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.

本质性研究通过开展三场医师领导者焦点小组访谈，探讨了美国医疗体系内母乳喂养与泌乳医学的整合实践。本研究采用EPIS框架开展分析，结果显示医疗体系对母乳喂养支持工作具有显著影响，领导者的态度与个人经历会对相关政策的制定产生塑造作用。参与者建议设立专属泌乳医学部门、强化员工教育培训、推进跨场景照护协调、支持泌乳期员工，并提升公众认知水平。研究识别的关键障碍包括部门壁垒、职场支持条件不足、薪酬补偿机制不完善，以及培训项目中母乳喂养相关内容的优先级偏低；而促进因素则涵盖多学科协作、扶持性政策、双向计费，以及优化后的电子健康记录（Electronic Health Record, EHR）工作流程。本研究结果凸显了体系层面的现存缺口，并提出了推进公平、循证的母乳喂养照护服务的可行策略；未来仍需开展相关研究以吸纳更广泛的利益相关方参与，并解决行政与财务层面的各类挑战。