title: Trifecta approach to breastfeeding: clinical care in the integrated mental health model.
abstract: The breastfeeding experience for the mother and infant is often complicated by a constellation of challenges that are difficult for lactation consultants alone to treat. To address this issue, a breastfeeding consultation clinic at Children's Hospital Colorado developed a multidisciplinary team: a pediatrician specializing in breastfeeding medicine, a lactation consultant, and a clinical psychologist specializing in infant mental health and child development. This Trifecta Breastfeeding Approach meets families' needs by addressing the infant's medical care, functional breastfeeding challenges, and the developing mother-infant relationship, and by screening for concurrent pregnancy-related mood disorders. The Approach also recognizes family dynamics and the transition to parenthood within the breastfeeding consultation. Issues of lost expectations, grief, infertility, high-risk infants, and fussiness often need to be addressed. Case examples here illustrate the benefits of this multidisciplinary, integrated health model. This type of integrated care will likely have an increased presence in health care systems as reimbursement for psychologists' fees and innovative models of care continue to emerge.
authors.affiliation: 1Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Bunik
authors.forename: Dena M
authors.initials: DM
authors.lastname: Dunn
authors.forename: Lorry
authors.initials: L
authors.lastname: Watkins
authors.forename: Ayelet
authors.initials: A
authors.lastname: Talmi
mesh_terms: D001942:Breast Feeding / Q000379:methods*; D003253:Consultants; D019052:Depression, Postpartum / Q000628:therapy*; D005260:Female; D006801:Humans; D008603:Mental Health; D010372:Pediatrics / Q000379:methods*; D011247:Pregnancy
keywords: breastfeeding; infant mental health; integrated mental health; lactation; maternal mental health; pregnancy-related depression