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Background: Although the benefits of breastfeeding are broadly acknowledged with the efforts of the government and several medical societies, the rate of exclusive breastfeeding through 6 months is lower in Korea than in developed countries., Purpose: This study aimed to investigate pediatricians' perceptions of breastfeeding barriers and the current breastfeeding counseling environment and propose government policies to encourage breastfeeding in Korea., Methods: Fourteen survey questions were developed during meetings of Korean Society of Breastfeeding Medicine experts. The Korean Pediatric Society emailed a structured questionnaire to domestic pediatricians registered as official members of the Korean Pediatric Society on May 4, 2021, and June 3, 2021. This study examined the survey responses received from 168 pediatricians., Results: The 168 respondents included 62 professors, 53 paid doctors, and 53 private physicians. Breastfeeding was recommended by 146 Korean pediatricians (86.9%). However, only 99 responders (59%) currently provide breastfeeding counseling in hospitals. Most respondents stated providing less than 15 minutes of breastfeeding counseling time in the clinic. Moreover, 89.88% of the respondents responded that they would participate in breastfeeding counseling education if an appropriate breastfeeding counseling program was newly established., Conclusion: This study showed that, although Korean pediatricians had a positive attitude toward breastfeeding, limited counseling was provided for parents. Along with policy support to improve the medical environment through the establishment of an appropriate breastfeeding counseling program, high-quality counseling and an increased breastfeeding rate are expected.

Background: Despite advances in neonatal intensive care and surgical procedures, perinatal mortality rates for premature infants with congenital heart disease (CHD) remain relatively high., Purpose: We aimed to describe the outcomes of premature infants with critical CHD and identify the risk factors including the new modified version of the Risk Adjustment for Congenital Heart Surgery (M-RACHS) category associated with in-hospital mortality in a Korean tertiary center., Methods: This was a retrospective cohort study of premature infants with critical CHD admitted to the neonatal intensive care unit from January 2005 to December 2016., Results: A total of 78 premature infants were enrolled. The median gestational age (GA) at birth was 34.9 weeks (range, 26.7-36.9 weeks), and the median birth weight was 1.91 kg (range, 0.53-4.38 kg). Surgical or percutaneous intervention was performed in 68 patients with a median GA at birth of 34.7 weeks (range, 26.7-36.8 weeks) and a median birth weight of 1.92 kg (range, 0.53-4.38 kg). The in-hospital survival rate was 76.9% among all enrolled preterm infants and 86.8% among patients who received an intervention. Very low birth weight (VLBW), persistent pulmonary hypertension of the newborn (PPHN), bronchopulmonary dysplasia (BPD), and M-RACHS category 5 or higher (more complex CHD) were independently associated with in-hospital mortality. For the 68 premature infants undergoing cardiac interventions, independent risk factors for mortality were VLBW, BPD, and CHD complexity. Late preterm infant and age at intervention were not associated with patient survival., Conclusion: For premature infants with critical CHD, VLBW, PPHN, BPD, and M-RACHS category ≥5 were risk factors for mortality. A careful approach to surgical intervention and prenatal care should be taken according to CHD type and neonatal condition.