neonatal ICU surrounded by new moms with tiny and/or very sick babies, and suddenly I was not just a doctor. I was also a new mom, full of hope yet feeling a little lost and clueless. It was then that I decided to study breastfeeding more seriously.
Fortunately, our NICU was incredibly breastfeeding-friendly. Breastmilk was the diet of choice for almost every baby, and babies were put to the breast as early as could be managed. It was done without a lot of fanfare – it simply was the norm. So while I continued to learn as much as I could about breastfeeding, I learned about many other things as well. I studied many things hi-tech and cutting-edge, and never really thought breastfeeding would be my mission.
Everything changed when I finished my 3-year fellowship and went home.
I came back to the Philippines to practice as had always been the plan. I was eager to use my new ‘gentle ventilation’ techniques on my sick newborns. I wanted to bring in new modes of treatment for critical pulmonary disease, and to use my newfound expertise to grow 1 lb preemies into happy, healthy babies.
Then came a call to see my first patient – a well newborn. I found a seemingly healthy infant in the nursery – placed in an incubator to be kept away from its mother for the next 24 hours because of hospital policy. Also by policy, he was to be fed glucose water and then formula (unless the mother had the strength to wheel herself to the nursery every 3 hours to attempt to breastfeed).
After 3 years in a baby-friendly hospital, I had forgotten what the outside world was like. The discovery of this new norm came as a shock. Babies were routinely separated from their mothers and fed formula. Mother who wanted to breastfeed were left to fend for themselves. More painful was the eventual realization that this was happening not just in my center but all over the country.
Breastfeeding has numerous benefits. Any Google search will bring up an extensive and impressive list. Topmost is that “Breastfeeding Saves Lives!” But what many doctors, health care workers and parents don’t realize is that breastfeeding works best when it is done from the very beginning (within the first hour of life), when it is done exclusively (meaning the child receives nothing but breastmilk – not even water), and when it is done for a prolonged period of time (at least 6 months, and up to 2 years and beyond). We also don’t realize that even though breastfeeding is natural, it is learned behavior. It needs to be taught and it requires practice.
As far as medical interventions go, there is no single treatment whose preventive and therapeutic effects even come close to breastfeeding. Also, it is free and it causes absolutely zero harm (no other medical treatment can claim to be free of side effects). It is effective regardless of the mother’s IQ, bank account or social status. It works on all babies small or large, preemie or term, sick or well. I like to think of breastfeeding as the great equalizer – it gives every baby and mother the best start, no matter what situation they are in.
I realized that none of my superspecialty experience or cutting-edge techniques would be of any help to these well babies. They didn’t need special ventilators or hi-tech treatments. What they needed was to be given to their mothers and to be breastfed. And my tiny sick babies would have much more to overcome if they weren’t receiving any breastmilk. That realization changed the course of my career.
15 years after medical school and 9 years after graduating from one of the best training programs in Neonatology, here I am being decidedly low-tech. I co-founded LATCH, a peer counseling group for breastfeeding mothers, and I became part of the Unang Yakap (Essential Intrapartum and Newborn Care) initiative in the Philippines. I breastfed 3 of my own children (my youngest for almost 3 years). I no longer practice medicine but I am often online at odd hours answering queries from breastfeeding mothers.
Because breastfeeding is so incredibly amazing, I feel it is my duty as a doctor, a mother, a parent, a member of society to promote it in every possible capacity. I have met many incredible people who share the same goal – colleagues in Medicine, counselors, mothers, friends. They are my heroes. I suppose some would say I have turned into one of THEM. If by being one of THOSE PEOPLE I can help make the babies a little healthier, help them live longer, help them have the best start so they can reach their full potential regardless of how or where they are born, then I gladly wear that badge with pride.