Background: Breastfeeding is good for both parents and babies. Although most families start out breastfeeding, many stop earlier than they want to, for many reasons. For instance, some do not get good advice from their healthcare team. Others have problems with pain or infections. Some have trouble making as much milk as their baby needs. Some babies have trouble attaching well to the breast to get milk. For parents who go back to work or school, it can be hard to pump milk and bring it home for the baby. For many of these problems, we do not know which solutions might work best. For families to meet their infant feeding goals, we need comparative effectiveness research studies that provide parents and providers with the information that they need to choose treatments that work for common breastfeeding problems.
We also do not know how to define “best.” That is, most studies measure how much breast milk the baby gets; fewer ask parents what their ideal strategy, situation, or outcome would be. We need patient-centered outcomes research that measures the effect of different treatment strategies on the outcomes that matter to families.
Proposed Solution to the Problem: The Academy of Breastfeeding Medicine (ABM) is an international group of medical doctors dedicated to educating and empowering health professionals to support and manage breastfeeding, lactation, and human milk feeding. In this project, ABM will bring together families, community members, and health team members to explore what breastfeeding challenges and outcomes are most important to them. It will begin with small group meetings, with a convening to be held in Baltimore, Maryland in September of 2022.
Objectives: The long-term goal is to make breastfeeding easier by finding out what works best to treat common problems. This project will bring together families, community members, and health team members to accomplish three goals:
- Choose important comparative effectiveness research questions that will help families work through challenges and breastfeed as long as they desire
- Define patient-centered outcomes that measure successful breastfeeding, as defined by families
- Share these findings so that future research focuses on the questions that matter most to families
Activities: The project team will connect with families, communities, and health team members in several ways, wrapping up with a meeting in Baltimore, Maryland, in September 2022. The meeting will occur just before ABM’s international meeting. To engage local families of color, ABM will partner with Reaching Our Sisters Everywhere (ROSE), a community-based organization that works to normalize breastfeeding by providing resources and networking opportunities for individuals and communities, to bring together Black families in the DC/Maryland/Virginia area to learn about what breastfeeding questions and outcomes matter most to them. To complement these perspectives, ABM will develop and share an online survey of families, lactation support providers, and health team members and share findings from these conversations and surveys at the meeting.
During the meeting, small groups will brainstorm comparative effectiveness research questions and patient-centered outcomes that measure successful breastfeeding. The project team will then share the top 10-15 concepts and measures in an online survey to allow stakeholders to rank the most important areas for future research.
Projected Outcomes and Outputs: ABM will identify five to seven important topics for future research, as well as three to five important patient-centered outcome measures of successful breastfeeding. ABM will also create a road map for including families and community members in planning comparative effectiveness research on infant feeding. In the one to two years after the project, the project team will publish results in the peer-reviewed literature and create a diverse family and community advisory board for ABM to ensure that all families get high-quality breastfeeding care. Long term, ABM will work with its members and community partners to conduct comparative effectiveness research that will help families make decisions about managing breastfeeding problems.
Patient and Stakeholder Engagement Plan: ABM designed this project with ROSE. ABM will compensate patient partners for their time and engage through in-person meetings and online surveys.
Project Collaborators: ABM will engage families and health team members through partnerships with multiple organizations, including ROSE, MomsRising, the American Academy of Pediatrics, Dr. Milk, the American College of Obstetricians and Gynecologists, and the Baby Friendly Hospital Initiative.
*All proposed projects, including requested budgets and project periods, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award contract.