early 1960s, first as a La Leche Leader and later as
a lactation consultant when it became a professional
practice discipline in 1985. As I look back over
those years I am struck both by how different things
are now and by how much things have stayed the
same. Although the breastfeeding initiation rate in
the United States has risen to almost 70 percent––a
vast improvement from 20 percent in the 1960s!––it
still takes time and patience to help a new breastfeeding
mother get her baby onto the breast.
New knowledge has changed the field. Research
studies now verify that breastfed children are
more intelligent and that not breastfeeding costs the
U.S. health care system billions of dollars annually.
Because of the new awareness of the importance of
breastfeeding, the number and influence of lactation
consultants has expanded. The International
Board of Lactation Consultants has certified more
than 10,000 health care workers in 36 countries.
Most hospitals, large and small, offer lactation services
of some type and employ lactation consultants.
Lest anyone question the powerful, positive
influence of interventions by health care workers on
breastfeeding, they only need to review the table of
intervention studies in Chapter 2. At the same time,
lest we follow that conflicted path that led to the
medicalization of childbirth, we must listen to
voices that warn of the danger of lactation consultants
medicalizing infant feeding.
Other changes affect lactation practice