Breastfeeding Services and Supplies

The Women’s Preventive Services Initiative recommends comprehensive lactation support services (including consultation; counseling; education by clinicians and peer support services; and breastfeeding equipment and supplies) during the antenatal, perinatal, and postpartum periods to optimize the successful initiation and maintenance of breastfeeding.

Breastfeeding equipment and supplies include, but are not limited to, double electric breast pumps (including pump parts and maintenance) and breast milk storage supplies. Access to double electric pumps should be a priority to optimize breastfeeding and should not be predicated on prior failure of a manual pump. Breastfeeding equipment may also include equipment and supplies as clinically indicated to support dyads with breastfeeding difficulties and those who need additional services.

Lactation support services include consultation, counseling and psychosocial support, education, breastfeeding equipment and supplies. Lactation support services should be delivered and provided across the antenatal, perinatal, and postpartum periods to ensure successful preparation, initiation, and continuation of breastfeeding. Lactation support services should be respectful, appropriately patient centered, culturally and linguistically competent, and sensitive to those who are having difficulty with breastfeeding, regardless of the cause. Clinical lactation professionals providing clinical care include, but are not limited to, licensed lactation consultants, the IBCLC®, certified midwives, certified nurse-midwives, certified professional midwives, nurses, physician assistants, nurse practitioners, and physicians. Lactation personnel providing counseling, education or peer support include lactation counselors/breastfeeding educators and peer supporters. Clinical trials of interventions including at least 5 in-person visits across antenatal, perinatal, and postpartum periods to promote and support breastfeeding showed benefit, but more visits may be required, including psychosocial counseling for breastfeeding.

• Studies of the effectiveness of methods to initiate and maintain breastfeeding that build on successful interventions in the existing body of research (eg, studies of psychosocial support; delivery in group settings).
• Studies of factors related to breastfeeding adoption and how to address them in clinical practice including the effects of perinatal mood disorders (depression, anxiety, other mental health conditions); impact of pregnancy, birth, and neonatal complications; effects of social determinants, including the impact of systemic racism; and workplace barriers to breastfeeding.
• Studies to determine the most effective frequency and methods of follow-up to facilitate breastfeeding continuation over time.
• Research on harms of interventions to initiate and maintain breastfeeding including anxiety, stigma, reduced confidence, and financial impact, among others.