A Collaboration with the University of Michigan and the Institute for the Advancement of Breastfeeding and Lactation Education

Authors: Anna Sadovnikova, Samantha A. Chuisano, Kaoer Ma, Aria Grabowski, Kate P. Stanley, Katrina B. Mitchell, Anne Eglash, Jeffrey S. Plott, Ruth E. Zielinski & Olivia S. Anderson

The open-access manuscript has been published in the International Journal of Breastfeeding Medicine


A key reason for premature cessation of breastfeeding is inadequate support from healthcare providers. Most physicians and nurses do not feel confident in their ability to support families with breastfeeding initiation or maintenance. Increasing health professional confidence in clinical lactation skills is key to improving maternal and child health outcomes. High-fidelity (realistic) simulators encourage learner engagement, resulting in increased clinical skills competency, confidence, and transfer to patient care. Lactation educators teach with low-fidelity cloth and single breast models. There are no high-fidelity breast simulators for health professional education in clinical lactation.

Development and evaluation of a high-fidelity lactation simulation model

In this commentary we describe the development of a high-fidelity Lactation Simulation Model (LSM) and how physician residents, nurse-midwifery students, and clinical lactation experts provided feedback on LSM prototypes.


The user-testing described in this commentary does not represent comprehensive validation of the LSM due to small sample sizes and the significant conflict of interest.


For breastfeeding rates to improve, mothers need support from their nurses, midwives, pediatricians, obstetricians and gynecologists, and all healthcare staff who interact with pregnant and lactating women. Clinical education with high-fidelity breastfeeding simulators could be the ideal learning modality for trainees and hospital staff to build confidence in clinical lactation skills. The ability of a high-fidelity breastfeeding simulator to increase a learner’s lactation knowledge and psychomotor skills acquisition, retention, and transfer to patient care still needs to be tested.

2017/2018 Presentations at the Academy of Breastfeeding Medicine annual meeting

Comprehensive Validation of the LiquidGoldConcept Lactation Simulation Models by Breastfeeding Medicine Experts (2018)

Traditional breast simulators are not realistic and cannot provide comprehensive lactation training. LiquidGoldConcept (LGC) developed the Lactation Simulation Models (LSMs) to teach health students and providers how to manage common breastfeeding issues. Until this study, the LSMs have not been systematically validated by breastfeeding medicine experts.

Past LSM Validation Study (2017) at the University of Michigan:

  • 17 OBGYN/Family Medicine residents.
  • Breastfeeding medicine ‘novices’ based on low self-efficacy score and inability to correctly identify features and pathologies on LSMs.
  • The data from the ‘novices’ are compared with the data from ‘experts.’


  • Evaluate the clinical relevance and realism of the look, feel, and features of the LGC LSMs.
  • To compare face, context, and construct validity between novices and experts.
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A Multi-Phase Validation of the LiquidGoldConcept Lactation Simulation Model with University of Michigan Pediatric, Obstetric, and Family Medicine Residents: Results from Phase One (2017)

Background: As part of the University of Michigan obstetric, pediatric, and family medicine house officer lactation education project, the investigators assessed the LiquidGoldConcept Lactation Simulation Model (LSM) May 2017 prototype. This trial is the first time any LSM is validated for its use in comprehensive breastfeeding management training of residents.


  1. Validate LiquidGoldConcept Lactation Simulation Model Questionnaire
  2. Assess look, feel, and realism of LiquidGoldConcept May 2017 LSM with first-year OB/GYN and Family Medicine Residents
  3. Use participant feedback to improve look, feel, and realism of LiquidGoldConcept LSM
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