Residency Curriculum Improves Breastfeeding Care
- 1 August 2010
- journal article
- research article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 126 (2), 289-297
- https://doi.org/10.1542/peds.2009-3250
Abstract
OBJECTIVES: Multiple studies have revealed inadequacies in breastfeeding education during residency, and results of recent studies have confirmed that attitudes of practicing pediatricians toward breastfeeding are deteriorating. In this we study evaluated whether a residency curriculum improved physician knowledge, practice patterns, and confidence in providing breastfeeding care and whether implementation of this curriculum was associated with increased breastfeeding rates in patients. SUBJECTS AND METHODS: A prospective cohort of 417 residents was enrolled in a controlled trial of a novel curriculum developed by the American Academy of Pediatrics in conjunction with experts from the American College of Obstetricians and Gynecologists, American Academy of Family Physicians, and Association of Pediatric Program Directors. Six intervention residency programs implemented the curriculum, whereas 7 control programs did not. Residents completed pretests and posttests before and after implementation. Breastfeeding rates were derived from randomly selected medical charts in hospitals and clinics at which residents trained. RESULTS: Trained residents were more likely to show improvements in knowledge (odds ratio [OR]: 2.8 [95% confidence interval (CI): 1.5–5.0]), practice patterns related to breastfeeding (OR: 2.2 [95% CI: 1.3–3.7]), and confidence (OR: 2.4 [95% CI: 1.4–4.1]) than residents at control sites. Infants at the institutions in which the curriculum was implemented were more likely to breastfeed exclusively 6 months after intervention (OR: 4.1 [95% CI: 1.8–9.7]). CONCLUSIONS: A targeted breastfeeding curriculum for residents in pediatrics, family medicine, and obstetrics and gynecology improves knowledge, practice patterns, and confidence in breastfeeding management in residents and increases exclusive breastfeeding in their patients. Implementation of this curriculum may similarly benefit other institutions.Keywords
This publication has 10 references indexed in Scilit:
- Pediatricians and the Promotion and Support of BreastfeedingArchives of Pediatrics & Adolescent Medicine, 2008
- Effect of Maternity-Care Practices on BreastfeedingPEDIATRICS, 2008
- An Investigation of the Field Trip Model as a Method for Teaching Breastfeeding to Pediatric ResidentsJournal of Human Lactation, 2006
- A Breastfeeding Curriculum for Residents and Medical Students: A Multidisciplinary ApproachJournal of Human Lactation, 2005
- Opinions and Practices of Clinicians Associated With Continuation of Exclusive BreastfeedingPEDIATRICS, 2004
- Clinician Support and Psychosocial Risk Factors Associated With Breastfeeding DiscontinuationPEDIATRICS, 2003
- Nationwide Survey of Pediatric Residency Training in Newborn Medicine: Preparation for Primary Care PracticePEDIATRICS, 2002
- Provider encouragement of breast-feeding: evidence from a national surveyObstetrics & Gynecology, 2001
- Pediatricians' Practices and Attitudes Regarding Breastfeeding PromotionPEDIATRICS, 1999
- National Assessment of Physicians' Breast-feeding Knowledge, Attitudes, Training, and ExperienceJAMA, 1995