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The effort to increase breast-feeding. Do obstetricians, in the forefront, need help?
Michael L Power1, Elaine Locke, Janet Chapin
1Department of Research and Division of Women's Health Issues, American College of Obstetricians and Gynecologists, 409 12th Street, SW, Washington, DC 20024. mpower@acog.org
Objective:
To assess the knowledge, training and attitudes of obstetricians concerning management of breast-feeding.
Study Design:
A survey was sent to 1,200 fellows of the American College of Obstetricians and Gynecologists; 397 practicing obstetricians responded.
Results:
Obstetricians who were satisfied with their patients' behavior (69.5%) estimated that on average > 70% of their patients planned to breast-feed, while those who were unsatisfied (21.4%) estimated that < 60% of their patients planned to breast-feed. African American race and eligibility for Medicaid both appear to predict low rates of breast-feeding among patients. Most physicians considered that they were very well qualified to treat mastitis, prescribe maternal medications and advise their patients regarding contraception. They were less certain of their qualifications regarding educating their patients about breast-feeding and aiding them in solving breast-feeding problems. Personal breast-feeding experience was a significant predictor of female physician confidence. Four of 10 physicians regarded their residency training as inadequate in terms of breast-feeding management.
Conclusion:
The perceptions of obstetricians regarding breast-feeding practices of their patients appear consistent with national surveys. Obstetricians consider counseling their patients and managing breast-feeding care to be important parts of their clinical responsibilities, but further training and educational materials are warranted.