Physician-Led Outpatient Breastfeeding Medicine Clinics in the United States

Abstract

Attrition of exclusive breastfeeding is highest during the first 3 months postpartum. Timely management of breastfeeding in the outpatient setting through innovative models of healthcare delivery may increase its duration and exclusivity. Our goal was to examine the structure and function of physician-led clinics in the United States that specialize in providing outpatient clinical support for breastfeeding-related issues ("breastfeeding medicine clinics"). We posted a survey on Listservs of the American Academy of Pediatrics, American Academy of Family Physicians, and Academy of Breastfeeding Medicine. The survey collected information on (1) clinic and physician demographics, (2) visit characteristics, (3) referral and reimbursement, (4) clinical activities, (5) continuing education resources, (6) teaching/education activities, and (7) advocacy activities, of physician-led outpatient breastfeeding medicine clinics. Lead physicians from 13 clinics responded to the survey. Their clinics provided clinical care for time-intensive breastfeeding problems. The clinics we described that were in existence longer than 2 years appeared to be economically sustainable. Most physicians who had provided specialized breastfeeding support for more than 5 years reported that their income was commensurate with others in their specialty. Most physicians who provided specialized breastfeeding medicine care additionally provided primary care services within the same clinical setting. Further research into fiscal and organizational aspects of establishing specialized physician-led breastfeeding clinics is needed. The potential of such clinics in contributing to collaborative practice-based research, as well as medical student and house staff education, needs to be explored.

The breastfeeding experience of women with major difficulties who use the services of a breastfeeding clinic: a descriptive study

“…Few studies of breastfeeding clinics in industrialized countries have been identified [ 10 - 17 ]. These clinics aim to increase breastfeeding duration and diminish the prevalence of difficulties [ 10 , 11 , 14 ].…”

Ankyloglossia Identification, Diagnosis, and Frenotomy

“…Our participants pieced together their own training curricula from existing literature and webinars; evidence-based methodologies and protocols were not part of their training. This practice was confirmed by Shaikh and Smillie (2008), who also have reported that the majority of surveyed physicians in breastfeeding clinics are educated via materials sought as a result of their own curiosity. Furthermore, Edwards and colleagues (2015) have suggested that frontline practitioners utilize free and convenient online resources, because time limitations, regional access, and financial limitations serve as barriers to formal continuing education.…”

General Practitioners Knowledge of Breastfeeding Management: a Review of the Literature

“…Two other studies in the United States were survey based and therefore not as rigorous in their methodology as the randomized intervention trials. Shaikh and Smillie [46] found through a self-reported survey of clinic based lead physicians (N = 13 clinics responded ) that while there was a growth of membership in the Academy of Breastfeeding Medicine there appeared to be no explicit educational program. Clinics used in house educational programs as well as materials provided by La Leche League International, The American Academy of Pediatrics and teaching hospitals.…”