Breastfeeding and clinician knowledge: An assessment among nurses, WIC staff, advanced practitioners, and dieticians

Background: Clinician knowledge on breastfeeding has been reported as lacking. Project HELP was an intervention to increase breastfeeding initiation in Massachusetts, by educating hospital and community-based clinicians with a 12 hour breastfeeding course.

Objective: To assess pre-existing breastfeeding knowledge among diverse clinicians attending an intensive breastfeeding course.

Methods: Teaching occurred between 2005 and 2006, at 4 institutions in 3 cities. Before each session, participants completed a pre-test to gauge pre-existing breastfeeding knowledge. Responses to 14 questions were used in this study; inclusion criteria were based on breadth of applicability and significance. Breastfeeding knowledge was analyzed using a Chi-Square test.

Results: 359 pretests were completed in 6 different teaching sessions. Clinicians were comprised of 287 nurses; 31 WIC personnel; 21 advanced practitioners (including physicians, educators, and nurse practitioners), and 20 dieticians. Overall by discipline, nurses scored highest, with 62% of correct answers, and advanced practitioners lowest, with 51% of correct answers. In total, 60% of all questions were answered correctly. The highest scores were on knowledge of Healthy People 2010 goals (87% correct), and the lowest, on knowledge of vitamin D recommendations for breastfeeding women from the American Academy of Pediatrics (13% correct). 48% of WIC staff knew maternal hepatitis C was not a contraindication to breastfeeding, compared to 23% of advanced practitioners. There were statistically significant differences among the proportion of correct answers between clinician groups.

Conclusion: Clinician knowledge of pertinent breastfeeding issues was poor. These findings suggest a need for further breastfeeding education, especially among advanced practitioners.