Building a Project From Clinical Experience at a Lactation Center
At first glance, an inpatient rehabilitation facility (IRF), psychiatric hospital, and lactation center seem to have nothing in common. The populations they serve are vastly different; the contrast in documentation demands is almost laughable; and the emotional, physical, and mental challenges vary widely. But that’s the beauty of occupational therapy (OT), isn’t it? We’re entering a field as diverse in its demands as the people we serve. What connects all these settings is the universal need to improve health outcomes and quality of life. No matter the population or location, the shared hope is for better days ahead.
These three settings—IRF, psychiatric hospital, and lactation center—are deeply significant to me. The first two were my Level II fieldwork placements, and the last was my capstone site. Long before my capstone officially began, I was curious about OT’s role in lactation support. During my first year in the Occupational Science program at Eastern Kentucky University, a guest speaker visited our lifespan development class and spoke about breastfeeding as a foundational occupation. She said, “This is the first major occupation a baby participates in.” That statement stuck with me and reemerged when it came time to develop my capstone.
A few years later, as I began planning my capstone, I was preparing for my first Level II fieldwork at an IRF in Texas. I already knew my second placement would be in a state psychiatric hospital back in Kentucky, right after my wedding during the winter break. Needless to say, I was overwhelmed. My mind was full of thoughts and questions: Would capstone be too much? Lactation OT is so specialized. What could I do to make this project helpful to the community while fitting into this busy season of life? I’d be lying if I said I had all the answers before I started. It wasn’t until week 3 of capstone that I realized I could integrate the skills I gained from both fieldwork settings into a meaningful, community-based project.
Skills I Learned From Each Level II Fieldwork Placement
Inpatient Rehabilitation Facility (IRF)
I completed my first fieldwork experience at an IRF in New Braunfels, Texas, where some of my family members live. I later learned the facility was ranked in the top 10% of IRFs nationwide—and it showed. My biggest takeaway from this placement was learning how to use therapeutic exercises and seeing the rapid progress patients often made in just a couple of weeks.
Psychiatric Hospital
My second fieldwork experience was in a state psychiatric hospital in Lexington, Kentucky. Here, I shifted from treating physical deficits to supporting people with mental and emotional needs. Therapy was primarily group-based, with individual sessions as needed. I learned to navigate complex group dynamics and use occupations like meal preparation, social skills, and home management as therapeutic tools. While this setting is known for its group therapy benefits, I saw how much growth occurred in one-on-one sessions—something hard to achieve consistently in a state-funded institution. Unlike the IRF, progress was slower. Some clients had been readmitted more than a dozen times, Yet this setting taught me how lifestyle patterns influence mental health outcomes and how to lead therapeutic groups effectively and compassionately.
Applying These Skills to a Capstone Project
I chose a clinical skills focus area for my Applied Leadership Experience (ALE), also known as capstone, at the Kentucky Breastfeeding Center in Lexington. This means I job shadowed and received hands-on practice underneath a registered occupational therapist who was also an International Board Certified Lactation Consultant (IBCLC). By week 3, I noticed most clients were financially stable. This raised a bigger question: Why is access to lactation support seemingly tied to socioeconomic status? I didn’t have the tools to fully answer that question, but I knew I could still make a difference. With guidance from the OTR/IBCLC at the center and support from my mom, a pediatric OT, I developed a free educational resource for expectant and new mothers (to be implemented in June 2025). I am currently working on making a YouTube video that presents both breast and bottle feeding through an OT-informed lens. Prior to making the video, I visited other lactation centers to deepen my understanding and asked if I could share the video with them after it was completed—encouraging its distribution through their social media and websites, or directly with clients.
To stay within my scope, the video would not provide medical advice or lactation counseling, but instead focus on building healthy routines, addressing common physiological barriers to feeding, and highlighting resources available in the Lexington, Kentucky area. The structure drew from Lifestyle Redesign® principles inspired by my mental health rotation and incorporated simple home exercises that I had gained confidence teaching during my IRF experience.
Final Thoughts
As a student juggling life’s many demands, creating a capstone project can feel overwhelming. My advice is this: work smarter, not harder. Take your life experiences— because they are unique to you—and use them to build something that helps others while honoring the season of life you're in. Fieldwork and capstone, though they may feel vastly different at times, don’t have to be separate. Let them inform and strengthen each other. Sometimes the most meaningful projects are born not from perfection, but from presence—showing up with what you have and where you are, and letting your story serve others.
Reference
Elizabeth A. Pyatak, Kristine Carandang, Chantelle Rice Collins, Mike Carlson; Optimizing Occupations, Habits, and Routines for Health and Well-Being With Lifestyle Redesign®: A Synthesis and Scoping Review. American Journal of Occupational Therapy September/October 2022, Vol. 76(5), 7605205050. doi: https://doi.org/10.5014/ajot.2022.049269
Cara Reynolds is a second year graduate student at Eastern Kentucky University who will be graduating in July of 2025. Cara feels fortunate that her professors encouraged her character growth by providing opportunities to serve the community during her time as Co-Service Chair for the Student Occupational Science Association (SOSA). Cara has an interest in pediatrics and would one day like to become IBCLC certified. Cara’s interest outside of OT is her identity in Christ, cooking, herbalism, and listening to podcasts about Homesteading. Cara would love to one day own a minimalist farm and potentially turn it into a private practice for farm-based occupational therapy.