The 'Breast is Best' Policy and Why Breastfeeding Should Receive the Same Kind of Medical Attention as Erectile Dysfunction

Typically when a woman experiences difficulty with breastfeeding she’s told to keep working at it because she’s probably just doing it wrong. After all, it’s what her body is meant to do. But our bodies are meant to do a lot of things—like produce insulin, eat peanuts, or get pregnant—that they sometimes can’t. Why do doctors, nurses, and lactation consultants believe so whole-heartedly in the infallibility of breastfeeding?

While it’s great that breastfeeding has shaken the stigma attached to it for most of the 20th century—before its health benefits were recognized and the practice was considered to be something for women who couldn’t afford formula or condensed milk—the pendulum has seemingly swung in the opposite direction. With public policy being created to restrict new mothers’ access to formula, the pressure to breastfeed is very real and very prominent. The intention is to encourage a “breast is best” mentality. But the result is that women who are unable to breastfeed, due to extreme pain or the inability to produce enough milk, feel like failures who aren’t able to provide “the best” for their newborns.

But instead of creating initiatives to educate new mothers about the benefits of breast milk, perhaps efforts would be better spent on helping them with the process of breastfeeding. Lactation consultants simply aren’t cutting it. They can’t run diagnostic tests or write prescriptions. What’s needed is scientific research to understand the physiology of why some women might have problems.

In a piece for Time that questions whether the medical community is failing breastfeeding mothers, writer Lisa Selin Davis points out that “lactation is probably the only bodily function for which modern medicine has almost no training, protocol or knowledge.”

What do doctors learn about breast-feeding in medical school? “We learned that it’s what’s best for baby,” said my own pediatrician. “But that’s it.” They’re introduced to evidence that prolonged breast-feeding reduces the possibilities of obesity, SIDS and allergies, but the science of it, what’s happening at the anatomical level? Not so much.

“It’s an hour, or a half a day, and [students] don’t remember anything,” says Dr. Todd Wolynn, a Pittsburgh pediatrician and executive director of the Breastfeeding Center of Pittsburgh. There were years, he says, when there was literally nothing said about breast-feeding at all.

Part of the problem is generational. Many of the leaders in the medical field today were in training themselves at a time when breastfeeding was not the norm. So, without being proactive about putting measures in place to educate doctors about breastfeeding, it might be awhile before any real improvement in training practices is seen. As it stands, there are only 88 doctors in the entire world who are fellows of the Academy of Breastfeeding Medicine, an “organization of physicians dedicated to the promotion, protection and support of breastfeeding and human lactation.”

But even Dr. Wolynn, who is a certified lactation consultant and ABM member, believes that “very few women really can’t breastfeed,” citing that it’s a “normal mammalian function” as evidence. Getting a boner is also a “normal mammalian function.” However, there are enough men with erectile dysfunction to warrant a competitive billion-dollar global market dedicated to its treatment.

Here’s a sad statistic:

Within the database of federally funded medical research, there are 70 studies on erectile dysfunction; there are 10 on lactation failure.

So why isn’t breastfeeding given the same kind of attention as ED? The answer is probably money. ED is a recognized disorder for which the diagnosis and treatment (like Viagra) is covered by insurance. Lactation dysfunction, however, “doesn’t even exist as a diagnosis,” so there is no health insurance code that doctors can bill.

One step in the right direction is that when the Affordable Health Care Act kicked in on August 1, health insurance companies were instructed to provide “comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment.”

But as many as five percent of all women have medical conditions that prevent or seriously hinder lactation (hypoplasia, thyroid problems, hormonal imbalances, insufficient glandular tissue, among others) and the lack of medical interventions and understanding sucks harder than a double electric breast pump.