Search

Introduction: Breastfeeding provides all essential nutrients for the first 6 months of life and plays an important role in ensuring health in neonates and mothers. This study was carried out among northern Iranian primary school teachers to determine the knowledge about breastfeeding. Materials and Methods: This is a descriptive-crossectional study and where 745 subjects were chosen by random and cluster sampling. Data was collected by questionnaire about social-demographic and the optimal food awareness at fist 6 months of age. Data was analyzed by SPSS win soft-war. Chi-2 test was used to compare groups. Results: Teacher's knowledge about exclusive breastfeeding and breastfeeding with breast milk substitutes as the best diet was 81.6% and 17.6%, respectively. There was no statistical difference between the teachers who were non-university graduates (78.0%) or those who were university graduates (83.3%). The knowledge of breastfeeding among Turkman and Non-Turkman was 85.1% and 80.2% and male to female was 80.6% and 82.6%, respectively. There were no statistical differences between these variables. Conclusion: The teacher's knowledge about advantages of breastfeeding was low and that it was influenced by social-economic factors. Further studies need to be carried out in this area for determining the difficulties of breastfeeding. Key words: Breastfeeding; Teacher; Knowledge; Ethnicity; Iran DOI: 10.3126/jnps.v31i1.3411 J Nep Paedtr Soc 2010;31(1):39-43

The aim of this study was to examine the relationship between knowledge levels of exclusive breastfeeding (EBF) and EBF practice among HIV-positive mothers, who had babies aged 0–6 months. A convenience sampling method was used to recruit 81 study participants. A structured interview schedule was used to question participants on practice and knowledge. A Pearson's correlation coefficient matrix was used to explore the relationship between knowledge and practice. Results showed a positive significant relationship between knowledge levels of EBF and EBF practice (r=.313, P=

The benefits of breastfeeding for infant, mother, family, and community are well recognized, and increasing breastfeeding rates is considered an important health-promotion strategy. Improving breastfeeding knowledge and practice among individuals caring for breastfeeding women is considered an important aspect of this strategy. The practice-development initiative described in this article aimed to improve hospital-based breastfeeding rates through the implementation of The Ten Steps to Successful Breastfeeding. The initiative included the development and implementation of an education program aimed at changing and improving breastfeeding practices. The program was evaluated in three ways: changes in breastfeeding rates at hospital discharge; client preparation for breastfeeding and satisfaction during the postnatal period; and staff knowledge and skills.

Breastfeeding offers numerous health advantages to children, mothers, and society. From obstetrics to pediatrics, breastfeeding dyads come in contact with a wide range of healthcare providers. The American Academy of Pediatrics (AAP) calls for pediatricians to support breastfeeding enthusiastically and for all children to have a medical home. We studied an inner-city healthcare system with a Dyson Community Pediatrics Training Initiative Model Medical Home clinic, to explore how a breastfeeding/baby-friendly medical home might be built upon this framework. We describe breastfeeding knowledge, attitudes, and practices among a full range of providers and healthcare system-level barriers to effective and coordinated breastfeeding services.We conducted eight focus groups using semistructured interviews: (1) pediatricians; (2) obstetricians; (3) pediatric nurses and allied health professionals; (4) obstetric nurses and allied health professionals; (5) 24-hour telephone triage answering service nurses; (6) public health nurses; (7) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) personnel; and (8) lactation consultants and peer counselors.We identified gaps in providers' breastfeeding knowledge, counseling skills, and professional education and training. Providers' cultures and attitudes affect breastfeeding promotion and support. Providers used their own breastfeeding experiences to replace evidence-based knowledge and AAP policy statement recommendations for breastfeeding dyads. There were communication disconnects between provider groups. Providers underestimated their own, and overestimated others', influence on breastfeeding. The system lacked a coordinated breastfeeding mission.This study illuminated key disconnectedness challenges (and, hence, opportunities) for a model medical home in fostering continuous, comprehensive, coordinated, culturally effective, and evidence-based breastfeeding promotion and support.

Examine association between socio-demographic characteristics and breastfeeding knowledge, self-efficacy and breastfeeding attrition prediction among rural Hispanic women. 46 rural Hispanic women, aged 18–38 years were enrolled from Regional West Medical Center, Scottsbluff, Nebraska. Intervention (n = 23) and attention control groups (n = 23) received bi-lingual breastfeeding education using touch screen computer and printed educational material. Participants were enrolled during last 6 weeks of pregnancy. Follow up assessments were at days 3 and 7, weeks 2 and 6, and months 3 and 6 postpartum. More than half of participants were single and had 10–12 years of education. Less than half of them had ever breastfed their children. No differences in knowledge, self-efficacy and intent to breastfeed scores were seen between two groups. Significant positive association was seen between self-efficacy and intent to breastfeed. Self-efficacy is an important predictor of intent to breastfeed among rural Hispanic women.

Background:Since 2003, WHO has recommended exclusive breastfeeding (EBF) for the first 6 months of life. In the NW Region of Cameroon only 34% of women EBF for six months. Previous research indicates that family members positively influence women's breastfeeding practices, but are often excluded from breastfeeding promotion campaigns. Study Objective: To design an Entertainment Education (EE) audio program to test the hypothesis that EE improves EBF knowledge, benefits, and decreases misconceptions and barriers among family members of breastfeeding women. Methods: Formative research consisting of 12 semi-structured interviews and 6 focus group discussions informed the content of an EE audio program using grounded theory. Differences in EBF knowledge, benefits, barriers and misconceptions between and within the control group and the intervention group were evaluated using pre-and post-tests and analyzed with Wilcoxon Sign Test and Mann-Whitney statistical tests. Results: The audio program significantly imp...

Background: It is prudent that health care professionals remain cognizant of breastfeeding-related issues to support nursing mothers. In 1995, Freed and colleagues noted deficits in breastfeeding knowledge among family medicine, pediatric, and obstetrics/gynecology residents and practitioners. Others reported similar findings despite calls to action and reports of successful breastfeeding interventions. Objective: This retrospective study compared baseline breastfeeding knowledge and attitude scores from Nevada health care professionals from 2004 through 2013. Methods: In-training and practicing professionals (pediatric/family practice/obstetric residents and attending physicians; hospital nursing staff; nursing and medical students) attended a 90-minute workshop at their sites. Following each session, attendees voluntarily completed a survey consisting of 2 knowledge and 2 attitudinal questions, using the post:pre-evaluation method, which diminishes overinflation of pretest scores as respondents can more accurately reflect their baseline levels. A Kruskal-Wallis test evaluated differences in baseline knowledge and attitude scores among 3 professional groups and for physicians over the 10-year period using Bonferroni post-hoc analyses. Results: A total of 889 professionals participated, with only physicians represented yearly. Except for knowledge of milk production, physician median baseline scores did not differ significantly over time. Overall, hospital nurses had significantly higher median baseline knowledge scores about initiation and frequent feeding than physicians and students. Nurses also had higher median attitude scores (likelihood of and confidence in talking with parents about breastfeeding) than physicians who had higher scores than students. Conclusion: Despite growing societal enthusiasm and support, the baseline knowledge of and attitudes toward breastfeeding showed minimal change over 10 years.

Contains fulltext : 154682.pdf (Publisher’s version ) (Open Access) PURPOSE: The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status. METHODS: Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers' employment status. RESULTS: Breastfeeding initiation rates were similar regardless of mothers' employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers. CONCLUSION: These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.

Poor breastfeeding practices are widely documented in Kenya, where only a third of children are exclusively breastfed for 6 months and only 2% in urban poor settings. This study aimed to better understand the factors that contribute to poor breastfeeding practices in two urban slums in Nairobi, Kenya. In‐depth interviews (IDIs), focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with women of childbearing age, community health workers, village elders and community leaders and other knowledgeable people in the community. A total of 19 IDIs, 10 FGDs and 11 KIIs were conducted, and were recorded and transcribed verbatim. Data were coded in NVIVO and analysed thematically. We found that there was general awareness regarding optimal breastfeeding practices, but the knowledge was not translated into practice, leading to suboptimal breastfeeding practices. A number of social and structural barriers to optimal breastfeeding were identified: (1) poverty, livelihood and living arrangements; (2) early and single motherhood; (3) poor social and professional support; (4) poor knowledge, myths and misconceptions; (5) HIV; and (6) unintended pregnancies. The most salient of the factors emerged as livelihoods, whereby women have to resume work shortly after delivery and work for long hours, leaving them unable to breastfeed optimally. Women in urban poor settings face an extremely complex situation with regard to breastfeeding due to multiple challenges and risk behaviours often dictated to them by their circumstances. Macro‐level policies and interventions that consider the ecological setting are needed.

PURPOSE This study assessed physician assistant (PA) students' self-perceived knowledge/counseling skills regarding breastfeeding before and after a newly implemented web-based curriculum and lactation consultant shadowing experiences. METHODS The study included 37 students (100% response rate) at the principal investigator's institution, Baylor College of Medicine. A 19-item, Likert-scale electronic questionnaire was provided to students before and after participation in a new breastfeeding curriculum experience. Wilcoxon signed-rank and Mann-Whitney U tests were used for analysis. The curriculum consisted of seven self-paced, web-based modules concerning fundamental topics of breastfeeding, as well as a 3-hour lactation consultant shadowing experience. RESULTS Significant improvement in self-perceived knowledge/counseling skills was noted, with an overall mean precurriculum score of 40.19, versus 76.59 for the postcurriculum score (statistically significant at z = -5.30, P < .05). Gender and age group score comparisons revealed no significant differences. CONCLUSION Participation in the new curriculum and shadowing experience significantly increased PA students' levels of confidence concerning their breastfeeding knowledge/counseling skills. Because PAs significantly participate in one-on-one patient care, they should be educated on the topic of breastfeeding to better promote the well-being of both infants and their mothers.

Introduction The purpose of this secondary analysis is to examine and report on pediatric nurse practitioners' (PNPs') attitudes, experience, and knowledge about breastfeeding and to compare the results with those from a sample of pediatricians and other nurse practitioners and nurse-midwives. Method A breastfeeding study questionnaire was sent to all PNPs (N = 95) in a northwestern state. The response rate was 81%. Results Respondents were nearly unanimous in their belief that “breast is best” and that it was their role to recommend breastfeeding to expectant mothers. In general, 74% of respondents believed they were effective or very effective in meeting the needs of breastfeeding patients. Although they were very supportive of breastfeeding, they were less knowledgeable about specific management strategies. Personal experience (nearly three fourths had themselves breastfed) was named by many as the most valuable source of information. Although PNPs appeared to have a more supportive attitude and better information than pediatric physicians, they reported themselves to be less effective in providing breastfeeding assistance than did their pediatric physician colleagues. Discussion PNPs generally agreed about the importance of promoting breastfeeding and their effectiveness in doing so. However, many PNPs did not gain experience in breastfeeding support and management in their educational programs and incorrectly answered questions on basic management strategies.

Objective To explore relationships among breastfeeding knowledge, breastfeeding confidence, and infant feeding plans and their effects on feeding practices in first-time breastfeeding mothers. Design Prospective descriptive design. Setting Telephone interviews were conducted prenatally and at 6 weeks, 3 months, and 6 months postpartum. Participants Seventy-four of 83 first-time mothers with prenatal intentions to breastfeed completed all study requirements. The majority were White (95%), between the ages of 21 and 30 years (73%), with a post–high school education (85%), and household incomes of more than 200% of the federal poverty guideline (88%). Main Outcome Measures Breastfeeding knowledge, breastfeeding confidence, planned infant feeding method, planned breastfeeding duration, weeks of daily human milk substitute feeding, breastfeeding duration, achievement of breastfeeding goals. Results Breastfeeding knowledge was strongly correlated with breastfeeding confidence (r=.262; p=.025) and actual lactation duration (r=.455; p =.0001). Compared with women planning to exclusively breastfeed their infants, those planning to combination feed planned shorter breastfeeding duration (p=.022), reported shorter actual duration (p=.004), and were less likely to meet their breastfeeding goal (p=.034). The variables maternal education, breastfeeding knowledge, and weeks of daily human milk substitute feeding were used to develop a prediction equation that correctly categorized 93% of participants who met their breastfeeding goal and 90% of those who did not. Conclusions Expectations and the actual breastfeeding experience differed among women planning to combination feed and those planning to exclusively breastfeed. Whether a cause or consequence, daily human milk substitute feeding was associated with negative breastfeeding outcomes.

Background: The issue of malnutrition that leads to food security is not just a technical issue, but also a matter of individual habit to meet nutrients needed, including nutrients for fetus. The Government agrees to address the issue of food security in the first 1,000 days of life. This study aims at determining the influence of Infant Feeding Planning (Intention) Education on Nutrition and Breastfeeding Knowledge, Mother’s Attitude, and Husband’s Support to gravid Mother in Samarinda.Methods: This study is a quasi-experimental research design with pre and post control group. The sample size was 30 in the intervention group and 30 in the control group. The independent variable in this study was intention to breastfeed, while the dependent variables were breastfeeding and nutrition knowledge, mother’s attitude and husband’s support. The data were analyzed using paired t test, Wilcoxon test, ANOVA and MANOVA.Results: The study found the differences between intervention group and control group in nutrition knowledge, breastfeeding knowledge, and attitude. There was no difference between the groups in intention. The variables that influenced knowledge were education and employment. The variables influenced by the intention to breastfeed were breastfeeding knowledge, nutrition knowledge, and attitude. Intention had the greatest impact on the attitude, with the power observed at 0.689 which means that the intention affected the attitude of breastfeeding by 68.9%.Conclusions: Infant feeding planning education influences breastfeeding and nutrition knowledge as well as breastfeeding attitude.

Healthcare provider’s knowledge has been identified as a factor associated with clinical practice skills and exclusive breastfeeding prevalence.To evaluate the level of knowledge and training in breastfeeding of healthcare provider’s that work in family healthcare centers of Maipu, Chile, (midwifes, physicians, nurses and nutritionists). To determine association among level of knowledge, profession and breastfeeding training.Quantitative, cross-sectional, analytical study. Participants were healthcare professionals regularly participating in healthy child exams of six month old babies. We used a validated survey based on the “Ten steps for successful breastfeeding”. Statistical analyses included frequencies, percentages, measures of central tendency as well as the association among level of knowledge, profession and training in breastfeeding.Results showed that of the total number of participants (n=78), 42.2% classified as “average”, 3.8% as “poor” and near 50% as “good” or “very good” knowledge. Nutritionists obtained the best scores in knowledge about breastfeeding with 50% of “very good”, followed by nurses and midwifes, with 39% and 35% respectively. On the other hand, most physicians obtained “good” (65.4%) and only 7.7% “very good”. Only 33% had had breastfeeding training at some point of their lives, and 6.4% had had one training session in the last year. We highlight that 34.6 to 42.3% of those who obtained “good” and “very good” scores had had breastfeeding training. Knowledge level was directly associated with breastfeeding training (p=0.033) and healthcare profession (p=0.019).Healthcare professionals have different levels of breastfeeding knowledge. Breastfeeding training sessions significantly increase knowledge, which could improve breastfeeding prevalence.El conocimiento sobre lactancia materna de profesionales de la salud ha sido asociado a diferencias en la práctica y prevalencia de lactancia materna exclusiva.Evaluar nivel de conocimientos sobre lactancia materna en los profesionales que participan del control de salud del niño en los centros de salud familiar de la comuna de Maipú (matrona o matrón, médico, enfermera o enfermero, nutricionista); y determinar si existe asociación entre el nivel de conocimientos, la profesión y el estado de capacitación en lactancia materna en el momento de la encuesta.Estudio de tipo cuantitativo, transversal y analítico. Los participantes fueron profesionales de salud que regularmente son parte del control de niño sano hasta el sexto mes de vida. Se aplicó una encuesta basada en los “Diez pasos para una lactancia materna exitosa”. El análisis descriptivo consideró frecuencias, porcentajes y medidas de tendencia central, así como la asociación entre nivel de conocimiento, profesión y estado de capacitación.De un total de 78 participantes, 42,2% logró un concepto de calificación “regular”, sólo el 3,8% obtuvo el concepto “malo” y más del 50% de los profesionales obtuvieron calificación “bueno” y “muy bueno”. Los profesionales que obtuvieron mejor calificación por sus conocimientos en lactancia materna fueron nutricionistas con 50% de “muy bueno”, seguido por enfermeras(os) y matronas(es) con 39% y 35% respectivamente. Por otra parte, el 65,4% de los médicos obtuvo calificación “regular” y sólo un 7,7% “muy bueno”. Del total de los profesionales, sólo el 33% contaba con capacitación en lactancia materna (histórico) y 6,4% recibió capacitación en este tema durante el último año, destacando que el 34,6 y 42,3% de aquellos que obtuvieron conceptos “bueno” y “muy bueno” corresponden a profesionales capacitados. Se encontró asociación estadísticamente significativa entre el nivel de conocimiento en lactancia materna, profesión (p=0,019) y presencia de capacitación (p=0,033).Los profesionales de salud presentan distintos niveles de conocimientos en lactancia materna. Las capacitaciones en esta temática incrementan significativamente los conocimientos, lo que podría mejorar la prevalencia en lactancia materna.

Background: This study was performed to assess mothers’ knowledge and awareness level regarding maternal medication intake during lactation and health care providers’ role in promoting lactation.Methods: This study is a cross-sectional, questionnaire based survey study and a convenient sample of (820) breastfeeding mothers in Ajman and Sharjah, United Arab Emirates (U.A.E.) participated in the study. The results were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20. Descriptive statistics were used to summarize the data concerning the demographic characteristics and breastfeeding knowledge. Categorical variables (such as nationality and educational level) were described by using frequency, percentages, bar chart and pie chart.Results: The current study revealed a (72%) of maternal knowledge compared to (60.4%) four years ago and the most identified encouraging factor for the initiation of lactation stated by the respondents was their own decision followed by family support (58.4%, 39.8% respectively). The health care providers’ role was positively improved (58.4%) as observed in the current study compared to (52.1%) four years ago in UAE.Conclusions: An improvement was observed in terms of knowledge among breastfeeding mothers in the UAE compared to previous years as well as healthcare providers’ role which was also positively improved. Pharmacists were observed to have a low impact on the initiation of lactation, but on the other hand it was found that they had a significant role in terms of assessing maternal medication safety during lactation.

PURPOSE: This study was conducted to identify effects of breastfeeding knowledge, attitude, and barriers on breastfeeding practice on twin mothers and to provide basic data for successful breastfeeding for twins. METHODS: Participants were 151 mothers with two to twelve months-old twins. Data were collected from online support groups by an online survey. RESULTS: Mean score for breastfeeding knowledge was 18.34±4.63, for breastfeeding attitude was 3.61±0.51, and for barriers to breastfeeding was 13.35±1.08. The breastfeeding practice rate was 27.8% when twins were two months old. The breastfeeding knowledge was significantly different depending on mother's occupation, number of children, utilization of postpartum caretaker, and age of the children. There were significant differences in the breastfeeding attitude depending on gestational week of twins, planned length of the breastfeeding, and decision period for the breastfeeding. The practice of the breastfeeding was significantly different depending on the number of children. Factors influencing the breastfeeding practice were the breastfeeding attitude (p

Background:Physicians’ attitudes and recommendations directly affect breastfeeding duration. Yet, studies in many nations have shown that physicians lack the skills to offer proper guidance to breastfeeding mothers.Objective:This study aims to assess breastfeeding knowledge, confidence, beliefs, and attitudes of Canadian physicians.Methods:A breastfeeding questionnaire was developed and piloted prior to study enrollment. These questionnaires were sent to 1429 pediatricians (PED), 1329 family physicians (FP), and final-year pediatric and final-year family medicine residents (PR and FMR).Results:The analysis included 397 PED, 322 FP, 17 PR, and 44 FMR who completed the questionnaire. Mean overall correct knowledge score was 67.8% for PED, 64.3% for FP, 72.7% for PR, and 66.8% for FMR. Two hundred eighty-five PED (74.2%), 228 FP (73.1%), 7 PR (41.2%), and 21 FMR (53.8%) felt confident with their breastfeeding counseling skills. Less than half (49.6% of PED and 45.4% of FP) believed that evaluating breastfeeding was a primary care physician’s responsibility, and few PED or FP (5.1% and 11.3%) routinely observed breastfeeding in mother-infant pairs.Conclusion:Several areas of potential deficits were identified in Canadian physicians’ breastfeeding knowledge. Physicians would benefit from greater education and support, to optimize care of infants and their mothers.

We conducted this analysis to examine determinants of the knowledge-practice gap in early and exclusive breastfeeding (BF). In a cross-sectional survey, we interviewed 10,834 mothers with children aged 0−23 months old in 11 of 63 provinces of Viet Nam about BF practices, knowledge, barriers and support. The knowledge-practice gap was defined when a mother knew about the benefit but did not perform the corresponding practice. The proportion of mothers with a knowledge-practice gap in early and exclusive BF was 34% and 66%, respectively. Mothers were ~10% less likely to have a knowledge-practice gap in early BF if they received BF advice and support from a health worker during pregnancy or at birth (P < 0.05; Poisson regression). The gap, however, was 60%, 140% and 20% more likely to occur among those with hospital delivery, cesarean delivery and BF difficulty, respectively (P < 0.05 for all). For exclusive BF, a 25% reduction in the gap was found if a mother believed that people who are important to her su...

Obese women are less likely to initiate and continue breastfeeding. We described barriers to breastfeeding and examined the association between support from a health professional and breastfeeding knowledge and practices, by prepregnancy obesity status.Using data from the Infant Feeding Practices Study II, a cohort of U.S. women (N = 2,997), we performed descriptive statistics to describe barriers to breastfeeding by prepregnancy obesity status. We conducted multivariable regression to examine the association of breastfeeding support from a physician or nonphysician health professional with knowledge of the recommended duration of breastfeeding, breastfeeding initiation, and breastfeeding duration, and whether breastfeeding support had different associations with outcomes by prepregnancy obesity status. Average marginal effects were calculated from regression models to interpret results as percentage-point changes.Believing that formula was as good as breast milk was the most commonly cited reason for not initiating breastfeeding, and milk supply concerns were cited as reasons for not continuing breastfeeding. Physician breastfeeding support was associated with a 9.4 percentage-point increase (p.05) in breastfeeding knowledge among obese women, although no increase was observed among nonobese women. Breastfeeding support from a physician or nonphysician health professional was associated with a significantly increased probability of breastfeeding initiation (8.5 and 12.5 percentage points, respectively) and breastfeeding for 6 months (12.5 and 8.4 percentage points, respectively), without differential associations by prepregnancy obesity.Support for exclusive breastfeeding is an important predictor of breastfeeding initiation and duration among obese and nonobese women. Health educational interventions tailored to obese women might improve their breastfeeding initiation and continuation.

Background: Infant feeding is governed by environmental as well as cultural factors. Breastfeeding knowledge and attitudes are known to be associated with breastfeeding duration. This study investigated breastfeeding information, attitudes and supplementary feeding in the central hills district of Nepal. Methods: A community-based prospective cohort study of 701 pregnant women was conducted. Information on breastfeeding attitudes, feeding practices and supplementary feeding was sought from the cohort at 4 weeks, 12 weeks and 22 weeks postpartum through repeated interviews using validated questionnaires. Results: Average duration of intended breastfeeding was 28 months (SD 7.9) and average target time to introduce solid foods was 6.1 months (SD 1.2). About 80% of women reported their husband, mother/mother-in-law preferred breastfeeding. Eleven percent of the cohort said that breastfeeding was not enjoyable. At 12 weeks and 22 weeks after birth, about a quarter (24.8%) and half (52.8%) of the infants were introduced cow/buffalo milk, respectively, while only 6.3% and 13.4% of them were given infant formula. Overall, any breastfeeding rate remained high at over 98% throughout the follow up period. Conclusions: Breastfeeding attitudes were encouraging in this population. Breastfeeding was almost universal. Use of infant formula was quite low, whereas cow or buffalo milk appeared to be popular supplementary foods.

Fifty maternal-newborn nurses and 136 breastfeeding mothers participated in a prospective study designed to identify characteristics of nurses and external factors that influence nurses' ability to provide effective informational, technical, and emotional support to breastfeeding mothers and their infants. Ajzen and Fishbein's theory of reasoned action guided the study. Using questionnaire data, multiple regression analyses revealed that the nurses'supportive behavior was best predicted by their breastfeeding knowledge and attitudes. The nurses' intentions to provide support did not influence their actual behavior. Breastfeeding knowledge deficits also were identified. Because breastfeeding knowledge is predictive of nurses’ supportive behavior, that knowledge must be accurate and complete to promote breastfeeding success and be considered helpful by the mother.

O objetivo deste estudo foi conhecer o nível de informação sobre amamentação entre as mulheres que participam do programa de pré-natal na Maternidade-Escola da Universidade Federal do Rio de Janeiro. A amostra totalizou 135 puérperas que responderam a questionário estruturado, contendo perguntas objetivas sobre aspectos práticos e teóricos do aleitamento materno. Os resultados mostraram que as mulheres iniciaram o pré-natal, em média, com 16 semanas de gravidez e realizaram cerca de oito consultas. Dentre elas, 53,3% afirmaram ter recebido informações sobre aleitamento materno durante o acompanhamento pré-natal e a informação mais lembrada por 22,2% foi a de amamentar até os seis meses de vida do bebê. Quanto ao momento ideal para a primeira mamada, 50,4% consideraram ser logo após o parto e 47,4% apontaram o leite materno como benéfico para proteger o bebê contra doenças. Embora as mães tenham conhecimentos básicos sobre aleitamento materno, questões como o momento ideal para a primeira mamada, a importância do colostro e aspectos nutricionais relacionados à nutriz ainda precisam ser melhor esclarecidos durante o pré-natal e no período pós-parto imediato. The purpose of this study was to evaluate knowledge of breastfeeding issues among post-partum women who had participated in a prenatal program at the Rio de Janeiro Federal University (UFRJ) Maternity Teaching Hospital. The sample totaled 135 post-partum women who answered a structured questionnaire with objective questions about practical and theoretical aspects of breastfeeding. The women had begun prenatal care at the 16th week of gestation on average, with an average of 8 medical consultations. Some 53.3% stated having received information about breastfeeding during prenatal care, and 22.2% stated that the information they remembered the best was that they should breastfeed for the first 6 months. Regarding the best moment for the first feeding, 50.4% identified it as immediately after delivery. Some 47.4% said breastfeeding protects the child from diseases. Thus, although the mothers demonstrated basic knowledge about breastfeeding, issues like the best moment for the first feeding, the importance of colostrum, and nutritional aspects for nursing mothers require further clarification during prenatal care and the immediate post-partum period.

Objective Although improving mothers' knowledge about breastfeeding can increase rates and duration of breastfeeding, little is known about the influence of fathers' knowledge. The purpose of this study was to assess the knowledge of mothers and fathers about breastfeeding before and after receiving postpartum advice and its relationship to the frequency of breastfeeding. Methods A clinical trial was performed with mothers and fathers of normal children born at the Hospital de Clinicas de Porto Alegre, Brazil, between July 1994 and March 1995. The study intervention consisted of postpartum advice supplied by means of a video film discussing basic topics of breastfeeding, an explanatory leaflet, and open discussion after viewing the video. The first 208 couples comprised the control group, the next 197 comprised experimental group 1, and the remaining 196 comprised experimental group 2. Immediately after delivery, mothers and fathers in the three groups answered a test on breastfeeding knowledge; they completed the same test at the end of the first month. All families received home visits at the end of the first, second, fourth, and sixth months, or until breastfeeding ceased. Logistic regression was used to evaluate the association between the mothers' and fathers' knowledge and frequency of breastfeeding. Results Postpartum advice increased the breastfeeding knowledge of mothers and fathers. The mothers with the highest level of knowledge had a 6.5 times higher chance of exclusively breastfeeding at the end of the third month, and 1.97 times higher chance of continuing breastfeeding to the end of the sixth month compared with other mothers. The fathers' knowledge also significantly influenced breastfeeding rates. The children whose fathers knew more had a 1.76 higher chance of being exclusively breastfed at the end of the first month, and 1.91 higher chance of receiving maternal milk at the end of the third month. Conclusion A simple, inexpensive strategy can increase the level of breastfeeding knowledge of mothers and fathers and, consequently, have a positive impact on the frequency of breastfeeding.

Background Mothers’ poor knowledge and negative attitude towards breastfeeding may influence practices and constitute barriers to optimizing the benefits of the baby-friendly initiative. This study assessed breastfeeding knowledge, attitude and techniques of postures, positioning, hold practice and latch-on among Nigerian mothers from a Semi-Urban community. Methods Three hundred and eighty three consenting lactating mothers who have breastfed for 6 months and up to two years volunteered for this cross-sectional survey, yielding a response rate of 95.7%. A self-administered questionnaire that sought information on maternal socio-demographic variables, knowledge, attitudes and breastfeeding techniques of mothers was employed. Results Based on cumulative breastfeeding knowledge and attitude scores, 71.3% of the respondents had good knowledge while 54.0% had positive attitude. Seventy one point three percent practiced advisable breastfeeding posture. Sitting on a chair to breastfeed was common (62.4%); and comfort of mother/baby (60.8%) and convenience (29.5%) were the main reasons for adopting breastfeeding positions. Cross-cradle hold (80.4%), football hold technique (13.3%), breast-to-baby (18.0%) and baby-to-breast latch-on (41.3%) were the common breastfeeding techniques. A majority of the respondents (75.7%) agreed that neck flexion, slight back flexion, arm support with pillow and foot rest was essential during breastfeeding. There was no significant association between breastfeeding posture practice and each of cumulative breastfeeding knowledge score levels (X2 = 0.044; p = 0.834) and attitude score levels (X2 = 0.700; p = 0.403). Conclusion Nigerian mothers demonstrated good knowledge and positive attitude towards breastfeeding. Most of the mothers practiced advisable breastfeeding postures, preferred sitting on a chair to breastfeed and utilized cross-cradle hold and baby-to-breast latch-on.

Background: Working mothers who place their infants into out-of-home child care face many challenges to sustaining breastfeeding. Child care providers, who are in frequent close contact with young families, may be potential resources for promoting breastfeeding. Objectives: This study focused on identifying child care providers’ attitudes toward and knowledge about breastfeeding as well as providers’ perceptions about strategies to increase breastfeeding rates among mothers of infants in child care centers. Methods: Seventy-five providers from 11 child care centers in the Baton Rouge, Louisiana, area were surveyed using paper and pencil questionnaires. Self-reported demographics, attitudes, knowledge, and perceptions about breastfeeding were collected. Results: Responses demonstrated a generally positive attitude toward breastfeeding among child care providers but a knowledge deficit in terms of the health impacts and proper handling of breast milk. A minority of providers reported that their center’s staff currently receives breastfeeding education, but most providers believed that measures to promote the use of breast milk in their center should target parents rather than the center staff. Conclusion: Child care providers need resources about the benefits of human milk, proper handling of expressed milk, and ways to make centers more breastfeeding friendly. Many providers feel ineffective in supporting breastfeeding and are unaware of the role they may play in mothers’ infant feeding decisions. Though child care providers do not appear to believe they can influence parents’ decisions about breastfeeding, educating and empowering them could play an important role in increasing breastfeeding rates.

Background Inadequate knowledge, or inappropriate practice, of breastfeeding may lead to undesirable consequences. The aim of this study was to assess breastfeeding knowledge, attitude and practice (KAP) among female teachers in the Abha Female Educational District and identify factors that may affect breastfeeding practice in the study population. Methods A cross-sectional study using a self-administered questionnaire was conducted among school teachers in Abha Female Educational District during the months of April to June, 2011. Breastfeeding KAP of participants who had at least one child aged five years or younger at the time of the study were assessed using a self-administered questionnaire, based on their experience with the last child. Results A total of 384 women made up of 246 (61.1%) primary-, 89 (23.2%) intermediate- and 49 (12.8%) high-school teachers participated in the study. One hundred and nineteen participants (31%) started breastfeeding their children within one hour of delivery, while exclusive breastfeeding for 6 months was reported only by 32 (8.3%) participants. Insufficient breast milk and work related problems were the main reasons given by 169 (44%) and 148 (38.5%) of participants, respectively, for stopping breastfeeding before two years. Only 33 participants (8.6%) had attended classes related to breastfeeding. However, 261 participants (68%) indicated the willingness to attend such classes, if available, in future pregnancies. Conclusions This study revealed that breast milk insufficiency and adverse work related issues were the main reasons for a very low rate of exclusive breastfeeding among female school teachers in Abha female educational district, Saudi Arabia. A very low rate of attending classes addressing the breastfeeding issues during pregnancy, and an alarming finding of a high percentage of babies receiving readymade liquid formula while still in hospital, were also brought out by the present study. Such findings, if addressed comprehensively by health care providers and decision-makers, will lead to the improvement of breastfeeding practices in the study community.

We assessed the relationships between psychosocial constructs (maternal intention, attitudes, self-efficacy, breastfeeding knowledge) at 7 mo gestation and exclusive or full breastfeeding at 3 mont...

The main aim of this study was to compare breastfeeding knowledge, attitude, and practice and infants nutritional status between rural and urban areas. In this cross-sectional study, Desa Jayabakti, Kabupaten Sukabumi represents rural area, while Kelurahan Kedung Jaya, Kota Bogor represents urban area. Samples were 31 mothers-infants in each area who were selected by simple cluster sampling method. The differences between two areas were analyzed with the independent t-test, chi-square test, and Fisher's exact test. The correlation between variables was analyzed with rank Spearman. The result of this study showed that mother's knowledge and attitude of nutrition, especially about exclusive breastfeeding, was higher in urban than in rural area. There were differences in mothers' knowledge and attitude between rural and urban areas (p0.05). The aspects of breastfeeding practices which statistically difference in rural and urban areas were the introduction of colostrums status and breastfeeding time (p0.05). Furthermore, exclusive breastfeeding practice was not associated with 4-12 months infants nutritional status (p>0.05). Mothers' family should be targeted as target of audience in breastfeeding promotion. Keywords: breastfeeding practice, exclusive breastfeeding, knowledge, attitude, infant nutritional status, rural and urban areas.

A breastfeeding protocol has been field-tested in three hospitals. A pre-and post-test design was utilized to measure breastfeeding knowledge of health professionals and mothers before and after implementation of a standard breastfeeding protocol. Although results demonstrated a statistically significant increase in knowledge scores for health professionals and mothers, actual change in score was less than two percent and one percent respectively, compared to pre-intervention scores. Scores of both groups were not high and indicated limited knowledge in the health professional group in particular. Despite the fact that protocol implementation did not significantly alter knowledge scores, it did initiate positive changes in policies and procedures which may continue to influence knowledge and practice of health professionals.

Knowledge of breastfeeding is necessary for health workers to adequately assist breastfeeding mothers. This paper examines the level of knowledge concerning breastfeeding in three rural maternity units in Ireland. Health workers responding to a self-report questionnaire felt that they had adequate knowledge, but their answers to the questions did not always bear this out. Health workers felt more staff training in breastfeeding would help to improve breastfeeding rates. Thirty-four percent of respondents had never attended continuing education on infant feeding topics. Manufacturers of artificial infant formula were the main source of continuing education information. The knowledge level of obstetricians did not appear to affect breastfeeding rates. Pediatricians' breastfeeding knowledge was good, but they had little input in the care of healthy babies. Rising breastfeeding rates were found in the unit where midwives were more recently qualified and had higher knowledge scores. The need exists for more breastfeeding education in all the units examined, ideally provided by a staff member with current lactation training.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T19:01:40Z No. of bitstreams: 1 S0104-11692009000600005.pdf: 93323 bytes, checksum: b3442e1064b8a21a233e28335368c4a3 (MD5) Made available in DSpace on 2013-08-22T19:01:40Z (GMT). No. of bitstreams: 1 S0104-11692009000600005.pdf: 93323 bytes, checksum: b3442e1064b8a21a233e28335368c4a3 (MD5) Previous issue date: 2009-12-01 Made available in DSpace on 2013-09-30T20:01:53Z (GMT). No. of bitstreams: 2 S0104-11692009000600005.pdf: 93323 bytes, checksum: b3442e1064b8a21a233e28335368c4a3 (MD5) S0104-11692009000600005.pdf.txt: 35295 bytes, checksum: 8c1ae027d38fa82898d6c581a8d1a891 (MD5) Previous issue date: 2009-12-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:15:53Z No. of bitstreams: 2 S0104-11692009000600005.pdf: 93323 bytes, checksum: b3442e1064b8a21a233e28335368c4a3 (MD5) S0104-11692009000600005.pdf.txt: 35295 bytes, checksum: 8c1ae027d38fa82898d6c581a8d1a891 (MD5) Made available in DSpace on 2014-05-20T15:15:53Z (GMT). No. of bitstreams: 2 S0104-11692009000600005.pdf: 93323 bytes, checksum: b3442e1064b8a21a233e28335368c4a3 (MD5) S0104-11692009000600005.pdf.txt: 35295 bytes, checksum: 8c1ae027d38fa82898d6c581a8d1a891 (MD5) Previous issue date: 2009-12-01 Objetivou-se avaliar conhecimentos e práticas sobre aleitamento materno de profissionais que atendem lactentes em unidades de atenção básica, ou maternidades públicas, de município do interior paulista, Brasil. É estudo epidemiológico, sendo a população composta por 89 enfermeiros e médicos. Suas respostas a um questionário estruturado foram analisadas no total e segundo o local de trabalho, aplicando-se o teste de diferença de proporções (qui-quadrado), considerando-se p

The purpose of this study was to survey nurses' knowledge of breastfeeding and to assess whether nurses' education, clinical experience, or personal experience predicted their breastfeeding knowledge. Results suggest that nurses have limited knowledge of breastfeeding, although no variable consistently predicted breastfeeding knowledge. Clinical experience produced the most consistent results, implying that leadership, variety in maternal and newborn nursing experiences, and years of experience result in nurses having more knowledge about breastfeeding.

The aim of this study was to identify the breastfeeding attitudes and knowledge of a sample of Australian general practice (GP) registrars and investigate how confident and effective they thought their interactions with breastfeeding women were. Between February and May 2007, a 90-item questionnaire containing demographic, attitude, and knowledge items was distributed to final-year Australian GP registrars. The mean attitude score (5 = maximum score) was 3.99. The mean knowledge score (5 = maximum score) was 3.40, indicating some degree of breastfeeding knowledge. However, 40% of the knowledge items were answered incorrectly by the majority of participants. Approximately 40% of the cohort were confident and thought they were effective assisting breastfeeding women. Having more than 26 weeks personal experience with breastfeeding (self or partner) increased breastfeeding knowledge, attitudes, confidence, and effectiveness. Further targeted training is needed to improve Australian GP registrars' breastfeeding knowledge, attitudes, confidence, and effectiveness. J Hum Lact. 24(4):422-430.

In conjunction with other health professionals, doctors believe they play an important role in promoting breastfeeding to women. Although many have positive breastfeeding attitudes, significant knowledge deficits often limit their capacity to effectively encourage, support and assist breastfeeding women and their infants. Personal breastfeeding experience (of self or partner) may be the main source of breastfeeding knowledge and skill development and is related to improved knowledge, more positive attitudes and greater confidence. This paper describes the relationship between the cumulative length of personal breastfeeding experience and the breastfeeding knowledge and attitudes of a cohort of Australian general practice (GP) registrars, as well as their confidence and perceived effectiveness assisting breastfeeding women. The Australian Breastfeeding Knowledge and Attitude Questionnaire containing demographic items, a 20-item attitude scale and a 40-item knowledge scale was distributed between February and May 2007 to Australian GP registrars in their final year of training. Participants with more than 52-week cumulative personal (self or partner) breastfeeding experience had the highest mean knowledge score, had more positive attitudes, and were more confident and effective than all other participants. Parents with limited personal experience (

OBJECTIVE: To assess attitudes to breastfeeding among children in primary education and to evaluate the influence of educational lectures on their knowledge. METHODS: This was a cross-sectional study of 503 students of both sexes from the fourth to the eighth grades of five different schools. The children were divided into two groups: control (n = 215) and intervention (n = 288) in order to evaluate the influence of educational lectures. A questionnaire containing 30 questions about different features of breastfeeding was used for data collection. The intervention took the form of a 30-minute lecture, given at the schools. RESULTS: The lecture increased the number of schoolchildren who answered that breastmilk is most beneficial for infants (p < 0.05) and that breastfeeding is the most practical way of feeding babies (p < 0.05). There was a reduction in the number who would give supplementary feeding during the first month of life (p < 0.05) and also in how many would give a baby a pacifier (p < 0.05). After the intervention less than half of the girls would chose to breastfeed for 1 year or more (39.1% in the control group vs. 43.2% in the intervention group); while the opposite was true of the males (54.7% in the control group vs. 51.7% in the intervention group). More of the boys (37.1%) were able to cite specific advantages for mothers from breastfeeding when compared to the females (19.9%). CONCLUSION: The results indicate that lectures on health education, presented at schools, have a beneficial effect on breastfeeding knowledge, awareness and attitudes.

OBJETIVO: Avaliar a percepção de estudantes do ensino fundamental em relação ao aleitamento materno e a influência de palestra educativa sobre seus conhecimentos. MÉTODOS: Realizou-se um estudo transversal em cinco escolas, envolvendo 503 estudantes da quarta à oitava série, de ambos os sexos, divididos em dois grupos, controle (n = 215) e de intervenção (n = 288), para avaliar a influência de palestra educativa. Para a coleta de dados, utilizou-se um questionário contendo 30 questões sobre diferentes aspectos da amamentação. A intervenção consistiu em uma palestra com duração de 30 minutos realizada nas escolas. RESULTADOS: A palestra aumentou o número de alunos que responderam que o leite materno é o mais adequado para a criança (p < 0,05) e que o ato de amamentar é a forma mais prática de alimentação (p < 0,05). Houve redução na intenção de realizar a suplementação alimentar no primeiro mês de vida (p < 0,05) e na oferta de chupeta ao bebê (p < 0,05). Após a intervenção, menos da metade das meninas optaria por um tempo de aleitamento igual a 1 ano ou mais (39,1% no grupo controle versus 43,2% no de intervenção); verificou-se o oposto para o sexo masculino (54,7% no controle versus 51,7% no de intervenção). Os meninos souberam citar vantagens específicas da amamentação para as mães com maior freqüência (37,1%), quando comparados ao sexo feminino (19,9%). CONCLUSÃO: Os resultados indicam que palestras de educação em saúde, realizadas em escolas, exercem influência benéfica sobre o conhecimento, percepção e atitudes em relação ao aleitamento materno. OBJECTIVE: To assess attitudes to breastfeeding among children in primary education and to evaluate the influence of educational lectures on their knowledge. METHODS: This was a cross-sectional study of 503 students of both sexes from the fourth to the eighth grades of five different schools. The children were divided into two groups: control (n = 215) and intervention (n = 288) in order to evaluate the influence of educational lectures. A questionnaire containing 30 questions about different features of breastfeeding was used for data collection. The intervention took the form of a 30-minute lecture, given at the schools. RESULTS: The lecture increased the number of schoolchildren who answered that breastmilk is most beneficial for infants (p < 0.05) and that breastfeeding is the most practical way of feeding babies (p < 0.05). There was a reduction in the number who would give supplementary feeding during the first month of life (p < 0.05) and also in how many would give a baby a pacifier (p < 0.05). After the intervention less than half of the girls would chose to breastfeed for 1 year or more (39.1% in the control group vs. 43.2% in the intervention group); while the opposite was true of the males (54.7% in the control group vs. 51.7% in the intervention group). More of the boys (37.1%) were able to cite specific advantages for mothers from breastfeeding when compared to the females (19.9%). CONCLUSION: The results indicate that lectures on health education, presented at schools, have a beneficial effect on breastfeeding knowledge, awareness and attitudes.

Purpose: Maternal knowledge, positive attitudes and interest toward breastfeeding may improve the sustainability of breastfeeding. This study examined the associations of knowledge, attitudes, and interest toward breastfeeding with the duration of breastfeeding in Korean mothers who used the internet. Methods: We conducted a cross-sectional study of 604 Korean mothers who breastfed their babies. Mothers were recruited through the internet and their knowledge, attitudes and interest toward breastfeeding were assessed using a web-based self-administered questionnaire. Geometric means and odds ratio (OR) with 95% confidence intervals were calculated. Results: Higher knowledge, attitudes, and interest toward breastfeeding were associated with longer duration of breastfeeding in Korean mothers. In particular, mothers who had optimal breastfeeding duration were more likely to be aware of the easiness of breast milk stimulation and breastfeeding, the development of attachment between mother and child, and pleasure from breastfeeding compared to those mothers with shorter duration. The association with optimal breastfeeding duration was more pronounced among mothers who graduated from high school for total attitude scores and total interest scores, compared to mothers who graduated from college or above. Conclusion: The results of this study suggest that it is important to improve maternal knowledge, attitudes, and interest toward breastfeeding in Korean mothers who use the internet as a source of knowledge. Also, the study results imply that the development of strategies to target mothers with relatively low education levels may improve breastfeeding rates.

A large number of mothers may not be practicing exclusive breastfeeding in rural Jamaica although no recent systematic study has been conducted. The impact of knowledge about and attitude toward breastfeeding on the duration of exclusive breastfeeding is also poorly understood. The objective of this study was to gather information about factors that influence exclusive breastfeeding and its duration. Across-sectional study was conducted in 11 health centers within the parish of Saint Ann Jamaica. A pretested questionnaire collected information on breastfeeding knowledge and attitudes toward intention to breastfeed and other relevant sociodemographic characteristics. Information was documented for 599 mother-child pairs. The prevalence of breastfeeding initiation was 98.2 percent; of mothers who initiated breastfeeding 22.2 percent practiced it exclusively (at least 6 months). No difference occurred between exclusive and nonexclusive breastfeeding mothers in terms of knowledge about and attitudes toward breastfeeding. Of potential predictors assessed the male partner’s role as the main source of income for the family was the only significant predictor for exclusive breastfeeding. Women whose male partner was the main source of income for the family were twice as likely to exclusively breastfeed their infants compared with the referent group (mothers as main source of income) (OR=2.0; 95% CI=1.4–3.0). In addition the dominant reason for partial breastfeeding was maternal anxiety that breastmilk alone might not provide sufficient nourishment. The level of exclusive breastfeeding was extremely low at the study site. Formulation of strategies to aggressively promote exclusive breastfeeding practices is urgently needed there. Such interventions should consider involvement of the male partner especially with respect to the financial support as well as alleviating maternal anxiety regarding nutritional adequacy of breastmilk. (authors)

A number of risk factors for HIV transmission during breastfeeding have been identified. The experience counseling HIV-infected women on infant feeding options has expanded to consider these risk factors. Programmatic evidence is limited, but the review presented here strongly argues for an end to the polarized debate about whether HIV-infected women should breast or formula feed. In reality, neither alternative is risk-free for HIV-exposed infants, and the balance of risks varies in different settings and over time.

Using a cross-sectional survey, the knowledge and beliefs about breastfeeding were evaluated among adults in Eastern Tobago (N = 509). Of the respondents, 95%, 69%, and 48% indicated that a baby should be exclusively breastfed at birth, 3 months, and 6 months, respectively. The baby's mother was thought to have the greatest influence on breastfeeding decisions. Of the respondents, 63% and 80% were unaware of expressed breast milk and cup-feeding a neonate, whereas 82% believed that a solely breastfed baby should receive water. Additionally, 23% and 44% felt that breastfeeding should be terminated before 6 months and between 6 and 12 months, respectively. Inadequate maternal nutrition and employment were reported as the principal factors affecting breastfeeding. There is a lack of knowledge about the anatomy and physiology of lactation and about the benefits of exclusive breastfeeding. These findings are useful for guiding the development and implementation of interventions to promote breastfeeding in Tobago.

Despite mounting evidence of the health importance of breastfeeding, physicians demonstrate persistent, suboptimal knowledge about and support for breastfeeding.1 Educational interventions can increase physician breastfeeding knowledge, and yet not necessarily improve behavior.2 This suggests the need for a richer understanding of physician attitudes towards breastfeeding, including how those attitudes relate to utilization of data and clinical practice.

Midwives all over Australia are furthering their breastfeeding knowledge and skills, to lead the world in lactation support. The certification exam conducted by the International Board of Lactation Consultant Examiners has played a central role in this extraordinary revolution by setting competency standards, motivating the acquisition of specialist skills, and opening up career opportunities. However, it is the consumers, the mothers and babies, who are the principal beneficiaries.