This table is listed in alphabetical order and is not exhaustive. Please refer to the legal guidelines for each specialty in your state. Every clinical teams’ makeup and culture of support is different but all referrals should be coordinated through the primary care provider (PCP) and where available coordinated by a patient-centered, medical home. This includes care coordination, referrals, and communication. This interprofessional breastfeeding table idea is based on this United States Breastfeeding Committee Table on the different lactation support providers.
Provider Type
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Description:
Their responsibilities include, but are not limited to, providing invaluable primary and preventative health care to the public. Advanced-practice providers treat and diagnose illnesses, advise the public on health issues, manage chronic disease and engage in continuous education and developments in the field under the supervision of a physician in most states.
Both APRNs and PAs can work in a variety of specialties such as women’s health, obstetrics, pediatrics, and psych-mental health, in both community and acute care settings.
Training
APRNs hold at least a master’s degree in addition to the initial nursing education and licensing required for all RNs. APRNs complete approximately 500-1,500 hours of clinical hours in training.
Advanced Practice Registered Nurses (APRNs) include nurses who specialize in the following areas: certified nurse midwives (CNM), certified registered nurse anesthetists (CRNA), clinical nurse specialists (CNS), and nurse practitioners (NP).
PAs are educated at the master’s degree level and are required to have a bachelor’s degree. PAs complete courses in basic and behavioral sciences as prerequisites. PAs complete more than 2,000 hours of clinical hours in training.Ways to work together to provide breastfeeding care
Advanced-practice providers, similar to physicians, can develop and implement primary care breastfeeding support and educational programs. Advanced-practice providers can coordinate the multidisciplinary care provided to the breastfeeding dyad and lactating woman. Advanced-practice providers may receive advanced training and experience to manage more complex breastfeeding and lactation issues.
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Description
Behavioral health professionals may be psychologists, social workers and other therapists who provide counseling.
Training
Most hold bachelor’s and a master’s degrees; some have doctorate degrees and have completed internships under clinical supervision.
Ways to work together to provide breastfeeding care
Behavioral health professionals may work with other clinicians to provide mental health services for patients who benefit from counseling or psychotherapy. They are important resources for the breastfeeding mother struggling with postpartum depression, anxiety, or psychosis. They are also crucial in the care of the mothers recovering from substance use disorders or domestic abuse.
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Description
Case/Care managers support the ability of patients to transition to home or other levels of care. They help ensure patients have the clinical support and resources needed to improve care outcomes.
Training
Case/Care managers are often registered nurses or licensed social workers.
Ways to work together to provide breastfeeding care
Case/Care managers can work closely with OB/GYNs, pediatricians, and other healthcare professionals to assess the needs of the breastfeeding dyad in order to avoid readmission or unnecessary emergency room visits (i.e. for jaundice or poor feeding). They can also help with connecting women to community resources.
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Description
Patient care/clinical support staff include Medical Assistants (MAs) and Patient Care Technicians. These individuals work alongside and under the supervision of an RN, APRN, PA, or MD, mainly in outpatient or ambulatory care facilities, such as medical offices and clinics.
Training
Patient care/clinical support staff are required to hold a high school diploma or take the General Educational Development test. Some states require training and certification through an accredited medical assistant program.
Ways to work together to provide breastfeeding care
Patient care/clinical support staff may provide breastfeeding support, education, and guidance as a complement to the assistance provided by health care providers with advanced training.
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Description
Patient navigators support patients in obtaining and attending needed medical appointments and in getting financial, legal, and social services. Under the supervision of a licensed healthcare professional, patient navigators assist patients in communicating with their health care professionals promoting the opportunity for patients and their families to engage in shared decision-making.
Training
Patient navigators or CHWs typically hold a bachelor’s or associate degree or comparable work experience. Community Health Workers and Patient Navigators training vary considerably state to state. Some states have specific training requirements and certification in certain health topics.
Ways to work together to provide breastfeeding care
Patient navigators can provide important support services to help facilitate patient engagement, coordination of services for the breastfeeding dyad, and enhance adherence to care. They can be helpful cultural allies to approach care in a culturally humble way. They can be especially useful when referring families to other members of the care team outside of the primary care setting.
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Description
Lactation professionals may be lactation consultants, breastfeeding counselors, breastfeeding peer counselors, doulas or others who provide breastfeeding/chestfeeding, milk expression, and lactation management and support.
Training
Lactation consultants must complete 90-hours of didactic education specific to lactation and meet other training requirements in order to qualify for the certifying exam. Certified Lactation Consultants (CLC’s) and International Board Certified Lactation Consultants (IBCLC’s) have similar scope but different certifying bodies.
Breastfeeding counselors undergo 45-52 hours of classroom training and an exam in order to receive certification.
Breastfeeding peer counselors and doulas receive specialized training and often are from the community where they work and share similar socio-demographic and breastfeeding backgrounds of the individuals they care for.
http://www.usbreastfeeding.org/p/cm/ld/fid=910Ways to work together to provide breastfeeding care
Lactation support professionals can assess maternal anatomy and infant latch and provide hands-on support to the dyad. They can collaborate with other clinicians in both the outpatient and inpatient settings to create individualized lactation plans for families.
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Description
Nursing professionals include Licensed Practical Nurses (LPNs/LVNs) and Registered Nurses (RNs). They provide routine and day-to-day patient care in the inpatient and outpatient setting.
Training
LPNs/ LVNs must obtain a diploma or certification through an accredited program. Becoming an LPN/LVN requires licensure through the National Council Licensure Examination for Practical Nurses (NCLEX-PN). LPNs/LVNs work alongside and under the supervision of an RN, APRN, PA, or MD.
RNs must earn an associate degree or a bachelor's degree with an emphasis in nursing. Becoming an RN requires licensure through the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam. For more information visit, https://www.asrn.org/Ways to work together to provide breastfeeding care
Nursing professionals provide bedside education about breastfeeding and human lactation. The nurse can support breastfeeding through frequent maternal-infant assistance in the inpatient and outpatient setting.
A referral can be made to a visiting nurse who can go to a patient’s home to provide breastfeeding support if the visiting nurse is trained on lactation.
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Description
Neonatal therapists [Occupational Therapists (OTs), Physical Therapists (PTs), Speech Language Pathologists (SLPs)] offer an integrated and holistic approach to the care of the medically complex or premature infant. They provide assessment and intervention, primarily in the NICU, but also in the outpatient setting, for infants with specialized health or developmental needs.
Training
OTs, PTs, and SLPs generally require a master’s degree as well as board certification. Providers that work with neonates generally have done specialized training or internships with this population. For more information visit, https://neonataltherapists.com/resources/
Ways to work together to provide breastfeeding care
Neonatal therapists can assess physical and developmental factors, which can impact breastfeeding success, such as torticollis. OTs can assist infants with coordination of feeding, provide bottle nipple recommendations that are appropriate to the infant’s abilities, and educate caregivers on developmentally appropriate feeding techniques.
PTs promote neuroprotective care and neuromuscular development by assessing positioning needs for infants and developing positioning plans to optimize flexion, alignment and containment. SLPs can assess oral motor skills and swallowing safety both at bedside and with tools such as videofluroscopy. -
Description
Pediatric dentists (DMDs) are dentists who specialize in the diagnosis and treatment of dental problems in children from infancy to young adulthood
Training
A pediatric DMD has completed a 4-year accredited dental school program as well as a 2-3 year residency specializing in pediatric dentistry. For more information and to find pediatric dentists in your area visit, https://www.aapd.org/
Ways to work together to provide breastfeeding care
Pediatric dentists can perform frenotomies/ frenectomies to correct ankyloglossia. They often use a laser to perform this procedure. They also can assess infants with natal teeth, which may interfere with breastfeeding
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Description
Pediatric Otolaryngologists (ENTs) are physicians who specialize in the surgical and medical management of conditions of the ears, airway, nose, and throat.
Training
Pediatric ENTs have completed a 4-year medical degree, a 3-5-year surgical residency program in otolaryngology, and often additional fellowship training at a pediatric center. For more information visit and helpful videos visit, https://aspo.us/page/familywebinars
Ways to work together to provide breastfeeding care
Pediatric ENTs can evaluate ankyloglossia and perform surgical lingual frenotomies (otherwise known as frenulectomy, frenuloplasty, or tongue tie release procedure). They can also assess and treat infants with anatomical anomalies of the face or airway (such as micrognathia), which can interfere with breastfeeding (although in some institutions this may fall under the purview of plastic surgeons, craniofacial specialists, or oral maxillary facial surgeons)
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Description
Primary care and hospitalist physicians who work with newborns and caregivers include, but are not limited to, OB-GYNs, family medicine doctors, pediatricians, internal medicine physicians, and neonatologists. Physicians may be allopathic (MDs) or osteopathic (DOs).
Training
Allopathic physicians (MDs) and osteopathic physicians (DOs) in the US have completed medical school, typically over four years, as well as a residency in their specialty. Physicians may also have completed additional specialized medical training, called a fellowship, which is often 1-3 years following residency.
Ways to work together to provide breastfeeding care
Physicians, in addition to delivering clinical care, initiate and coordinate systems-based patient care. For more information see the ACOG Policy: The Physician’s Role in Human Milk Feeding.
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Description
Registered Dietitians (RDs) are trained nutrition professionals who advise and counsel others on food and nutrition.
Training
RDs must complete a bachelor's degree in dietetics and/or nutrition that is accredited by the Accreditation Council for Education in Nutrition and Dietetics of the Academy of Nutrition and Dietetics. Must also complete a 1-year internship and pass a licensure exam. For more information visit, https://www.eatrightpro.org
Ways to work together to provide breastfeeding care
Referrals can be made to registered dieticians to make recommendations for parents who are interested in improving their own diets, have special nutritional needs, and assess their child’s feeding patterns, or any additional nutritional needs infants may have in special circumstances.