1 Center for Biobehavioral Health, The Research Institute , Nationwide Children's Hospital, Columbus, Ohio.
2 Department of Pediatrics, College of Medicine, The Ohio State University , Columbus, Ohio.
Breastfeed Med. 2017 Jul/Aug;12(6):345-350. doi: 10.1089/bfm.2017.0032. Epub 2017 May 30.
Conventional medicine pediatric care providers (e.g., pediatricians) have been shown to be influential in women's decisions to initiate and sustain breastfeeding. Alternative pediatric care providers (e.g., naturopaths and chiropractors) may also provide breastfeeding support, but this has not been the subject of prior research. Our objective was to compare breastfeeding mothers' perceptions of support from these two provider types in a large sample of women who breastfed for more than 12 months.
We conducted a cross-sectional study of 49,091 U.S. women through online questionnaire distributed through peer breastfeeding groups. We used log-binomial regression to compare those who used an alternative pediatric healthcare provider to care for their child to those who used a conventional provider on perceptions of support and key factors influencing the decision to breastfeed for more than 12 months.
Those who used an alternative provider were more likely to discuss breastfeeding (Adj RR = 1.25, 95% CI 1.17-1.33), feel comfortable discussing breastfeeding (Adj RR = 1.17; 95% CI 1.15-1.19), and feel supported by the provider (Adj RR = 1.25; 95% CI 1.23-1.28). However, providers' recommendations were not important factors in these women's decision to breastfeed beyond 12 months of age.
Mothers who used an alternative care provider as their child's primary source of healthcare rated the provider's breastfeeding support more favorable than those who used a conventional provider (usually a pediatrician). Improving breastfeeding support may be one way to retain families in conventional pediatric primary care, and thereby, ensure children receive comprehensive, evidence-based care.
传统医学儿科保健提供者（如儿科医生）在影响妇女开始和维持母乳喂养的决定方面已被证明具有影响力。替代儿科保健提供者（如自然疗法医生和脊椎按摩师）也可能提供母乳喂养支持，但这不是先前研究的主题。我们的目的是在一个母乳喂养时间超过 12 个月的大量妇女样本中，比较这两种提供者类型的母乳喂养母亲对支持的看法。
我们通过在线问卷调查对 49091 名美国妇女进行了一项横断面研究，该问卷通过同行母乳喂养小组分发。我们使用对数二项式回归比较了那些使用替代儿科医疗保健提供者照顾孩子的人与那些使用传统提供者的人在支持和影响母乳喂养超过 12 个月的决定的关键因素方面的看法。
那些使用替代提供者的人更有可能讨论母乳喂养（调整后的 RR=1.25，95%CI1.17-1.33），感到舒适地讨论母乳喂养（调整后的 RR=1.17；95%CI1.15-1.19），并感到提供者的支持（调整后的 RR=1.25；95%CI1.23-1.28）。然而，提供者的建议并不是这些妇女在 12 个月后母乳喂养的决定的重要因素。
将替代护理提供者作为其孩子主要医疗保健来源的母亲对提供者的母乳喂养支持评价优于那些使用传统提供者（通常是儿科医生）的母亲。改善母乳喂养支持可能是留住传统儿科初级保健家庭的一种方式，从而确保儿童接受全面、基于证据的护理。
