Journal of Human Lactation最新文献

{"title":"Role of Silver Nipple Protectors in Treating Nipple Trauma: A Non-Randomized Comparative Trial.","authors":"Maya Nakamura, Hiroyuki Sugimori, Yoko Asaka, Yasuhiko Ebina","doi":"10.1177/08903344251342564","DOIUrl":"https://doi.org/10.1177/08903344251342564","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding is crucial for infant health, but nipple trauma remains a common challenge. In particular, nipple trauma can lead to the onset of mastitis and psychological distress for mothers. Silver nipple protectors have been suggested to alleviate this issue, but detailed research is needed.</p><p><strong>Research aim: </strong>This study aims to clarify the effectiveness of silver nipple protectors in treating nipple trauma in Japanese women.</p><p><strong>Methods: </strong>A non-randomized comparative trial compared 47 participants (94 nipples) using silver nipple protectors with a control group of 50 participants (100 nipples) from historical data. The assessment included chronological changes in nipple condition, level of nipple pain, and safety, among other factors. Data collection spanned from 2023 to 2024.</p><p><strong>Results: </strong>The group using silver protectors experienced fewer instances of severe nipple trauma and showed a higher frequency of healing patterns. Many of these patterns involved a transition from mild erythema or swelling toward a healing state. Specifically, the level of nipple pain on the 4th postpartum day was significantly lower. No safety issues from the use of silver protectors were noted.</p><p><strong>Conclusion: </strong>This study suggests that silver nipple protectors may prevent the occurrence of severe nipple trauma and are safe and beneficial for Japanese women. Future research should focus on the mechanism of silver protectors, their long-term effects, regional differences, practical challenges for implementation, and comparisons with other common treatments.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251342564"},"PeriodicalIF":2.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"About Research Intervention Study.","authors":"Jung Eun Lee","doi":"10.1177/08903344251345706","DOIUrl":"https://doi.org/10.1177/08903344251345706","url":null,"abstract":"","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251345706"},"PeriodicalIF":2.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Feeding and Swallowing Function in Breastfeeding Infants Via Fiberoptic Endoscopic Evaluation of Swallowing (FEES).","authors":"Tina M Tan","doi":"10.1177/08903344251342216","DOIUrl":"https://doi.org/10.1177/08903344251342216","url":null,"abstract":"<p><p>Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is a procedure utilized by speech language pathologists to evaluate swallowing function in infants and children. FEES has been found to be a valid and reliable procedure for the assessment of pediatric dysphagia. It is the only option for instrumental examination of swallowing in breastfeeding infants. This article describes the differences between the more common videofluoroscopic swallow study (VFSS) and FEES, as well as management of interprofessional collaboration.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251342216"},"PeriodicalIF":2.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons for Breastfeeding Avoidance: A Multicenter Insight in Mothers With Systemic Lupus Erythematosus.","authors":"Massimo Radin, Silvia G Foddai, Karen Schreiber, Irene Cecchi, Flavio Signorelli, Guilherme de Jesús, Kuniyuki Aso, Michihito Kono, Maria Letizia Urban, Beatrice Bacco, Silvia Gallo Cassarino, Luca Lo Sardo, Marta Arbrile, Alice Barinotti, Ignacio Gómez García, María Isabel Quaglia, Yohana Tissera, Fiammetta Gervasoni, María Ángeles Aguirre-Zamorano, Paula Alba, Chiara Benedetto, Tatsuya Atsumi, Olga Amengual, Giacomo Emmi, Danieli Andrade, Luca Marozio, Dario Roccatello, Savino Sciascia","doi":"10.1177/08903344251338242","DOIUrl":"https://doi.org/10.1177/08903344251338242","url":null,"abstract":"<p><strong>Background: </strong>Limited research exists on breastfeeding among women with systemic lupus erythematosus, despite known benefits of human milk.</p><p><strong>Research aim: </strong>To investigate reasons for breastfeeding avoidance among postpartum women with systemic lupus erythematosus.</p><p><strong>Methods: </strong>This is a descriptive study, conducted in January 2023, combining retrospective pregnancy outcome data collection with a structured telephone questionnaire.</p><p><strong>Results: </strong>Almost half of respondents (<i>n</i> = 22; 54.5%) experienced a disease flare within 24 months post-delivery. Reasons given by participants for breastfeeding avoidance included healthcare professional advice (<i>n</i> = 8; 36.4%), fear of medication harm (<i>n</i> = 5; 22.7%), and maternal/neonatal complications (<i>n</i> = 10; 45%). Most participants (<i>n</i> = 21; 95.5%) expressed a willingness to breastfeed if possible.</p><p><strong>Conclusion: </strong>Breastfeeding rates and breastfeeding specific care could be enhanced for patients with systemic lupus erythematosus through patient networks and appropriate practitioner education.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251338242"},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Relationship Between Workplace Breastfeeding Support and Employment Guilt in Working Mothers.","authors":"Hülya Türkmen, Nazan Tuna Oran, Serpil Gürol, Çiğdem Gök, Kübra Aydın İnce","doi":"10.1177/08903344251337391","DOIUrl":"https://doi.org/10.1177/08903344251337391","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mothers working in organizations where breastfeeding support is inadequate may experience employment guilt, which refers to the feelings of conflict or distress related to balancing work responsibilities with breastfeeding and may eventually feel the need to stop breastfeeding.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research aim: &lt;/strong&gt;This study aimed to evaluate the relationship between workplace breastfeeding support and employment guilt among working mothers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study (&lt;i&gt;N&lt;/i&gt; = 147) was conducted with mothers who were both breastfeeding and working in Türkiye between 1 December 2022 and 31 May 2023. Participants were recruited using an online survey distributed via social networking websites and mobile communication applications. The data were collected using a Personal Information Form, the Workplace Breastfeeding Support Scale (WBSS), and the Maternal Employment Guilt Scale (MEGS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The primary outcome measure was the relationship between workplace breastfeeding support and employment guilt. As workplace breastfeeding support decreased, the employment guilt levels of the participants significantly increased (&lt;i&gt;t&lt;/i&gt; = -5.389; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). The secondary measures included the sociodemographic, obstetric, workplace-related, and breastfeeding concern-related characteristics of the participants. As satisfaction with breastfeeding support in the workplace increased, we found higher income level, lighter heavy workload (&lt;i&gt;t&lt;/i&gt; = 2.360; &lt;i&gt;p&lt;/i&gt; = 0.016), less report of breastfeeding leave from the workplace (&lt;i&gt;t&lt;/i&gt; = -2.668; &lt;i&gt;p&lt;/i&gt; = 0.009), and more anxiety due to unsuitable conditions for expressing milk and breastfeeding at work (&lt;i&gt;t&lt;/i&gt; = 5.052; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Employment guilt total scores were higher in individuals with an education level of high school and below (&lt;i&gt;t&lt;/i&gt; = -3.155; &lt;i&gt;p&lt;/i&gt; = 0.002), private sector employment (&lt;i&gt;t&lt;/i&gt; = -2.785; &lt;i&gt;p&lt;/i&gt; = 0.006), and less leave after childbirth (&lt;i&gt;t&lt;/i&gt; = -3.042; &lt;i&gt;p&lt;/i&gt; = 0.003). They also reported more worries about not being able to take as much unpaid leave as desired due to economic reasons (&lt;i&gt;t&lt;/i&gt; = 2.282; &lt;i&gt;p&lt;/i&gt; = 0.024), unsuitable conditions for expressing milk and breastfeeding at work (&lt;i&gt;t&lt;/i&gt; = -2.058; &lt;i&gt;p&lt;/i&gt; = 0.041), and infant care and nutrition when returning to work (&lt;i&gt;t&lt;/i&gt; = -1.990; &lt;i&gt;p&lt;/i&gt; = 0.049).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Inadequate workplace support for breastfeeding can hinder successful breastfeeding, resulting in employment guilt among mothers. Organizations choosing to provide good breastfeeding support might consider improving leave policies, in particular in relation to breastfeeding. They might also consider support for childcare and appropriate facilities for expressing milk. Healthcare professionals could help inform and increase awareness among mothers who consider returning to work after childbirth about the necessity of breast","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251337391"},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Mastitis in the Hospital Setting: An International Audit Study.","authors":"Lisa H Amir, Kelly P Coca, Marcia Juliana Mello Da Silva, Marcia Massumi Okada, Güliz Onat Demir, Busra Duran, Süleyman Kargin, Kübra Güllü, Lara Delic, Magdalena Dragicevic, Maria Rosenbauer, Mee-Har Michelle Ngan, Wirawan Jeong, Moni Rani Saha, Irena Zakarija-Grkovic","doi":"10.1177/08903344251338245","DOIUrl":"https://doi.org/10.1177/08903344251338245","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding is strongly promoted by health authorities, but there is little research on whether health professionals provide best-practice care for women experiencing mastitis/breast abscess.</p><p><strong>Research aim: </strong>To explore management of mastitis/breast abscess in hospital emergency departments (EDs).</p><p><strong>Methods: </strong>Medical records of patients presented to hospital EDs in Australia, Brazil, Croatia, Germany and Türkiye with lactational mastitis/abscess between 2017 and 2023 were reviewed. Demographic and clinical information (including symptoms, management, and investigations) was extracted and analyzed.</p><p><strong>Results: </strong>A total of 580 women with mastitis/breast abscess (646 Emergency Department presentations, mostly in the first 8 weeks postpartum) were identified during the study period. The majority of the women had symptoms of mastitis/breast abscess (breast pain, lump, and inflammation) for > 48 hours before presenting in the Emergency Department. In Australia, culture and sensitivity testing of milk was available for 44% (146/331) of presentations. <i>S. aureus</i> was the most common bacteria isolated (33%, <i>n</i> = 48), of which 6% (<i>n</i> = 3) were methicillin-resistant. The use of diagnostic ultrasound varied between sites, from 5% (3/65) in Croatia to 82% (40/49) in Germany. Breast abscesses were mostly managed by ultrasound-guided aspiration in Australia, whereas incision and drainage was standard care in Germany. Amoxicillin/clavulanate was most commonly prescribed in Croatia (57%, 31/54) and Türkiye (69%, 28/42), whereas flucloxacillin, cephalexin, or cefuroxime was primarily used in Australia (86%, 272/322), Brazil (62%, 66/106), or Germany (80%, 33/41), respectively.</p><p><strong>Conclusions: </strong>The management of mastitis/breast abscess varied considerably between countries. International evidence-based guidelines for the management of lactational mastitis are urgently needed.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251338245"},"PeriodicalIF":2.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Adherence to Breastfeeding Recommendations in Mothers Treated With Antirheumatic and Antidepressant Medications.","authors":"Essi Whaites Heinonen, Diana L Johnson, Alec Todd, Christina D Chambers","doi":"10.1177/08903344251337384","DOIUrl":"https://doi.org/10.1177/08903344251337384","url":null,"abstract":"<p><strong>Background: </strong>Exclusive breastfeeding for 6 months is recommended, but breastfeeding safety data is insufficient for several medications.</p><p><strong>Aim: </strong>To determine if mothers treated with chronic medications are less likely to breastfeed.</p><p><strong>Methods: </strong>For this secondary analysis, 6383 pregnant women in the MotherToBaby cohort recruited from the United States and Canada between 2010 and 2022 were included. Participants treated with antirheumatic medications (ARM), selective serotonin reuptake inhibitors (SSRIs), and asthma medications during pregnancy were divided into two groups based on their medication use: continuers and discontinuers. Breastfeeding initiation, supplementation with commercial milk formula, and discontinuation of breastfeeding before 6 months were compared between those exposed and unexposed to medication use. Adjusted risk and hazard ratios (aRR, aHR) and 95% Confidence Intervals (CI) were calculated with modified Poisson and Cox regressions adjusted for year, parity, socioeconomic status, body mass index, smoking, illicit drug use, race and ethnicity.</p><p><strong>Results: </strong>The sample included 799 (12.5%) continuers and 475 (7.4%) discontinuers of ARM, 293 continuers (4.6%) and 63 (1.0%) discontinuers of SSRIs, and 217 (3.4%) continuers and 97 (1.5%) discontinuers of asthma medications. There were 4,439 (69.6%) participants who were unexposed to the study medications. Both ARM continuers and discontinuers were more likely to not breastfeed (aRRs 95% CI: 3.92 [3.03, 5.07] and 3.08 [2.19, 4.33]), to supplement (aRRs 95% CI: 1.12 [1.01, 1.26] and 1.25 [1.10, 1.43]) and stop breastfeeding before 6 months (aHRs 95% CI: 1.72 [1.29, 2.31] and 1.41 [0.92, 2.15]). SSRI continuers were more likely to supplement (aRR 95% CI: 1.26 [1.08, 1.47]).</p><p><strong>Conclusion: </strong>Participants treated with chronic medications, primarily ARMs, were less likely to breastfeed. Targeted lactation support for mothers with chronic illnesses is recommended along with development of breastfeeding safety data for these medications.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251337384"},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural Interpretations of Patients and Employees in an Organization Certified Through the Baby-Friendly Hospital Initiative: A Focused Ethnographic Study.","authors":"Keri Durocher, Kimberley T Jackson, Richard Booth, Panagiota Tryphonopoulos","doi":"10.1177/08903344251337375","DOIUrl":"https://doi.org/10.1177/08903344251337375","url":null,"abstract":"<p><strong>Background: </strong>When organizations are certified through the Baby-Friendly Hospital Initiative, health care providers implement various policies that are intended to support long-term and exclusive breastfeeding. Despite the availability of evidence to support these policies, research findings are inconsistent in whether these goals are met. Exploring cultural interpretations through the lens of individuals within these organizations may reveal new evidence of breastfeeding experiences and needed support.</p><p><strong>Research aim: </strong>To explore organizational cultural aspects of a Baby-Friendly certified organization from the perspective of patients and employees.</p><p><strong>Method: </strong>Researchers implemented a focused ethnography design in one certified organization in Ontario, Canada. One-to-one, semi-structured interviews were performed with two participant groups, including 10 patients and eight employees within intrapartum and postpartum care areas between 2023-2024. An inductive data analysis approach followed Roper and Shapira's framework, including (1) coding for descriptive labels, (2) sorting for patterns, (3) identification of outliers, (4) generalizing with constructs and theories, and (5) memoing.</p><p><strong>Results: </strong>Five core themes emerged from the data, including (1) knowledge is power, (2) community of support, (3) contextual considerations, (4) environment for breastfeeding, and (5) patient factors. Through narrative descriptions, these interrelated themes exhibit how patients and employees have experienced or provided care that is consistent with breastfeeding-supportive policies as well as additional gaps that may not be addressed through policy research.</p><p><strong>Conclusion: </strong>The results provide implications for breastfeeding support within an organization certified through the Baby-Friendly Hospital Initiative. Understanding cultural interpretations of breastfeeding can provide information for future education and interprofessional development.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251337375"},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hispanic Birthing Parents' Experiences With Lactation Support Received In-Hospital: A Quality Improvement Needs Assessment.","authors":"Cati G Brown-Johnson, Samantha M R Kling, Erika A Saliba-Gustafsson, Zakiyah K Williams, Julie Najar, Anna Sophia Lessios, Sonia Rose Harris, Kate A Shaw, Lisa M Goldthwaite, Jonathan G Shaw, Susan D Crowe","doi":"10.1177/08903344251321777","DOIUrl":"10.1177/08903344251321777","url":null,"abstract":"<p><strong>Background: </strong>Human milk-feeding benefits infants and parents. Exclusive human milk (EHM) feeding is recommended for infants younger than 6 months; however, many U.S. infants do not receive this recommendation. Documented disparities exist between White and historically marginalized populations, including Hispanic/Latino parents.Quality Improvement Needs Assessment Aims:To explore Hispanic birthing parents' experiences with human milk-feeding and lactation support as part of a quality improvement needs assessment project, identifying barriers and facilitators during post-birth hospital recovery.</p><p><strong>Methods: </strong>We collected and triangulated three data sources for 37 interviews: (1) in-hospital observations that included opportunistic informal interviews, as well as telephone interviews with (2) English- and Spanish-language-preferring Hispanic birthing parents, and (3) pediatric clinician interviews (via snowball sampling recruitment). In-hospital observations were collected in March 2022 at a Northern California academic medical center. Interviews included birthing parents, physicians, nurses, clinical trainees, administrators, and lactation consultants. Telephone interviews occurred between March and May 2022. We used rapid and thematic analysis, subsequently mapping themes to the socioecological model as an organizing framework.</p><p><strong>Results: </strong>Interpersonal growth opportunities were identified: trust-building through deep listening, better communication between patients and clinicians, particularly at night, and better cross-language understanding. At the hospital level, identified needs included supportive maternity care practices, lactation staff availability, and more perinatal lactation education and resources (e.g., iPads, pumps). Spanish-language-preferring patients reported needing better interpretation services.</p><p><strong>Conclusion: </strong>This quality improvement project identified opportunities for improvement in relationships with patients, clinician communication, and training and physical resources.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"207-219"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Field - Designing Baby-Friendly Hospital Step 2 Training A Hospital Case Study.","authors":"Cassandra P Leahy","doi":"10.1177/08903344251319363","DOIUrl":"10.1177/08903344251319363","url":null,"abstract":"<p><p>Maintaining Baby-Friendly Hospital Initiative (BFHI) standards within a complex healthcare system presents unique challenges. This case study from a regional perinatal center in the northeast United States details the design and implementation of a program to address BFHI Step 2, which requires ongoing competency assessment and team member training to ensure breastfeeding support. The shift of BFHI competencies to continuous professional development introduced logistical challenges, compounded by staff turnover and budget constraints. To address these, the hospital team developed an in-house learning management system tailored to BFHI requirements. The learning management system offered modular, role-specific content, self-paced learning, and interactive assessments, ensuring adaptability, cost-effectiveness, and scalability. Administrative tools supported compliance tracking and reviews of test results, which assisted with timely resolution of knowledge gaps. A hybrid approach, including in-person training and team meetings, further reinforced staff competence. This sustainable, integrated system fostered continuous learning, and enhanced staff preparedness toward supporting breastfeeding families.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"191-195"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}