Team-Based Breastfeeding Support at a Federally Qualified Health Center: Efficacy, Utilization, and Patient...

Area of Science:

• Public Health
• Maternal and Child Health
• Healthcare Quality Improvement

Background:

• Integrated lactation consultant (LC) and primary care provider (PCP) programs show promise for improving breastfeeding rates in outpatient settings.
• Limited research exists on the efficacy of these programs in diverse, socioeconomically disadvantaged communities.
• Federally Qualified Health Centers (FQHCs) serve vulnerable populations, making them critical sites for evaluating such interventions.

Purpose of the Study:

• To assess the utilization, breastfeeding rates, and patient satisfaction of a team-based LC/PCP care program implemented at an FQHC.
• To evaluate the impact of integrated LC/PCP care on breastfeeding duration in a diverse patient population.
• To determine the feasibility and patient-reported helpfulness of this collaborative care model.

Main Methods:

• Retrospective chart review comparing feeding status pre- and post-implementation of team-based LC/PCP care.
• Analysis of breastfeeding rates at 2-week, 2-month, 4-month, and 6-month well visits.
• Subanalysis of patients who initiated breastfeeding, examining feeding status and LC support, supplemented by a patient satisfaction survey.

Main Results:

• Among patients who initiated breastfeeding, those receiving LC/PCP care were significantly more likely to breastfeed at 2 weeks (94% vs. 80%) and 4 months (68% vs. 45%).
• Overall practice breastfeeding rates did not significantly differ before and after program implementation.
• 72% of breastfeeding families utilized LC services, with a median of 1.18 LC visits per patient; helpful aspects included latch instruction and answering questions.

Conclusions:

• Team-based LC/PCP care is a feasible model within an FQHC setting.
• The integrated care approach was found to be helpful by patients.
• Receiving LC/PCP care was associated with increased breastfeeding duration through 4 months for families who initiated breastfeeding.