Results from the Breastfeeding/Lactation Support for Medical Trainees Policy Implementation Learning Collaborative

• Context: When medical trainees choose to breastfeed, they often do not receive adequate support from their institutions and colleagues and do not meet their breastfeeding goals. It is important for physicians in training to be supported in reaching their breastfeeding goals because their personal experience can have long term impacts for themselves and on the education and support they provide their patients. The American Academy of Pediatrics (AAP) & American Academy of Family Physicians (AAFP) created a learning collaborative to foster and evaluate uptake and implementation of the AAFP model policy, Breastfeeding & Lactation Support for Medical Trainees.

Objective: Support, facilitate, and evaluate residency program implementation of the AAFP model policy through an action-oriented virtual learning collaborative.

Study Design and Analysis: Evaluation of the virtual learning collaborative, including each site’s written policy, policy implementation, and culture concerning breastfeeding support for medical trainees.

Setting: Two cohorts of ten residency programs over a two-year period (20 total) participated in an eight-month virtual learning collaborative.

Population Studied: Multidisciplinary teams from family medicine, pediatric, and OB/Gyn residency programs including administration, nursing, faculty, and medical trainee representatives.

Intervention/Instrument: Six educational sessions including speakers, resources, homework, and sharing of ideas for each cohort. Instruments included pre/post surveys assessing how current organizational policy and practices align with the tenets of the model policy and pre-intervention survey of resident attitudes and experiences with lactation during training.

Outcome Measures: Alignment with the model policy domains: culture of support, lactation facilities, protected time, and roles and responsibilities.

Results: Alignment scores improved. Each site successfully wrote a policy. Resident surveys from cohorts 1 and 2 showed positive attitudes toward protected time and support for lactation.

Conclusions: Support exists among medical trainees for implementation of lactation policies. External resources, education, and a dedicated time for team collaboration allowed teams to develop an implementation plan for breastfeeding and lactation policies at their respective programs/institutions.