Expanding Clinicians’ Roles in Breastfeeding Support: Focus on Maternal & Infant Care Prenatally and During the Hospital Stay: Continuing Medical Education (CME) Online Tutorial

The original version of this course was supported by Cooperative Agreement CDC-RFA-DP13-1305, “State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health” from the Centers for Disease Control and Prevention. The 2019 revision was supported by The Maternal Child Health Bureau-Health Resources & Services Administration (MCHB/HRSA).  Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or MCHB/HRSA.

Hardware / Software requirements:

This course should be run with recent versions of common browsers including Firefox and Google Chrome.

Designation Statement:

Melrose Wakefield Healthcare designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Massachusetts Medical Society through the joint providership of Melrose Wakefield Healthcare and Massachusetts Department of Public Health, Nutrition Division. Melrose Wakefield Healthcare is accredited by the Massachusetts Medical Society to provide continuing medical education for physicians.

The Massachusetts Department of Public Health collaborated with Melrose Wakefield Healtcare in this effort.

Registered Nurses receive 1.5 American Nurses Credentialing Center CNE contact hours for participation in this educational activity.

Term of Approval:

July 31, 2019 to July 31, 2022

CME Posttest:

You need to answer 12 of 16 questions correctly to receive the continuing education credits.

The course is composed of 6 modules:

  • Section 1: Prenatal Activities
  • Section 2: Maternity Care Practices
  • Section 3: Maternity Care Challenges
  • Section 4: Special Topics
  • Section 5: Integrative Case Studies
  • Section 6: Resources and Posttest


This continuing education online course is designed to complement the existing course, Expanding Pediatricians’/Clinicians’ Roles in Breastfeeding Support: Focus on Maternal & Infant Care After Discharge Continuing Medical Education (CME) Online Course. The need for additional course content for providers that is more focused on delivering care to pregnant women and new mothers who want to breastfeed motivated its creation. This course includes one page of background about the implications of not breastfeeding for those who have not completed the initial companion CME. If specific topics are of interest to those only completing this course, links to the companion CME are included.

Section 1 provides additional background on breastfeeding’s role in helping address disparities and dispelling common myths about breastfeeding. It also offers materials that will help clinicians provide anticipatory guidance to pregnant women interested in breastfeeding. The section includes some additional information about breast anatomy and physiology oriented toward breast examination and assessment prior to delivery.

Section 2 is focused on maternity care practices that influence breastfeeding outcomes. It highlights the importance of skin-to-skin contact for the newborn, the role of rooming in, and the evidence base for the 10 Steps of the Baby Friendly Hospital Initiative. It includes one section dedicated to the effect of inductions and labor medications on breastfeeding initiation and outcomes.

Section 3 addresses some neonatal circumstances that are often challenges in the care of the breastfeeding mother and her newborn: weight loss, supplementation, hyperbilirubinemia, and late preterm infants. It also includes a section dedicated to tips for supporting a breastfeeding mother during these early post-partum days.

Section 4 has information on some special topics: family planning, breastfeeding for infants in the NICU, and ankyloglossia (tongue tie).

Section 5 provides four integrative case studies designed to bring information from the prior four sections together in a practical way.

Section 6 includes a page with links to various resources, the references, and the posttest.

This 1.5 hour online continuing education activity is designed to meet the educational needs of practicing physicians and other clinicians who provide primary care to pregnant women and new mothers.

A 15 question posttest is available at the end of the tutorial.

Learning Objectives:

By the end of this CME, physicians and other primary care providers should be able to:

  • Explain the importance of breastfeeding for the infant and the mother;
  • Describe how to create an office culture that is supportive of breastfeeding families;
  • Identify what needs to be shared with mothers prenatally to enable and support breastfeeding;
  • Describe how to conduct the breast assessment and other assessments that affect breastfeeding;
  • Identify labor, delivery, and in-hospital practices that influence breastfeeding;
  • Identify potential barriers or risks to breastfeeding success.


This continuing education activity is designed for use by healthcare professionals for educational purposes only. Information and opinion offered by the contributors represent their viewpoints. Conclusions drawn by the participant should be derived from careful consideration of all available scientific information. Prescription information and use of medical devices should be undertaken only after confirmation of information by consulting the FDA-approved uses and information. We make every effort to have accurate information presented; no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use. Links are provided to other Internet sites solely for the convenience of users. Once you link to another site, you are subject to the site’s terms and conditions of use including copyright and licensing restrictions.


The authors have reported no relevant financial or other relationships with commercial entities whose products/services may relate to the educational content of this activity.

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