Norwegian general practitioners' knowledge and beliefs about breastfeeding, and their self-rated ability as breastfeeding counsellor

Abstract

BackgroundBreastfeeding is considered the best infant-feeding method. Norway is one of the leading countries in terms of breastfeeding initiation and duration. To maintain this high breastfeeding rate, it is important to understand the factors that influence breastfeeding. A doctor s advice can improve the rates of breastfeeding initiation and duration, but not all doctors are competent in breastfeeding counselling.ObjectivesThe aim of this study was to identify the knowledge and beliefs of general practitioners (GPs) about breastfeeding in Norway and to investigate how important they considered guidance about breastfeeding initiation and duration before and after birth.DesignA questionnaire study about knowledge and beliefs according to predefined correct responses and about self-perceived competence as an advisor.Subjects122 GPs engaged in apprenticeship for medical students.ResultsThe response rate was 57%, 69 GPs participated. The questions were answered correctly according to national consensus for 49 % for the knowledge items and 64 % of the belief items. The GPs believed that their guidance was more important after than before birth. Female GPs had more confidence in their guidance ability than male GPs. Confidence in the GPs own guidance after birth was associated with knowledge about contraindications to breastfeeding.ConclusionAlthough the GPs expressed beliefs favouring breastfeeding they partly lacked basic knowledge. The GPs confidence in own guidance was better after than before birth and was higher among those with more knowledge. Improved knowledge and emphasis on guidance before birth should be promoted among GPs. Key pointsBreastfeeding is the best infant-feeding method. Doctors’ advice improves the rates of breastfeeding, but not all doctors have sufficient knowledge. This study mapped the knowledge and beliefs among Norwegian GPs. The study revealed that:GPs partly lacked basic knowledge to effectively promote breastfeeding.GPs had less confidence as advisers during pregnancy than after delivery.Most GPs agreed that knowledge about breastfeeding is basic and should be taught as an integral part of medical school programmes.

Experiences of primary care physicians managing postpartum care: a qualitative research study

“…The lack of formal structured training, self-efficacy in accessing informal training and resource materials influenced PCPs’ mastery of postpartum care. In developed countries such as Canada [ 20 ], Norway [ 21 ] and Australia [ 22 ], PCPs similarly reported that they were aware of the benefits of breastfeeding but lacked basic knowledge to assess and advise on breastfeeding. Postpartum care training, including assessing breastfeeding and normal feeding behaviour of the baby can be incorporated into the national Family Medicine training programmes to increase the competency of PCPs in this field [ 23 ].…”

Exploring Physicians’ Perspectives on the Introduction of Complementary Foods to Infants and Toddlers

“…These are very encouraging results. However, some studies show that physicians often misunderstand the nutritional guidelines, thus it is worth clarifying and discussing these guidelines, for example, during training meetings and workshops [22][23][24]. As a matter of fact, knowledge on the influence of nutrition during the first years of life on later health has grown significantly in recent years, both among doctors and the general population [25,26].…”

Are the doctors of the future ready to support breastfeeding? A cross-sectional study in the UK

“…A survey from the 1970s suggesting half of paediatricians and obstetricians would have benefited from a specific breastfeeding curriculum whilst at medical school [30]. This view is still relevant today with 85% Norwegian GPs believing that infant feeding should be taught before gaining their registration [12]. Additionally, doctors who reported lower confidence in breastfeeding clinical skills were less likely to engage with further training, suggesting the need to incorporate breastfeeding into a core curriculum [13].…”

“…There are several examples in the literature of where poor knowledge and training around infant feeding has been shown to have negative impacts. In a Norwegian survey of GPs, only 26% could identify the differences between infant formula and human milk, which consequently affected their confidence in counselling patients [12]. Furthermore, approximately half of GPs and paediatricians surveyed in the UK advised parents to introduce solids before the WHO/UNICEF recommendation of around 6 months [13].…”