Geographic Access to International Board-Certified Lactation Consultants in Pennsylvania.
Kristin N Ray, Jill R Demirci, Lori Uscher-Pines and 1 others
PMID 29969344WHAT IT FOUND
Most young children in Pennsylvania lived within 15 miles of a certified lactation consultant, but access was lower for rural children and for outpatient consultants.
This measures distance to listed providers, not proof that care was available.
Key findings
01Certification-board data showed that 96% of young children lived within 15 miles of an IBCLC, and directory data showed that 80% did.
02Hospital-based IBCLCs were the most accessible: 75% of young children lived within 15 miles of one, compared with 51% for office-based, 59% for private-practice, and 39% for WIC-affiliated IBCLCs.
03Access was lower for rural children than urban children: 18% versus 88% within 15 miles by directory data, and 73% versus 99% by certification-board data; children in counties with the lowest breastfeeding initiation rates had lower hospital access, 69% versus 88%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study covered only Pennsylvania, so it may not apply to other states. The IBCLC lists came from different sources, and a list could include people who no longer practice or moved, while another could miss active providers. Reported locations may have been home addresses rather than practice sites. The analysis used straight-line distance, not travel time, so families who rely on public transportation may have less access than the numbers suggest. It measured geographic proximity only, not affordability, ability to seek care, or quality of care. It looked only at breastfeeding initiation, not exclusivity or duration. It did not include other lactation support providers.
Declared interests
No conflict of interest was declared. One author is an IBCLC.
The easy way to misread this
Do not treat these percentages as evidence that families received or could reach lactation care. The study counted straight-line distance to listed IBCLCs, not travel time, affordability, ability to seek care, or breastfeeding outcomes.