Nipple and breast pain, mastitis, low milk supply, medical problems and the baby being tongue-tied can all create problems with breastfeeding. "It's not uncommon to get sore nipples when you start breastfeeding," says Dr Lisa Amir, lecturer and researcher at the Key Centre for Women's Health in Society (KCWHS). "It's a big shock to the system when you have your first child and women need time to sort out any problems they encounter. It is no wonder that many women give up and turn to formula feeding," she says.
As a clinician, lactation consultant, researcher and lecturer, as well as editor, Lisa Amir wears a number of hats.
"Breastfeeding can be contentious," says Lisa. "For example, there is disagreement amongst clinicians about the existence of tongue-tie in babies – we need more research to distinguish between myth and reality with regards to breastfeeding," says Lisa. "There are still a lot of questions we do not know the answer to."
This year World Breastfeeding Week is taking place from 1 – 8 August.
"We've experienced a bit of a backlash to breastfeeding, because women may feel disappointed if they are not successful," says Lisa.
"The real message to get out there is that women need to be supported in breastfeeding and need more help when they encounter difficulties," she says.
"Fathers, family members and the community need to support mothers to breastfeed. Women need to feel comfortable breastfeeding in public and shouldn't be trying to cope alone," says Lisa.
"Generally hospital staff are better trained to assist women in their first attempts at breastfeeding, but women are having very short hospital stays and often there is not enough time for women to become confident that they know how to breastfeed," she says.
In our society, women face a number of barriers that discourage them from breastfeeding.
Breastfeeding is the normal way to nourish an infant, but it can take up to three months for it to be fully established. This message can be reassuring to women and help them decide to persevere even when faced with problems. Victoria has very good community-based services available to women to assist them in breastfeeding.
Lisa undertook a study that looked at the rates of breastfeeding over a 15 year period. She found that women with higher education and higher income were more likely to breastfeed. "The rates of breastfeeding over that timeframe remained the same, but it became apparent that the gap between rich and poor is widening," says Lisa. The study has been published in the Medical Journal of Australia. Read the paper.
In 2007 there was a parliamentary enquiry into breastfeeding at which Lisa appeared twice.
"I asked for funding towards breastfeeding research, with little success, however, the enquiry did lead to more recognition of breastfeeding issues," says Lisa. Lisa will be participating in a consultation workshop 29 July to work on a National Breastfeeding Strategy.
It was her role as a mother that led her to research. After taking a break from working as a GP for Family Planning Victoria to have children, Lisa joined the Nursing Mothers Association.
"It was a good way to meet other women in my own neighbourhood. I took on the job of administering the group library and started to read the books on breastfeeding and familiarise myself with the research in the area. I came to realise that there is a science behind this! I noticed that a lot of my friends were having problems and I was giving them advice. They encouraged me to become a lactation consultant," says Lisa. In 1990 Lisa enrolled in the Graduate Diploma in Women's Health at the KCWHS. She went on to do a Masters there and later completed a PhD at La Trobe University.
Apart from conducting research, Lisa also lectures to University of Melbourne medical students in their 10th semester.
"Obstetricians, surgeons and paediatricians are not particularly interested in breastfeeding. Often medical students will encounter the breast when learning about breast cancer, but they learn little about the normal function of the breast in breastfeeding," she says.
Open access journals are a good way of getting research out to a global audience of academics and Lisa is also the editor of the peer-reviewed, online, open access journal International Breastfeeding Journal which she launched in 2006 after completing her PhD.
"I was interested in writing and publishing and had done a lot of reviewing for journals," says Lisa.
Using her international networks, Lisa invited people around the world with expertise in obstetrics, paediatrics, infection and immunity, midwifery and other fields to be on the Editorial Board.
Lisa says that the advantages of open access peer-reviewed journals such as those published through BioMed Central are that they can be freely downloaded from the internet, and because they are peer-reviewed, are academically sound. "Wherever you are in the world - it is possible for readers to post comments online in response to articles and there is no limit to the coloured pictures or audio-visual content that can be included to illustrate the research."
Also, authors are able to monitor the number of people accessing their article. "This is my way of being able to contribute to the transfer of knowledge globally," says Lisa.
By Florienne Loder, Science Writer, MDHS Faculty Research Unit