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Clinical Pediatrics
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Prenatal Office Practices Regarding Infant Feeding Choices

Lois B. Dusdieker, MD, MS

Carver College of Medicine and Department of Pediatrics, The Children’s Hospital of Iowa, Iowa City

Claibourne I. Dungy, MD, MPH

Carver College of Medicine and Department of Pediatrics, The Children’s Hospital of Iowa, Iowa City

Mary E. Losch, PhD

Department of Psychology and Center for Social and Behavioral Research, University of Northern Iowa, Cedar Falls, IA

The objective of this study was to determine the obstetric care providers’ roles in breast-feeding promotion during prenatal care. A questionnaire addressing breast-feeding issues was sent to family practitioners (FP), obstetric-gynecologists (OB/GYN), and nurse midwives (NM) in Iowa, USA. All NM, 97% of FP, and 85% of OB/GYN reported asking infant feeding preference—usually only at the first prenatal visit. NM (73%) were most likely to provide extensive breast-feeding counseling. OB/GYN (68%) and FP physicians (90%) reported doing their own breast-feeding counseling. Breast examinations targeting future breast-feeding problems were done in 82% to 84% of patients. NM practices shared more information supportive of breast-feeding. Nearly all providers offered prenatal classes, but only 41% of FP offered breast-feeding classes. Free formula samples were available in 73% of FP, 54% of OB/GYN, and 36% NM offices. Pamphlets on formula feeding and also breast-feeding were readily available. Overall NM (64%) reported being strong breast-feeding advocates compared to only 13% of FP and 7% of OB/GYN. In conclusion, little promotion of breast-feeding occurs in most prenatal practice settings.

Clinical Pediatrics, Vol. 45, No. 9, 841-845 (2006)
DOI: 10.1177/0009922806294220
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