The NDC Lactation Fellowship: what makes it different
Locating the NDC Lactation Fellowship in the context of breastfeeding and lactation medicine internationally, and why our Lactation Fellowship is worth considering
Currently within our health systems in advanced economies, there is widespread conflicting advice for breastfeeding problems, and breastfeeding mothers report dissatisfaction with the help that is available when common problems arise. The NDC Lactation Fellowship offers
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A core curriculum of up-to-date breastfeeding and lactation medicine content, drawn from latest research
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From which clinical guidelines for both common and complex breastfeeding and lactation challenges are developed
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Nested in the context of Neuroprotective Developmental Care - inclusive of the latest evidence-based clinical approaches in the domains of infant sleep, cry-fuss problems, sensory motor development
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A forum for respectful and lively debate, disagreement, discussion.
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You can find out about the Lactation Medicine Lab which is freely available for any medical practitioner here.
Lactation medicine is a research frontier
Breastfeeding and lactation medicine, or clinical breastfeeding and lactation support, remains a research frontier.(1) We know from implementation science that explicit naming (and debating) of a theoretical frame through which research is instigated and interpreted is essential for best practice translation of existing research into clinical guidelines.
Unfortunately up to 85% of research in health is wasted in methodologically poor studies, in part because the theoretical frames which underpin the question and the interpretation of results have not been robustly and explicitly named and examined (2). Often clinicians are upskilled in clinical approaches to breastfeeding and lactation support which are not genuinely evidence-based, or are not built from robust theoretical frames. It's possible that this occurs more commonly in the field of clinical breastfeeding and lactation support than other health fields, due to a historical failure of our health systems to prioritise funding for research into breastfeeding and lactation support.
Many current approaches to breastfeeding and lactation use unnecessary and costly pharmaceuticals, surgery or bodywork exercises, which lack an evidence base, risk unintended consequences, and which, in the absence of evidence, often also lack a plausible scientific rationale. Ideological positions concerning breastfeeding and lactation continue to underpin both overservicing and overtreatment.
A montage style of clinical management guideline development in breastfeeding and lactation medicine education results in unstable clinical management approaches, which alter regularly in response to changing consensus opinions.
The NDC theoretical models are developed from an interplay between clinical experience and reviews of extensive interdisciplinary research literature, with clinical translations iteratively refined in response to feedback (that is, NDC is developed using best practice implementation science). These strong theoretical models and the use of implementation science have resulted in the NDC clinical approaches tending to be stable and corroborated by new studies as they emerge, rather than requiring change, though NDC remains responsive to emerging research.
An example of a novel, evolutionarily robust theoretical frame in NDC is the programs' integration of the emerging field of mechanobiology, which investigates the effects of mechanical forces on living tissues and cells. In the NDC lactation domain, mechanobiology foundationally informs the NDC approach to fit and hold (the gestalt method), management of nipple pain and damage, and management of the spectrum of breast inflammation.
How this course is different to other opportunities
This content is distinguished from other lactation course content available internationally because the NDC Lactation Fellowship
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Uniquely and comprehensively integrates lactation science with infant sleep science, the research concerning fussy infant behaviour, research concerning infant sensory motor development, and the latest psychological and neuroscience research concerning attachment and infant development (all translated into clinical and educational programs which have been formally evaluated in multiple peer-reviewed research publications).
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Acknowledges that from an evolutionary perspective, clinical breastfeeding and lactation support will have limited effectiveness unless the latest science and clinical implications of these other domains are comprehensively addressed in the one content-aligned service (not dealt with in silos by multiple providers offering conflicting advice). That is, the NDC LF offers uniquely integrative lactation medicine.
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Clearly acknowledges its research-based interpretative lenses (complexity science, evolutionary biology, holistic generalist clinical care) when making sense of the latest lactation science. That is, the NDC Lactation Fellowship also explores what it means to claim to be evidence-based.
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Not only avoids ideologically-informed clinical practice, but analyses the dangers of both ideologically-informed clinical practice and ideological powers acting within professional organisations.
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Is deeply committed to addressing the broader sociocultural contexts in which women breastfeed, including the international trends towards worsening overdiagnosis and overtreatment and dominance of market forces within health education and clinical services, which profoundly affect how clinical breastfeeding and lactation support skills are taught and delivered.
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Does not exclude formula-feeding families by the use of a title which excludes formula (since an NDC Lactation Fellowship is genuinely integrative, flagged by NDC in the title)
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Does not use ideological reasons to exclude other doctors, health professionals, or researchers from educating e.g. in our Guest Speaker series, or in the research selected. The practice of exclusion is currently normalised within breastfeeding non-profits, skewing the kind of education and research-base offered to participants. This occurs for ideological reasons in the absence of evidence of benefit for either health professionals, parents, or their breastfeeding infants. There are convincing and science-based reasons to think that this exclusion of educators and researchers by breastfeeding non-profits delays adoption of evidence-based and effective interventions for breastfeeding families, and worsens overdiagnosis, paramedicalisation, and overtreatment.
Related resources
About The NDC Lactation Fellowship
The NDC Lactation Fellowship: upskilling leaders in lactation medicine
The NDC Lactation Fellowship: cost and comparisons
NDC Lactation Fellowship Curriculum (Transitioning from interim 2024-25 curriculum to the final 2026 curriculum)