Current Scope of Practice for Breastfeeding and Lactation Medicine Physicians and Providers: Description of an Emerging Subspecialty.

Abstract

Breastfeeding and Lactation Medicine is an emerging medical subspecialty that addresses the physiology, pathology, and sociodemographic components of breastfeeding and lactation. In the past 50 years, the field has grown into an international subspecialty supported by the Academy of Breastfeeding Medicine. Training programs are emerging in many countries, and it has become a reimbursable, board-certified medical specialty in the United States and Canada. Breastfeeding and Lactation Medicine providers manage routine and complex issues arising during lactation, across multiple care settings. Care requires a comprehensive skill set that includes a strong understanding of the distinct and interdependent physiologies of presenting patients as well as a consideration of the context in which families are immersed. Providers in this field are also advocates, researchers, policy consultants, and educators, leading global improvement in the clinical care and social support for families who are breastfeeding or lactating. Struggles for the field have included difficulties with institutionalizing programs, a research agenda not focused on diagnosis and management of common conditions, competition with commercial milk formula marketing practices, and limited training opportunities. This paper was developed by an international group of Breastfeeding and Lactation Medicine providers and the Academy of Breastfeeding Medicine to describe the scope of the field, who practices in the field, the problems addressed, challenges faced, and some cases that exemplify this work.