P3A091: Establishing a Breastfeeding Medicine Clinic at a Large Academic Children’s Hospital: A Needs Assessment

Purpose/Objectives: As breastfeeding rates increase and the importance and complexities of breastfeeding are further understood, demand for Breastfeeding Medicine specialists is growing nationally. To meet this demand, Cleveland Clinic opened a Breastfeeding Medicine Clinic in June of 2022. The objective of this quality assessment is to determine the educational and clinical needs of providers at a large, tertiary academic center in order to define the highest-impact quality improvement initiatives for Cleveland Clinic's newly-created Breastfeeding Medicine Clinic.

Design/Methods: After IRB exemption was obtained, an anonymous RedCAP survey was sent to all providers who care for breastfeeding dyads at Cleveland Clinic and completed in May 2022 before the Breastfeeding Medicine Clinic opened. Basic statistical analyses were conducted.

Results: 126 providers completed surveys (30% response rate). The most common provider-reported breastfeeding support needs of patients are: 1) latch issues (86%), 2) nipple pain (73%), 3) undersupply (64%), 4) frenotomy assessment (44%), and 5) infant medical diagnoses (37%). The most common provider resources or support needs included: 1) access to lactation consultants (66%), 2) patient education (58%), 3) access to a breastfeeding physician (56%), 4) physician education (43%), and 5) home visits (40%). The most common patient misconceptions providers encountered were: 1) that it’s easy or natural (30%), 2) perceived low milk supply (13%), and 3) milk comes in and baby latches right away (7%). The most common provider misconceptions were 1) that it should be easy or natural (8%), 2) perceived low supply (6%), and 3) medication safety (4%).

Conclusion/Discussion: Our survey highlighted a number of specific opportunities to provide both educational and clinical support for patients and providers when creating a Breastfeeding Medicine Clinic, which could be generalized to other academic centers with multispecialty care. Changes made to date include provider and trainee education and streamlining patient access, among others with additional planned initiatives based on results.