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Shouldn’t the Breast Surgeon Know Lactating Breasts?

Medical books; physicians should be familiar with lactating breasts.

Here’s a sentence I saw today in an email message.  With small variations, I have seen or heard this sentence many times throughout my career:“The mother saw a breast surgeon, who did not have a vast knowledge of the lactating breast, but…”

Knowing your specialty

Okay, the writer is entitled to call a spade a spade and state the surgeon’s shortfall of knowledge of not being familiar with lactating breasts. I’m okay with that. In fact, I hear it often enough that I don’t doubt it’s true. What I can’t understand is, why, exactly, a doctor whose work is to operate on the breast “[does] not have a vast knowledge of the lactating breast”?

Knowing the biological function of the breast

After all, the biological function of the human breast is to lactate. That is its very purpose. So how can a breast surgeon not be knowledgeable about the organ when it is functioning as intended? Admittedly, most breast surgeons are performing reduction surgeries or reconstruction surgery on women who have had breast cancer. But those same women might be lactating in the future, right? Understanding the lactating breast is crucial.

Having double standards when it comes to lactating breasts

Consider: When would we ever hear someone say, “The man saw a lung surgeon who did not have a vast knowledge of the breathing lung…” or “The ballerina saw a foot surgeon who did not have a vast knowledge of the dancing foot…” Puh-leeeze!

True, most of the breasts a breast specialist sees in a day may not be lactating at the time. But many of the feet that a foot specialist sees in a day may not be dancing. Or running. Yet, the dancers and the runners need a specialist from time to time. The same is true for the breast.

How is it possible that a doctor could be authorized to diagnose, treat, and incise an organ for which he or she “did not have a vast knowledge of” it working as intended, performing the function it’s supposed to do? Help! I don’t get it!

Questioning the term “specialist”

It is simply unacceptable that breast “specialists” do not have a complete understanding of the lactating breast. Specialists should have a specialized knowledge of breasts at all stages of gestation and lactation.

Considering one’s self to be a “specialist” and having knowledge only for those times an organ is not functioning seems rather silly, don’t you think?

Have you encountered a physician who is not knowledgeable about lactating breasts? Tell me in the comments below!

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  1. Roberta

    Marie, I agree with you wholeheartedly. You have made some very good points here. My take away from this article is that overall breastfeeding is not protected, promoted and supported on a national level.

    • Marie Biancuzzo

      Indeed, yes! You and I can work our hearts out all day long, but until The WHO’s mantra of “protect, promote, and support breastfeeding is embraced at a societal level, it will be very difficult to make real strides. Thanks, Roberta, for identifying this as a take-home message!

    • Marie Biancuzzo

      Yes, Roberta, yes indeed. And perhaps even closer to home: Breastfeeding is not protected, promoted, and supported even within the specialized medical community.

  2. Rachael

    I’ve said this for years! I work in a WIC clinic and often need to make referrals for new breastfeeding mothers in cases that are out of my scope as a peer helper & CLC. It makes no sense at all to me that trying to find contact info for a hospital’s IBCLC on a hospital’s website is so difficult, but one can easily find a “breast health center” or a “women’s center” full of doctors who don’t seem to know a thing about lactation.

    • Marie Biancuzzo

      What an interesting observation! I hate to say it, but honestly, “breastfeeding” doesn’t seem to rank as a “women’s issue” or part of “women’s health” in the minds of many. It makes me wonder how many college-level courses called Women’s Issues” have one word about breastfeeding. Yikes! Well, Rachel, I guess that you and I will have a job for a long time. There’s a LOT of work to be done here! Thanks for writing.

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