title: Integrating routine lactation consultant support into a pediatric practice.
abstract: BACKGROUND
  Although research shows that healthcare professionals' support improves breastfeeding duration, many physicians do not believe they have adequate time to address breastfeeding concerns during office visits. This study evaluated the impact of a pediatric practice's postnatal lactation consultant intervention. To improve breastfeeding support, the study practice changed policy and began using a lactation consultant overseen by a physician, to conduct the initial postpartum office visit for all breastfeeding infants.
  
  
  METHODS
  A retrospective chart review was performed on consecutive newborns before (n = 166) and after (n = 184) implementation of the program. Feeding method was assessed at each well child visit during the infant's first 9 months. χ² and logistic growth curve analyses were used to test the association between implementation status and non-formula feeding (NFF).
  
  
  RESULTS
  Mothers and infants in 2007 and 2009 were similar with regard to type of insurance, parity, gestational age, multiple births, and cesarean sections. Overall, NFF improved after program implementation (odds ratio = 1.12, 95% confidence interval 1.02-1.23). In 2009, NFF rates at 2 months, 4 months, 6 months, and 9 months were greater than 2007 rates by 10%, 15%, 11%, and 9%, respectively. Logistic growth curve analysis indicated the difference across these time points was significant between 2007 and 2009.
  
  
  CONCLUSIONS
  A routine post-discharge outpatient lactation visit coordinated within a primary care practice improved breastfeeding initiation and intensity. This effect was sustained for 9 months.
authors.affiliation: Department of Family Medicine, Case Western Reserve University, Cleveland, Ohio, USA. awitt@bfmedneo.com
authors.forename: Ann M
authors.initials: AM
authors.lastname: Witt
authors.forename: Samantha
authors.initials: S
authors.lastname: Smith
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Mason
authors.forename: Susan A
authors.initials: SA
authors.lastname: Flocke
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation; D008875:Middle Aged; D009035:Mothers; D009820:Ohio / Q000453:epidemiology; D010372:Pediatrics / Q000458:organization & administration*; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult