Breastfeeding Medicine Is Essential Postpartum Care
A firsthand account of why more mothers should know about it, what exactly they should do, and how it can help.
Published June 6, 2025
By Syra Madad, D.H.Sc., M.Sc., MCP, CHEP
Public Health Editor-at-Large
Three weeks postpartum, I developed a painful, swollen lump in my breast–mastitis. Despite having breastfed all three of my children for over a year each, and now currently my fourth, I was still caught off guard by the physical toll. I spiked a fever, experienced intense chills, and felt utterly fatigued. I had to pile on two blankets just to stop shivering and spent two full days in bed, only getting up to breastfeed the baby. It was a stark reminder of how vulnerable the postpartum period can be, no matter how experienced you are.
My mastitis persisted for nearly a week. I required antibiotics and tried multiple strategies: warm and cold compresses, therapeutic massage, and nursing in awkward positions to relieve the blockage. On the third day, I sought out a lactation consultant who eventually referred me to a physician specializing in breastfeeding medicine (also known as lactation medicine), a field I wasn’t even aware of until I needed it.
The experience was eye-opening. The clinic provided comprehensive medical care tailored to the unique and complex needs of lactating mothers. Staffed by board-certified pediatricians and International Board-Certified Lactation Consultants, the practice offered deep expertise, careful evaluation, and timely follow-up. Services addressed not only mastitis but also challenges such as low or excess milk supply, painful latch, and breastfeeding after surgery.
Contributing to Therapeutic and Public Health Strategies
Over the years, I’ve experienced an oversupply of breast milk and have frequently donated to milk banks to support other families. During the first year of the COVID-19 pandemic in 2020, just after giving birth to my third child, I participated in a groundbreaking study at the Icahn School of Medicine at Mount Sinai, led by human milk immunologist Rebecca Powell, PhD. In April 2020, I tested positive for COVID-19. Shortly afterward, I joined a research effort examining whether breast milk from women who had recovered from COVID-19 and later, those who were vaccinated, contained protective antibodies that could be used therapeutically.
The study enrolled 1,600 lactating women, including 600 who, like me, had tested positive for COVID-19. Early findings revealed that 14 out of 15 donors had significant levels of virus-reactive antibodies in their milk. These antibodies, known as secretory immunoglobulins, are uniquely suited for mucosal surfaces like the lungs, where respiratory viruses such as SARS-CoV-2 initiate infection.
The idea that breast milk could not only nourish infants but also contribute to therapeutic and public health strategies was both humbling and profound. In a related piece published on the blog for the Harvard Kennedy School’s Belfer Center for Science and International Affairs, I argue how “profoundly alarming” it was when Health and Human Services Secretary Robert F. Kennedy, Jr. removed COVID-19 vaccines from the CDC’s immunization schedule for healthy pregnant women and children.
And yet, despite how vital lactation support is, it often ends the moment a mother is discharged from the hospital. While pediatric care continues seamlessly for the infant, mothers are frequently left to manage complex breastfeeding challenges on their own, with little clinical guidance or structured follow-up.
Safeguarding Health, Dignity, and Resilience
This gap in care is reflected in national data: while 84% of U.S. mothers initiate breastfeeding, only 59% continue at six months, and just 39% at one year. These numbers don’t reflect a lack of motivation–60% of mothers report that they stop breastfeeding earlier than they intended. Instead, they highlight systemic failures: challenges with latching and milk supply, concerns about medications, inadequate parental leave, unsupportive work environments, cultural pressures, and hospital practices that fall short. All of this unfolds during one of the most physically and emotionally demanding times in a mother’s life.
Mastitis alone affects up to 25% of breastfeeding women. It can lead to early weaning, chronic pain, or even hospitalization. Yet many mothers are unaware that medical treatment exists for these complications. Too often, they are left to trouble shoot on their own while exhausted, overwhelmed, and in pain.
The Fourth Trimester, the 12 weeks following childbirth, is a critical period of recovery and adjustment for both mother and baby. Yet it remains one of the most neglected phases in maternal healthcare. Mothers are typically discharged with minimal support and may not see a provider again for six weeks, even as their infants receive multiple well-child visits during that same period. This disparity in care must be addressed.
Whether navigating breastfeeding for the first time or the fourth, mothers should not have to go it alone. Breastfeeding medicine should be fully integrated into routine postpartum care, just as pediatric care is standard for newborns. Supporting mothers in this way isn’t just about helping them feed their babies, it’s about safeguarding the health, dignity, and resilience of families and communities.
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