AAP Voices Blog

The Pediatrician’s Role in Lactation Care

The summer after my first year of medical school, I randomly attended a conference presentation about Breastfeeding Basics for Physicians. I left interested in how the physician described using his skills as an International Board-Certified Lactation Consultant (IBCLC) to provide lactation support at the point of care without always having to refer to a lactation consultant.

I left that talk determined to do the same and with the understanding that breastfeeding care is a role for a physician. After all, breastfeeding was nearly universally recommended; why wouldn’t I learn how to help my patients and their families?

After all, breastfeeding was nearly universally recommended; why wouldn’t I learn how to help?

My pediatrics residency experience highlighted a lack of lactation education. We received a single 1-hour lecture, and I noted that lactation care was marginalized, even in the NICU where human milk is critically important for survival. The subject was rarely discussed on rounds or in notes. Fellow physicians were often supportive but, usually, were unable to provide much clinical input or oversight.

Instead, my overworked IBCLC colleagues were often tasked with every lactation-related issue, even those that seemed out of scope like medication safety questions. My early years as an outpatient pediatrician were similar, for every coworker thrilled that I was an IBCLC - a certification I earned before my MD - there were others who were confused by it or told me that breastfeeding support “wasn’t what doctors did.”

More than 25 years after that lecture, I directly provide lactation support as part of my role as a newborn hospitalist and breastfeeding medicine physician. The evolution of my career  looks very different than I could have ever imagined and although I recognize that this will not be the experience of many of my colleagues – the great news is that I am seeing more interest in breastfeeding and lactation education from physicians.

Younger physicians and physicians in training are more highly engaged, a pattern I see routinely when teaching residents, fellows, and medical students about lactation in core classes and rotations. I am honored to have been a part of increasing the lactation education that they receive as it is a far cry from what I personally experienced in training.  

More families are breastfeeding now than ever; each year, 84% of new parents begin breastfeeding. However, many are unable to meet their own breastfeeding goals or national recommendations with just 27% of U.S. babies being exclusively breastfed through their first six months and less than 40% are still receiving breast milk by 12 months. Significant disparities exist, with some of the lowest rates seen among non-Hispanic Black and American Indian/Alaska Native families, that result from more than individual choices. They encounter barriers in the workplace, health care systems differences, and unequal access to lactation support.  

The 2026 AAP policy statement “Opportunities for Pediatricians to Address Racism and Bias to Reduce Racial Disparities in Breastfeeding and the Use of Human Milk” directly calls for pediatricians to close these gaps by providing evidence-based, culturally responsive care - among other recommendations.

For future physicians and those in training, the path to providing this care seems reasonably clear: take an elective, spend time with lactation professionals, check out the AAP Breastfeeding Curriculum, consider joining the AAP Section on Breastfeeding, or undertake a research project. Those who trained in the era where little was taught about lactation have a larger gap to remediate. They are also, importantly, the senior physicians that trainees and communities rely on for support, compounding the difficulties in training younger physicians to provide lactation care.

Here in Georgia, our AAP Chapter has sought to fill these gaps through public health-supported programmatic work that equips pediatricians with the knowledge, skills, and tools to support breastfeeding families. Perhaps the best example of this is the GA Breastfeeding Friendly Pediatrician certification program. These physicians have all demonstrated key practice changes based on AAP’s 2017 report “The Breastfeeding-Friendly Pediatric Office Practice” and now provide evidence-based support for breastfeeding families in their offices, an important step toward health equity. Other AAP chapters are now considering similar programs.

As pediatricians, we cannot see these disparities in breastfeeding outcomes and continue to allow breastfeeding support to be an optional or a marginalized part of our routine pediatric care. We have come a long way from the days when I trained but must continue to improve.  

For those who did not learn enough in their years of training but want to provide equitable lactation support to families, ask your AAP chapters to support similar programs. These programs expand our wealth of knowledge and, in turn, help provide support in our communities and practices for all breastfeeding families.  Lactation support for every family is our job—we pediatricians can and should learn how to help.  

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.