It’s often repeated that doctors and nurses learn “nothing” about breastfeeding. But is it really true? I would argue that it’s not. And here’s why.
While curriculum varies widely across countries and between institutions, I feel confident in saying that no one is teaching physicians or nurses that infants do not need to eat. With a little less confidence, I think it’s still also reasonable to say that breastfeeding is understood to be the global reference for feeding infants, even where the difference between human milk and substitutes is vastly understated.
Physicians, nurses, and others may not receive adequate education on infant feeding, but it doesn’t mean that they learn nothing about it. They learn a great deal about it, even when it is not on the syllabus.
The space that a subject takes up within a curriculum is a signal of its own of how important the topic will be to future practice. Dr. Jack Newman, a Canadian pediatrician who has spent most of his career supporting breastfeeding, has been known to comment that he recalls multiple courses in his pediatric training about lupus erythematosus, but none about breastfeeding - which led him to a rather misleading conclusion about how often lupus would arise in his practice versus breastfeeding.
In the absence of a well-developed curriculum on breastfeeding and human lactation, learners don’t have a void - their understanding is filled in by experience and beliefs. It is also filled in with ‘pseudo education provided by marketing both for the general public and those specifically aimed at health care providers, particularly those early in their careers. Even where breastfeeding is an important part of initial training, health care workers still arrive at the bedside with their beliefs and experience, many of which will have been shaped by commercial influences.
Recognizing this in ourselves and in others is a key step as we deepen our understanding of infant feeding and how to promote, protect and support breastfeeding within our workplaces and communities. None of us knows “nothing” - even when what we know may not be accurate or helpful to the families and communities we care for.
Michelle Pensa Branco MPH IBCLC
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