Breastfeeding Interventions: Miriam Labbok, MD, MPH, FACPM, FABM, IBCLC

By Christine Staricka, BS, IBCLC, CCE, ILCA Medialert Team

Screenshot 2015-01-22 09.55.20One of the amazing things about attending a live conference with lactation professionals is hearing the history of our profession from the people who have made it happen.  Dr. Miriam Labbok, MD, MPH, FACPM, FABM, IBCLC has significantly advanced the field of lactation over her career, and her presentation at the 2014 ILCA Conference, Breastfeeding Interventions: What We Know and Do Not Know, reflects her deep knowledge of our field.

This presentation has now been made available as a study module through the International Lactation Consultant Association® (ILCA®)’s CERPs on Demand portal and is worth 1 L-CERP and 1 contact hour.

Dr. Labbok’s presentation is an excellent primer on how to critically read research and includes plenty of examples to drive home the concepts.  She shares that her personal interest and pathway into research came from learning that, “clinical medicine turned out to be less about patient support and more about rote prescription of medicines, and [I] turned to public health to allow me to think outside the box.”

In the presentation, she also shares insights into why certain questions about breastfeeding have been studied and from where the motivation and funding arise for these studies.  She discusses the classic question for lactation professionals reading research, “What is the definition of breastfeeding?”  She leads the audience through a consideration of the challenges of ethics in research, provides a helpful how-to on setting up a study, ponders the problems with data mining, and ends with an inspiring call to action for new research.

In a written interview after the conference, Dr. Labbok shared her thoughts on the most pressing needs for research:

CS: Hearing historical perspectives on issues around breastfeeding (such as the history discussed in this presentation surrounding the definition of breastfeeding) is so influential for newer IBCLCs [International Board Certified Lactation Consultants®] like me; in fact, it is a huge motivator to invest in attending conferences such as ILCA.  How can the next generation hold on to these stories in a meaningful way?

ML: Honestly, this is a question that might better be answered by someone in the next generation! I would suggest that the next generation be encouraged to keep an open mind to what came before. Today, much of this is available on the web, IF you know what to look for. Actively asking for history is also good; trying not to take things at surface value, but asking “How did that come about? How was that decision reached?”  Again, I think you would have a better answer to this than I.

CS: Did you ever face a choice between spending your professional time and energy on clinical work vs. focusing more on research? How did you choose?

ML: My own decision to do research on breastfeeding was actually quite circuitous. My interest began before I even finished medical school and public health school, as Dr. Cicely Williams was my adviser.  At the time, unfortunately, I thought of her as being old and out of touch (she was in her 70s, and I, in my 20s), just as many of my students today find me.

As time has passed, I have realized that her approach, which was always to ask for dialogue and to liberally share anecdotes, still serves me today when I try to illustrate a point or challenge folks to try original thinking.  I found that clinical medicine turned out to be less about patient support and more about rote prescription of medicines, and I turned to public health to allow me to think outside the box.  In public health, the entire population is your patient!

CS: What research would you love to see in the next 5 years?  What research do you think would be most useful for helping today’s mothers?

ML: At least 5 areas of research are needed immediately to support today’s new mothers:

  • Safe, long-acting contraception for use during breastfeeding that does not have any negative impact on breastfeeding.
  • Value of breastfeeding in economic terms including the costs of alternatives, excess DALYs, and hospital/medical costs. These could be used to help sway policy towards paid maternity leave.
  • Cost to the environment of formula feeding, including the carbon footprint of the dairy industry, wasted plastics, excess pharmaceutical use, trucking, etc.
  • Differential impact on women’s and children’s health of expressed milk feeding vs direct breastfeeding.
  • Identification and reduction of remaining barriers to breastfeeding success, including continuity of care, prenatal prophylactic education, etc.

As a leader in policy research, Dr. Labbok’s presentation is highly enlightening and inspiring. It will certainly be viewed as a seminal conversation between the newest and the most experienced IBCLCs — a way to forge strong connections between what has been done and what is to come in the future.

CERPs on Demand from ILCA conferences are a great way to catch conference presentations that you missed while earning CERPs. You can access CERPs on Demand at the times that work best for you!

ILCA Members receive a 50% discount on all CERPs on Demand.

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Dr. Miriam Labbok, MD, MPH, FACPM, FABM, IBCLC, is currently a professor at the University of North Carolina Gillings School of Global Public Health. She also serves as the Director of the Carolina Global Breastfeeding Institute, which offers a comprehensive program of research, service to the greater community, and education related to breastfeeding and optimal reproductive health.


Christine2Christine Staricka, BS is a hospital-based IBCLC. Christine is the co-owner of California Advanced Lactation Institute, which provides lactation education to professionals and expectant parents. She has contributed to USLCA’s eNews as well as this blog. She enjoys tweeting breastfeeding information as @IBCLCinCA and maintains a blog by the same name. She is a wife and mother of 3 lovely and intelligent daughters and aunt to 4 nephews and 2 nieces, all of who have been or are still breastfeeding.


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