Breastfeeding Curriculum for OBGYN Residency Programs January 2018

CREOG Committee: Breastfeeding Curriculum Objective: to establish a curriculum with organized educational material and assessments that addresses the CREOG objective regarding breastfeeding education that can be utilized in OBGYN residency programs

Breastfeeding Curriculum: Learning Objectives Objective: to prepare residents to better counsel patients on the benefits of breastfeeding as well as manage common situations associated with breastfeeding Describe the anatomy of the breast Describe the physiology of lactation Be able to counsel a pregnant woman about the advantages of breastfeeding Learn the true contraindications of breastfeeding Be able to take a breastfeeding history Learn to help a mother initiate breastfeeding after delivery Manage breastfeeding problems that may occur in the mother

Breastfeeding Curriculum : Learning Objectives Medical Knowledge Describe the anatomy of the breast and lactogenesis. Understand the indications and application of breastfeeding technology (manual and mechanical breast milk expression, supplemental feeding methods, milk storage, donor human milk). Describe the influence of contraceptive methods on breastfeeding (lactational amenorrhea method, other non- hormonal and hormonal methods, and how they influence breastfeeding). Patient Care Evaluate positioning and latch-on Demonstrate hand expression Manage common breastfeeding problems

Breastfeeding Curriculum: Learning Objectives Systems Based Practice Describe the general benefits of and risks of not breastfeeding for the infant, mother, and the community at large, and be able to list common barriers to successful breastfeeding. Understand why it is important to work actively toward eliminating hospital policies and practices that discourage breastfeeding for patients, employees, and residents. Identify the Baby Friendly Hospital Initiative, The Ten Steps to Successful Breastfeeding as described by the World Health Organization and UNICEF, and supported by the AAP, ACOG, and AAFP policy statements

Breastfeeding Curriculum: Learning Objectives Practice Based Learning Participate in the development of educational materials on breastfeeding. Interpersonal Communication Skills Practice communication skills about the topic of breastfeeding

Learning Resources Wellstart International Lactation Management Self –Study Modules Self-study modules addressing The Health Care Providers to Breastfeeding A free handbook to guide providers in addressing patients’ breastfeeding needs Created by the Department of Health, Texas American Academy of Pediatrics (AAP) Breastfeeding Curriculum Objective based curriculum with learning tools, assessment tools, and other resources

AAP Breastfeeding Curriculum Basic Breastfeeding Assessment Description of breastfeeding positions Description of proper and improper latch Description of adequate transfer Management of Common Breastfeeding Situations Perception of low milk supply Slow weight gain Normal feeding positions, latch, and feeding behaviors Sore nipples Inverted nipples Management of Common Breastfeeding Problems Delayed lactogenesis The ineffective suckle Engorgement Mastitis Breastfeeding jaundice Dehydration Yeast and bacterial infections Blocked Ducts Clinical Cases Use of Antidepressants and Breastfeeding Slow Weight Gain and Breastfeeding Low Milk Supply and Breastfeeding Jaundice and Breastfeeding Oversupply of Milk and Breastfeeding Food Allergy and Breastfeeding Cultural Case Studies

Implementation of Curriculum (Suggested Activities) Prior to beginning the learning activities, provide one of the learning resources listed above in one or more of the following formats: Self-study Grand Rounds Weekly resident didactics The “Flipped Classroom” Week 1 Shadow a lactation nurse during postpartum rounds Week 2 Counsel an expectant mother/father on the benefits and mechanism of breastfeeding Week 3 Counsel new mother on postpartum rounds how to properly breastfeed (i.e. breastfeeding positions, proper latch, adequate transfer) Week 4 Complete Objective Structured Clinical Exam (OSCE) Exam Assessment

Recommendations to the committee Provide this as a Tool Kit on the CREOG Website