Building breastfeeding knowledgeable health systems: Focus groups with physician leaders -- BKHS Focus Group Deidentified Transcripts

This qualitative study explored breastfeeding and lactation medicine integration within U.S. health systems through three physician leader focus groups. Using the EPIS framework, analysis revealed that health systems significantly influence breastfeeding support, with leadership attitudes and personal experiences shaping policies. Participants recommended establishing dedicated lactation medicine divisions, improving staff education, coordinating care across settings, supporting lactating employees, and raising public awareness. Key barriers included departmental silos, inadequate workplace accommodations, poor reimbursement structures, and low prioritization in training programs, while facilitators involved multidisciplinary collaboration, supportive policies, dyadic billing, and optimized electronic health record workflows. Findings underscore systemic gaps and propose strategies for advancing equitable, evidence-based breastfeeding care, with future research needed to engage broader stakeholders and address administrative and financial challenges.