Impact of a Formal Lactation Curriculum for Residents on Breastfeeding Rates Among Low-Income Women.

Background: Due to lack of breastfeeding training, many physicians are unable to address basic breastfeeding needs. Previous studies have demonstrated that obstetrics-gynecology residents and practicing physicians do not have adequate training in lactation management. A formal breastfeeding curriculum has been shown to increase physician knowledge and improve breastfeeding rates in their patients. Objective: The goal of this study is to investigate the impact of a targeted lactation curriculum for obstetrics and gynecology residents on breastfeeding rates in a diverse low income popu- lation. Study design: A retrospective cohort study was performed at a community based, university affiliated hospital, one resi- dency program implemented the curriculum. Breastfeeding outcomes of women with a singleton live-born infant at term gestation were analyzed before and after implementation of curriculum. Detailed demographic information, medical his- tory, and breastfeeding rates were derived from hospital lac- tation record log and electronic medical records from the clinic and hospital where residents trained. The v2, independent- sample t tests and Mann Whitney U tests were used where appropriate. A multivariate logistic regression analysis was also performed. Results: The study included 717 women, 337 prior to inter- vention and 380 after intervention. The mean age was 25 years, most women were multiparous (64%), unemployed (61%), Hispanic (57%), married or in a stable relationship (76%). The women who delivered after institution of the curriculum were more likely to breastfeed exclusively at 6 weeks postpartum (OR: 1.96 [95% CI: 1.24-3.11]). Another factor significantly associ- ated with exclusive breastfeeding at 6 weeks was being in a stable relationship (