Canadian physicians lack knowledge and confidence about breastfeeding

Posted on Tuesday, June 10, 2014

The results of a national research project to assess the breastfeeding knowledge, confidence, beliefs, and attitudes of Canadian physicians are available today in the Journal of Human Lactation.

“Physicians' attitudes and recommendations are known to directly impact the duration that a mom breastfeeds,” said Dr. Catherine Pound, Assistant Professor of Pediatrics at the University of Ottawa, pediatrician and lead author of the study at the Children's Hospital of Eastern Ontario (CHEO). “Worldwide, healthcare organizations readily promote the benefits of breastfeeding, and yet now we find a gap exists where patients least expect it – with their physician.”

The research team surveyed pediatricians, family physicians and medical residents across Canada. They defined an overall knowledge score of 70% as acceptable because this is the minimum score pediatricians must achieve in their specialty examination to be certified the Royal College of Physicians and Surgeons of Canada.

They found that Canadian physicians' breastfeeding knowledge was suboptimal: the mean survey score was less than 70%. Several deficits in breastfeeding knowledge were identified, such as information about appropriate breastfeeding techniques, latch, and milk supply and breast pump recommendations.

Certain factors were positively associated with breastfeeding knowledge and confidence, namely whether the physician was female, between 30 and 50 years' old, having a practice with high percentage of babies, and personal experience of breastfeeding.

“Most physicians would benefit from greater education and support to help optimize care of infants and their mothers,” said Dr. Pound. “Moms need to know that their doctor might not have the skill or confidence to help them with breastfeeding. Don't give up – breastfeeding is simply too important – look elsewhere, for now, for support and information.”

Attending physicians were randomly selected for the survey, but resident participants volunteered to participate.  Score differences between the two groups suggest that breastfeeding skills may be learned primarily through clinical and life experiences, rather than in residency. This suggests a potential gap in pediatric and family medicine residency training, which the research team is currently working to address.

About the CHEO Research Institute

The CHEO Research Institute coordinates the research activities of the Children's Hospital of Eastern Ontario (CHEO) and is affiliated with the University of Ottawa. Its three research programs are molecular biomedicine, health information technology, and evidence-to-practice research. Key themes include cancer, diabetes, obesity, mental health, emergency medicine, musculoskeletal health, electronic health information and privacy, and the genetics of rare diseases. The CHEO Research Institute makes discoveries today for healthier kids tomorrow. For more information, visit

About the University of Ottawa

The University of Ottawa is committed to research excellence and encourages an interdisciplinary approach to knowledge creation, which attracts the best academic talent from across Canada and around the world. It is an important stakeholder in the National Capital Region's economic development.

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