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Attitudes and practices of physicians concerning breast-feeding and its management.



The attitudes and practices of a selected sample of American obstetricians and pediatricians was studied in an effort to gain insight into why more mothers do not choose to breast feed their babies and why many mothers, who really want to breast feed, are unsuccessful in their attempts. Emphasis was on studying physicians' attitudes toward the general value of breast feeding and to the practical advice and help they give to mothers who want to breast feed their children. The names and addresses of a total of 205 physicians were obtained from the 1974-1975 Directory of the Los Angeles County Medical Association. The final sample included 105 obstetricians and 73 pediatricians. A 5-page self-administered questionnaire was mailed to all physicians in both samples. 46 usable obstetrician questionnaires and 52 usable pediatrician questionnaires were returned. 58% of the pediatricians as compared to 38% of the obsteticians said that breast feeding was "very important." None of the pediatricians said that breast feeding was "not very important" and only 4% reported neutral feelings about it. 33% of the obstricians gave these answers. It was not possible to determine the specific reasons why the physicians felt that breast feeding was or was not important. Only 30% of the physicians indicated that they routinely try to persuade their patients to breast feed. 52% said they would try to persuade a mother to breast feed only if she expressed an interest in it. 42% replied that they would encourage an undecided mother to breast feed. Many questions regarding the type of advice given by the physicians were concerned with the lactation management practices which are considered to make a crucial difference between success and difficulty. 73% of the total sample indicated that they discuss nursing techniques but only a minority reported that they give their patients either a prenatal or postnatal talk about the anatomy of the breast and the "let-down reflex." 42% of the pediatricians as compared to 7% of the obstetricians correctly instructed mothers to wash their nipples with water only. Books and other individuals (65% and 64%, respectively) were physicians' sources of breast feeding information. The study findings indicate that the attitude of American physicians towards breast feeding is generally 1 of indifference with pediatricians appearing more interested in and knowledgeable about breast feeding than obstetricians.

[Indexed for MEDLINE]

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