2024-2025 M3/M4 Course Syllabi
Obstetrics & Gynecology
COURSE NUMBER:
11 01 47
TITLE:
Breastfeeding Management
4th year students will spend 2 weeks working in both inpatient and outpatient settings to learn strategies to promote breastfeeding and support the breastfeeding mother-baby dyad. Students will observe novel methods to support patient education, including breastfeeding support groups group prenatal care.
PREREQUISITES:
26920371 (FAMILY MEDICINE CORE CLKSP), 26946374 (OBSTETRICS/GYN CORE CLKSP), 26961373 (PEDIATRICS CORE CLKSP)

  1. Successful completion of OB/Gyn, Family Medicine, and Pediatric Core Clerkships
  2. Badging and Epic training requirements
  3. Optional student membership in the Academy of Breastfeeding Medicine ($25/student).   For information see:   https://abm.memberclicks.net/membership
  4. Cell phone
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
4
CREDIT WEEKS:
2
DOMESTIC VISITING:
NO
INTERNATIONAL VISITING:
NO
GRADED:
Pass/Fail
COURSE QUALIFICATIONS:
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
2 weeks
DIRECTOR:
Jane Morris, MD
Jane.Morris@uc.edu

ADMINISTRATIVE SUPPORT PERSON:
Natalie Cassady
cassadnc@ucmail.uc.edu
558-7653
MSB, 4461
SITE(S):
UC Health West Chester Hospital
University of Cincinnati Medical Center
MAX ENROLL:
1 
ROTATIONS:
Rotation Dates Max
1 05/20/2024 - 05/31/2024 1
2 06/17/2024 - 06/28/2024 1
3 07/15/2024 - 07/26/2024 1
4 08/12/2024 - 08/23/2024 1
5 09/09/2024 - 09/20/2024 1
6 10/07/2024 - 10/18/2024 1
7 11/04/2024 - 11/15/2024 1
10 01/27/2025 - 02/07/2025 1
11 02/24/2025 - 03/07/2025 1
12 03/24/2025 - 04/04/2025 1
13 04/21/2025 - 05/02/2025 0

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
8:00 am – 5 pm, Monday-Friday, may include weekend hours
REPORT 1ST DAY:
UC Health 3rd floor, outside of NICU, LC office is on the 4th floor. Room #4032. You will receive an email from the nurse prior to your start telling you exactly where to go.

INSTRUCTION

LEARNING ACTIVITIES:
  • Clinical Experience - Inpatient
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Patient Presentation--Learner
  • Research
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
10% Attending Physician
10% Other Faculty
80% Other Allied Health Professional(s)
FEEDBACK:
IBCLC Certified Nurses and Registered Dieticians
ASSESSMENT:
 Participation, clinical performance.

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Participation
FINAL GRADE:
GRADE ASSIGNED BY: Course director

OBJECTIVES

Curricular Resources :
Well Start Self-Study Level I (2014) (REQUIRED)

    http://www.wellstart.org/Self-Study-Module.pdf

    Complete pre-test by the first Monday of rotation.  Complete post-test on Friday of second week. Please send these both to the coordinator, as well as the course director. 

    Submit both for grade.

 


Books (available from Natalie Cassady's office for loan during the rotation). Lawrence, R. A.& Lawrence, R. M. (2016). Breastfeeding:A guide for the health profession (8th ed.).   Philadelphia, PA:Elsevier. ($65 replacement fee)

Hale, T. W.& Rowe, H. W. (2017). Medications and mothers' milk (17th ed.). New York, NY: Springer Publishing. ($65replacement fee)




Academy of Breastfeeding Medicine Protocols (REQUIRED Reading)

Protocols1-20 are in Appendix J from     Lawrence, R.A. & Lawrence, R. M. (2016). Breastfeeding:A guide for the health profession

    (8thed.). Philadelphia, PA: Elsevier.  

   


Some of the protocols

     T. Colaizy(2016). Donor human milk in VLBW infants: Experience, research, and future

    direction.  Presented at ABM Physian workshop, Alexandria, VA, October 2016. (PDF handout

   of slides available from Dr. Hamel, with additional references.)

 

  ACOG readings (available for download at ACOG website with student membership)

     Committee on Breastfeeding (2016).   ACOG Breastfeeding toolkit for providers.

    http://www.acog.org/About-ACOG/ACOG-Departments/Toolkits-for-Health-Care-

    Providers/Breastfeeding-Toolkit   (Accessed November 1, 2016)



    Committee for Healthcare of the Underserved. (2009) Committee Opinion 423: Motivational

    interviewing: A tool for behavior change.


AAP curriculum
     Several videos, power point lectures, and a pre- and post-test are available

    https://www2.aap.org/breastfeeding/curriculum/
Instructional Methods:
  • Clinical Experience
  • Presentations
  • QI Projects
  • Self-Directed Learning
  • Pre/Post Test
Knowledge/Skills:
  1. Know breast anatomy and physiology of lactation
  2. Know the 10 Hospital Steps to Successful Breastfeeding
  3. List the various healthcare organizations and their recommendations for breastfeeding practices and duration (i.e. WHO, AAP, ACOG) (NUTRITION)
  4. Know the maternal/infant benefits of breastfeeding andrisks of formula feeding (PREVENTION & RISKS/BENEFITS)
  5. Know the unique benefits of breast milk, including donor milk, for the high risk neonate (NICU) (PREVENTION, NUTRITION, & MEDICAL DECISION MAKING)
  6. Know the nutritional variations in donor milk, mom's own milk, and formula.
  7. Know the medical indications for formula supplementation (MEDICAL DECISION MAKING)
  8. Know the benefits of early skin to skin
  9. Recognize common breastfeeding problems and manage these (MEDICAL DECISION MAKING)

  •      Engorgement
  •      Mastitis/Breast Abscess
  •      Sore nipples
  •      Low supply(actual and perceived)

  1. Know the indications for interventions: pumping (with proper phalange fitting), supplemental nursing system, nipple shields, breast shells)
  2. Understand indications for referral to IBCLC (MEDICAL DECISION MAKING)
  3. Recognize cultural variations in breastfeeding practices
  4. Understand pharmacologic parameters used to evaluate drug safety in lactation (CLINICAL PHARMACOLOGY CONSIDERATIONS)
Main Course Topics :
  • Cost efficient and effective medical decision making
  • Risk/benefit issues
  • Prevention
  • Nutrition
  • Clinical Pharmacology considerations/common drugs appropriate for the field
Procedures:
  1. Counsel a mom about the benefits of breastfeeding and the risks of formula feeding (PREVENTION & RISKS/BENEFITS)
  2. Assist a mom/baby with latch
  3. Identify mothers at risk for breastfeeding challenges(based on PMH, PSH, social factors, anatomical findings) (MEDICAL DECISION MAKING)
  4. Perform a breastfeeding-focused breast exam
  5. Assess infant oral anatomy (i.e. palate and for evidence of ankyloglossia) (MEDICAL DECISION MAKING)
  6. Demonstrate and teach hand expression
  7. Demonstrate and assist a mom with correct use of electric breast pump
  8. Demonstrate reverse pressure softening for breast engorgement/areolar edema
  9. Develop a feeding plan for infant/breastfeeding management strategy for mom (MEDICAL DECISION MAKING)
  10. Provide breastfeeding discharge education to the breastfeeding dyad  
  11. Assess medications for safety in lactation using published pharmacologic parameters and online references. (CLINICAL PHARMACOLOGY CONSIDERATIONS)
Remediation Plan:
Self-Directed Assignments

SAMPLE WEEK

Monday:
8:00AM 3:30PM UCMC Lactation Rounds/ Calls
Tuesday:
8:00AM 3:30PM UCMC Lactation Rounds/ Calls
Wednesday:
8:00AM 3:30PM UCMC Lactation Rounds/ Calls
Thursday:
8:00AM 3:30PM Hoxworth Outpatient Lactation
Friday:
8:00AM 3:30PM UCMC Lactation Rounds/ Calls
SCHEDULE NOTE:

You will recieve an email from the course coorindator prior to your start. The IBCLC will send an addtional email closer to the start with more specific instructions about the schedule that week. Please email the course cooridinator with any questions.

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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