What is Evidence-Based Medicine?

When it comes to Breastfeeding, you may see the term evidence-based medicine thrown around, but what does it mean? What does it mean for you, as a nursing mother?

To quote Wikipedia:

Evidence-based medicine (EBM) is an approach to medical practice intended to optimize decision-making by emphasizing the use of evidence from well-designed and well-conducted research.

To put it simply, Evidence-Based Medicine involves practices and policies that are put in place based on solid, peer-reviewed research and backed by established scientific principles. In other words – they know it works, because it has been tested and tested again.

How does Evidence-Medicine affect Breastfeeding?

When it comes to breastfeeding, Evidence-Based Medicine has been a blessing. For far too many years, most of the research done into breastfeeding was based on the milk itself; what it contained, how much fat was in it, what it did, etc. While this is important information to know, it did little to answer the how’s and why’s of breastfeeding, or address the physical problems that can arise.

Fortunately, research into Lactation has increased in recent years, looking deeper into the biological process than just the nutritional content of Breastmilk. Now, we have studies based on positioning, production, longevity, pumping and much more. The field of Lactation is stretching out, encouraging researchers to dive in and discover more about this amazing process. Their efforts reward clinicians with new evidence to base their own practices on, confirm what we have already suspected, and in some cases, rewrite what we thought we once knew.

Take the Milk Sinuses, for example. For years, it was dogma to teach that infants needed to compress the milk sinuses in order to release the milk from the nipple. However, a groundbreaking study in 2005 (read the full study here) proved via ultrasound technology that those precious milk sinuses, also referred to as lactiferous sinuses, may not even exist at all. For clinicians, this changed the way breastfeeding was taught, moving the focus from applied pressure to proper positioning and latch, something those in the ‘know’ had been aware of for years.

A framework for practice

For Breastfeeding Professionals and mothers alike, Evidence-Based Medicine offers the best framework on which to develop practices and policies, yet there are many aspects of Lactation that have yet to be researched. Rigorous scientific studies require time and resources, often leading even the best question t go unanswered for some time. When scientific evidence lacks, what is a Breastfeeding Professional or mother to do?

In these cases, Evidence-Based practice hinges what science has already proven and our own experiences, both in the clinic and with our own children. The U.S. Preventive Services Task Force (USPSTF) considers this type of Evidence as:

Level III:Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.

Facts are presented and guidance is offered based on known and accepted practices, while taking into account the mother’s specific circumstances, goals, desires and outlook. It does little to insist that every mother breastfeed if the mother in question has no desire or wish to nurse – despite the best evidence-based advice that ‘breast is best.’ In those moments, tailoring the advice to the specific need is paramount and leads to better outcomes for all involved.

The Best Outcomes

When practices and advice is based on a strong foundation of Evidence, then Clinicians and families alike can take comfort in the tried and true, while still allowing some wiggle room for change and adaptation. No two families are alike and no two nursing dyads are alike. Evidence-Based Medicine makes room for all of them.

If you are looking for amazing websites for Breastfeeding answers and support, then check out a previous post of mine, Online Breastfeeding Resources. If you prefer to read a book (there is just something about holding a book in your hands…) then here is a list of a few fantastic and highly recommended Breastfeeding Books. 

What does Evidence-Based Medicine mean to you? Has it affected your own breastfeeding journey?

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