Journal of Human Lactation最新文献

{"title":"Maternal Breastfeeding Technique and Early Breastfeeding Problems as Predictors of Exclusive Breastfeeding Duration in the Neonatal Period.","authors":"Sergio Agudelo-Pérez, Maria Jose Maldonado, Paola Diaz Ritter, Mónica Fagua Rodríguez, Cristian Leonardo Vargas Fiallo","doi":"10.1177/08903344261426887","DOIUrl":"10.1177/08903344261426887","url":null,"abstract":"<p><strong>Background: </strong>Globally, exclusive breastfeeding (EBF) rates remain < 50%, with the highest rate of discontinuation occurring within the first 30 days. Early identification of breastfeeding difficulties is essential for timely intervention and extension of the EBF duration.</p><p><strong>Research aim: </strong>To determine the association between early assessment of breastfeeding techniques (within 48 hr postpartum), breastfeeding-related breast complications (e.g., mastitis, fissures, engorgement, and pain), and EBF duration during the first month.</p><p><strong>Method: </strong>This prospective observational study included 120 mother-infant dyads who were followed up for 30 days postpartum. The breastfeeding technique was assessed during rooming-in using the United Nations Children's Fund (UNICEF) Breastfeeding Observation Aid, and breast-related problems were recorded. The EBF duration was tracked through weekly telephone follow-up. Kaplan-Meier survival curves and Cox regression models were used to analyze the associations between breastfeeding technique, breast complications, and EBF duration.</p><p><strong>Results: </strong>At 30 days of age, 43% of the infants were exclusively breastfed. Each additional breastfeeding difficulty was associated with a 17% higher risk of EBF interruption over time (adjusted HR: 1.17; 95% CI [1.08, 1.30]; <i>p</i> < 0.001). Breast-related problems during the first week postpartum, present in 29.2% of dyads, were also linked to early EBF cessation (adjusted HR, 1.77; 95% CI [1.07, 2.92]; <i>p</i> = 0.020).</p><p><strong>Conclusion: </strong>Difficulties in breastfeeding techniques and breast-related problems were significantly associated with a shorter EBF duration in the first month. Structured tools such as the Breastfeeding Observation Aid may support the early identification of at-risk dyads and improve EBF outcomes during the neonatal period.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"535-545"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623200","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":"Maternal or Neonatal Factors at Discharge Predicting Breastfeeding Success at 3 Months of Age Among Small for Gestational Age Neonates.","authors":"Sajad Ahmed Bhat, Tapas Bandyopadhyay, Sushma Nangia","doi":"10.1177/08903344261460717","DOIUrl":"https://doi.org/10.1177/08903344261460717","url":null,"abstract":"<p><strong>Background: </strong>Exclusive breastfeeding (EBF) has been identified as a potentially protective factor for small for gestational age (SGA) neonates, promoting healthier growth patterns as well as improving longterm cardiometabolic health. Two groups of factors are important for successful breastfeeding: neonatal and maternal factors. The neonatal factors can be evaluated using the LATCH tool, and the maternal aspects with the Breastfeeding Self-Efficacy Scale-Short Form (BSEF-SF).</p><p><strong>Research aim: </strong>To determine the EBF rate at discharge, and the barriers and facilitators associated with successful EBF at 3 months of age among SGA neonates.</p><p><strong>Methods: </strong>This was a prospective cohort study of 1095 SGA neonates admitted to a tertiary care hospital. The breastfeeding effectiveness at discharge was assessed using LATCH and BSEF-SF scores. Further, we performed univariate analysis followed by binary logistic regression analysis to identify the factors predicting successful EBF at 3 months of age.</p><p><strong>Results: </strong>All enrolled neonates were exclusively breastfed at discharge; however, at 3 months of age, 660 (73.2%) babies were being exclusively breastfed. The mean (<i>SD</i>) LATCH score and BSES-SF scores were 7.33 (0.88) and 53.45 (3.93), respectively. The LATCH score and BSES-SF scores at discharge were significantly associated with successful EBF at 3 months of postnatal age.</p><p><strong>Conclusions: </strong>Assessment of breastfeeding effectiveness at discharge using LATCH and BSES-SF scores enables early identification of SGA neonates at risk of EBF failure at 3 months postnatal age.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261460717"},"PeriodicalIF":2.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630721","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":"Traditional Approaches Used by First-Time Breastfeeding Mothers in the Prevention and Management of Nipple Pain and Cracks: A Qualitative Study.","authors":"Meltem Aslan, Bengisu Akoglu, Secil Dogan Ekincioglu","doi":"10.1177/08903344261460213","DOIUrl":"https://doi.org/10.1177/08903344261460213","url":null,"abstract":"<p><strong>Background: </strong>Nipple pain and cracks are common in breastfeeding, and while traditional and non-pharmacological methods are used, evidence on their effectiveness is inconsistent. The findings of this study contribute to further health professionals' provision of culturally sensitive, evidence-based care.</p><p><strong>Research aim: </strong>This study explored the experiences and perceptions of first-time breastfeeding mothers regarding traditional approaches used to prevent and manage nipple pain and cracks, as well as their evaluations of the effectiveness of these practices.</p><p><strong>Methods: </strong>A qualitative descriptive phenomenological design was employed. A total of 24 first-time breastfeeding mothers were recruited through snowball sampling, with data collection continuing until saturation. Face-to-face, semi-structured interviews lasting 20-25 minutes were conducted and audio-recorded with consent. Interviews were transcribed verbatim, anonymized (M1-M24), and analyzed using MAXQDA (Version 24), following Braun and Clarke's thematic analysis approach. The study adhered to the Consolidated Criteria for Reporting Qualitative Research, with themes refined through expert input.</p><p><strong>Results: </strong>Analysis identified four main themes and eight subthemes. Nipple pain and cracks were mainly linked to physiological issues during early lactation and mechanical trauma from incorrect latch. Mothers reported physical discomfort and impacts on self-confidence and maternal identity. Traditional remedies like human milk and herbal oils offered temporary relief, while professional counseling and proper technique were essential for effective management.</p><p><strong>Conclusion: </strong>Traditional approaches may provide supportive relief for nipple pain and cracks in first-time breastfeeding mothers, but are insufficient as standalone interventions. Integrating culturally sensitive counseling with evidence-based breastfeeding support is essential to promote effective and sustainable breastfeeding practices.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261460213"},"PeriodicalIF":2.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620354","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":"Insights Into Policies, Stakeholders, and Governance of Breast Pump Provision in Germany.","authors":"Melissa A Theurich, Laura Fischer, Jelica Gencel Augusto, Stephanie Lücke, Regina Ensenauer","doi":"10.1177/08903344261460205","DOIUrl":"https://doi.org/10.1177/08903344261460205","url":null,"abstract":"<p><p>In Germany, low breastfeeding rates are a public health concern, undermining long-term health benefits for both mothers and children. To address this, some public health and workplace policies supporting breastfeeding and milk expression have already been established. This paper examines policies in Germany related to breastfeeding and human milk expression, with a focus on breast pumps as a key medical technology, and explores pathways for accessing breast pumps. Stakeholders relevant for governing aspects around breastfeeding at work and breast pumps in Germany were identified. In addition, we examine the existing German regulatory environment governing breast pumps as medical devices. This paper contributes to informing future research and policy on health insurance coverage of breast pumps in Germany.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261460205"},"PeriodicalIF":2.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603774","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":"Breastfeeding Cessation Readiness Scale: A Mixed-Methods Methodological Study for Development and Validation.","authors":"Seçil Hür, Ayça Şolt Kırca","doi":"10.1177/08903344261453690","DOIUrl":"https://doi.org/10.1177/08903344261453690","url":null,"abstract":"<p><strong>Background: </strong>Terminating breastfeeding is a significant transition for both mother and infant. However, no standardized, valid, and reliable tool currently exists to assess the readiness of mother-infant pairs (with infants over 6 months old) for this process.</p><p><strong>Aim: </strong>The aim of this study was to develop and psychometrically evaluate the Breastfeeding Cessation Readiness Scale for use among mothers planning to cease breastfeeding.</p><p><strong>Methods: </strong>This study used an exploratory sequential mixed-method design conducted among mothers in Turkey who were planning to cease breastfeeding. In the qualitative phase, semi-structured interviews with 14 mothers were analyzed using content analysis. In the quantitative phase, items generated from the qualitative findings and literature review were used to develop a draft scale, which was tested on 272 mothers. Validity was assessed using content validity, exploratory factor analysis, and confirmatory factor analysis. Reliability analyses included Cronbach's alpha, split-half method, test-retest reliability, and item-total correlation analysis.</p><p><strong>Results: </strong>The final scale consisted of 20 items across four factors mother readiness, infant readiness, process management, and environmental readiness explaining 56.24% of the total variance. Internal consistency was high (Cronbach's alpha = 0.863), and factor loadings ranged from 0.480 to 0.829. Confirmatory factor analysis supported construct validity (<i>p</i> < 0.001). Confirmatory factor analysis supported the four-factor structure with acceptable model fit (χ²/df = 1.776, CFI = 0.936, TLI = 0.924, RMSEA = 0.054). These findings indicate that the scale demonstrates satisfactory construct validity and reliability for assessing mothers' readiness for breastfeeding cessation.</p><p><strong>Conclusion: </strong>This newly developed tool offers a psychometrically sound method to assess readiness for breastfeeding cessation. It can enhance clinical decision-making and guide individualized counseling by midwives and other healthcare professionals. By identifying areas where support is needed, the scale may also indirectly contribute to the prolongation of breastfeeding duration.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261453690"},"PeriodicalIF":2.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620300","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":"An Examination of Breastfeeding Support Services in Perinatal Substance Use Disorder Treatment Programs in the United States.","authors":"Lauren T Narbey, Jill R Demirci, Joo H Lee, Nancy A Niemczyk, Susan M Sereika, Elizabeth E Krans, Katherine R Standish","doi":"10.1177/08903344261452002","DOIUrl":"10.1177/08903344261452002","url":null,"abstract":"<p><strong>Background: </strong>Many perinatal substance use disorder (PSUD) programs are providing services to women with substance use disorders (SUDs) in the United States. Breastfeeding is associated with improved maternal and infant outcomes, yet breastfeeding rates are low in this population, and our understanding of breastfeeding support in PSUD programs is limited.</p><p><strong>Research aim: </strong>To describe breastfeeding support services, and barriers and facilitators to improving breastfeeding support and breastfeeding outcomes within PSUD programs in the United States.</p><p><strong>Methods: </strong>From January to April 2024, a 61-item survey was sent electronically to a convenience sample of PSUD programs. Quantitative survey responses were analyzed using descriptive statistics to report frequencies. Open-ended survey responses were analyzed using content analysis.</p><p><strong>Results: </strong>Representatives from 35 programs across 16 states reported limited within-program lactation support with 10 (29%) having a lactation consultant on staff. Barriers to breastfeeding support include: complex medical and social challenges individuals with SUDs face, lack of provider/staff education, referral-based lactation consultants not attuned to the specific challenges of SUDs, disagreement among providers regarding breastfeeding support, and no or outdated policies which restrict breastfeeding. Suggestions for enhancing breastfeeding support included increasing postpartum support, inclusion of peer support, increasing provider/staff education on breastfeeding and SUDs, increasing understanding of lactation support during the birth hospitalization, and updating policies to allow more individuals with SUDs to breastfeed.</p><p><strong>Conclusion: </strong>Programs reported limited support for breastfeeding individuals with SUDs. More research is needed to explore how breastfeeding interventions tailored for programs may improve outcomes for individuals with SUDs.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261452002"},"PeriodicalIF":2.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620304","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":"Breastfeeding-Friendly Hospital Practices and Missed Care Among Immigrant and U.S.-Born Black Mothers: \"In the Hospital, Hell, There Was No Help There\".","authors":"Marcia Burton McCoy, Munira Maalimisaq, Jamila Abdukadir, Aarin Gabriela Urevig","doi":"10.1177/08903344261452649","DOIUrl":"https://doi.org/10.1177/08903344261452649","url":null,"abstract":"<p><strong>Background: </strong>Implementation of the Ten Steps of the Baby-Friendly Hospital Initiative (BFHI) has been shown to reduce disparities in breastfeeding exclusivity and duration. The Pregnancy Risk Assessment Monitoring System (PRAMS) includes questions on care during the delivery hospital stay that are correlated with the Ten Steps, but immigrants are under-represented in that data.</p><p><strong>Research aims: </strong>Researchers assessed whether Somali and U.S.-born Black women received best-practice care in lactation during their delivery hospital stay, and how their experiences compared to U.S.-born Black women as reported by Minnesota PRAMS.</p><p><strong>Methods: </strong>A total of 28 Somali immigrant and eight U.S.-born Black women completed a survey and participated in one of six focus groups. Researchers completed a thematic analysis of the focus group discussions and analyzed survey data which included an 11-question item from the PRAMS Phase 8 questionnaire.</p><p><strong>Results: </strong>Mothers felt they needed more prenatal education but were not comfortable raising the topic. Those comfortable with asking questions reported breastfeeding significantly longer. Despite high rates of breastfeeding initiation, participants reported missing essential care. Participants were significantly less likely than PRAMS respondents to receive information on or assistance with breastfeeding, to exclusively breastfeed, or to receive a telephone number for post-discharge support. Three out of five participants reported being offered formula when they had not requested it, and almost half reported they were given formula at discharge.</p><p><strong>Conclusion: </strong>Among this cohort, experiences differed markedly from the care reported by U.S.-born Black PRAMS respondents. Hospitals need to improve lactation support and cease promotion of formula in this population.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261452649"},"PeriodicalIF":2.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604132","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":"Trends and Determinants of Exclusive Breastfeeding in Turkey: A Trend Analysis and Determinants Analysis of Four Demographic and Health Surveys, 2003-2018.","authors":"Caner Baysan, Seher Palanbek Yavaş, Faruk Keskin","doi":"10.1177/08903344261451977","DOIUrl":"https://doi.org/10.1177/08903344261451977","url":null,"abstract":"<p><p>Background;This study aimed to examine temporal trends in exclusive breastfeeding (EBF) rates among infants aged 0-5 months in Turkey and to identify determinants of EBF using a comprehensive national-level approach.Methods;The research was based on a pooled secondary analysis of data from the 2003, 2008, 2013, and 2018 Turkish Demographic and Health Surveys.Results:Analyses revealed that EBF rates in Turkey showed an increasing trend over time, but when 2018 was taken as a reference, the likelihood of EBF in 2003 was significantly lower (adjusted odds ratio [aOR] = 0.37, 95% CI 0.22-0.64). The likelihood of EBF was higher among second-born infants than among firstborns (aOR = 1.85, 95% CI 1.17-2.92) and among mothers who gave birth for the first time between the ages of 25 and 34 years compared with those aged 18-24 years (aOR = 1.97, 95% CI 1.19-3.26). In contrast, the likelihood of EBF was lower in infants perceived as very large or larger than average compared with those perceived as average or smaller than average (aOR = 0.51, 95% CI 0.29-0.90) and among those living in the southern region compared with the West (aOR = 0.47, 95% CI 0.27-0.84). No significant association was found with socioeconomic status or mode of delivery.Conclusions:Although EBF rates in Turkey have increased, gains remain inconsistent and below World Health Organization targets. Findings demonstrate that breastfeeding success is shaped by maternal experience, maternal age, and regional inequalities. Strategies targeted specifically for primiparous mothers, younger age groups, and high-risk regions are essential.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261451977"},"PeriodicalIF":2.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603864","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":"Impact of Returning to Work on Nurses' Breastfeeding and Milk Expression Experiences: A Qualitative Study.","authors":"Ayşen Karataş, Merlinda Aluş Tokat","doi":"10.1177/08903344261465263","DOIUrl":"https://doi.org/10.1177/08903344261465263","url":null,"abstract":"<p><strong>Background: </strong>Returning to work can disrupt breastfeeding continuity, particularly when workplace environments do not support milk expression. Adequate time, privacy, and appropriate physical spaces are essential for sustaining breastfeeding among working mothers.</p><p><strong>Objective: </strong>This study explored nurses' experiences, perceptions, and expectations regarding breastfeeding and milk expression after returning to work postpartum.</p><p><strong>Methods: </strong>A qualitative descriptive phenomenological approach was used. Data were collected from 13 nurses working in a public hospital in Türkiye through semi-structured interviews conducted until data saturation. Thematic analysis was used to analyze the interview transcripts.</p><p><strong>Results: </strong>Five themes were identified: maintaining breastfeeding, thoughts about breastfeeding/expressing breast milk at work, experiences of expressing breast milk, evaluation of the breastfeeding/milk expression environment, and nurses' expectations during the period of expressing breast milk at work. Nurses reported challenges such as limited time for milk expression, lack of privacy, inadequate or uncomfortable lactation spaces, and insufficient organizational and colleague support. Supportive coworkers and accessible lactation facilities facilitated continued breastfeeding.</p><p><strong>Conclusion: </strong>Workplace conditions strongly influence nurses' ability to sustain breastfeeding after returning to work. Insufficient lactation spaces, limited time, and lack of privacy hinder milk expression, whereas supportive colleagues and organizational policies facilitate it. Creating dedicated, private, and comfortable lactation rooms, and strengthening workplace support systems, may improve breastfeeding continuity among nurses.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261465263"},"PeriodicalIF":2.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592171","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":"Perception, Barriers, and Facilitators to Obtaining the International Board-Certified Lactation Consultant (IBCLC) Certification Among Current and Aspiring IBCLCs in the United States.","authors":"Oluchukwu Loveth Obiora, Mandy Golman","doi":"10.1177/08903344261452563","DOIUrl":"https://doi.org/10.1177/08903344261452563","url":null,"abstract":"<p><strong>Background: </strong>The benefits of exclusive breastfeeding (EBF) and the need to support lactating individuals to achieve EBF are well documented. The International Board-Certified Lactation Consultant (IBCLC) certification is the gold standard for lactation care. However, only 19,930 IBCLCs serve the entire United States, and there is a notable lack of diversity among them. While considerable effort has focused on measuring the role of IBCLCs on breastfeeding outcomes, studies examining the experience of becoming a lactation consultant and obtaining IBCLC certification are scarce.</p><p><strong>Research aims: </strong>This study aimed to explore perceptions of the IBCLC certification and identify the barriers and facilitators to obtaining the IBCLC certification among current and aspiring IBCLCs in the United States.</p><p><strong>Methods: </strong>Participants were selected using a purposive sampling method. The sample included 20 individuals who had successfully obtained the IBCLC certification or were in the process of obtaining one. Thematic analysis was conducted following Clarke and Braun (2013) six-phase framework. Themes were interpreted using Bourdieu's forms of capital.</p><p><strong>Results: </strong>Facilitators in obtaining the IBCLC certificate included personal motivation and passion, supportive mentorship, scholarships and financial aid, strong networking, and flexible learning options. The identified barriers included high monetary costs, difficulty finding mentorship, balancing multiple responsibilities, gatekeeping, a lack of standardization in training, insurance and compensation issues, and exam preparation and anxiety.</p><p><strong>Conclusion: </strong>The identified facilitators and barriers to obtaining the IBCLC certification are multifaceted. To address the significant barriers identified in this study, recommendations include developing interventions that focus on reducing costs while increasing mentorship opportunities.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261452563"},"PeriodicalIF":2.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592192","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}