BMC Breastfeeding Task Force
The Task Force brings together staff and providers from throughout BMC and Boston Healthnet Health Centers to address issues of patient care, equity and employee protections around lactation. We are inviting departmental champions and other stakeholders to join these quarterly meetings in order to ensure sharing of best practices and cross-institution collaboration.
The first meeting will be held virtually on October 3, 2023 at 5:30pm. Please contact katherine.standish@bmc.org for details.
Referring and Scheduling in the Breastfeeding Medicine Clinic
- From within BMC: Use Epic "Referral to Breastfeeding Clinic." Choose indication, or select other (use “other” for prenatal consults)
- From a BMC Healthnet Health Center: Please login to BMC EPIC (or contact a colleague who has EPIC login) and send a referral as described above.
- From outside of the BMC Health System: Please instruct the patient to call the OB/GYN clinic at 617.414.2000.
- Please include both the mother (parent) and baby information in the referral (MRN is ideal). Remind your patients that baby must attend with mother except if baby is still in the hospital.
While your patient is awaiting an appointment, or for less complex issues:
- Boston Breastfeeding Coalition Warmline (7 days /week, 9a-5p), 857-301-8259 or breastfeedingboston@gmail.com, serviced by CLC/Breastfeeding peer counselors who are in training for IBCLC, under supervision of an experienced IBCLC. Their hours serving families on the warmline count toward IBCLC hours.
- For other support groups, lactation consultants and breastfeeding medicine specialists in our area: https://www.zipmilk.org
Placing an E-consult for Breastfeeding Medicine
- E-consult is a provider-to-provider communication for which the specialist does not physically see the patient, but which is billed to insurance. The referring provider should pose a specific question within the e-consult
- Any provider who may be caring for a lactating or pregnant patient or breastfeeding child (whether in a maternity care setting or elsewhere, e.g. ED, surgery, ICU, adult primary care) might consider placing an e-consult.
- Common reasons for e-consult: Maternal medication, imaging contrast and other breastmilk safety questions; Maternal illness or hospitalization; Mastitis spectrum, plugged ducts, other nipple/breast infection; Breast mass or other breast pathology in lactating/pregnant patient; Nipple/breast pain or engorgement; Prenatal consults; other issues relating to the mammary gland/secretion in pregnant/lactating patient. Milk production are not usually appropriate for e-consult and in most cases are best addressed in a breastfeeding clinic/telehealth appointment (see above).
- To place the order: Order “e-consult to ob/gyn: breastfeeding” in Epic. It is best to do so with patient with you as patients’ verbal consent to place the e-consult is required, and the order requests clinical lactation information you may not routinely collect. You do not need to have had an in-person encounter with patient, it could be placed in a phone encounter.
- CHC providers who have BMC Epic access can place e-consults for CHC patients registered at BMC within a telephone note in the patient’s BMC chart.
Education/Resources for Your Patients
For breastfeeding resources to provide to your patients both prenatally and postpartum, see the Patient Resources section.
Breastfeeding Education and Resources for Providers
- Breastfeeding overview, assessment and common problems with videos, from Stanford: https://med.stanford.edu/newborns/professional-education/breastfeeding.html
- Academy of Breastfeeding Medicine has 34 evidence-based clinical protocols, 8 statements
- https://lacted.org/ has many resources and on-demand webinars for health professional continuing education in lactation/breastfeeding related clinical topics.
- Jack Newman’s International Breastfeeding Centre has information sheets and videos with management suggestions for common lactation problems.