Prenatal office practices regarding infant feeding choices

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Pediatrics

Background:

• Breastfeeding offers significant health benefits for infants and mothers.
• Prenatal care is a critical period for establishing infant feeding intentions and practices.
• Understanding healthcare providers' roles is essential for improving breastfeeding support.

Purpose of the Study:

• To assess the extent of breastfeeding promotion by obstetric care providers during prenatal care.
• To identify differences in breastfeeding support practices among family practitioners (FP), obstetric-gynecologists (OB/GYN), and nurse midwives (NM).

Main Methods:

• A questionnaire survey was distributed to FP, OB/GYN, and NM in Iowa, USA.
• The survey collected data on providers' practices regarding infant feeding preferences, breastfeeding counseling, and provision of educational materials.
• Data were analyzed to compare breastfeeding promotion efforts across provider types.

Main Results:

• All NM, 97% of FP, and 85% of OB/GYN inquired about infant feeding preferences, typically at the first prenatal visit.
• Nurse midwives were most likely to provide extensive breastfeeding counseling (73%), while OB/GYNs (68%) and FP (90%) reported providing their own counseling.
• Breast examinations for future breastfeeding issues were common (82-84%), but NM practices shared more breastfeeding-supportive information. Formula samples were more prevalent in FP and OB/GYN offices than NM offices.
• NM (64%) strongly advocated for breastfeeding compared to FP (13%) and OB/GYN (7%).

Conclusions:

• Breastfeeding promotion is limited in most prenatal care settings.
• Significant disparities exist in breastfeeding support practices among different obstetric care provider types.
• Interventions are needed to enhance prenatal breastfeeding education and support across all provider disciplines.