Is your practice breastfeeding friendly?

Tarayn Fairlie, MD, MPH, Chair – EPIC Breastfeeding Education Program Advisory Committee

Have you noticed that more of your patients are breastfeeding? You aren’t imagining things-breastfeeding rates in Georgia are increasing. However, many mothers still don’t reach their breastfeeding goals, and studies cite lack of support from health care providers as one of the reasons for not meeting them. Georgia families need physicians who can actively support breastfeeding them.  Yet between 43% and 50% pediatricians, neonatologists, obstetricians/gynecologists, and family medicine physicians don’t feel they were adequately prepared for clinical evaluation of breastfeeding problems, and a similar proportion feel that they were inadequately prepared for clinical treatment of breastfeeding problems. This isn’t surprising, as there is little or no formal instruction on breastfeeding and human lactation in medical schools.  The EPIC Breastfeeding Program is here to help fill this gap for practicing physicians and can either jumpstart a big shift for your practice or be the impetus for small improvements. The modules and resources of the EPIC program can help you develop your skills and further develop your practice. EPIC has resources available to assist you to develop, enhance and/or update your skills. Here are some ways EPIC can help you better support breastfeeding families:

Start at the beginning! We know that a mother’s prenatal intention to breastfeed is strongly influenced by input from and support of her physician.  If you see expectant parents, encourage them to breastfeed and answer any questions they might have about breastfeeding. Another good place to start is to track breastfeeding rates in your practice. Knowing what your patient population is doing can be helpful at setting practical goals to help mothers adhere to AAP recommendations for breastfeeding: exclusive breastfeeding until 6 months of age and then continued breastfeeding until at least age 1. Through our modules, we can help train support staff and providers to have open-ended conversations about infant feeding that assesses an expectant mother’s breastfeeding intention in a comfortable, non-pressured way.

Look at your practice environment. What are you currently promoting? Do parents see formula companies represented in your practice? Do you still provide free formula gift packs or have formula marketing materials from your waiting area? Ensuring that your patient education is free of commercial influence is an important step in supporting informed feeding choices for all new families, whether breastfeeding or not.   Our resource kit includes samples of well- designed and up-to-date patient education materials in English and Spanish.

Put it in writing. Collaborate with staff to develop a written breastfeeding policy for your practice.  We can provide examples and guidance. A clear policy can ensure that your staff are supported when they return to work by providing space, time and supplies to express milk for their babies, increasing both their job satisfaction and performance.

Offer culturally competent feeding care. Different cultures have varying beliefs and customs relating to infant feeding.  Knowing them and providing appropriate anticipatory guidance can improve your practice and your customer satisfaction ratings. Do you and your staff encourage breastfeeding in the waiting area and provide a private place if desired? Having posters and signs welcoming and encouraging breastfeeding can help parents feel comfortable and supported.  We provide samples in our Resource Kit.

Triage breastfeeding concerns easily. Your phone triage nurses should be provided with training and resources to provide evidence-based recommendations to families calling for advice.  Our Resource Kit includes the AAP published Breastfeeding Telephone Triage and Advice book, 3rd edition.  Our one-hour breastfeeding education programs can provide this education, as well as continuing education hours for nurses and physicians, at no cost to your office.

Make it part of the visit. Our training will also help guide you in incorporating breastfeeding into routine care.  Learn what effective breastfeeding looks like, what mothers’ common concerns are, and what strategies to employ that preserve breastfeeding and milk production if/when problems arise.  Learn about milk expression and how to support mothers when they return to work or school. Our program also provides resources on coding, billing, and documentation so you can be paid for the work that you do!

Learn who else can help. When further breastfeeding expertise or peer support is indicated, it’s helpful to be familiar with lactation support in your community and where families can find it.  Also, more and more pediatricians, ob/gyns and family practice physicians whose practices see many newborns are directly hiring or contracting with lactation consultants to provide care in the office.  Accessible breastfeeding support can help your practice attract new and growing families, and Georgia is one of the first states to license lactation consultants.

Schedule your EPIC Breastfeeding Program today.  Let us provide you with resources to make your practice more breastfeeding friendly.  We offer convenient, physician-led, peer-to-peer breastfeeding education in your office or hospital. Our modules are one-hour sessions held during lunch or any time that is more convenient. Each program site receives a free Breastfeeding Resource Kit as part of the presentation, with resources for you, your staff and your patients. There are three topics to choose from: Breastfeeding Fundamentals, Supporting Breastfeeding in the Hospital, and Advanced Breastfeeding Support. Free continuing education is provided.  Complete an online program request form at www.GaEPIC.org or call the program office at 404-881-5068. The EPIC Breastfeeding Program is brought to you by the Georgia Chapter, American Academy of Pediatrics with support from the Georgia Department of Public Health.