Breast surgeon creates ‘space of positivity’ for physician moms who breastfeed
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It all started with a case of thrush.
Sangeetha Kolluri, DO, a breast surgery specialist at Austin Cancer Centers-Central who was pregnant at the time, had been frequenting a popular physician-led Facebook page about breastfeeding medicine.
It was during one of her visits to this page that Kolluri saw the discussion about nipple thrush. Thrush, a yeast infection that can grow in the mouth, throat and other moist areas of the body, had been diagnosed in a baby’s mouth. When the baby’s mother subsequently developed nipple irritation, the consensus on the Facebook group was that it was nipple thrush.
There was only one problem: nipple thrush does not exist. Although breastfeeding women can get thrush passed from their newborns, it typically occurs within the breast.
“For yeast to overgrow, you need to have a persistently warm, dark area,” Kolluri said in an interview with Healio. “That’s not a nipple. It might be under the armpit, or under the breast in large-breasted women, but it’s definitely not a nipple. I’ve never seen a case of nipple thrush — there is no such thing.”
It was somewhere around that time that Kolluri got the idea to create her own Facebook page for physicians who are breastfeeding. Today, the group, Inclusive Breastfeeding Doctor Moms, is 2.7K members strong and thriving.
A ‘very different perspective’
Kolluri was, in part, able to identify the inaccurate information about thrush because she had had the benefit of a unique fellowship education. She relocated from Brooklyn to Amarillo, Texas, for a breast surgical fellowship after meeting the physician who would become her mentor.
“We’ve all had that teacher who defined who we were as a person and made us want to do more,” she said. “I very much wanted that teacher as part of my professional development, and I found her in Amarillo.”
The fellowship also provided her with an opportunity to learn about lactational medicine, which is generally not a significant aspect of breast surgery fellowships.
“The breast surgical fellowship had been folded in with women’s health, so we had OB and OB/GYN residents who were rotating with the breast surgical fellowship,” Kolluri said. “That’s very unusual; you don’t usually see that. So, it was a very different perspective. I probably got more exposure to lactational medicine than a lot of breast surgeons do.”
Kolluri added that lactational medicine does not appear to be solidly rooted in the curriculum of any particular medical specialty.
“I realized that nobody actually has the corner on taking care of these patients with complex lactational needs,” she said. “OB/GYNs get virtually no training on breasts, even though they are the gatekeepers of mammography. I’m not blaming any of these specialties, but there’s no one who is in charge of this.”
It was this knowledge gap that Kolluri sought to fill by establishing her own breastfeeding group. Inclusive Breastfeeding Doctor Moms is described as “a physician-led group focused on supporting all physician mothers who breastfeed, use donor milk or formula, in an inclusive way that does not shame anyone.”
Moving past shame
Another aspect of the lactation medicine conversation that Kolluri wanted to correct was the culture of shame and judgment she had witnessed on the Facebook group she’d been following
“I started to observe some toxic attitudes on this other group,” she said. “They wouldn’t permit any questions on formula even if it was because you had to supplement. They were often very discouraging of sleep training, which a lot of people feel they need to do.”
Kolluri reached her personal limit when the group advised a breastfeeding mother with breast cancer to continue pumping her milk even as she underwent chemotherapy.
“I know how hard it is for a patient to maintain appropriate nutrition and hydration for themselves while undergoing chemotherapy,” she said. “Now, they’re going to tell someone they should pump for the entire 4-to-6-month course of chemotherapy?”
She said putting this kind of pressure on a patient with cancer would serve only to compound parental guilt for the new mother.
“I thought, ‘they are not setting this person up for success,’” Kolluri said. “Physicians are a high-achieving group, and they don’t take failure very well. There was just a lot of toxic judgment going on.”
Kolluri remained in the group for a time, hoping to serve as the voice of dissent on some of these judgmental comments. After taking up some of her concerns with the group’s administrators, she learned that they were not interested in broadening their views or changing their approach.
“So, I thought, ‘Let’s make a different space,’” she said. “Let’s make a space that is more focused on inclusivity. If you’re feeding your kid with breast milk or donor milk or formula, we’re here for you. We’re here to answer your questions.”
The group has five rules: First, the post must be at least somewhat related to breastfeeding or formula feeding; two, no toxic or negative posts are permitted; three, no “milestone” posts of breastfeeding or formula feeding success that could generate unhealthy envy or discouragement among struggling moms; four, you must be a physician to join the group; and five, if you are dispensing advice on the site, you should state your medical specialty and qualifications for doing so.
“I’m not trying to be biased against anyone, but I felt I just needed to have some focus and boundaries on what the group was going to be,” she said. “I wanted the group to be specific to the needs of physicians, medical students and residents.”
Within a year, the group has grown into the atmosphere of encouragement, knowledge sharing and positivity Kolluri envisioned. She and another breast surgeon moderate the group, and Kolluri said she is newly impressed each time she logs in and reads the posts and comments.
“It’s remarkable how committed everybody is to preserving this space of positivity,” she said. “If someone says they might be ready to wean, there are comments like ‘That’s wonderful! Here are some tips and tricks to make it go smoothly for you.’ Or if someone posts that they were crying from exhaustion or some setback, people respond by saying ‘Hey, we’ve been there.’ It’s women supporting each other, and I feel so lucky to be part of it.”
Kolluri said she likes to maintain some levity by posting funny memes on the page, and described one that typified her message of inclusivity. The meme shows two slides on a playground, with a child about to go down each slide. One is labeled “breastfed” and the other is “formula fed.” The two slides meet in the middle and ultimately land the children in the same destination, which is labeled “eating Cheetos off the floor of your car.”
“That’s where they’re going to land, whether or not they have been drinking this precious fluid,” Kolluri said. “There’s no point in judging people about this because, either way, they are going to be eating stuff off the floor of your car in 2 or 3 years. Whatever your approach to breastfeeding is, it’s is just the beginning of the parenting journey.”
For more information:
Sangeetha Kolluri, DO, can be reached at slkolluri2@gmail.com.
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