One Team, One Voice: Key Takeaways from the SYNOVA Perinatal Leadership Conference on Supporting the Mother–Baby Dyad

At the SYNOVA Perinatal Leadership Conference, held in Tucson, Arizona in November 2025, Jae Kim, MD, PhD, Institute Co Director and Perinatal Institute Director in the Division of Neonatology at Cincinnati Children’s Hospital Medical Center, and Professor in the UC Department of Pediatrics, shared a compelling call to action for perinatal leaders. Invited by Medela to speak at the conference, Dr. Kim challenged attendees to rethink how breastfeeding support is delivered, emphasizing that meaningful improvement requires alignment, a shared purpose, and collective responsibility across the care continuum. Grounded in the concept of “One Team, One Voice,” his remarks underscored the importance of supporting the mother–baby dyad—particularly in the NICU—through a shared mental model among clinicians, leaders, and healthcare systems working together to optimize outcomes.

A Paradigm Shift: Human Milk as a Liquid Tissue

Early in his remarks, Dr. Kim reflected on a paradigm shift that reshaped his own understanding after decades in medicine: human milk is not merely nutrition, but a living, liquid tissue. Human milk contains human cells, immune factors, and microbial elements that actively contribute to protection against infection and inflammation while supporting critical biologic processes in the infant. This evolving scientific understanding reframes human milk as one of the most impactful medical interventions available—particularly for vulnerable infants. It also reinforces the need for healthcare systems to treat lactation support not as an optional service, but as essential, foundational care.

The Complexity of the Preterm Nutrition and Lactation Journey

For premature infants—some born as early as one third to halfway through gestation—the journey to successful oral feeding is long and complex. These babies must first tolerate enteral nutrition while navigating developmental immaturity and medical fragility, often over weeks or months of care.

In parallel, mothers of preterm infants face a significantly more complicated lactation journey. Early milk volumes may be low, stress levels are high, and sustained, intentional support is required to establish and maintain milk production over time. Dr. Kim emphasized that success depends on setting realistic expectations, providing structured education, and delivering consistent encouragement—particularly during early phases of lactation when progress may not yet be obvious.

Three Foundational Messages for Change

To drive meaningful and sustained improvement, Dr. Kim distilled his message into three foundational principles for perinatal and neonatal teams.

1. Respect the Mother–Baby Dyad 

Care should be intentionally designed to keep mother and baby connected. While historical models often separated infants and mothers into different hospital settings, modern perinatal care increasingly recognizes that outcomes improve when this dyad is preserved and supported as a single unit of care.

2. Build a Shared Mental Model

Supporting the mother–baby dyad requires collaboration across many disciplines—including neonatology, nursing, lactation, nutrition, pharmacy, and quality improvement. Dr. Kim stressed that teams must share a common understanding of what success looks like and how to achieve it. A shared mental model improves clarity, accelerates decision making, and better aligns actions across roles and settings. 

3. It Takes a Village

Successful infant feeding begins in the hospital but extends well beyond discharge. Families, outpatient providers, community lactation resources, and quality improvement leaders all play essential roles in supporting long term success.

From Evidence to Implementation: Bridging the Human Gap

Despite a strong and growing body of evidence supporting the benefits of human milk and breastfeeding, implementation often lags by decades. Dr. Kim highlighted that this gap—commonly 15 to 20 years—reflects not a lack of data, but the inherent complexity of healthcare systems influenced by human behavior, culture, and process design.

Frameworks such as the Baby Friendly Hospital Initiative and structured models like the Ten Steps for Supporting Premature Infant Nutrition provide practical scaffolding to translate evidence into action. Dr. Kim noted that intentionally bringing nutrition and lactation teams together under a unified “one team” approach has proven especially effective in accelerating improvement.

High Reliability Requires Intentional Design

As access to mother’s milk and donor milk has increased, NICUs now manage more milk handling steps than ever before. With this progress comes increased responsibility and risk, making high reliability systems essential.

Dr. Kim outlined several quality improvement strategies that can help teams reduce variation and sustain gains over time: 

• Standardized processes to improve consistency and outcomes 
• Key driver diagrams to visually align goals, drivers, and interventions
• Small scale PDSA cycles (Plan–Do–Study–Act) to test change, learn quickly, and scale what works
• Automation and routine practices, such as structured nutrition rounds or EHR integration, to support reliability without relying solely on individual effort

Flattening traditional hierarchies is equally important. Psychological safety—where every team member feels empowered to speak up—remains a cornerstone of safe, effective care.

Moving from “Me Medicine” to “We Medicine”

Dr. Kim closed with a broader vision for the future of perinatal care: a shift from siloed, individual decision making to a collaborative “we medicine” approach. Optimizing outcomes, he noted, requires shared ownership of both systems and results.

Fully realizing the benefits of human milk depends on collective responsibility for the lactation journey, respect for the mother–baby dyad, and sustained teamwork across disciplines and care settings.

Key Takeaways 

1. Respect the mother–baby dyad 

2. Develop and sustain a shared mental model

3. Remember that a village is required for success 

When teams align around a common purpose and speak with one voice, lasting improvement becomes possible—for babies, for mothers, and for the systems that care for them.

This article is based on insights shared by Jae Kim, MD, PhD, during the SYNOVA Perinatal Leadership Conference held in Tucson, Arizona, November 2025.

Additional Information and Resources:

• Discover new insights from Paula Meier, PhD, RN revealing how decades of “pump more” advice are giving way to evidence supporting a personalized pumping approach to better help mothers achieve secretory activation, coming to volume and reach their full milk making potential.
• Learn how you can support moms withLactation Risk Factorsearly and effectively, so more newborns can receive breast milk, and more families can achieve their breastfeeding goals.
• Explore the Hospital & Healthcare Professionals Hub for a comprehensive selection of educational materials designed to support mothers and infants.