Prenatal Provider Support for Breastfeeding: Changes in Attitudes, Practices and Recommendations Over 22 Years

Background: Prenatal care providers play a central role in breastfeeding outcomes. A survey on obstetricians’ support of breastfeeding was conducted in 1993 in Monroe County, NY. Since the landscape of prenatal care and breastfeeding support has changed significantly in the past 2 decades, we repeated and extended this survey in 2015. Research aim: To determine changes in breastfeeding support by prenatal care providers over a 20 year period. Methods: We sent a 46-item on-line or paper questionnaire to all categories of prenatal care providers identified by an online search. A breastfeeding support score was created based on the prior survey, with a maximum score of 3. One point was awarded for: (1) personally discussing breastfeeding; (2) generally suggesting breastfeeding; and (3) commonly receiving questions from patients. Data were analyzed using Chi-square. Results: We had 164 participants (response rate 80%). More current participants, compared to 1993, reported discussing (97% vs. 86%, p < .001) and recommending (93% vs. 80%, p = .001) breastfeeding. Only 10% of 2015 participants gave infant formula samples, compared with 34% in 1993 ( p < .0001). Improvement in the support score was seen, with 98% of current participants having high scores compared to 87% in 1993 ( p < .001). Similar numbers reported receiving breastfeeding education, though more reported that the education was inadequate (54% vs. 19%, p < .0001). Conclusion: Breastfeeding support improved significantly over time, even though breastfeeding education has not improved in quality or quantity. Improving education of prenatal care providers may help future providers be more prepared to support breastfeeding.

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Trends in breastfeeding practices and mothers’ experience in the French NutriNet-Santé cohort

International Breastfeeding Journal ◽

10.1186/s13006-021-00397-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Frédéric Courtois ◽

Sandrine Péneau ◽

Benoît Salanave ◽

Valentina A. Andreeva ◽

Marie Françoise Roland-Cachera ◽

...

Keyword(s):

Public Health ◽

Census Data ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Breastfeeding Support ◽

The Public ◽

The Past ◽

Breastfeeding Practices ◽

Breastfeeding Education ◽

Breastfeeding Cessation

Abstract Background France has one of the lowest rates in the world regarding breastfeeding initiation and duration. Few studies have explored breastfeeding practices in France since the middle of the twentieth century, or following from initiation to cessation. The purpose of our study was to determine trends in breastfeeding over the past decades regarding public health recommendations, and to examine mothers’ perceptions about factors known to have an impact on breastfeeding support and cessation. Methods From the NutriNet-Santé cohort, 29,953 parous women (launched in 2009 to study relation between nutrition and health), were included in the present study. Using web-questionnaires, they were asked retrospectively if they had breastfed their youngest child or not, and if so, the duration of exclusive and total breastfeeding. For those who had breastfed, we investigated their perceptions about support at initiation and during the entire breastfeeding period and reasons for breastfeeding cessation. We also asked those who did not breastfeed about their perceptions and reasons for infant formula feeding their youngest child. Analyses were weighted according to the French census data. Results In the NutriNet-Santé cohort, 67.3% of mothers breastfed their youngest child. The proportion of breastfed children increased over the past few decades, from 55.0% (95% CI 54.3, 55.6) in the 1970s to 82.9% (82.4, 83.4) in the 2010s. Total and exclusive breastfeeding duration went from 3.3 months and 2.4 months respectively in the 1970s to 5.9 months and 3.2 months respectively in the 2010s. Most mothers felt supported at initiation and during the breastfeeding period. A reported desire to have breastfed longer than two months was 59.5%. Mothers who did not breastfeed did it by choice (64.3%). They did not feel guilty (78.2%) and did not perceive a problem not to breastfeed (58.8%), but almost half of them would have liked to have breastfed (45.9%). Conclusion Breastfeeding duration has increased in the past decades but did not reach the public health recommendations threshold. Targets other than mothers have to be considered for breastfeeding education, like the partner and her environment, to increase breastfeeding practices. Trial registration The study was registered at ClinicalTrials.gov (NCT03335644).

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Should prenatal care providers offer pregnancy options counseling?

BMC Pregnancy and Childbirth ◽

10.1186/s12884-018-2012-x ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Nancy F. Berglas ◽

Valerie Williams ◽

Katrina Mark ◽

Sarah C. M. Roberts

Keyword(s):

Prenatal Care ◽

Care Providers ◽

Prenatal Care Providers

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Lessons from prenatal care provider-based recruitment into the National Children’s Study

Pediatric Reports ◽

10.4081/pr.2015.6056 ◽

2015 ◽

Vol 7 (3) ◽

Cited By ~ 1

Author(s):

James M. Robbins ◽

Melissa D. Bridges ◽

Elizabeth M. Childers ◽

Roseanne M. Harris ◽

Pearl A. McElfish

Keyword(s):

Prenatal Care ◽

Care Providers ◽

Recruitment Method ◽

Equivalent Number ◽

Prenatal Care Providers ◽

Status Number ◽

Public Clinics ◽

Benton County ◽

Birth Records ◽

Successes And Challenges

In response to recruitment difficulties experienced by the National Children’s Study, alternatives to the door-to-door recruitment method were pilot tested. This report describes outcomes, successes, and challenges of recruiting women through prenatal care providers in Benton County, Arkansas, USA. Eligible women residing in 14 randomly selected geographic segments were recruited. Data were collected during pregnancy, at birth, and at 3, 6, 9, 12, 18, and 24 months <em>postpartum</em>. Participants were compared to non-enrolled eligible women through birth records. Of 6402 attempts to screen for address eligibility, 468 patients were potentially eligible. Of 221 eligible women approached to participate, 151 (68%) enrolled in the 21-year study. Enrolled women were similar to non-enrolled women in age, marital status, number of prenatal care visits, and gestational age and birth weight of the newborn. Women enrolled from public clinics were more likely to be Hispanic, lower educated, younger and unmarried than those enrolled from private clinics. Sampling geographic areas from historical birth records failed to produce expected equivalent number of births across segments. Enrollment of pregnant women from prenatal care providers was successful.

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