226528 Role of Doctors and Hospitals in WIC Mothers' Breastfeeding Initiation and Duration

Wednesday, November 10, 2010

Caitlin Cross-Barnet, PhD , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Marycatherine Augustyn, PhD , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Amy Resnik, MS, RD, CSP, LDN , Maryland WIC Program, Maryland State Department of Health and Mental Hygiene, Balitmore, MD
Susan Gross, PhD, MPH, RD , Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Joy P. Nanda, DSc, MS, MHS, MBA , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
David M. Paige, MD MPH , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Introduction: Following recommendations by The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics, the USDA Special Supplemental Nutrition Program (WIC) promotes breastfeeding as the optimal infant feeding method and provides its prenatal and breastfeeding participants with breastfeeding education and support. This support is increasingly given by Breastfeeding Peer Counselors (PCs). However, many WIC participants don't initiate or breastfeed only briefly. We report qualitative analysis of mother's experiences with the medical community and subsequent breastfeeding outcomes. Design: Eight Maryland Breastfeeding PCs and 81 PC clients with infants were interviewed at 3 Maryland WIC clinics. Mothers reported on breastfeeding education and support from obstetricians, hospital staff, and pediatricians. PCs related participant experiences as told to them. Results: All mothers reported that at least one medical professional asked about feeding plans or told them breastfeeding was the healthiest choice. Few reported hearing other benefits. While in the hospital, many intending to breastfeed were encouraged to supplement with formula, introduce pacifiers, or attempt to pump. Some infants received formula without maternal consent. Few mothers received hands-on support. PCs' reports supported mothers' experiences. Discussion: Results indicate that medical personnel generally believe that breastfeeding is the optimal choice but are not effectively supporting their patients. Mothers' breastfeeding ability and confidence were undermined by introduction of bottles, pacifiers, and breast pumps during the postpartum hospital stay and by limited pediatrician assistance. In order for breastfeeding to be successful, medical personnel need to focus on personalized prenatal education and postnatal hands-on support.

Learning Areas:
Advocacy for health and health education
Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Identify forms of breastfeeding information and support that WIC mothers receive from medical personnel. Evaluate the effectiveness of medical education, support, and policies. Analyze the impact prenatal, in-hopsitall and postnatal contact with physicians and other medical personnel have on mother's breastfeeding initiation and duration.

Keywords: Breastfeeding, Physicians

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a researcher with the Maryland WIC Peer Counselor Evaluation for three years. AL of my research pertains to issues related to gender and poverty.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5017.0: Breastfeeding Poster Session