Lactation non-profits and the ethical lactation medicine of the future
"Philosophy of science is the process of clarifying and taking responsibility for the assumptions necessary to do complex intellectual work." Hayes et al 2013 p.2
| Characteristics of lactation non-profits | Consequences for wellbeing of lactating women, their infants and families, and the professionals who care for them | Ethical lactation medicine of the future (e.g. NDC) | |
|---|---|---|---|
| 1 | Structurally embedded ideology. Ideology is a simplified belief which fails to consider dynamic contexts and complexities. Ideology is structurally embedded in lactation non-profits despite absence of evidence of benefit to families in high income countries. The explicit intention is to sanction, that is, to punish and cause commercial harm, to those who are labelled as ideological violators. | Silencing of researchers and researcher-clinicians silences research-based dissent and debate, which holds back advancement in science-based education and professional support, and impacts negatively on wellbeing of families. | Structurally embeds mechanisms to protect high calibre science-based education, which invites in and celebrates dissent and debate |
| 2 | Exclusion of researchers, researcher-clinicians and researcher-educators on ideological grounds. Exclusion is applied inconsistently and selectively, without transparency or due process, in violation of usual professional norms. Affects dozens of researchers and educators globally, in what remains a small research community | Silencing of researchers and researcher-clinicians silences research-based dissent and debate, which holds back advancement in science-based education and professional support, and impacts negatively on wellbeing of families. | Requires declarations of conflicts of interest according to the international best practice standards upheld by universities and journals |
| 3 | Extraction of work of researchers and innovative researcher-clinicians without their appropriate inclusion or acknowledgement | Professionals who are innovating in research and education are best placed to accurately communicate and debate their own work with lactation professionals. Extraction of colleagues’ work without appropriate recognition, or by having others teach it, is a continuation of centuries of the silencing and co-opting of women’s work | Includes and celebrates diverse research and innovations by wide range of research and education contributions in lactation medicine, based upon calibre of interdisciplinary research base, clinical efficacy of work, and evaluations |
| 4 | Promotion of non-evidence-based education using simplistic concepts of what ‘evidence-based’ practice is; expert based approaches presented as fact and not named according to theoretical models used or the individuals proposing them; failing to understand or utilise implementation science | Absence of transparent guardrails protecting calibre of education promotes overdiagnosis, paramedicalisation, and overtreatment, which is currently widespread in care of breastfeeding women and their infants | Structurally embedded mechanisms protect high calibre science-based education, and invite in dissent and debate. Implementation science is used to develop clinically effective interventions; theoretical models are distinguished from evidence-based fact; approaches are transparently named so they can be evaluated |
| 5 | Participation requires members to embrace ‘groupthink’, that is, a collective belief system and to refrain from disturbing the status quo | Groupthink requires exclusion of ‘outsiders’ who are depersonalised or even dehumanised (subject to projection without evidence to support claims). That is, the effect of excluding behaviours on the wellbeing and professional survival of the excluded clinicians, educators, and researchers are ignored, minimised, or even relished in. If the outsider resists, this is dealt with by indirect behaviours and plausible deniability, by gaslighting, and by offering false narratives about the outsider | Lactation medicine is deeply integrated with psychological medicine, that is, is built upon the evidence-based knowledge that colleagues and patients need to belong in healthy systems, if both individual and system health is to be maintained |
| 6 | Prioritises breast milk for infant over mental health and wellbeing of mother because of structural ideological positioning - at the same time as development of effective interventions for breastfeeding problems is held back on ideological grounds, through exclusions | Research shows that anti-formula ideology worsens maternal mental health. Research also shows that most approaches used to support breastfeeding women and babies lack an evidence base. Often, approaches which have been shown not to work are still popularly recommended by lactation doctors and other professionals | Breastfeeding and lactation are promoted and supported for enjoyment and ease, in the service of the whole woman and the whole infant (in the context of family wellbeing), which includes considerations of emotional wellbeing and mental health |
| 7 | The title ‘lactation medicine’ prioritises breastfeeding over all infant care domains | All infant care domains interact together and can’t be optimally managed separately. The co-optation of all infant care domains into lactation medicine highlights exclusion of families who are using commercial milk formula. Current attempts to co-opt all infant care domains into lactation medicine risk significant harm to family wellbeing, due to ideological exclusion of researchers and educators with high levels of expertise in other domains, and excludes families who are unable to breastfeed | Aims to include all families. Integrates all infant care domains and does not use a title which aims to coopt infant care. Operates from evolutionary norm of breastfeeding which underpins all infant care domains. (Bottle use mirrors patterns of breastfeeding when problems emerge). [NDC pioneers this integrative approach to lactation medicine internationally] |
| 8 | Exclusion and extraction is supported by leadership. Although members are typically unaware, all leaders in lactation medicine are aware of and required to comply with these ideological filters. If leaders do not agree, the viability of conferences and education courses are threatened, due to withdrawal of continuing professional development points for doctor-IBCLCs and IBCLCs | If lactation medicine doctors form the view that sanctioning researchers and clinician-researchers is unscientific and unethical, they may avoid speaking out in order to belong and to avoid discomfort; they may find that they are experiencing uncomfortable cognitive dissonance; and they may cease being active in the lactation non-profit | High calibre alternatives to the global monopoly of lactation non-profits exert over lactation medicine education and therefore clinical practice is urgently required, for the sake of families and their infants |
By Dr Pamela Douglas, Goomburra 12 April 2026
Related resources
Possums Breastfeeding & Lactation articles which address lactation non-profits, ideology, and harm
Selected references
Azad MB, C NN, Bode L. Breastfeeding and the origins of health: interdisciplinary perspectives and priorities. Maternal and Child Nutrition. 2020;17:e13109.
Chetwynd E. From censorship to conversation: agnotology, market influence, and the ethics of breastfeeding research. Journal of Human Lactation. 2025;4(3):303-305.
Chetwynd E. The 4-year question: optics, ethical clarity, and the future of lactation research in times of upheaval. Journal of Human Lactation. 2025;41(4):451-453 doi:410.1177/08903344251387116.
Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, Pistorello J. Acceptance and Commitment Therapy and Contextual Behavioral Science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behavioral Therapy. 2013;44(2):180-198.
Kendall-Tackett K. Have we returned to the Dark Ages: Excommunication and its chilling effect on science. Clinical Lactation. 2020;November:DOI: 10.1891/CLINLACT-D-1820-00024.
Perez-Escamilla R, Tomori C. Breastfeeding: crucially important, but increasingly challenged in a market-driven world. The Lancet. 2023;401(10375):486-502.