Background: New Accreditation Council of Graduate Medical Education (ACGME) requirements mandate lactation accommodations for resident physicians and fellows. However, to date, few training programs have developed and reported robust lactation support programs or policies. Objective: The authors aimed to develop an evidence-based, ACGME-compliant policy to optimize lactation support for residents and fellows at their institution. Methods: Six Sigma process improvement methodology was utilized to structure this 2018-2019 project. Qualitative methods included stakeholder analysis, feedback sessions, formal needs assessments, and a thorough review of breastfeeding law, societal guidelines, and best practices. Quantitative methods included use of a standardized grading tool for lactation facilities. Quality assurance efforts are ongoing to ensure successful implementation of the developed policy. Results: The authors present a framework for improving lactation support for residents and fellows and share an institutional policy suitable for implementation by other graduate medical education departments. Conclusions: To ensure compliance with ACGME requirements and address breastfeeding challenges faced by medical trainees, it is crucial that U.S. residencies and fellowships implement lactation policies to support trainees. The authors welcome the modification and utilization of the evidence-based, ACGME-compliant policy reported herein.
Keywords: breastfeeding; lactation; policy; process improvement; quality improvement; wellness.