Skip to main content
SpringerLink
Log in

Physicians and Breastfeeding: Beliefs, Knowledge, Self-efficacy and Counselling Practices

  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

A pilot-tested questionnaire was mailed to 325 obstetricians, pediatricians, family practitioners and general practitioners of a British Columbian maternity hospital to measure aspects relating to physicians’ attitudes toward breastfeeding counselling. Response rate was 67.3%. The measures of selfefficacy, knowledge and beliefs were added to a regression model containing measures of gender, specialty, years in practice and personal or spousal breastfeeding experience to determine whether additional variance in counselling behaviour could be accounted for. Physicians attempted to convince women to breastfeed if: 1) they believed in the immune properties of breastmilk (OR = 1.23, SE = 0.07) and 2) they were confident in their own breastfeeding counselling (OR = 1.88, SE = 0.36). Likewise, encouraging women to continue breastfeeding in the face of breastfeeding problems was related to confidence in breastfeeding counselling (OR = 1.22, SE = 0.10) and belief in the immune properties of breastmilk (OR = 2.83, SE = 0.45).

Résumé

Différents aspects relatifs à l’attitude des médecins par rapport à l’allaitement maternel ont été déterminés par un questionnaire préalablement vérifié qui a été expédié à 325 obstétriciens, pédiatres, médecins de famille et généralistes affiliés à une maternité de la Colombie Brittanique. Le taux de réponse était de 67,3 %. Les paramètres de la confiance en soi, des connaissances et des croyances ont été ajoutés au modèle de régression en tenant compte des paramètres du genre, de la specialité, du nombre d’années d’expérience et de l’expérience de l’allaitement, personnelle ou de l’épouse, pour déterminer si certaines variances pourraient être attribuées au comportement de counselling. Les médecins ont tenté de convaincre les femmes d’allaiter lorsqu’ils avaient confiance dans les qualités immunologiques du lait maternel (RRE = 1,23, ET = 0,07) ainsi que dans leur aptitude en counselling de l’allaitement (RRE = 1,88, ET = 0,36). Pour les mêmes raisons, les médecins ont encouragé les femmes à poursuivre l’allaitement si des problèmes surgissaient (respectivement RRE = 2,83, ET = 0,45 et RRE = 1,22, ET = 0,10

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adebonojo, FO. Artificial, vs. breastfeeding: Relation to infant health in a middle class American community. Clin Pediatr 1972;11:25–29.

    Article  CAS  Google Scholar 

  2. Aloia JF, Cohn SH, Vaswani A, et al. Risk factors for post-menopausal osteoporosis. Am J Med 1985;78:95–100.

    Article  CAS  PubMed  Google Scholar 

  3. Byers T, Graham S, Rzepka T. Lactation and breast cancer. Evidence for a negative association in premenopausal women. Am J Epidemiol 1985;121:661–74.

    Article  Google Scholar 

  4. Canadian Paediatric Society Nutrition Committee. Meeting the iron needs of infants and young children: An update. CMAJ 1991;144:1451–54.

    Google Scholar 

  5. Cunningham AS, Jelliffe DB, Jelliffe EFP. Breastfeeding and health in the 1980s: A global epidemiologic review. J Pediatr 1991;118:659–65.

    Article  CAS  PubMed  Google Scholar 

  6. Damus K, Pakter J, Krongard E, et al. Postnatal medical and epidemiological risk factors for the sudden infant death syndrome. In: Harper RM, Soffman HJ (Eds.), Sudden Infant Death Syndrome: Risk Factors and Basic Mechanisms. New York: PMA Publications, 1988;187–201.

    Google Scholar 

  7. Davis MK, Savitz D, Graubard, BI. Infant feeding and childhood cancer. Lancet 1988;2:365–68.

    Article  CAS  PubMed  Google Scholar 

  8. Frank JW, Newman J. Breast-feeding in a polluted world: Uncertain risks, clear benefits. CMAJ 1993;149(1):33–37.

    Google Scholar 

  9. Layde PM, Webster LA, Boughman AL, et al. The independent associations of parity, age at first full term pregnancy and duration of breastfeeding with the risk of breast cancer. J Clin Epidemiol 1989;42:963–73.

    Article  CAS  PubMed  Google Scholar 

  10. Avard D, Hanvey L. The Health of Canada’s Children: A CICH Profile. Ottawa: Canadian Institute of Child Health, 1989.

    Google Scholar 

  11. Labbok MH, Simon, SR. A community study of a decade of in-hospital breastfeeding: Implications for breastfeeding promotion. Am J Prev Med 1988;4(2):62–67.

    Google Scholar 

  12. Winikoff B, Meyers D, Laukaran V, Stone R. Overcoming obstacles to breastfeeding in a large municipal hospital: Applications of lessons learned. Pediatrics 1987;80:423–33.

    CAS  PubMed  Google Scholar 

  13. Rajan L. The contribution of professional support, information and consistent correct advice for successful breastfeeding. Midwifery 1993;9(4):197–209.

    Google Scholar 

  14. Hollen, BK. Attitudes and practices of physicians concerning breastfeeding and its management. Environmental Child Health 1976;22:288–93.

    CAS  PubMed  Google Scholar 

  15. Lawrence, RA. Practices and attitudes towards breast-feeding among medical professionals. Pediatrics 1982;70:912–20.

    CAS  PubMed  Google Scholar 

  16. Reames, ES. Opinions of physicians and hospitals of current breast-feeding recommendations. J Am Diet Assoc 1985;85:79–80.

    CAS  PubMed  Google Scholar 

  17. Lowe T. Breastfeeding: Attitudes and knowledge of health professionals. Austral Fam Phys 1990;19:392, 395.96, 398.

    CAS  Google Scholar 

  18. Michelman DF, Faden R, Carlson Gielen A, Buxton, KS. Pediatricians and breastfeeding promotion: Attitudes, beliefs, and practices. Am J Health Prom 1990;4:181–86.

    Article  CAS  Google Scholar 

  19. Goldstein AO, Freed, GL. Breast-feeding counseling practices of family practice residents. Fam Med 1993;25:524–29.

    CAS  PubMed  Google Scholar 

  20. Green LW, Kreuter, MW. Health Promotion Planning: An Educational and Environmental Approach. Toronto: Mayfield Publishing Company, 1991.

    Google Scholar 

  21. Green LW, Eriksen MP, Schor, EL. Preventive practices by physicians: Behavioral determinants and potential interventions. Am J Prev Med 1988;4(4):S101–7.

    Google Scholar 

  22. Davis DA, Thomson MA, Oxman AD, Haynes RB. Evidence for the effectiveness of CME: A review of 50 randomized controlled trials. JAMA 1992;267:1111–17.

    Article  Google Scholar 

  23. Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance: A systematic review of the effect of continuing medical education strategies. JAMA 1995;274:700–5.

    Article  CAS  PubMed  Google Scholar 

  24. Oxman AD, Thomson MA, Davis DA, Haynes RB. No magic bullets: A systematic review of 102 trials of interventions to improve professional practice. CMAJ 1995;153:1423–31.

    CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Health Care and Epidemiology, Institute of Health Promotion Research, Canada

    Maria J. Burglehaus MSc, RDN,  Lorie A. Smith MD, CCFP, Samuel B. Sheps MD, MSc, FRCPC & Lawrence W. Green DrPH

  2. Department of Family Practice, University of British Columbia, Canada

    Maria J. Burglehaus MSc, RDN,  Lorie A. Smith MD, CCFP, Samuel B. Sheps MD, MSc, FRCPC & Lawrence W. Green DrPH

Authors
  1. Maria J. Burglehaus MSc, RDN
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lorie A. Smith MD, CCFP
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Samuel B. Sheps MD, MSc, FRCPC
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lawrence W. Green DrPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Financial support was provided by the Department of Family Practice, University of British Columbia and by the British Columbia Medical Services Foundation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Burglehaus, M.J., Smith, L.A., Sheps, S.B. et al. Physicians and Breastfeeding: Beliefs, Knowledge, Self-efficacy and Counselling Practices. Can J Public Health 88, 383–387 (1997). https://doi.org/10.1007/BF03403911

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03403911

Search

Navigation