National Assessment of Physicians' Breast-feeding Knowledge, Attitudes, Training, and Experience

Freed, Gary L.; Clark, Sarah J.; Sorenson, James R.; Lohr, Jacob A.; Cefalo, Robert C.; Curtis, P.

doi:10.1001/jama.1995.03520300046035

Cited by 228 publications

(79 citation statements)

References 14 publications

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“…The focus of a large number of workers has been on factors that lead to lower breastfeeding rates. There is enough evidence to show that lack of information for mothers; poor knowledge amongst health workers; underqualified health workers providing advice and the use of didactic lectures adversely affects breastfeeding [1,4,5]. Increasing knowledge and counseling skills of health workers and providing additional written instructions to mothers have been shown to improve breastfeeding rates [3,12,13].…”

Section: Discussionmentioning

confidence: 99%

“…Though it is now widely accepted that breast milk is the best for the baby, it is also a well-known fact that exclusive breastfeeding rates in early infancy are still too low [1][2][3]. A number of studies have shown that deficits in knowledge amongst health workers [1,4,5] and lack of adequate information being given to mothers [6][7][8][9] are major factors responsible for low rates of exclusive breastfeeding. Maternal education, race and socio-economic factors are also known to influence breastfeeding decisions [6,10,11].…”

Section: Introductionmentioning

confidence: 99%

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Maternal and Neonatal Factors Adversely Affecting Breastfeeding in the Perinatal Period

Narayan

Natarajan

Bawa

2005

Medical Journal Armed Forces India

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Background: Despite its known advantages, breastfeeding rates are low world over. Large number of factors affect breastfeeding. This study was designed to detect maternal and neonatal factors that adversely affect breastfeeding in the perinatal period. Methods: A prospective, single-blinded study was conducted on randomly chosen mother-infant pairs in the maternity ward of a tertiary care service hospital. Only full term singletons born by normal vaginal delivery were studied. The B.R.E.A.S.T observation score and time spent by the infant at the mother's breast were primary outcome variables. Maternal age, gravida, para status and education level were recorded. Birth weight, sex, gestation age of the infant and time interval from birth to observation were also recorded. Initial univariate analysis followed by multivariate analysis was performed using SPSS ver 7.5 software. Results: A total of 54 mother-infant pairs formed the study group; 19(35.2%) were primigravidas. Primigravidas status of the mother led to significantly lower scores (p<0.04; 95% CI 0.10 to 3.62) as did maternal age < 26 years (p<0.04; 95% CI 0.2. to 3.46) on univariate analysis. Low birth weight (<2500 g) was the only neonatal factor that significantly lowered breastfeeding scores (p<0.02;95%Cl 0.56 to 6.31). On multivariate analysis only primigravida status was significantly associated with lower scores (p<0.02). The alpha value of the study was 5% and the power was 74%. Time spent by infant on breast was not significantly different between primigravida and non-primigravida mothers. Conclusion: Primigravida status adversely affects breastfeeding scores; therefore counseling and support should be focused on this group. Extra care should also be taken to ensure adequate breastfeeding by younger mothers and in those with low birth weight infants. Larger studies with long-term follow up will be able to identify other factors and dertermine the effects of focused counseling and support in the perinatal period upon long-term breastfeeding rates. MJAFI 2005; 61 : 216-219

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Maternal and Neonatal Factors Adversely Affecting Breastfeeding in the Perinatal Period

Narayan

Natarajan

Bawa

2005

Medical Journal Armed Forces India

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“…[32] Obstetricians and pediatricians are by their own admission poor at technical breastfeeding support. [33,34] Further study of the content of providers' encouragement on breastfeeding practices is needed.…”

Section: Weaknessesmentioning

confidence: 99%

Evaluating the impact of provider breastfeeding encouragement timing: Evidence from a large population-based study

Chao

Goldfinger

Gozalians

et al. 2016

JER

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Background: Exclusive breastfeeding is the healthiest and most economical form of infant nutrition. Although research has indicated that professional support increases the length of time women breastfeed, the optimal timing of provider encouragement to sustain mothers' breastfeeding is unknown. We evaluated the impact of the timing of provider encouragement on breastfeeding initiation and three-month duration, especially among racial/ethnic minority mothers who have been underrepresented in breastfeeding outcomes research. Methods:We used data from the 2010 Los Angeles Mommy and Baby (LAMB) Survey. LAMB is a population-based mail survey, distributed to women in Los Angeles County who recently gave birth to a live infant. Participants were asked about their perceptions of provider encouragement of breastfeeding at three specific time points: during prenatal care visits, during the birth hospital stay after the baby was born, and during early well-baby checkups. Mothers were asked whether they breastfed or pumped breast milk to feed their baby after delivery and if they were still breastfeeding at the time of the survey.Results: Overall, 87.6% of LA County mothers initiated breastfeeding after delivery. At 3 months, 60% were still breastfeeding. Adjusted logistic regression analysis showed a positive association between provider encouragement at the delivery hospital and breastfeeding initiation (aOR = 2.7, 95% CI = 1.60-3.96) that was significant across all races/ethnicity. Encouragement during well-baby checkups was positively associated with breastfeeding at 3 months (aOR = 1.5, 95% CI = 1.22-1.93). This latter association was found among all races and ethnicities, except for Black mothers. There was no association between encouragement provided during prenatal care and breastfeeding practices. Conclusions:The optimal timing of provider encouragement on breastfeeding initiation is likely during the birth hospitalization, while sustained breastfeeding likely requires professional support after discharge. Culturally appropriate interventions to maintain positive breastfeeding practices must be identified, especially for black mothers.

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“…4,5 In addition, some hospital infant feeding practices may impede breastfeeding promotion. 3,6,7 All these factors contribute to less than optimal rates of initial and continuing breastfeeding.…”

Section: Introductionmentioning

confidence: 99%

Pediatricians' Practices and Attitudes Regarding Breastfeeding Promotion

1999

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ABSTRACT.Objective. Public awareness of the benefits of breastfeeding is expected to increase during and after the national, federally funded Best Start Breastfeeding Promotion Campaign. It is anticipated that this will result in more breastfeeding-based interactions between families and pediatricians. The American Academy of Pediatrics conducted a survey of its members to identify their educational needs regarding breastfeeding to assist in the design of appropriate information programs.Method. An eight-page, self-administered questionnaire was sent to 1602 active Fellows of the American Academy of Pediatrics.Results. The response rate was 71%. Breastfeeding, as the exclusive feeding practice for the first month after birth, was recommended by only 65% of responding pediatricians; only 37% recommended breastfeeding for 1 year. A majority of pediatricians agreed with or had a neutral opinion about the statement that breastfeeding and formula-feeding are equally acceptable methods for feeding infants. Reasons given for not recommending breastfeeding included medical conditions with known treatments that did not preclude breastfeeding. The majority of pediatricians (72%) were unfamiliar with the contents of the BabyFriendly Hospital Initiative. The majority of pediatricians had not attended a presentation on breastfeeding management in the previous 3 years; most said they wanted more education on breastfeeding management.Conclusion. Pediatricians have significant educational needs in the area of breastfeeding management. T he American Academy of Pediatrics (AAP) has long promoted breastfeeding as the optimal infant nutrition.1,2 Most pediatricians agree on the importance of breastfeeding and support breastfeeding promotion activities.3,4 However, many primary care physicians believe their training in breastfeeding management has been inadequate, and they lack confidence in their breastfeeding management abilities. 4,5 In addition, some hospital infant feeding practices may impede breastfeeding promotion. 3,6,7 All these factors contribute to less than optimal rates of initial and continuing breastfeeding. 8 It is anticipated that breastfeeding awareness will increase nationwide as the federally funded Best Start Breastfeeding Promotion Campaign is launched.9 This campaign is targeted initially at 10 states to raise public awareness of breastfeeding through pre-and postnatal parent counseling and media promotion. Increased public awareness is expected to increase breastfeeding-related interactions between families and physicians.The AAP Division of Chapter Services and the Work Group on Breastfeeding of the Committee on Community Health Services initiated this survey of Fellows of the AAP (FAAP) to assess breastfeeding attitudes, knowledge, and management skills of pediatricians, as well as awareness of their hospitals' breastfeeding promotion activities. Results from this survey are expected to help in the design of appropriate breastfeeding education programs for physicians. METHODSThis was the 30th in a series o...

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National Assessment of Physicians' Breast-feeding Knowledge, Attitudes, Training, and Experience

Cited by 228 publications

References 14 publications

Maternal and Neonatal Factors Adversely Affecting Breastfeeding in the Perinatal Period

Maternal and Neonatal Factors Adversely Affecting Breastfeeding in the Perinatal Period

Evaluating the impact of provider breastfeeding encouragement timing: Evidence from a large population-based study

Pediatricians' Practices and Attitudes Regarding Breastfeeding Promotion

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