Caring about breastfeeding in prenatal care

In an effort to ensure the health of both mother and baby, most pregnant women make multiple visits for prenatal care. Few behaviors impact health outcomes for mother and baby more than breastfeeding, so one would expect these prenatal care visits to include extensive breastfeeding guidance.

In a recent study, researchers audiorecorded 172 first visits for prenatal care at a large academic medical center to assess the nature of breastfeeding discussions.
Overall, less than a third of visits (to 36 obstetric residents, 6 midwives, and 5 nurse practitioners) included any discussion of breastfeeding, and only 2% included an explicit recommendation that breastfeeding is superior to artificial feeding. Midwives were more likely to discuss breastfeeding, but only 42% (vs. 10% of obstetricians) assessed pregnant women’s prior exposure to or experience with breastfeeding.

As most mothers make decisions about how they are going to feed their infants before their babies are born, prenatal care providers have the potential to play an important role in educating women about the maternal and infant health risks associated with not breastfeeding. Unfortunately, at least at this hospital, few women seem to be getting the message that their prenatal clinician actually cares about breastfeeding. Efforts are needed to make sure that training programs across the country effectively convince prenatal care providers to care about infant feeding.

Eleanor Bimla Schwarz, MD, MS is a clinician and researcher at the University of Pittsburgh, Departments of Medicine, Epidemiology, and Obstetrics, Gynecology and Reproductive sciences.

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