Introduction The World Health Organization recommends exclusive breastfeeding for the first six months of life and continuation of breastfeeding for at least two years. In Canada, 91.0% of parents initiate breastfeeding, yet only 38.0% continue six-month exclusive breastfeeding. The Winnipeg Breastfeeding Centre (WBC) is the only clinic in Manitoba providing physician-level lactation care. My project aimed to describe the WBC patients’ demographic characteristics, breastfeeding difficulties, diagnoses, and treatments. Methods This retrospective study describes the WBC population from March 2018 – December 2023 using the clinic’s electronic medical records, following the exclusion of follow-up appointments. The data included: intake questionnaire (n=3,230), referral data (n=6,778), and a random sample of the visit notes (n=79). To facilitate descriptive analysis, I manually extracted and coded the free text data from visit notes, which involved converting the "assessment and plan" sections into discrete variables reflecting diagnoses and interventions (i.e. education and supportive psychotherapy). Results WBC received referrals from physicians (79.7%), nurse practitioners (1.1%), and midwives (0.1%). The mean infant and maternal age were 8.7 weeks (SD ± 11.4, 95% range 1.0 - 37.4) and 34.8 years (SD ± 4.7; 95% range 25.0 - 44.0), respectively, with 57.9% primiparity and 65.7% vaginal delivery. The WBC patient population mostly resided in Winnipeg (75.0%), Southern Health (15.0%), and Interlake-Eastern (8.1%) regional health authorities. Fort Garry, River East, and Saint Boniface were the most common locations in Winnipeg (34.4 % combined). Referrals to the WBC rose 2.1-fold after March 2020 (COVID-19 pandemic onset) compared to pre-pandemic and remained elevated post-restrictions (May 2023), reflecting both clinic growth over the years and COVID-19 pandemic conditions. At the time of referral, 40.6% of the patients were taking medication, and 42.1% had one or more medical conditions, with the most common being depression or anxiety (20.1%) and thyroid disorder (8.8%). Patients reported supply issues (54.6%), nipple pain (43.8%), and tongue tie concerns (29.6%) as reasons for attending the WBC. In comparison, infant feeding mechanic challenges (35.4%), low milk supply (30.4%), and nipple issues (30.4%) were the most common WBC physician-diagnosed difficulties. The higher percentage of reported low milk supply compared to diagnosed cases indicates that many parents perceived having a low milk supply without actually having it. Education, supportive psychotherapy, and prescriptions were identified as the main WBC intervention strategies. The most common education topics included infant care discussion (77.2%), feeding guidance (74.7%), and latch education (73.4%). The most common supportive psychotherapy topic was emotional status (anxiety and adjustment reactions) (43.0%). 10.5% of the WBC dyads received a prescription, with domperidone being the most common, prescribed to 6.1% of the clinic dyads. Conclusions This study lays the foundation for future research within the WBC and highlights the need to expand specialized lactation care beyond the Winnipeg region, provide timely interventions or referrals (e.g. tongue-tie release), and integrate infant care and lactation education into existing services.