Date of Publication


Project Team

Rebecca Nagle, Courtney Walker-Borch


Background: While the evidence supporting exclusive breastfeeding is abundant, parents meet several challenges in the early postpartum period that place them at risk of early breastfeeding cessation. In the U.S., exclusive breastfeeding rates drop from 83.2% to 62.6% in the first week postpartum. Step 10 of the Baby-Friendly Hospital Initiative (BFHI) outlines the importance of care coordination upon discharge to ensure outpatient lactation support.

Objectives: This project aimed to determine whether implementation of a proactive lactation care workflow affects the percentage of breastfeeding dyads receiving lactation support in the early postpartum period. Staff confidence with using the workflow was assessed using a Likert-scale survey.

Methods: Infants were identified for inclusion based on whether they were born at the medical center and had an in-network primary care provider. A smart phrase integrated into the patient after-visit summary was used by staff lactation consultants to document outpatient lactation supports. Primary care provider notes were reviewed to determine whether lactation supports were received within 7 days postpartum.

Results: 49 infants met inclusion criteria in the reactive group and 20 infants met inclusion criteria in the proactive group. Half of the infants in the proactive group received outpatient lactation care within 7 days postpartum. Primary care providers proved to be the most utilized form of outpatient lactation care.

Discussion: IBCLC staff reported an increase in confidence in using the proactive workflow. Despite efforts to connect families with lactation resources, further research is needed to determine if families are receiving support in the early postpartum period.

Document Type


Available for download on Thursday, April 30, 2026