2025 Theses Doctoral

Building Expertise in Breastfeeding and Lactation Medicine: A Program Evaluation of Lessons in Lactation Advanced Curriculum, a Breastfeeding and Lactation Medicine Fellowship

Buckingham, Allison

Context: Guidance from health care providers about breastfeeding and lactation is cited as an important factor in breastfeeding decisions, yet clinicians report low levels of knowledge, confidence, and clinical competence in this area. This is due to a lack of standardized, evidence- based education and training in breastfeeding for health care providers, leaving clinicians to rely on personal experience with breastfeeding, or information gathered from a variety of online sources and conferences. This lack of cohesive educational programs and resources results in insufficient training for clinicians to adequately support breastfeeding and lactating families.

Objective: Lessons in Lactation Advanced Curriculum (LILAC) is a two-year, fellowship-level breastfeeding and lactation medicine (BFLM) curriculum for post-residency health care providers that provides them with the depth of knowledge and clinical skills necessary to practice breastfeeding and lactation medicine.

Target Audience: Maternal health care providers, including physicians, midwives, and nurse practitioners.

Description: The LILAC Fellowship has three components: didactic, clinical, and research/QI. The fellowship begins with a week-long contemporaneous session to establish foundationalknowledge in breastfeeding and lactation medicine, followed by 18 monthly modules, built by experts, that cover the Academy of Breastfeeding Medicine (ABM) core competencies in breastfeeding medicine. Fellows complete a research or quality improvement project and obtain 1000 hours of practice in breastfeeding and lactation medicine with clinical oversight of a mentor that is a fellow of the ABM.

Evaluation: Kirkpatrick’s four-level evaluation model will be used to evaluate fellowship feasibility, acceptability, and efficacy.

Conclusion: The LILAC fellowship was feasible, acceptable, and effective in providing fellows with the knowledge and skills needed to practice breastfeeding and lactation medicine independently. Fellows reported that participation in LILAC positively impacted their patient interactions, helped to increased BFLM consultations, attendance at BFLM conference, and BFLM-related research publications, key factors in growing this nascent field.