Research to assess breastfeeding knowledge and confidence of Canadian physicians

The results of a national research project to assess breastfeeding knowledge, confidence, beliefs, and attitudes of Canadian physicians are available today in the Journal of Human Lactation.

"Physicians' attitudes and recommendations are known to directly impact the duration that a mom breastfeeds," said Dr. Catherine Pound, pediatrician and lead author of the study at the Children's Hospital of Eastern Ontario (CHEO). "Worldwide healthcare organizations readily promote the benefits of breastfeeding, and yet now we find a gap exists where patients least expect it - with their physician."

The research team surveyed pediatricians, family physicians and medical residents across Canada. They defined an overall knowledge score of 70% as acceptable, because it's the minimum score pediatricians must achieve in their specialty examination to receive certification from the Royal College of Physicians and Surgeons of Canada.

They found that Canadian physicians' breastfeeding knowledge was suboptimal; the mean survey score was less than 70%. Several deficits were identified in their breastfeeding knowledge, including appropriate breastfeeding techniques, latch, and recommendations pertaining to milk supply and breast pumps for example.

Certain factors had a positive association with knowledge and confidence about breastfeeding, namely: if the physician is female; between the ages of 30-50 years old; their practice includes a high percentage of patients under 1 year old; and they have personal breastfeeding experience.

"Most physicians would benefit from greater education and support, to help optimize care of infants and their mothers," said Dr. Pound. "Moms need to know their doctor might not have the skill or confidence to help them with breastfeeding. Don't give up - breastfeeding is simply too important - look elsewhere, for now, for support and information."

Attending physicians were randomly selected for the survey, but residents self-selected to participate. The difference in scores between the two groups could suggest that breastfeeding skills are primarily learned with clinical and life experience, rather than in residency. These point to a potential gap in pediatric and family medicine residency training, of which the research team is currently working to address.