Team Up! Primary Care Breastfeeding Support

As primary care providers we have a unique opportunity to help families meet their breastfeeding goals, improve breastfeeding initiation and duration, and improve the health of families. It is important to provide breastfeeding support within primary care practices because….

There are barriers to families breastfeeding in our country.  The US Surgeon General Call to Action on Breastfeeding identifies 7 key barriers to breastfeeding. While we cannot address all barriers at once, as part of the health care system we can work to deliver excellent, evidence-based support to particularly address the barriers of lactation problems and health care services.

Breastfeeding can be hard and families need support in reaching their individual breastfeeding goals. As primary care providers (PCPs), we know that:

• Breastfeeding improves health outcomes for both mother and infant.
• With an 84% breastfeeding initiation rate in the US, most families want to breastfeed.
• Many families will experience challenges during their breastfeeding journey.

We also know that the two most common reasons for weaning are pain and low milk supply. Families readily need access to care when experiencing these lactation problems and the PCP should provide this access. 

Support by health care providers makes a difference. Studies show that primary care interventions improve breastfeeding initiation and duration. Routinely providing breastfeeding support as part of prenatal, postnatal, and well-child visits demonstrates to families our commitment to breastfeeding and provides opportunities to navigate challenges as they occur.

The bottom line is that integrated primary care breastfeeding support helps improve access to health care services and support to resolve lactation problems. 

Yet, as the Surgeon General report notes, there are barriers to health care providers successfully delivering this care. PCPs receive limited education on breastfeeding and have limited time during visits to provide needed support. Did you know that studies have found the median number of hours pediatric and family medicine residents receive training on breastfeeding is 3 hours per year and 6 hours per year for obstetricians?  And even if PCPs have obtained education, there are not enough hours in the day for the PCP to discuss all the preventive recommendations. Teaming up with lactation consultants is one way to address these barriers and provide ready access to breastfeeding support within a primary care practice.  

Team-based lactation consultant/primary care provider (LC/PCP) visits combine the infant's primary care appointment with lactation consultant counseling. The PCP provides medical evaluation and support, while the LC provides detailed breastfeeding counseling. These visits not only improve access but also facilitate the time needed for a full feeding evaluation and problem solving. Having lactation support within the patient’s medical home improves access to evidence-based breastfeeding support.

With primary care breastfeeding support, when families want to breastfeed they have a partner within the healthcare system to provide them education and guidance. When breastfeeding is hard, families have an immediate place to turn!

~ by Ann M. Witt, MD, FABM, IBCLC