Physicians, nurses, and other health care professionals who provide prenatal care, inpatient maternity care, and postpartum care.

At the completion of this module participants will be able to:

1. Identify commonly encountered areas of concern for breastfeeding mothers and contraindications to breastfeeding in the United States.
2. Recall methods to assist breastfeeding infants who are preterm, low birth weight, or ill by understanding the advantages of human milk and differences in pre-term and term milk.
3. Recall how to manage clinical concerns such as jaundice, infants with cleft palates/lips, and neurological problems.
4. Indicate knowledge of medication interactions with breastfeeding and where to find this information if not known.

The Curriculum in Support of Keystone 10: The Ten Steps to Successful Breastfeeding A 15 Hour Interdisciplinary Breastfeeding Management Course & Suggested Additional Reading:


These instructional modules were developed in collaboration between the Pennsylvania Keystone 10 Quality improvement Project and Johns Hopkins School of Nursing. They are intended to provide education which prepares hospital maternity staff to create an environment that is aligned to advance to 10 steps to successful breastfeeding and to meet the Keystone 10.


Running times for each of the 15 training modules vary, however total time for each module is 60 minutes in length. With completion of pre- and post-tests, this training meets the 15 hour didactic requirement of Keystone 10. Staff will still need to complete their competencies at their own site. Hospital staff can either complete the modules online here or can work with their hospital administrators to offer them for continuing education credits. In addition Keystone 10 offers face to face trainings and also trains trainers. For more information please email Dottie Schell at dschell@paaap.org.

Parker, L. A., Sullivan, S., Krueger, C., Kelechi, T., & Mueller, M. (2012). Effect of early breast  milk expression on milk volume and timing of lactogenesis stage II among mothers of  very low birth weight infants: a pilot study. Journal of Perinatology, 32(3), 205-209.  doi:10.1038/jp.2011.78

A Department of Health data: https://www.health.pa.gov/topics/programs/Breastfeeding/Pages/Data.aspx

Joint Sponsor Statement - Note: This Accreditation Statement Supersedes All Other Statements:

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Pittsburgh School of Medicine and Pennsylvania Chapter American Academy of Pediatrics. The University of Pittsburgh School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. The University of Pittsburgh School of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credits'. Each physician should only claim credit commensurate with the extent of their participation in the activity.

Other health care professionals are awarded .10 continuing education units (CEUs), which are equal to 1.0 contact hours. Faculty for this activity have been requested to identify significant financial or other relationships with manufacturer(s) of any commercial product(s) or with provider(s) of any commercial service(s) which might affect the balance of their presentation.