Researchers studied how nutrition specialists help babies who are breastfeeding. They looked at 92 infants and found that when nutrition specialists kept better records and visited more often, babies had fewer feeding problems. About 68% of babies showed improvement in their nutrition issues after receiving help from these specialists. The study shows that nutrition specialists play an important role in helping breastfeeding succeed, and keeping detailed notes about what they do makes a real difference in outcomes.

The Quick Take

  • What they studied: Whether nutrition specialists’ record-keeping quality and visit frequency affect how well breastfeeding problems improve in babies
  • Who participated: 92 breastfeeding infants tracked from July 2020 to June 2024 who received care from registered dietitian nutritionists (nutrition specialists with advanced training)
  • Key finding: Babies whose nutrition specialists kept better records and visited more frequently showed significantly better improvement in feeding problems—68% of nutrition diagnoses improved overall, with some specific problems improving in up to 83% of cases
  • What it means for you: If you’re struggling with breastfeeding, seeing a nutrition specialist who keeps detailed records and visits regularly may help solve feeding problems. However, this is a small study, so talk with your doctor about whether this applies to your situation.

The Research Details

This was a prospective observational study, which means researchers followed 92 breastfeeding infants over time and collected information about the care they received. The study ran from July 2020 to June 2024. Researchers looked at the medical records that nutrition specialists created for each baby, examining how detailed and complete the documentation was. They used a special tool called the NCP-QUEST (Nutrition Care Process Quality Evaluation and Standardization Tool) to score how well the records were written. They tracked whether babies’ feeding problems improved between the first visit and follow-up visits.

This research approach is important because it shows real-world results from actual patient care rather than a controlled experiment. By examining actual medical records, researchers could see what documentation practices were most helpful. The study also created standards for how nutrition specialists should document breastfeeding care, which could help other specialists provide better care.

This study has some strengths: it tracked real patients over several years and used a standardized tool to measure documentation quality. However, it’s relatively small (92 babies), so results may not apply to all populations. The study also didn’t compare outcomes to babies who didn’t see nutrition specialists, so we can’t be completely certain the improvements were due to the specialist care alone. Documentation of breastfeeding duration was poor, meaning researchers couldn’t fully track how long babies breastfed.

What the Results Show

The main finding was that higher-quality documentation and more frequent visits from nutrition specialists predicted better improvement in babies’ nutrition problems. Babies whose specialists had higher NCP-QUEST scores (better documentation quality) were 1.58 times more likely to show improvement in their diagnoses. Babies who had more frequent visits from nutrition specialists were 1.77 times more likely to improve.

Overall, 68% of nutrition diagnoses improved when babies were reassessed after receiving care. This means that about 2 out of 3 babies showed improvement in their feeding or nutrition problems. Some specific problems improved even more frequently: breastfeeding difficulty improved in 55% of cases, predicted breastfeeding difficulty in 83%, inadequate vitamin D intake in 83%, and underweight in 83%.

The most common problems nutrition specialists addressed were breastfeeding difficulty (18% of cases) and inadequate nutrient intake. The most common treatments involved either providing special foods or nutrients (46% of cases) or coordinating care between different healthcare providers (43% of cases).

The study found that breastfeeding duration averaged about 34 days, though this information was poorly documented in many cases. The research identified that the most frequent reason babies needed nutrition help was breastfeeding difficulty. The study also showed that nutrition specialists used a variety of intervention strategies, with food/nutrient delivery and care coordination being most common. These secondary findings suggest that nutrition specialists address multiple aspects of breastfeeding support beyond just nutrition.

This is described as the first known study to comprehensively describe nutrition specialist care plans for breastfeeding infants and to show that these plans improve common breastfeeding-related nutrition problems. Previous research has shown that nutrition specialists help with many health conditions, but their specific role in breastfeeding support hasn’t been well documented. This study fills that gap and suggests nutrition specialists should be more involved in breastfeeding support.

The study is relatively small with only 92 infants, so results may not apply to all populations or all types of breastfeeding problems. There was no comparison group of babies who didn’t receive nutrition specialist care, so we can’t be completely certain the improvements were due to the specialist care alone. Documentation of actual breastfeeding duration was poor, making it hard to measure one of the most important outcomes. The study was conducted through one organization’s registry, so results may not represent all nutrition specialist care. Finally, the study couldn’t determine whether better documentation quality caused better outcomes or whether specialists who were already better at helping babies also happened to keep better records.

The Bottom Line

If you’re having breastfeeding difficulties, consider asking your doctor for a referral to a registered dietitian nutritionist (nutrition specialist). Evidence suggests (moderate confidence) that seeing a nutrition specialist, especially one who keeps detailed records and provides regular follow-up visits, may help resolve feeding problems. This is particularly helpful if you’re dealing with breastfeeding difficulty, vitamin D concerns, or if your baby is underweight.

Parents and caregivers struggling with breastfeeding should care about this research. Healthcare providers, especially those who work with breastfeeding families, should also pay attention. Nutrition specialists themselves should use this research to improve their documentation practices. This research is less relevant for families with no breastfeeding concerns.

Based on this study, improvements in nutrition diagnoses were measured at reassessment visits, which typically occur weeks to months after initial care. You shouldn’t expect immediate changes, but rather gradual improvement over several weeks of working with a nutrition specialist.

Want to Apply This Research?

  • Track breastfeeding challenges weekly (difficulty latching, pain level 1-10, duration of feeds, baby’s weight gain) and note when you see a nutrition specialist. This creates a clear record similar to what the study found was most helpful.
  • Schedule regular follow-up appointments with your nutrition specialist (at least monthly) and keep a simple log of what advice you’re following and how your baby is responding. Share this log at each visit.
  • Use the app to record your nutrition specialist visits, document specific feeding problems before and after visits, track baby’s weight gain, and note any improvements in feeding difficulty. This mirrors the documentation practices that the study found most effective.

This research describes how nutrition specialists can help with breastfeeding problems, but it is not a substitute for medical advice. Always consult with your pediatrician or healthcare provider before making changes to your breastfeeding routine or infant feeding plan. This study involved a relatively small number of infants, so results may not apply to all situations. If you’re experiencing breastfeeding difficulties, seek care from qualified healthcare professionals including your doctor, lactation consultant, or registered dietitian nutritionist.