Describing the Infrastructure of Breastfeeding and Lactation Medicine Divisions and Centers Established Within U.S....

There is a well-described need for a more coordinated, systems-based approach to breastfeeding care delivery in the United States. Although several Breastfeeding and Lactation Medicine (BFLM) Divisions, Centers, and Institutes (D/C/Is) exist within U.S. health systems, they remain poorly described. We aimed to describe the U.S. national landscape of BFLM D/C/Is and the clinical and nonclinical activities they conduct.

We present a secondary analysis of cross-sectional survey data collected from U.S. BFLM prescribing clinicians from November 2024 to February 2025. Participants were recruited from conferences, professional listservs, and social media groups relevant to BFLM clinicians. If they reported working under a BFLM D/C/I, additional questions assessed clinical infrastructure and non-clinical activities of their D/C/I. Descriptive summaries were completed.

Of 138 participants in our final sample, 20 (15%) from 10 states worked under a BFLM D/C/I and thus were included in this secondary analysis. Participants were physicians (n = 14, 70.0%), midwives (2, 10.0%), and nurse practitioners (4, 20.0%) with an average of 10.5 (standard deviation 8.6) years of BFLM experience. Most (70.0%) held positions as directors. D/C/Is had existed for an average of 7.2 years and delivered outpatient (95.0%), electronic (45.0%, i.e., "e-consult"), and inpatient (35.0%) clinical consultation services for an average of 7.9, 2.1, and 5.6 years, respectively. Most provided evidence-based staff education (95.0%), oversaw system lactation services and policies (75.0%), and conducted quality improvement and research (65.0%).

Our national description of BFLM D/C/Is can inform future research and expansion of BFLM infrastructure in U.S. health systems.