Is Jack Newman God?

His desire to help Canadian women solve breastfeeding problems grew during the time he spent as a staff paediatrician at Toronto’s Hospital for Sick Children, where he was surprised to meet mothers and babies struggling with breastfeeding on a daily basis. It was there that Newman started Canada’s first hospital-based breastfeeding clinic in 1984. Back then, he admits, he knew very little. Twenty-two years later, he knows a lot. Ask Sharon Woolf.

Woolf, who lives in Thornhill, Ont., has never met Newman face to face. But he’s solved her breastfeeding problems twice, by phone and email. Newman was Woolf’s last hope seven years ago when she had sore nipples that, as she puts it, “made everybody gasp at one breastfeeding clinic.” Her family doctor and a dermatologist had been unable to help. Newman nailed her problem in two minutes by phone — candida, a yeast infection. “Dr. Newman told me to go to the drugstore for some gentian violet (a purple dye used to treat thrush and vaginal yeast infections) and to paint it in the baby’s mouth and on my nipples,” says Woolf. “Within 24 hours, I was a new person.”

Mothers have tales of driving for hours to see Newman — one came all the way from the Yukon — or leaving him weepy, late-evening voice mail messages. But his influence goes beyond helping patients. Though he is often at odds with other health professionals — in 22 years he has lectured only twice on breastfeeding at medical schools in Toronto — Newman has profoundly influenced the way many people think about breastfeeding.

One of his revolutionary ideas is how to tell a baby is actually drinking. “When a baby is getting milk, you will see a definite pause in the movement of his chin,” he says. “That’s when his mouth is filling up. A baby who is not getting much milk will have a fast sucking pattern without any of these mouth-wide-open pauses. If we could teach all mothers to recognize this and how to get a good latch, it would prevent many problems, and they’d be able to cut through most of the bullshit they are told.”

The last sentence may offer a clue as to why a guy who gets such stellar results sometimes has an uneasy relationship with hospitals that have housed his clinics. Over the years, Newman’s clinics have been and gone at seven Toronto hospitals, most recently North York General. Hospital administrators will say they are funded to provide acute care and that they want to focus their resources on in-patients. (Breastfeeding clinics and lactation consultants have recently been cut in other parts of Ontario, as well.) Newman’s services can indeed be delivered outside of a hospital, although he prefers to be inside, where he can influence the support given to new mothers. “Ninety percent of breastfeeding problems could be prevented,” he says. “Getting mothers off to a good start is the key, and almost all start in hospitals.” Newman has left some hospitals of his own accord, but in other cases has felt that he was not wanted. That could be partly because of his willingness to criticize policies and practices.

At Etobicoke General, for example, Newman lobbied against a policy requiring that all babies born by Caesarean section be separated from their mothers for 24 hours. “Now it’s down to four hours, but only because of my bitching.” He has sent hundreds of letters to maternity wards or heads of paediatrics.

Such actions do not endear Newman to some colleagues. But others say he speaks truths that need to be spoken. Linda J. Smith, a lactation consultant and activist in Dayton, Ohio, says there is no one quite like Newman in the US. “He’s one of the best clinicians around and he’s not afraid to tell it like it is. Often, he has been two to five years ahead of the research.” One example: Newman’s idea to combine an antifungal and an antibiotic in one nipple ointment.

Being ahead of the research, however, leaves Newman vulnerable to accusations that his approaches aren’t always based on solid evidence. For example, some colleagues feel he is too rigid in his dislike of supplementing breastfed babies with bottles of formula, though the ones we contacted were unwilling to criticize Newman publicly.

Newman does not say that bottles always lead to early weaning, but he’s seen it happen and feels that most supplementation is unnecessary. He also notes that many past and present medical practices are not evidence-based. “For that matter, what study has proven that it’s safe to give a bottle of formula to a two-day-old baby whose gut was designed to get colostrum? I assure you those studies have not been done.”

How does this no-holds-barred approach play out with patients? The demand for his services, as well as the hundreds of mothers who wrote letters and the more than 2,000 who signed a petition to have his clinic at North York General reinstated, speak for themselves. However, his direct manner doesn’t work for everyone.

The third and last time Martha Davis went to Newman’s clinic, six years ago, she was near the end of her rope. Try as she might, she couldn’t get the latch Newman had showed her working at home. “He’d grab my breast, push the baby’s head towards me and, boom, she was on,” she says, “but it didn’t work at home.” She can’t remember Newman’s exact words, but the way she heard it was something like: “I don’t see what the problem is. Why can’t you get this going?” Her heart sank. “If the guru couldn’t get me latching, what hope did I have?”