Lactation Care Management: Advancing Rural Health Equity With an Integrated Care Delivery Model.

Area of Science:

• Public Health
• Maternal and Child Health
• Health Services Research

Background:

• Access to International Board Certified Lactation Consultants (IBCLC) is crucial for infant feeding but limited in rural populations.
• Health equity in lactation support remains a challenge, particularly for underserved communities.

Purpose of the Study:

• To develop and implement a lactation care management program for rural communities within an accountable care organization (ACO).
• To improve health equity and infant feeding outcomes through seamless IBCLC care delivery.

Main Methods:

• A transitions care management model was employed, led by an IBCLC.
• Care was integrated across obstetric, in-patient, and pediatric settings, with 6-month postpartum follow-up.
• The program focused on person- and family-centered care, education, resource connection, and advocacy.

Main Results:

• The program significantly improved human milk feeding initiation and duration rates compared to benchmarks.
• Patients reported enhanced lactation experiences across care settings.
• Healthcare providers experienced more satisfying care delivery.

Conclusions:

• The lactation care management program demonstrated effectiveness and success in improving infant feeding outcomes and satisfaction.
• The model's success warrants sustained funding and replication in other rural areas.
• This program offers a scalable model for improving lactation support and health equity.