Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel.
Department of Family Medicine and Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Int Breastfeed J. 2022 Aug 30;17(1):62. doi: 10.1186/s13006-022-00506-4.
The guidelines of all leading professional organizations recommend providing adequate support and education regarding breastfeeding; yet many mothers feel that they receive inadequate information from their health care providers in the primary care setting. This is in line with studies that demonstrate that physicians' knowledge about breastfeeding is lacking. The aim of this study was to expand our understanding of the breastfeeding-related experiences of mothers with primary care physicians (PCPs).
In this qualitative study, we interviewed breastfeeding mothers in Israel in the first six months after delivery. The interviews were conducted between December 2020 and May 2021. We used thematic analysis to explore women's attitudes and experiences with their PCPs regarding breastfeeding concerns. All authors read the transcribed interviews and independently marked statements regarding breastfeeding. Then, in a joint process, codes, subthemes and themes were defined. Each subtheme was backed up with a quote from the interviews.
We interviewed 13 women aged 24 to 37. We identified four main themes. The first of these was physicians' inconsistent attitudes toward breastfeeding. Some were indifferent, while others related to breastfeeding solely in the context of infant development. Some were supportive, while others opposed breastfeeding. Several women revealed physicians' inappropriate and disturbing attitudes to breastfeeding. The second theme was physicians' lack of knowledge regarding medical treatment for breastfeeding issues. This theme included lack of knowledge, incorrect treatment of breastfeeding problems, and contradictions among HCPs. The third was mothers' preference for alternative resources, including individualized breastfeeding counselling, maternity and childcare nurses, mothers' groups (in person or online), and family and friends over medical treatment for breastfeeding problems. The fourth theme involved mothers' suggestions for PCPs, which highlighted the importance of communication, prenatal physician-initiated dialogue on breastfeeding, expanding professional knowledge on breastfeeding, and increasing the availability of treatment for breastfeeding problems.
The women in this study reported unsatisfactory breastfeeding support by PCPs and incorrect or inadequate treatment of medical problems related to breastfeeding. They also felt they had no medical experts to approach with breastfeeding-related problems. We believe that physicians should expand their knowledge on breastfeeding medicine so that they can provide comprehensive patient-centered treatment to both mothers and infants. Education programs for improving knowledge and skills in breastfeeding issues should be implemented throughout the medical training.
所有主要专业组织的指南都建议提供足够的支持和教育，以促进母乳喂养；然而，许多母亲表示，她们在初级保健环境中从医疗保健提供者那里获得的信息不足。这与研究结果一致，这些研究表明医生对母乳喂养的知识不足。本研究旨在扩大我们对母亲与初级保健医生（PCP）之间母乳喂养相关经验的理解。
在这项定性研究中，我们在以色列对分娩后头 6 个月的母乳喂养母亲进行了采访。采访于 2020 年 12 月至 2021 年 5 月进行。我们使用主题分析来探讨女性对 PCP 关于母乳喂养问题的态度和经验。所有作者都阅读了转录的访谈，并独立标记了与母乳喂养相关的陈述。然后，在一个联合过程中，定义了代码、子主题和主题。每个子主题都有来自访谈的引语支持。
我们采访了 13 名年龄在 24 至 37 岁的女性。我们确定了四个主要主题。第一个主题是医生对母乳喂养的态度不一致。有些医生漠不关心，而有些医生仅将母乳喂养与婴儿发育联系起来。有些医生表示支持，而有些医生则反对母乳喂养。一些女性透露了医生对母乳喂养的不当和令人不安的态度。第二个主题是医生对母乳喂养问题的医疗处理缺乏知识。这一主题包括缺乏知识、对母乳喂养问题的不正确处理以及卫生保健提供者之间的矛盾。第三个主题是母亲对替代资源的偏好，包括个性化的母乳喂养咨询、母婴护理护士、母亲小组（面对面或在线）以及家庭和朋友，而不是医疗处理母乳喂养问题。第四个主题涉及母亲对 PCP 的建议，强调了沟通的重要性、产前医生发起的关于母乳喂养的对话、扩大对母乳喂养知识的专业知识以及增加治疗母乳喂养问题的可及性。
本研究中的女性报告说，PCP 提供的母乳喂养支持不尽如人意，并且对与母乳喂养相关的医疗问题的处理不正确或不充分。她们还觉得自己没有医学专家可以处理母乳喂养相关的问题。我们认为，医生应该扩大他们在母乳喂养医学方面的知识，以便为母亲和婴儿提供全面的以患者为中心的治疗。应该在整个医学培训过程中实施提高母乳喂养问题知识和技能的教育计划。
