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Abstract

A retrospective review of data from a lactation program’s productivity reports at a large tertiary care teaching hospital (4200 births per year) measured actual hours worked by international board certified lactation consultants (IBCLCs) over a 2-year period, allocated the hours to their respective activities, and developed ratios for optimal IBCLC staffing for each component of service delivered. Optimal IBCLC staffing was calculated as follows: mother/baby inpatient requires 1 full-time equivalent (FTE) per 783 breastfeeding couplets; neonatal intensive care unit (NICU) inpatient requires 1 FTE per 235 infant admits; mother/baby outpatient requires 1 FTE per 1292 breastfeeding couplets discharged; NICU outpatient requires 1 FTE per 818 breastfeeding infants discharged; telephone follow-up requires 1 FTE per 3915 breastfeeding couplets or infants discharged; education requires 0.1 FTE per 1000 deliveries; program development/administration requires 0.1 FTE per 1000 deliveries; and research requires 0.1 to 0.2 FTE total. Using the formulas provided, IBCLC staffing can be calculated for desired services based on patient numbers.

Keywords

lactation program(s)staffing IBCLC staffing

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References

Gartner LM , Morton J , Lawrence RA , et al. Breastfeeding and the use of human milk. Pediatrics. 2005;115: 496-506.

World Health Organization . The Global Strategy for Infant and Young Child Feeding. Geneva: World Health Organization; 2003.

EU Project on Promotion of Breastfeeding in Europe . Protection, Promotion and Support of Breastfeeding in Europe: A Blueprint for Action. Luxembourg: European Commission, Directorate Public Health and Risk Assessment; 2004. Available at: http://europa.eu.int/comm/health/ph_projects/2002/promotion/promotion_2002_18_en.htm.

Centers for Disease Control and Prevention . Breastfeeding: Data and Statistics - Results From the 2004 National Immunization Survey. Available at: http://www.cdc.gov/breastfeeding/data/NIS_data/data_2004.htm.

Dewey KG , Nommsen-Rivers LA , Heinig MJ , Cohen RJ. Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics. 2003;112(3 Pt 1): 607-619.

Riordan J. Breastfeeding and Human Lactation. 3rd ed. Sudbury, Mass: Jones and Bartlett; 2005.

Lukac M , Riley JK , Humphrey AD. How to integrate a lactation consultant in an outpatient clinic environment. J Hum Lact. 2006;22: 99-103.

Winikoff B , Laukaran VH , Myers D , Stone R. Dynamics of infant feeding: mothers, professionals, and the institutional context in a large urban hospital. Pediatrics. 1986;77: 357-365.

Winikoff B , Myers D , Laukaran VH , Stone R. Overcoming obstacles to breast-feeding in a large municipal hospital: applications of lessons learned. Pediatrics. 1987;80: 423-433.

10.

Hinson P. A lactation clinic offering in-hospital and outpatient care: key business concerns that impact clinical care. In: Auerbach KG , ed. Current Issues in Clinical Lactation. Sudbury, Mass: Jones and Bartlett; 2000:43-47.

11.

American Academy of Pediatrics . Clinical practice guideline: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2006;114: 297-316.

12.

International Lactation Consultant Association . Clinical Guidelines for the Establishment of Exclusive Breastfeeding. Washington, DC: US Department of Health and Human Services, Maternal/Child Health Bureau; 2005.

13.

Shealy KR , Li R , Benton-Davis S , Grummer-Strawn LM. The CDC Guide to Breastfeeding Interventions. Atlanta, Ga: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2005.

14.

United Nations Children’s Fund . The Global Criteria for the WHO/UNICEF Baby-Friendly Hospital Initiative. Geneva: World Health Organization; 1991.

15.

Bonuck KA , Trombley M , Freeman K , McKee D. Randomized, controlled trial of a prenatal and postnatal lactation consultant intervention on duration and intensity of breastfeeding up to 12 months. Pediatrics. 2005;116: 1413-1426.

16.

Rishel PE , Sweeney P. Comparison of breastfeeding rates among women delivering infants in military treatment facilities with and without lactation consultants. Mil Med. 2005;170: 435-438.

17.

Spear HJ. Breastfeeding behaviors and experiences of adolescent mothers. Am J Matern Child Nurs. 2006;31: 106-113.

18.

Chu KH , Tai CJ , Chien LY. The relationship between in-hospital breastfeeding rates and hospital type [in Chinese]. Hu Li Za Zhi. 2005;52: 40-48.

19.

Merten S , Dratva J , Ackermann-Liebrich U. Do baby-friendly hospitals influence breastfeeding duration on a national level? Pediatrics. 2005;116: e702-e708.

20.

Giovannini M , Riva E , Banderali G , Salvioni M , Radaelli G , Agostoni C. Exclusive versus predominant breastfeeding in Italian maternity wards and feeding practices through the first year of life. J Hum Lact. 2005;21: 259-265.

Staffing for Hospital Lactation Programs: Recommendations From a Tertiary Care Teaching Hospital

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