Division of Adolescent Medicine, Department of Pediatrics, Cooper University Hospital, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Camden, NJ 08103-1438, USA.
Pediatrics. 2010 Aug;126(2):289-97. doi: 10.1542/peds.2009-3250. Epub 2010 Jul 5.
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.
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. Six intervention residency programs implemented the curriculum, whereas 7 control programs did not. Residents completed pretests and posttests before and after implementation. Breastfeeding rates were derived from randomly selected medical charts in hospitals and clinics at which residents trained.
Trained residents were more likely to show improvements in knowledge (odds ratio [OR]: 2.8 [95% confidence interval (CI): 1.5-5.0]), practice patterns related to breastfeeding (OR: 2.2 [95% CI: 1.3-3.7]), and confidence (OR: 2.4 [95% CI: 1.4-4.1]) than residents at control sites. Infants at the institutions in which the curriculum was implemented were more likely to breastfeed exclusively 6 months after intervention (OR: 4.1 [95% CI: 1.8-9.7]).
A targeted breastfeeding curriculum for residents in pediatrics, family medicine, and obstetrics and gynecology improves knowledge, practice patterns, and confidence in breastfeeding management in residents and increases exclusive breastfeeding in their patients. Implementation of this curriculum may similarly benefit other institutions.
多项研究表明住院医师培训期间母乳喂养教育存在不足，最近的研究结果证实，执业儿科医生对母乳喂养的态度正在恶化。在此，我们评估了住院医师课程是否改善了医生在提供母乳喂养护理方面的知识、实践模式和信心，以及实施该课程是否与患者母乳喂养率的提高有关。
一项前瞻性队列研究纳入了 417 名住院医师，他们参加了一项由美国儿科学会与美国妇产科学院、美国家庭医师学会和儿科学会项目主任协会的专家合作开发的新型课程的对照试验。6 个干预住院医师项目实施了该课程，而 7 个对照项目没有。在实施前后，住院医师完成了预测试和后测试。从住院医师培训的医院和诊所中随机选择病历得出母乳喂养率。
接受培训的住院医师在知识（优势比 [OR]：2.8 [95%置信区间 (CI)：1.5-5.0]）、与母乳喂养相关的实践模式（OR：2.2 [95% CI：1.3-3.7]）和信心（OR：2.4 [95% CI：1.4-4.1]）方面的改善可能性大于对照组的住院医师。在课程实施的机构中，婴儿在干预后 6 个月更有可能进行纯母乳喂养（OR：4.1 [95% CI：1.8-9.7]）。
针对儿科、家庭医学和妇产科住院医师的针对性母乳喂养课程可提高住院医师在母乳喂养管理方面的知识、实践模式和信心，并增加其患者的纯母乳喂养率。实施该课程可能同样使其他机构受益。
