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Tuesday
Dec022008

Pediatricians attitudes about breasfeeding deteriorating

While I am saddened and disappointed, I'm not surprised at the results of a survey that compared the attitudes of pediatricians towards breastfeeding in 2004 with those in 1995. These results were reported the current issue of the Journal of Pediatrics and Adolescence Medicine:
Compared with the results of the 1995 survey, in 2004, pediatricians were less likely to believe that the benefits of breastfeeding outweigh the difficulties or inconvenience (adjusted odds ratio, 0.60; 95% confidence interval, 0.47-0.76), and fewer believed that almost all mothers are able to succeed. More pediatricians in 2004 reported reasons to recommend against breastfeeding.

Pediatricians in 2004 were more likely to recommend exclusive breastfeeding (adjusted odds ratio, 1.55; 95% confidence interval, 1.23-1.94) and follow supportive hospital policies. Respondents with personal breastfeeding experience were 2.3 times more likely to recommend supportive policies (adjusted odds ratio, 2.3; 95% confidence interval,1.74-3.08) in 2004 than in 1995. Those with no personal breastfeeding experience were also slightly more likely in 2004 to recommend these policies (adjusted odds ratio, 1.49; 95% confidence interval, 1.09-2.03).

Conclusions: Although pediatricians seem better prepared to support breastfeeding, their attitudes and commitment have deteriorated. Personal experience mitigates poor attitudes and seems to enhance breastfeeding practices among those surveyed.

I think it is sad that while pediatricians are more likely to recommend exclusive breastfeeding (and therefore obviously understand the benefits), they seem to just accept that breastfeeding is "difficult" or "inconvenient" rather than trying to figure out how they can help mothers to overcome these difficulties.

I've posted before about how to support a breastfeeding mother and I think that this is a topic that obviously needs to be revisited in more detail among pediatricians. They also need to be reminded of what is normal for breastfeeding and understand how to deal with common concerns.

You can also assess for yourself whether your medical professional is supportive of breastfeeding and if your doctor is giving advice that is detrimental to breastfeeding and contrary to current research, you can try discussing it with him or her or writing a letter to the practice. If he or she continues to insist on giving bad breastfeeding advice, you may wish to consider reporting the doctor to the relevant regulatory board.

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Reader Comments (15)

A woman in Florida almost killed her baby recently because she was watering down his formula. At 5 months, he weighed a scant 8 pounds. I mention this because it is a perfection illustration of the issues you've just described. This mom said she tried nursing her first baby, but she "always seemed hungry" so she never bothered with the second. So no one explained to her what a normal breastfeeding infant feeding schedule is like. This mother is also on WIC. So no one at WIC encouraged her to nurse or explained to her how dangerous it would be to water down her son's formula. She is on medicaid. So no pediatrician that she ever saw realized that her child was too thin, not hitting milestones, and failing to thrive?

How do we reach women like this mom, who've been let down by nurses, doctors and WIC peer counselors?

December 3, 2008 | Unregistered CommenterElita @ Blacktating

This pretty much echoes my experience, really. When I went in really worn down at the 4-month appointment, my pediatrician's response was, "well, you gave it a good shot. It's totally fine if you switch to formula." Not quite the cheerleading I was hoping to hear... When I went to the 6-month appointment and told them that I'm still exclusively breastfeeding, both the pediatrician and nurse looked at me like I had two heads. They are super-supportive of breastfeeding, but absolutely amazed that a working mom can actually do it. Geez, it's not easy, but it's not climbing Mount Everest! Give women some credit!

December 3, 2008 | Unregistered CommenterJulia

Meant to include this in the post, but forgot! Here is one example of the type of thing they were talking about in this study: http://www.mothering.com/discussions/showthread.php?t=1004070

December 3, 2008 | Unregistered Commenterphdinparenting

It is really very discouraging! I strongly go against it, Pediatricians seems to have gone mad, I am not at all happy with what has been said about breastfeeding, I am sure most of the women like me would be thinking about the same! I request all those that support breastfeeding unite and oppose what Prdiatricians are saying.

December 5, 2008 | Unregistered CommenterAmeda

My 2nd has always been on the small side, and when he learned to crawl his weight dipped below the 5th percentile line on the growth charts. My pediatrician did a whole bunch of tests and when they all came back negative, referred me to a pediatric nutritionist. The stupid R.D. advised me to stop nursing (my DS was 7 mos) and switch to high-calorie preemie formula.

I called my lactation consultant to find out if there was any reason for me to be concerned about continuing breastfeeding. As I was nursing on-demand every 2-3 hours and my DS was having the proper number of wet diapers, she told me to just ignore the dietitian.

December 20, 2008 | Unregistered CommenterCrimson Wife

[...] So what is going on here? Why are hospitals treating jaundice this way if it’s a “normal, possibly even beneficial process?” Is the real problem that pediatricians attitudes about breastfeeding are deteriorating? [...]

I think a lot of it goes back to the health insurance companies. They pay out so little that Dr.'s are forced to see more and more patients per day to keep business in the black, meaning you get less one on one time with the Dr. They simply don't have time to work with mothers on these things.

February 15, 2009 | Unregistered CommenterSuburban Oblivion

[...] are moms who get horrible advice from health professionals or loved ones or buy into propaganda circulated by formula companies or baby trainers and end up [...]

[...] Your doctor is not a parenting expert and usually not a breastfeeding expert: I hear of so many new parents that feel bad after they leave their doctors office. It isn’t [...]

[...] I have heard of some doctors having merely a few hours of training on breastfeeding. In addition, pediatricians attitudes about breastfeeding are declining, doctors whose skills are most lacking are least likely to seek training to upgrade their knowledge [...]

[...] I have heard of some doctors having merely a few hours of training on breastfeeding. In addition, pediatricians attitudes about breastfeeding are declining, doctors whose skills are most lacking are least likely to seek training to upgrade their knowledge [...]

[...] Their attitudes about breastfeeding are declining [...]

[...] often bombarded with Booby Traps: bad advice from friends, family or health professionals who have inadequate training in lactation.  Bad breastfeeding advice often leads to low milk supply and eventually starving babies if the [...]

[...] important question. It is one that I have asked numerous times on this blog, raising issues like lacking lactation training among health professionals, giving formula samples as a “breastfeeding prize”, the impact of formula samples given [...]

[...] I have heard of some doctors having merely a few hours of training on breastfeeding. In addition, pediatricians attitudes about breastfeeding are declining, doctors whose skills are most lacking are least likely to seek training to upgrade their knowledge [...]

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