371 - Research Priorities in Human Milk and Lactation Science: Perspectives from 50 Clinicians who Practice Breastfeeding and Lactation Medicine Around the World

Publication Number: 3358.371

Deanna Nardella, Yale School of Medicine, New Haven, CT, United States; Casey Rosen-Carole, Golisano Children's Hospital at The University of Rochester Medical Center, Rochester, NY, United States; Mariana Colmenares, Yale-New Haven Children's Hospital, London, England, United Kingdom; María-Teresa Hernández-Aguilar, N/A, L'Eliana, Comunidad Valenciana, Spain; Meredith Young, Yale School of Medicine, Madison, CT, United States; Emily Swisher Rosa, Boston Medical Center, Hanson, MA, United States; Mona Sharifi, Yale School of Medicine, New Haven, CT, United States; Veronika Shabanova, Yale School of Medicine, New Haven, CT, United States; Katherine R. Standish, Boston University School of Medicine, Boston, MA, United States

Background: Several research gaps exist in human milk and lactation science. Yet, little is known about which research gaps are of highest priorities to those medical clinicians practicing Breastfeeding and Lactation Medicine (BFLM).

Objective: To inform high impact research to improve care delivery and patient outcomes, we aimed to identify those areas of research most pertinent to clinical care from the perspective of BFLM clinicians worldwide.

Design/Methods: Our team, including five BFLM clinician-researchers, designed a cross-sectional online survey in 2024 and disseminated it to BFLM clinicians worldwide via several professional and informal platforms from November 2024-February 2025. An optional, single free-text question asked, “If you wish, please list 2-3 clinical scenarios or areas you would like more research evidence around to inform the BFLM care you provide.” Content analysis was performed on free text responses, identifying key themes and sub-themes.

Results: Of 138 participants who completed the survey, 50 clinicians provided a response (36% response rate). Most (78%) practiced within the United States; 10% practiced in Canada, 4% in the United Kingdom, and 2% each in Ireland, New Zealand, Saudi Arabia, and South Africa. Participants were physicians (88%), advanced practice nurses (8%), one certified nurse midwife (2%), and one physician assistant (2%). Several themes and sub-themes for additional clinical research were identified. Themes most commonly reported were: (1) low milk production and insufficient glandular tissue, including risk factors, diagnosis, management, efficacy of galactagogues, and the role of donor milk (reported by 46% of participants); (2) BFLM clinical care implementation, including infrastructure, models of delivery, and billing (22%); (3) infant ankyloglossia diagnosis and management (22%); (4) lactational mastitis risk factors (e.g., milk stasis, oversupply, inflammation, blebs, and milk dysbiosis) and treatment (16%), (4) breast pump science, including risks, best practice guidelines for pump use to address low milk production, and person-centered approaches to selecting pump models and parts (14%); (5) adaptations to breastfeeding (BF) counseling that consider maternal mental health (10%), and (6) interventions to improve BF outcomes for those with geographical, social, and/or medical barriers to reaching their BF goals (10%).

Conclusion(s): Our findings will inform future research priorities in lactation science aligned with knowledge gaps most pertinent to clinicians who deliver BF and lactation medical care globally.