P3.050: Improving breastfeeding education and clinical competency through implementation of a standardized breastfeeding curriculum

Background: Breastfeeding is widely recognized for its health benefits to both infants and mothers. However, many physicians report insufficient knowledge in breastfeeding management and support. To address this gap, we developed a curriculum tailored to medical trainees. This study evaluates the curriculum’s effectiveness by assessing ​participants’ knowledge​ and confidence in providing ​breastfeeding support ​before and after completion.

Methods: A self-paced curriculum was developed using content from Academy of Breastfeeding Medicine (ABM), the Institute for the Advancement of Breastfeeding and Lactation Education (IABLE), the American Academy of Pediatrics (AAP), UpToDate, other online resources, and personal experience. It was incorporated into a well-baby nursery rotation and consisted of a written portion, videos/images, online resources, and an optional case-based component. Topics covered included (but were not limited to) benefits and contraindications, latch, positioning, weight loss assessment, insurance coverage, milk supply, and maternal health during lactation. Anonymous pre- and post-surveys were administered to all participants. Residents were asked to rate their comfort level on 23 topics related to breastfeeding. Responses were converted to numeric values using a Likert scale. Residents were also asked to rate their overall comfort supporting breastfeeding dyads on a scale from 1 to 10. Additional information was collected on previous breastfeeding education (formal, informal, or none) as well as any personal history of breastfeeding.

Results: Statistically significant improvements (p < 0.05) were observed in all 23 topics after curriculum implementation. Average overall confidence increased from 4.33 to 7.29 (p < 0.001). Pre-survey scores on overall confidence in supporting breastfeeding dyads did not differ significantly (p = 0.15) between residents with and without prior breastfeeding education in medical school. However significant differences were found in specific areas, including counseling on milk transition (p = 0.04), using evidence-based resources to evaluate weight loss (p = 0.04), and providing anticipatory guidance to prevent engorgement and mastitis (p = 0.04). Residents with personal breastfeeding experience (n = 4) reported significantly greater (p < 0.05) confidence in counseling patients on nearly all topics, with the exception of milk transitioning, breastfeeding frequency and duration, contraindications, and hormonal regulation of milk supply.

Conclusion: The limited informal breastfeeding education that only a minority of residents receive in medical school is insufficient to prepare them to effectively support breastfeeding patients. Even residents with personal breastfeeding experience benefit from additional structured education. Our curriculum significantly improves residents' knowledge and confidence in breastfeeding support. Further research is needed to evaluate long-term knowledge retention, implementation into clinical practice, and impact on patient outcomes.