In 1976 I was Chief Res­i­dent in Pae­di­atrics at the Bal­ti­more City Hos­pi­tal. My chief was Dr Harold Har­ri­son who went on to be­come Pro­fes­sor Emer­i­tus of Pae­di­atrics at the Johns Hop­kins Hos­pi­tal. Like most pae­di­a­tri­cians in train­ing at that time, I re­ceived a one-hour talk on breast­feed­ing as a med­ical stu­dent at the Cen­tral Uni­ver­si­ty of Venezuela in Cara­cas and six hours on for­mu­la feed­ing. When I ar­rived at Dr Har­ri­son’s unit I knew al­most noth­ing about breast­feed­ing ex­cept for the lip ser­vice, still com­mon to­day, that it was sup­posed to be the best kind of food for new­borns. Like most doc­tors still to­day, at that time I had no idea what that meant.

In those days Bal­ti­more al­ways had an out­break of “sum­mer di­ar­rhoea” and to my sur­prise, Dr Har­ri­son’s treat­ment of di­ar­rhoea con­sist­ed of oral­ly re­hy­drat­ing the gas­tro cas­es and en­cour­ag­ing those moth­ers who could breast­feed to do so. He had been do­ing this for years and his re­sults were ex­cel­lent. No one ever seemed to die from gas­tro and most chil­dren went home in two to three days.

For those few doc­tors who reg­u­lar­ly read this col­umn and for those gen­er­al­ly in­ter­est­ed in the truth, you can read his ar­ti­cle, “The Treat­ment of Di­ar­rhoea in In­fan­cy”, pub­lished in Pae­di­atric Clin­ics of North Amer­i­ca, Vol­ume 1, Is­sue 2, May 1954, Pages 335 to 348.

It is the first sci­en­tif­ic and there­fore hu­mane ap­proach to the man­age­ment of gas­tro that I know, al­though there are some writ­ings from San­skrit lit­er­a­ture, sug­gest­ing that oral flu­ids could be help­ful in cholera. Sus­ru­ta, the fa­ther of Ayurvedic med­i­cine (1500 BCE), ad­vised that di­ar­rhoea vic­tims should be “giv­en to drink a pro­fuse quan­ti­ty of tepid wa­ter in which rock salt and mo­lasses have been dis­solved; or clar­i­fied wa­ter com­bined with rice gru­el”, Sus­ru­ta Samhi­ta 1, verse I.

I was al­so work­ing in the Neona­tal In­ten­sive Care Unit, the re­fer­ral cen­tre at that time for the state of Mary­land and parts of Wash­ing­ton, DC. There were many in­stances of pre­ma­ture ba­bies con­vuls­ing. They were all be­ing fed for­mu­la. Many of these ba­bies were found to have low blood cal­ci­um. Why? Dr Har­ri­son point­ed out that the for­mu­la was heavy with phos­pho­rus and phos­pho­rus drove the cal­ci­um down. We sub­sti­tut­ed breast­milk for the for­mu­la and the con­vul­sions abat­ed.

My wife was preg­nant at the time with our sec­ond child and we de­cid­ed that she had to breast­feed at birth. Ear­ly one night she went in­to labour. Our hous­es­taff apart­ment was with­in walk­ing dis­tance of the hos­pi­tal so off we went. The ba­by was face up. “We’ll need to keep you and mon­i­tor to see if she turns, if she doesn’t, we’ll have to op­er­ate,” said the con­sul­tant. “No way”, an­swered my wife, “I’m go­ing home to labour.” Since we lived near and since I was Chief Res­i­dent, we went home and my wife laboured all night. Ini­tial­ly, I tried to stay up with her. Then she felt sor­ry for me and sent me off to sleep with our old­er daugh­ter.

At five she woke me, “ba­by on its way.” We called a Croat friend who lived near­by, to stay with our old­er daugh­ter and be­gan walk­ing back to the hos­pi­tal. Halfway there she went down to her knees as I watched help­less­ly. Men are use­less when women go in­to labour. She man­aged the pain and we con­tin­ued to the hos­pi­tal. Ex­am­i­na­tion showed the ba­by had turned and was in the per­fect po­si­tion. Would she have turned if she had laboured in a hos­pi­tal bed?

Saman­tha was born at 6 am and, as was the cus­tom in those bar­bar­ic days, quick­ly re­moved from our vicin­i­ty. I stayed with my wife for an hour and then de­cid­ed to go look for my ba­by. I found her alone, all by her­self, in an iso­lette, valiant­ly try­ing to get her fin­ger in­to her mouth. I de­cid­ed enough was enough, pulled rank, and much against the wish­es of the head nurse, wheeled her out of the nurs­ery to her moth­er.

I was Chief Res­i­dent. Oth­er fa­thers would not have got away with that.

My wife was doz­ing. I had ab­solute­ly no idea what to do. Nei­ther did she. We looked at each oth­er help­less­ly. I placed the iso­lette at the edge of the bed and said, “Try feed­ing her!” “How?” “I don’t know. You should know, no?”

So my wife leaned over, picked up the ba­by and put the ba­by to the breast and mir­a­cle of mir­a­cles, the ba­by seemed to know what to do and a minute lat­er my wife looked up at me and said won­der­ing­ly, “She’s do­ing it.”

This week is World Breast­feed­ing Week. My thanks go out to Dr Har­ri­son, my wife, my daugh­ters and all those moth­ers who taught me about breast­feed­ing.