The Breastfeeding and Lactation Medicine Center’s mission is to make BMC Health System a breastfeeding-supportive and knowledgeable institution that supports all BMC patients in meeting their infant feeding intentions.
Our Work
We are addressing our patients’ needs through innovation, research, advocacy, training and expanding clinical services for lactation, including:
- Establishing long-needed outpatient clinical breastfeeding services. We founded the first breastfeeding medicine clinic at BMC in December 2021 with two providers, and as of September 2022 had served over 200 mother–baby dyads. We plan to expand providers/sessions and add an e-consult service to meet demand as well as increase collaboration across various departments to support additional lactation resources.
- Increasing lactation education and training. We manage a medical student breastfeeding elective and have obstetrics and family medicine residents attend clinic sessions. With expanded clinical sessions, we plan to host more learners, particularly community members and staff from under-represented groups similar to our patient population.
- Conducting equity-focused research and quality monitoring. We monitor breastfeeding rates by race and other demographic and clinical characteristics in order to direct interventions where they are needed most. The Center brings investigators together to foster collaboration on breastfeeding research that impacts our patients, our community, and beyond.
- Advocating for lactating families at BMC and beyond. In addition to continuing to ensure Baby-Friendly care at BMC and access to lactation support, we are connecting with colleagues and organizations across Massachusetts to support lactating families across the state. Recent work includes presenting to our colleagues about non-gestational lactating parents and writing a policy on management of antenatally-expressed breastmilk in the hospital.
Our Team
Resources for Patients
Please reach out to your BMC provider if you are looking for clinical support with breastfeeding/chestfeeding concerns.
Breastfeeding Medicine Clinic
The BMC Breastfeeding Medicine Clinic cares for lactating patients and their infants with complex breastfeeding problems that require medical management.
BMC Health System patients can be referred to the clinic by a BMC provider or lactation consultant.
Lactation consultants outside of BMC can contact the clinic directly to place referrals.
The clinic is located physically within the BMC Obstetrics & Gynecology outpatient clinic and offers telemedicine/virtual as well as in-person appointments.
Boston Baby Cafés
Free, drop-in breastfeeding support, in-person or online
Breastfeeding can be hard. “Baby cafés” are free drop-in sessions that offer breastfeeding support from trained lactation professionals and information for new and soon-to-be mothers in the community.
A baby café is a place where you can join a relaxed, informal, and safe group environment for help, if you are:
- Pregnant and interested in breastfeeding
- Already breastfeeding and want to meet other moms
- Seeking answers to your breastfeeding questions
For in-person events, light snacks are served. Virtual meetups are also available. No appointment or registration is needed. Partners and young siblings are welcome!
In the Boston area, Baby Cafés are supported by the Vital Village Breastfeeding Coalition. For more information, email BostonBreastfeeding@bmc.org.
Breastfeeding Task Force
The Breastfeeding Task Force brings together staff and providers from throughout BMC and the Boston HealthNet Community Health Centers (CHCs) to address issues of patient care, equity, and employee protections around lactation.
We invite departmental champions and other stakeholders to join these quarterly meetings in order to ensure sharing of best practices and cross-institution collaboration.
Please contact Katherine.Standish@bmc.org for details.
Resources for Providers
Referring and Scheduling
- From within BMC: In Epic, choose “Referral to Breastfeeding Clinic.” Choose indication, or select “other” (use “other” for prenatal consults).
- From a BMC HealthNet Community Health Center: Use BMC Epic (or contact a colleague who has an Epic login) and send a referral as described above.
- From outside the BMC Health System: Instruct your patient to call the OB/GYN clinic at 617.414.2000.
Please include both the birthing parent (mother)’s and baby’s information in the referral (MRN is ideal). Remind your patients that baby must attend with the birthing parent, unless baby is still in the hospital.
E-Consults
An 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, for example ED, surgery, ICU, or adult primary care) might consider placing an e-consult.
Common Reasons for E-Consult
Common reasons for e-consult include:
- Breast mass or other breast pathology in lactating/pregnant patient
- Imaging contrast and other breastmilk safety questions
- Mastitis spectrum, plugged ducts, or other nipple/breast infection
- Maternal illness or hospitalization
- Maternal medication
- Nipple/breast pain or engorgement
- Prenatal consults for people with comorbidities such as diabetes, PCOS, history of breast surgery, chronic medical conditions, substance use disorder, or history of significant lactation problems with prior children
- Other issues relating to the mammary gland/secretion in pregnant/lactating patient
Milk production issues are not usually appropriate for e-consult and in most cases are best addressed in a breastfeeding clinic or telehealth appointment.
To Place the Order
Order “e-consult to OB/GYN: Breastfeeding” in Epic.
It is best to do so while the patient is with you, as a patient’s 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 an in-person encounter with patient (it could be placed during 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.
Educational Resources
- Academy of Breastfeeding Medicine: Protocols: Thirty-four evidence-based clinical protocols and eight statements from ABM
- Dr. Jack Newman’s International Breastfeeding Centre: Information sheets and videos with management suggestions for common lactation problems
- Institute for the Advancement of Breastfeeding and Lactation Education (IABLE): Resources and on-demand webinars for health professional continuing education in lactation/breastfeeding–related clinical topics
- Stanford Medicine: Getting Started with Breastfeeding: Overview, assessment, and discussion of common problems, with videos