The book Clinical Management of Breastfeeding by Dr Anil Mokashi and Dr Santosh Nimbalkar presents a sound thinking that health workers and professionals need to spend time in gaining skills to manage human lactation. It makes a point. Lactation management is the need of all health systems.

We have come a long way but still miles to go!

The book clearly lays emphasis on building skilled breastfeeding or infant and 8young child feeding counselors. This is necessary for all health facilities, public or private. Women who come to deliver in health facilities trust health workers/professionals, therefore, it is highly justified that they acquire the knowledge and skills that are needed to make a woman successful in breastfeeding within one hour and maintain exclusive breastfeeding for the first 6 months.

Several chapters of the book deal with different and varied issues including how to talk to a mother, how to take history and dealing with low birth weight babies makes it special. The chapter dealing with production and intake of breast milk is critical for success as is the understanding that breastfeeding is a process determined by hormonal control and dependent on sucking by the baby. Chapter on inadequate milk gives a view to deal with this issue with utmost care as this is just a symptom of a problem, which needs investigation and more of perceived risk than real. Expressing breast milk is another important skill to be learnt by all health workers and women who come for delivery.

The book clearly underlines the need for skill building of health workers and counselors for breastfeeding and infant and young child feeding counseling. Coupled with the knowledge that it provides in easy, readable and understandable manner, this can be a useful resource to prevent and manage problems of breastfeeding and especially when women perceive that they do not have enough milk for their babies. It can give confidence to its readers who can then build the confidence of mothers; the most critical link if broken, leads to failure of breastfeeding or adoption of artificial feeding.

Needless to say, the book will make an important addition to the education materials for lactation management in health systems.

I hope this kind of curriculum gets into all medical and nursing studies both in theory and clinical practice. All health workers who deal with women and children must get this kind of knowledge and skills.

There is a massive lack of trained manpower in this field. “Professional, Practicing Lactation Management Counselors” is a social need of the nation. Few doctors know the science of lactation and breastfeeding. Still few have practised the art. Qualified doctors, busy in curative practice, take breastfeeding lightly. They are not serious, responsible, accountable and committed to breastfeeding.

Unfortunately, lactation management has no place in ‘any educational curriculum’. Educated families also make grave mistakes, leading to lactation failure, affecting growth and development of child/infant population. Lactation failure is not a disease to be cured by drugs. The people and actions against natural process of lactation leads to lactation failure. Lactation is a matter of confidence. It is the people around who can increase or decrease it.

Lactation management counselors are trained to: (1) Handle lactation problems, (2) Motivate families to have a positive approach, (3) Visit the mother in hospital on the day of delivery, (4) Enquire about pregnancy, delivery and previous lactation experience, (5) Examine the breasts and the baby, (6) Observe the breastfeed and (7) Guide if there is any problem.

It is not essential to be a doctor to become a lactation management counselor. Pediatricians, gynecologists, doctors, physiotherapists, clinical psychologists, naturopaths, dietitians, home science graduates, their wives or close relatives can 10pursue this career. This book is designed for Lactation Management Counselors (LMCs). Thanks to innumerable sources we have drawn from!