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Educational Objectives and Skills for the Physician with Respect to Breastfeeding

The Academy of Breastfeeding Medicine Statement, 2011

Introduction

The science of breastfeeding and human lactation requires that physicians from many different specialties have a collaborative forum to promote progress in physician education. To optimize breastfeeding practices globally, physicians must incorporate the attitudes and skills needed to practice evidence-based breastfeeding medicine. The study of breastfeeding and human lactation is not currently recognized as a medical subspecialty, so that the maintenance of a multispecialty, physician-only organization dedicated to physician education and expansion of knowledge in this field has been vital.

Background

The benefits of breastfeeding have been well documented. Medical doctors worldwide play a key role in advocating for breastfeeding, and they interact with women and children throughout the lifespan.
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Breastfeeding Residency Curriculum

Breastfeeding is best for the health of infants and mothers. As more mothers are choosing to breastfeed, physicians need to be trained to successfully support these mothers. The American Academy of Pediatrics developed this Breastfeeding Residency Curriculum to help residents develop confidence and skills in breastfeeding care.

This Web site is designed to help residency program directors and faculty incorporate breastfeeding education into existing curriculum through implementation and evaluation strategies, useful tools, and other trusted resources. It can be applied to Pediatric, Family Medicine, Preventive Medicine, Internal Medicine, and Obstetric/Gynecologic Residency Programs. The curriculum has been organized based on the Accreditation Council for Graduate Medical Education Core Competencies.
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Residency Curriculum Improves Breastfeeding Care

Feldman-Winter L, Barone L, Milcarek B, Hunter K, Meek J, Morton J, Williams T, Naylor A, Lawrence RA.
Pediatrics. 2010 Jul 5.

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.
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Breastfeeding promotion for infants in neonatal units: a systematic review and economic analysis

Renfrew MJ, Craig D, Dyson L, McCormick F, Rice S, King SE, et al.

Health Technol Assess 2009;13(40).

Objectives: To evaluate the effectiveness and costeffectiveness of interventions that promote or inhibit breastfeeding or feeding with breastmilk for infants admitted to neonatal units, and to identify an agenda for future research.

Conclusions: Despite the limitations of the evidence base, kangaroo skin-to-skin contact, peer support, simultaneous breastmilk pumping, multidisciplinary staff training and the Baby Friendly accreditation of the associated maternity hospital have been shown to be effective, and skilled support from trained staff in hospital has been shown to be potentially cost-effective.
All these point to future research priorities.
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Hospital Education in Lactation Practices (Project HELP): Does Clinician Education Affect Breastfeeding Initiation and Exclusivity in the Hospital?

Xena Grossman, Jana Chaudhuri, Lori Feldman-Winter, Jessica Abrams, Kimberly Niles Newton, Barbara L. Philipp, Anne Merewood
BIRTH 36:1 March 2009

Background: A woman’s decision to breastfeed may be influenced by her health care practitioners, but breastfeeding knowledge among clinicians is often lacking. Project HELP (Hospital Education in Lactation Practices) was an intensive education program designed to increase breastfeeding knowledge among health care practitioners. The purpose of this study was to determine whether educating practitioners affected breastfeeding initiation and exclusivity rates at hospitals with low breastfeeding rates.

……
Results: Combining data from all hospitals, breastfeeding initiation increased postintervention from 58.5 to 64.7 percent (p = 0.02).
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A Breastfeeding-Friendly Approach to Depression in New Mothers

Curriculum and Resource Guide for Health Care Providers

Curriculum Objectives

After completing this curriculum, health care providers will be able to:

  • Identify women who may be at risk for depression in the perinatal period.
  • Recognize the symptoms of depression and other mood disorders in pregnant and postpartum women.
  • Describe how postpartum mood disorders may impact breastfeeding.
  • Describe the causes of postpartum depression.
  • Provide information to mothers so they can weigh the risks and benefits of various treatment options for depression.
  • Work with mothers to preserve the breastfeeding relationship whenever possible.

A teljes dokumentum letölthető innen.
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The Effect of Training Nursery Staff in Breastfeeding Guidance on the Duration of Breastfeeding in Healthy Term Infants

E.S. Shinwell, Y. Churgin, M. Shlomo, M. Shani, O. Flidel-Rimon
Breastfeeding Medicine. 2006, 1(4): 247-252.

Abstract

Background: Promoting breastfeeding is a central aim of child health care. It is critical to develop approaches that are inexpensive, effective, and suitable across cultural and socioeconomic groups.

Objective: To study the effect of training perinatal–neonatal nursing and medical staff in breastfeeding guidance on the duration of breastfeeding in a middle-income urban population.

Methods: This was an interventional study with data collection before and after. The intervention was an intensive course on breastfeeding guidance provided to all of the neonatal nurses and midwives in a local general hospital (2001–2002).
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Turning policy into practice: more difficult than it seems. The case of breastfeeding education

Mary Smale phd, Mary J. Renfrew phd, Joyce L. Marshall phd and Helen Spiby mphil
Matern Child Nutr. 2006 Apr;2(2):103-13.

Abstract

Breastfeeding is increasingly recognized as a health policy priority. To achieve real change in breastfeeding rates, those who advise and support childbearing women need to be appropriately educated and trained so that they do not disrupt breastfeeding. The aim of this study was to conduct a needs analysis about breastfeeding training among a range of people who advise and support breastfeeding women, including breastfeeding women themselves, to contribute to future provision of education. A qualitative, interview-based study was conducted in one northern UK city with practitioners who support breastfeeding, and breastfeeding women, selected using purposive sampling.
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Effect on rates of breast feeding of training for the Baby Friendly Hospital Initiative

Cattaneo A, Buzzetti R.
BMJ. 2001 Dec 8;323(7325):1358-62.

Abstract

PROBLEM: Breastfeeding rates and related hospital practices need improvement in Italy and elsewhere. Training of staff is necessary, but its effectiveness needs assessment.

CONTEXT: Eight hospitals in different regions of Italy.

DESIGN: Controlled, non-randomised study. Data collected in three phases. Training after the first phase in group 1 hospitals and after the second phase in group 2.

STRATEGIES FOR CHANGE: Training of trainers and subsequent training of health workers with a slightly adapted version of the 18 hour Unicef course on breastfeeding management and promotion.

KEY MEASURES FOR IMPROVEMENT: Hospital practices, knowledge of 571 health workers, and breastfeeding rates at discharge, three, and six months in 2669 mother and baby pairs.
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