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Improving Doctors’ Breastfeeding Literacy

March 21, 2017

We’ve all heard it time and again: Breast is best. So why do so many doctors charged with caring for mothers and babies seem to know so little about it? Holly Ellis Spiegel gets the lowdown from OB/GYN and IBCLC Susan Rothenberg, Associate Director of Obstetrics at Mt. Sinai Downtown in New York City.


Dr. Susan Rothenberg admits it: “doctors are used to being the smartest person in the room and don’t really like when someone’s asking a question that they don’t have the answer to.” And when it comes to breastfeeding, “there is a definite knowledge deficit. It can be challenging for a lot of doctors, and they tend to go on the defensive.”

This is not surprising to any new mother who has gone to her OB or child’s pediatrician asking for help with a breastfeeding challenge. Even though the American Academy of Pediatrics recommends babies be exclusively breastfed for the first 6 months and then continue to nurse for at least one year, “most doctors learn almost nothing about breastfeeding in medical school or in residency. There are no standards for breastfeeding education and there’s no requirement for medical schools to teach breastfeeding, except in a very superficial way,” Dr. Rothenberg says.

Thankfully, Dr. Rothenberg isn’t like most doctors.

After nearly 20 years as a practicing obstetrician, Dr. Rothenberg was challenged with improving her hospital’s breastfeeding promotion and practice. She began educating herself about the public health benefits of breastfeeding and how she could better serve her patients by learning more about breastfeeding. She went so far as to become an Internationally Board Certified Lactation Consultant (IBCLC) and now lectures nationally and serves on several task forces to improve breastfeeding literacy for both OB/GYNs and pediatricians.

Among the key lessons Dr. Rothenberg feels the medical community needs to learn are:

  • Get back to basics: Put the baby skin-to-skin with the mother immediately after delivery and leave him there until he’s had a chance to latch on all by himself. “We as a culture have sort of lost the concept that babies are born knowing how to breastfeed,” says Dr. Rothenberg. “Like every mammal on the planet, newborn babies are born knowing how to find the breast on their own. You don’t see dogs and cats hiring lactation consultants; their babies find the breast independently, and our babies will do that too, if we let them.”
  • Arm patients with information: Taking a breastfeeding class with a certified instructor before they give birth has been shown to have a significant effect on women meeting their breastfeeding goals. “That’s a simple thing an OB can do that has a big impact in the long run,” says Dr. Rothenberg.
  • Arm doctors with information, too: “Not answering every question with ‘oh, well if you can’t figure it out, just give formula,’ is a big thing,” says Dr. Rothenberg, and she admits she gave this answer more than once before she became better informed on breastfeeding. She says that doctors need to learn where to search properly for information, such as what medications are and aren’t safe. “So many women get sabotaged by someone telling them ‘you have to take this medication, you should stop breastfeeding or you should pump and dump for a couple of days,’” she warns. “For a lot of people that’s the beginning of the end of breastfeeding.”
  • Fill the Rolodex: Doctors should develop a stable of people to whom they can refer their patients on a regular basis. They should have phone numbers for 3 or 4 lactation consultants, as well as breastfeeding friendly pediatricians in your area that you know and trust.
  • Step aside: It’s often just little things that can make a big difference for patients. “A lot of the time, if [doctors] would just get out of the way and let women trust their babies, trust their bodies, they’d be better off,” says Dr. Rothenberg.

Dr. Rothenberg is working on multiple task forces to improve breastfeeding education among medical professionals, but there is a long way to go to setting and implementing breastfeeding standards among OBs and pediatricians, so expectant mothers should educate themselves and have a plan for breastfeeding support before they give birth.

Stay tuned for Dr. Rothenberg’s more detailed advice to breastfeeding mothers and women who plan to breastfeed for speaking to their doctors about their breastfeeding challenges.


Holly Ellis Spiegel is a writer and freelance film and video producer based in Brooklyn. She’s produced four feature films including the Sundance-selected Prairie Love and countless videos for parents and families on CafeMom and other outlets. She is also a new mom. See her work at www.hollylynnellis.com.

Susan D. Rothenberg, MD, IBCLC, FACOG is the Associate Director of Obstetrics for the Department of Obstetrics and Gynecology at Mount Sinai Downtown in New York City, where she has been a faculty member since 2000. A breastfeeding advocate for many years, she lectures on breastfeeding support at the local, regional, and national level. Dr. Rothenberg is a member of the American College of Obstetricians and Gynecologists Breastfeeding Expert Work Group, and serves on the board of directors of the Academy of Breastfeeding Medicine.