Monday, August 13, 2012

Action 10: Basic Breastfeeding Support from Health Care Providers

This is the second article in our series about the Surgeon General's Call to Action for Breastfeeding Promotion. Today we're focusing on an action step that we can actually help with significantly.

Action 10. Include basic support for breastfeeding as a standard of care for midwives, obstetricians, family physicians, nurse practitioners, and pediatricians. 
Photo courtesy of the IBLCE   
Midwives, obstetricians, family physicians, nurse practitioners, and pediatricians provide care that supports their patients’ interests and health needs, including breastfeeding. Their full support of breastfeeding may be limited by the use of  practices that unintentionally and unnecessarily interfere with breastfeeding. These practices directly affect mothers’ and babies’ abilities to start and continue breastfeeding.

Implementation Strategies 

Define standards for clinical practice that will ensure continuity of care for pregnant women and mother-baby pairs in the first four weeks of life. The standard of care should include actions that are important for the promotion and support of breastfeeding, including providing prenatal counseling on feeding decisions, setting accountability standards for postpartum follow-up care, monitoring neonatal weight gain, and establishing referral mechanisms for skilled lactation care. Models should be established to integrate assistance with breastfeeding into routine practice settings.

 Conduct analyses and disseminate their findings on the comparative efectiveness of different models for integrating skilled lactation support into settings where midwives, obstetricians, family physicians, nurse practitioners, and pediatricians practice. Skilled lactation support may be provided by trained physicians, by lactation consultants affiliated with a physician practice, through stand-alone clinics, or by referrals. Models of care differ in the degree to which care is provided for all breastfeeding mothers to prevent difficulties and the extent to which care is provided for women already having problems. Identification of best practices and optimal care models is needed.

Getting Involved

We are blessed to live in an area where excellent health-care is available. Many pediatricians are quick to refer mothers to lactation consultants for breastfeeding support. We regularly get calls from their offices requesting consultations for their patients. However, some pediatricians are still quick to suggest that mother's supplement unnecessarily or even stop nursing altogether. Whereas some ob/gyn's are extremely supportive of their breastfeeding patients, others are dismissive at best. 

In many parts of the country lactation consultants are an integral part of the pediatric practice. Therefore, we have designed a program especially for our local doctors to give them the benefit of having a lactation consultant available without having to hire another staff member. Our LC in Your Office program allows even the smallest pediatric or family practice to provide professional breastfeeding support to their patients in the privacy of their office.

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