Sustaining Breastfeeding Together

Team-Based Care is a Sustainable Practice

Prioritise Breastfeeding: Create Sustainable Support Systems is the theme for World Breastfeeding Week 2025. The theme highlights protecting and promoting breastfeeding  to help protect our environment.  Breastfeeding is a natural, renewable food.  Increases in breastfeeding naturally decrease pollution, packaging, and waste that are produced with artificial feeding. Thus, improving support within our healthcare system and protecting breastfeeding is a sustainable practice.

Team-based lactation consultant (LC)/primary care provider (PCP) support is one option that not only supports environmentally sustainable infant feeding practices, but does it in a way that is itself sustainable within a practice. Integrated visits within the primary care practice decrease disjointed care, decrease the frequency of visits (which also decreases transportation cost and environmental impact), and confirm your practice’s support of breastfeeding. By sharing the responsibility for lactation care with your breastfeeding-supportive team, you also decrease the burden on any one provider and diversify billing options.

Case Study: Newborn Weight Loss, Jaundice & Latching Difficulties

Newborn weight loss, jaundice, and breastfeeding difficulties are common in the first weeks postpartum. Take for example a 3-day-old infant 10% below birth weight and with a jaundice level 3 points below light level. This baby requires prompt follow-up and evaluation again within 24 hours. Additionally, the family needs immediate breastfeeding support. For this case, the newborn and breastfeeding parent are struggling with latching, and while milk supply is increasing, it appears borderline. The family tried pumping when their baby could not latch, but stopped because it hurt. The family has a lot of questions. To support lactation we need time to provide guidance on latch, hand expression, and pump evaluation-- all of which also helps this baby gain weight and improve hyperbilirubinemia.

With team-based lactation support in the primary care office, the family can receive the needed breastfeeding education while also getting weight and jaundice evaluation, including blood work and facilitating phototherapy as needed. Otherwise the family will need two appointments--one for lactation support and one with their PCP for jaundice and weight check. Two appointments means different times and facilities. Given the barrier of extra visits, it is not uncommon for the lactation appointment to be pushed off, either because of lack of availability or because of too many appointments in early postpartum.  If unable to resolve latching difficulties, pain, and pumping challenges quickly, the family is at increased risk of premature weaning. Integrated breastfeeding support within a primary care practice helps extend breastfeeding duration.  In this case, extending breastfeeding duration will not only improve infant and maternal health, but will reduce the negative impact on the environment caused by frequent office visits and supplemental feeding.

Linking the Warm Chain of Breastfeeding Support

Team-based care also improves sustainability because it serves to connect lactation and primary care within our existing health care system, which helps strengthen the "Warm Chain" of support for breastfeeding. The World Alliance for Breastfeeding Action (WABA) “Warm Chain campaign places the mother-baby dyad at the core. It strives to link different actors across the health, community and workplace sectors to provide a continuum of care during the first 1000 days."  WABA promotes the integration of healthcare and community support and highlights that the Warm Chain of breastfeeding support needs to include all of us-- because we all benefit when breastfeeding families are supported to meet their breastfeeding goals.

To expand and strengthen the sustainability of the Warm Chain of breastfeeding support, we can increase and improve outpatient primary care support through integrated lactation visits. Maintaining outpatient PCP support in the early postpartum improves breastfeeding duration and intensity. This model of care is consistent with the United States Preventative Task Force recommendation that “clinicians provide interventions during pregnancy and after delivery to support breastfeeding”. As the WABA campaign highlights-- along with this year's World Breastfeeding Week Theme--continuity of lactation care is critical but is often missing in our current society and thus we need to seek innovative and creative options, for the sake of all families. When we improve continuity of care by strengthening the Warm Chain, we are also doing important work for our environment.

Adaptation and Flexibility is a Must

In our practice, we have created an ongoing system of breastfeeding support since 2009. Establishing team-based visits is a first step. Maintaining a sustainable system requires flexibility and an ability to adapt. In our experience, we have met these needs with ongoing needs assessments, training, and flexibility. As new staff and medical providers join a practice, ongoing training is needed. Flexibility includes changing based on new needs within the practice--whether it be changing a schedule or expanding to meet additional needs like our group well visits, which created another touch point for lactation support as well as expanded mental health support.

In the past years, we have had to adapt our model to meet the needs of the practice and the community-- whether it was during COVID lockdown or a formula shortage or healthcare provider changes. With Breastfeeding Medicine & Primary Care, we are here to share what we've learned from these experiences and support you as you innovate your own practices.

Bottom Line: We Sustain Breastfeeding Together!

Each practice will have its own challenges and successes, but by considering the option of team-based breastfeeding support, you are showing your support for the breastfeeding families you care for, as well as all of us living on this planet. We have shown the success of this model in different practice environments, and have supported others as they adapt to their individual practice. With the celebration of World Breastfeeding Week this is another opportunity to pause and explore options for your community!