The Academy of Breastfeeding Medicine's Signature Product: Our Clinical Protocols.
Venue: Breastfeeding medicine the official journal of the Academy of Breastfeeding Medicine

As promised in the last issue of Breastfeeding Medicine, this month's President's Corner serves as an introduction to and update on one of the Academy of Breastfeeding Medicine's (ABM's) seven key committees, the Protocol Committee, including its mission, function, and products. A central goal of ABM is the development of clinical protocols to help physicians and other healthcare providers manage common medical problems that may impact breastfeeding success. ABM protocols are evidenced based guidelines for the care of breastfeeding mothers and infants. They guide but do not delineate an exclusive course of treatment or serve as standards of medical care since variations in treatment may be appropriate according to the needs of individual patients or mother baby dyads around the world. The Protocol Committee is currently chaired by ABM's Immediate Past President, Wendy Brodribb. Most key committees have one or more subcommittees; the Protocol Committee has just one, the Translations Sub committee, which is chaired by Larry Noble. Other ABM members who currently serve on the Protocol Committee include Nancy Brent, Maya Bunik, Cadey Harrel, Ruth Lawrence, Kathleen Marinelli, Kate Naylor, Sarah Reece Stremtan, Casey RosenCarole, Tomoko Seo, Rose St. Fleur, and Michal Young. Committee chairs and members are each to be commended on the critically important work that they do for our organization during and between their monthly meetings. All major ABM documents, including protocols, are systematically updated every 5 years with the most current evidenced based information. At this time, ABM has 25 different clinical protocols that are up to date, current but soon due for revision, or expired and being revised. Every one of our clinical protocols has been translated into Spanish and several have been translated into other languages. The overall number of translated protocols is an astounding 57. Our clinical protocols, both active and expired, in English and any translations, can be located on ABM's website (www.bfmed.org/Resources/Protocols.aspx) In the context of that scope of work, there has always been a rigorous production process for creating an individual protocol. First, the committee identifies potential or previous authors who are experts in the relevant field. All authors and committee members must adhere to conflict of interest policies as determined by the Ethics Sub committee of the Governance Committee described in a recent President's Column. One of the first steps in creating a protocol de novo is for the selected author(s) to create an annotated bibliography, which is a comprehensive list of relevant references with a brief summary of each citation and an assigned 'level of evidence' using an international quality of evidence system. Each protocol is then assigned a 'shepherd' a single Protocol Committee member who works in close collaboration with the author(s) to navigate the document through to production. At any one time, each committee member/shepherd is guiding anywhere from one to four protocols at different stages. Once the actual protocol has been drafted with levels of evidence included, the shepherd brings it to the committee for review and then incorporates feedback and edits. Either simultaneously or sequentially, protocols are sent out for international review by ABM members or other experts outside of the United States to be sure that each document has a global reach. Once these steps are complete, every member of ABM's Board of Directors has time to comment and then ultimately to vote on the final clinical protocol. For any protocol that is translated from English into another language, there is typically a separate translation and back translation process. So clearly there is a tremendous amount of work involved, but worth it in that protocols provide great credibility, visibility, and impact for our organization. They are truly our signature product. In addition to being posted on the website, new and revised protocols are published in this journal. All reviewers are formally recognized on an annual basis. New protocols are often presented at conferences. Please be sure to stop by the ABM booth at the Annual Conference in Washington, DC in October, 2016 to meet board members as well as Protocol Committee members and authors in person. Protocols are cited in Pubmed, used by clinicians and academics, linked to the National Guideline Clearinghouse (www. guideline.gov/ and cited by others. The top four protocols cited in 2015, in descending order, were: Guidelines for Breastfeeding and Substance Use; Breastfeeding friendly Physician's Office; Mastitis; and Guidelines for Blood Glucose Monitoring and Treatment of Hypoglycemia. The key priority in ABM's 2016 2020 strategic plan that aligns directly with the Protocol Committee's ongoing work is to 'streamline the production, translation, and maintenance of protocols, while preserving quality. As specific examples, this year, the Protocol Committee's top priority is continued revision and maintenance of current protocols. By 2017, the committee hopes to have zero loss of protocols due to expiration; by 2018, they would like to start publishing at least one new protocol per year. To meet these ambitious targets, the committee has several concrete strategies they are implementing, including but not BREASTFEEDING MEDICINE Volume 11, Number 5, 2016 a Mary Ann Liebert, Inc. DOI: 10.1089/bfm.2016.29011.jjt