1. Breastfeeding Curriculum for OBGYN Residency Programs
January 2018

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

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