At Nest Collaborative, we believe that breastfeeding success is about more than milk supply—it’s about support, access, and equity. That’s why we’re proud to celebrate our Director of Clinical Services, Dr. Larissa Luce, DHSc, RD, LD, IBCLC, PMH-C, whose groundbreaking research was published in the journal of Clinical Lactation.

Her study, “Development and Validation of the Navigating External Support Themes (NEST) Breastfeeding Scale Tool,” introduces a validated instrument designed to assess social determinants of health (SDOH)—such as access to care, community support, education, and socioeconomic conditions—that impact breastfeeding outcomes.

While many existing breastfeeding assessment tools focus on internal factors like confidence or self-efficacy, Dr. Luce’s work highlights the powerful external influences that shape a parent’s feeding journey. The NEST Breastfeeding Scale offers a reliable way to identify barriers that exist beyond the individual—within families, workplaces, communities, and healthcare systems.

By understanding these external factors, clinicians and lactation professionals can better tailor support, ensuring that care is equitable, compassionate, and responsive to every family’s unique situation.

Dr. Luce’s study is based on the Social Ecological Model, which looks at how personal, interpersonal, and community-level influences interact to affect health outcomes. Through this framework, the NEST Scale becomes more than a survey—it’s a tool for change.

By integrating the NEST Breastfeeding Scale into clinical and community settings, providers can:

• Identify external factors that may place families at higher risk of early breastfeeding cessation
• Guide targeted education and resources to improve breastfeeding outcomes
• Strengthen collaboration between families, healthcare providers, and community support systems
  

Dr. Luce’s research was inspired by, and aligns closely with Nest Collaborative’s mission to make expert lactation care accessible to all families, regardless of background or circumstance. Her work represents an important step toward addressing inequities in maternal and infant health—and ensuring that every parent has the support they need to meet their feeding goals.

We’re honored to have Dr. Luce leading our clinical team and helping to shape the future of lactation care through evidence-based innovation.

Read the full article in Clinical Lactation here.