Editor's note: This story is part of Southwest Michigan Second Wave's On the Ground Battle Creek series.

Breastfeeding is a cornerstone of public health, says Dr. Karen Garcia.
 
“I think there is a greater awareness of how integral breastfeeding truly is,” says Garcia, a Newborn Hospitalist with the Bronson Hospital System. “It reduces the risk of health issues like asthma and obesity for children. The health of breastfeeding parents is affected as well because it reduces the risk of heart attacks, strokes, diabetes, and breast cancer.”
 
Already a board-certified Pediatrician and Lactation Consultant, she will add another board certification — Breastfeeding and Lactation Medicine — after taking an exam this month. She will be part of a group sitting for the second exam in this medical specialty. A bout with COVID prevented her from taking the very first exam offered in October.
 
“It’s becoming a more recognized specialty,” she says.
 
Her decision to seek this newest certification took place in 2012 when she became a Pediatrician caring for newborns and their parents in Calhoun and Kalamazoo counties.
 
“In all honesty, my role as a Newborn Hospitalist definitely opened my eyes to how much support is needed after a woman gives birth and when she gets home from the hospital,” Garcia says. “Hormones change, babies wake up more, and endorphins can fluctuate.”
 
Although she is already an International Board of Lactation Consultant, Garcia says the specialty in Breastfeeding and Lactation Medicine will enable her to balance her medical training with this certification.
 
“It allows me to support breastfeeding families at a different level because I can provide prescriptions, order tests, and diagnose for things that are not easily identified,” Garcia says.
 
Up until the invention of the first baby formula in 1865  women breastfed. They likely never indicated if they were having difficulties and could use a wet nurse if they had the financial means or rely on other female friends to help them out. Because challenges weren’t discussed publicly, the conventional wisdom was that breastfeeding was a natural and simple practice.
 
Not so, say lactation consultants like Garcia.
 
“A lot of times the issues we end up seeing are latching difficulties that can be helped with osteopathic therapy to help infants with muscular and ligament impediments that contribute to their not latching on,” she says. 

“Babies delivered through C-sections can experience tension in their heads because they are pulled out by the head which can cause muscular strain and trauma. We also will see a lot of muscular issues affecting the floor of the tongue. Things that we perceive as oral tethers can be relieved through osteopathic manual therapy.”
 
A resurgence, not a trend
 
By the 1940s and 1950s physicians and consumers regarded the use of formula as a well-known, popular, and safe substitute for breastmilk. Consequently, breastfeeding experienced a steady decline until the 1970s, according to the National Institutes of Health).
 
“In the United States, groups such as the National Council of Churches Interfaith Center on Corporate Responsibility and the Infant Formula Action Coalition initiated public awareness campaigns on the importance of breastfeeding. Over the next 30 years, their efforts resulted in a steady increase not only in the percent of infants breastfed in the United States but also in the duration of breastfeeding,” according to an article on the NIH website.
 
The upward trajectory came alongside the creation in 1995 of the Academy of Breastfeeding Medicine.
 
Garcia says the organization was formed by a “core group of 12 physicians. More and more physicians are looking into the medicine of breastfeeding and putting out protocols for research and research studies.”
 
In addition, there are nonprofit organizations including Milk Like Mine in Battle Creek which was established in 2019 to give mothers in the African American community access to lactation specialists who looked like them. In 2023 MLM opened a Baby Café for all breastfeeding women and their families in partnership with Bronson Battle Creek Hospital and Bronson Methodist Hospital. 
 
“It’s very hard to find people who look like you and understand your culture to get high-quality breastfeeding support. It has gotten better, but there’s that sense of safety that comes into play when you have someone that looks and sounds like you and understands your family dynamic,” Garcia says, adding that resources like MLM increase the likelihood that people will be successful.
 
“We definitely know within the Hispanic community that being able to speak to someone who speaks your language reduces a lot of the barriers to explain what’s going on without that filter piece of translators and interpreters.”
 
Garcia is a co-facilitator at MLM and a board member of the Michigan Breastfeeding Network. She also is the owner of Garcia Consulting and Lactation Services which combines “expert medical knowledge with compassionate care to address women’s breastfeeding challenges,” the website says. She makes home visits to nursing mothers and has already seen more than 100 women and their families.
 
She bills for her services primarily through insurance to reduce outpatient costs and works with families who don’t have insurance to make it affordable. She has not received any pushback from insurance providers — another sign that what she does is being taken seriously.
 
Referrals come from MLM, area doulas, and Grace Health among others. Garcia sees clients from Calhoun and Kalamazoo counties.
 
“I have a small office at Milk Like Mine for families who don’t feel comfortable having a home visit,” Garcia says.
 
During the visits, she engages dads by showing them things that they can do to help mom latch the baby on and what that mom needs to be eating and drinking during the day.
 
“I tell my dads that I can’t stay here this weekend so they will be mom’s go-to,” Garcia says. “I’m incredibly excited to help support these women and their families.”