Infant feeding education and support in prenatal care

Infant feeding practices have been investigated, and practices without breastfeeding have been associated with chronic ill health. Obstetricians are in position to offer breastfeeding education and support during prenatal care, a critical time to choose breastfeeding. Practicing obstetric members of Mississippi State Medical Association were surveyed for agreement, awareness, and practice of WHO/UNICEF Ten Steps to Successful Breastfeeding. A questionnaire was developed with a panel of experts and pilot tested. Three-wave mailing resulted in 59.2% response. Analysis included frequencies, percents, and cross tabulations with chi-square tests. A majority of obstetricians were Caucasian (85.3%), males (68.1%), and in group practice (89.2%). More than half (53.4%) practiced obstetrics for 16+ years. Ninety-plus percent agreed with two of eighteen statements on Ten Steps. Fifteen (12.9%) were familiar with Ten Steps. Sixty-nine percent discussed infant feeding, 68.1% encouraged breastfeeding, and 54.3% recommended breastfeeding classes. Referrals to breastfeeding specialists such as lactation consultants (IBCLCs) and La Leche League Leaders were minimal. Obstetricians (77.6%) reported no training in lactation management within the last three years. Chi-square tests indicated five significant comparisons (p<.05, two-tailed). Female and male obstetricians differed in agreement with Ten Steps and frequencies of discussions on infant feeding and distribution of formula coupons. More obstetricians with 11-15 years of practice did not agree that discussions on breastfeeding influence patient's decision to breastfeed. Rooming-in practice was unfamiliar to more obstetricians with no children of their own. These findings suggest disconnection between current research breastfeeding education and support and Mississippi obstetric maternity care practice patterns.