PREREQUISITES AND PLACEMENT IN THE CURRICULUM:  Completion of the following core clerkships: OB/Gyn and Pediatrics. Special circumstances (medical student with previous breastfeeding experience, student with previous doula experience, etc) will be evaluated on a case-by-case basis.

PURPOSE: 
Although breastfeeding is supported by the medical literature as the preferred and normal way to feed the human infant, clinical practices continue to exist that serve as barriers to exclusive breastfeeding. These include deficits in prenatal education, practices in L&D and the newborn nursery that undermine breastfeeding (absence of baby friendly practices), and lack of effective follow up care from knowledgeable clinicians. Evidence has shown that implementing physician education has positive clinical outcomes on breastfeeding exclusivity and duration.

The purpose of this elective is to improve breastfeeding knowledge and attitudes of medical students, especially those interested in providing primary care to mothers and infants. Upon successful completion of this elective, the student will become comfortable with promoting breastfeeding, gain a basic understanding of the principles of lactation, learn how to manage common lactation problems, and learn ways to implement baby friendly practices into their medical practice. The student will also obtain a certificate of completion that allows them to serve as a lactation educator at UIH and possibly other sites in the future. Additionally, completion of the Wellstart Self-Study Modules and a score of 80% or greater on the final exam meets the Baby-Friendly USA, Inc. criteria for 3 hours of breastfeeding management.

OBJECTIVES:

1.   List the health risks of not breastfeeding for children, mothers, families, and society.
2.   Describe the anatomy, physiology, and endocrinology of milk production and secretion.
3.   Explain the biochemical and immunologic properties of human milk.
4.   Identify the demographic associations of ethnicity, maternal education, and socioeconomic status on breastfeeding initiation and duration.
5.   Identify national and/or international goals for breastfeeding rates and goals for      breastfeeding practices, as appropriate.
6.   Counsel a breastfeeding mother about basic nutritional needs for herself and her child.
7.   Describe and recommended evidence-based practices for maternity care providers that have been shown to result in increased initiation and duration of breastfeeding.
8.   Identify factors that contribute to parental decision making about breastfeeding.
9.   Recognize the effects of labor and delivery interventions on initiation of breastfeeding.
10.  Be able to facilitate and assist with the first feeding immediately after delivery.
11.  Recognize correct attachment and effective suckling at the breast.
12.  Counsel mothers about establishing and maintaining milk supply during separation due to illness or return to study or employment.
13.  Discuss causes, prevention, and management of common breastfeeding problems (e.g., sore nipples, low milk supply, poor weight gain, and jaundice).
14.  Describe appropriate timing, introduction, and selection of complementary foods.
15.  Recognize that most infants, even those with special healthcare needs, can breastfeed.
16.  Understand normal growth patterns for breastfed babies.
17.  Coordinate services with, and provide appropriate referral to, other professionals, lay persons, and community groups.

INSTRUCTIONAL FEATURES:

L&D-student will spend 2 days/wk working with midwives and OB’s assisting in deliveries. The impact of birthing practices on breastfeeding will be emphasized.

Inpatient rounds-student will spend 1 ½ days/wk participating in lactation rounds with the lactation consultant and going over case studies from the Wellstart Learning Module. 


Field experience-1 day/wk will be devoted to community experiences. Student will choose 4-8 community experiences that pertain to breastfeeding. Opportunities include but are not limited to; Illinois Maternal and Child Health Coalition, WIC office, private lactation consultations, Mother’s Milk Club, prenatal classes, UIC baby-friendly meeting, Le Leche League, and various lactation meetings and support groups at surrounding hospitals. Opportunities will expand as more contacts are established.
It is recommended that the student has access to own car.

Independent study - student will have 1 afternoon/wk of protected study time that can be used for completing the Wellstart Learning Module with accompanying case studies and to research a topic in breastfeeding. They will present a breastfeeding topic of their choosing during a designated meeting/lecture. (Chicago Breastfeeding Task Force monthly meeting, M3 pediatric clerkship lecture, M3 OB clerkship lecture, M3 family medicine clerkship lecture, and/or other designated meetings/lectures as determined by participating faculty.) Additionally, the student will be assigned readings relevant to breastfeeding medicine and evidence based practices. 


Weekly lecture- pertains to the field of pediatrics and is attended by all students who are taking an elective within the pediatrics department. 1 hr in duration each week.


*Mandatory meetings include:  The Lactation Club @ UIH held weekly and Chicago Breastfeeding Task Force meeting held monthly @ Stroger.

Pediatrics E&M Conference: This is an educational enhancement specifically designed for the M4 student in Pediatrics - a case-based learning session designed to focus on issues that you likely will face as residents. All students in pediatrics elective will gather at 8am every Thursday of their rotation in 1208 CSB (12th floor conference room).

ASSESSMENT:

1.  Satisfactory completion of H&P and/or progress notes on all mothers and infants seen in the mother-baby unit.
2.  Satisfactory presentation of H&P's (two for a 2 week elective and four for a 4 week elective) to one or more faculty involved in the elective.
3.  Active participation in inpatient rounds.
4.  Completion of 4 community experiences for a 2 wk elective and 8 community experiences for a 4 wk elective.
5.  The student will maintain a logbook of all community field experiences. Signatures from staff will be required to verify attendance at each of these experiences.
6.  Completion of Wellstart International Program Lactation Management Self-Study Module I-III and accompanying examination.
7.  Completion of (7) case studies in the Wellstart Lactation Module.
8.  Presentation of topic related to breastfeeding at resident/medical student lecture or Chicago Breastfeeding Task-Force meeting.
9.  Completion of pre and post test (not counted toward grade but required).

ADMINISTRATIVE:

Program Number: 
ELEC 265
Location:
UIH and Children's Hospital of the University of Illinois
Program Director:
Michelle Barnes, MD  Email: mbarnes@uic.edu
Coordinator:
Christopher Hansen  Email: chanse6@uic.edu
Telephone:
312-996-1125
Duration:
2 weeks
Night Call:
No
Weekends:
No
Students Accepted:
Min. 1   Max. 1
Housestaff Used as Faculty:
No
Lectures/Conferences/Faculty Contact: 
12
Laboratory: 
8 (field experience)
Independent Study:
  4
Outpatient: 
0
Inpatient: 
28
Total Hours/Week:
  40

INFORMATION: To inquire about scheduling this elective, please contact Christopher Hansen, Student Programs Coordinator at chanse6@uic.edu

Approved: 7/17/13