Infant feeding knowledge, attitudes,and beliefs predict antenatal intention among first-time mothers in Queensland

Aim: This study assessed infant feeding knowledge, attitudes, and beliefs among women from Queensland, Australia, in their first pregnancy. Antenatal feeding intention in this group was described, and the hypothesis was tested that antenatal knowledge, attitudes, and beliefs about infant feeding are associated with antenatal intention for the duration and exclusivity of breastfeeding for the infant’s first year. Subjects and Methods: The Feeding Queensland Babies Study is a prospective survey of infant feeding attitudes and behaviors among first-time mothers in Queensland, Australia. Data on infant feeding knowledge, attitudes, beliefs, and intention were collected antenatally, and an Infant Feeding Attitudes Score was calculated. Results: Although 85% of respondents endorsed breastfeeding as most appropriate for infants, 11% valued formula feeding equally. Intention to give any breastmilk during the first weeks was 98%, but it fell to 18% during the second year. More than one-quarter of women reported intention to introduce foods other than breastmilk before 5 months of infant age. The infant feeding attitudes and beliefs score correlated positively with feeding intention for breastfeeding and the introduction of complementary solids. Conclusions: Enhancing women’s knowledge of recommendations and their understanding of breastfeeding’s specific benefits and the reasons for recommended scheduling of feeding transitions may positively impact breastfeeding exclusivity and duration and the age-appropriate introduction of complementary solids. Communication of detailed feeding recommendations for the infant’s first year and specific information about the health benefits of breastfeeding should be a goal of healthcare providers working with pregnant women

Postpartum health professional contact for improving maternal and infant health outcomes for healthy women and their infants (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effect of health professional contact (e.g. home visits, telehealth contact (other than by telephone), or visits to clinics) with postpartum women, not enrolled in specialised programs, within the first four weeks following hospital discharge on maternal and infant health outcomes

Would a student midwife run postnatal clinic make a valuable addition to midwifery education in the UK? - A systematic review

Background – There is growing evidence in the UK that some National Health Service improvements, particularly in the postnatal period, are having an impact on the quality and variety of student midwives’ clinical experiences, making it challenging for them to meet the standards set by the regulatory body for midwives and receive a licence to practice. A possible solution to this may be the introduction of a Student Midwife integrated Learning Environment (SMiLE) focusing upon the delivery of postnatal care (PN) through a student run clinic Objective - To identify the current state of knowledge, regarding the educational outcomes of students who engage with student run clinics (SRC) and the satisfaction of patients who attend them Search strategy - BNI, CINAHL, EMBASE, MEDLINE were searched for articles published until April 2014. Selection criteria - Studies nationally and internationally, that were carried out on healthcare students running their own clinics. Outcome measures were the evaluation of educational outcomes of students and client satisfaction were included Data collection and analysis - Data were extracted, analysed and synthesised to produce a summary of knowledge, regarding the effectiveness of SRC’s Main results - 6 studies were selected for this review Authors conclusions – The findings that SRC can offer advantages in improving educational outcomes of students and provide an effective service to clients is encouraging. However, given the limited number of high-quality studies included in this review, further research is required to investigate the effectiveness of SR

Which mothers receive a post partum home visit in Queensland, Australia? A cross-sectional retrospective study

Objective While home visiting in the early postpartum period appears to have increased, there are limited data defining which women receive a visit and none that include Queensland. We aimed to investigate patterns of postpartum home visiting in the public and private sectors in Queensland. Methods Data were collected via a retrospective cross-sectional survey of women birthing in Queensland between 1st February and 31st May 2010 at 4 months postpartum (N = 6948). Logistic regression was used to assess associations between receiving a home visit and sociodemographic, clinical and hospital variables. Analyses were stratified by public and private birthing sector because of significant differences between sectors. Results Public sector women were more likely to receive a visit from a nurse or midwife (from the hospital or child health sector) within 10 days of hospital discharge (67.2%) than private sector women (7.2%). Length of hospital stay was associated with home visiting in both sectors. Some vulnerable sub-populations in both sectors were more likely to be visited, while others were not. Conclusions Home visiting in Queensland varies markedly between the public and private sector and is less common in some vulnerable populations. Further consideration to improving the equity of community postpartum care in Queensland is needed

Improving the breastfeeding knowledge and skills of GP registrars

Abstract Background The National Health and Medical Research Council and the Royal Australian College of General Practitioners recommend exclusive breastfeeding for the first six months of an infant’s life and continued breastfeeding with the addition of appropriate complementary food until at least 12 months. While most Australian women initiate breastfeeding, many wean earlier than recommended due to breastfeeding difficulties. As most women consult their GP frequently in the first six months postpartum, GPs are in an ideal position to provide encouragement, evidence-based information and advice that breastfeeding women need. In addition, women are more likely to initiate and continue to breastfeed if their doctor supports and encourages them to do so. The limited Australian data available question whether GPs have the skills to be able to effectively assist breastfeeding women, although no research has specifically addressed the breastfeeding knowledge or attitudes of Australian GPs. Additionally, there are no data detailing the breastfeeding training available to medical students, GP registrars or GPs. Aim This study aimed to identify the breastfeeding educational needs of Australian GP registrars and to develop a relevant and applicable breastfeeding educational resource within the context of these identified needs. Research design Triangulation methodology, using more than one data source and qualitative and quantitative data-collection methods, was chosen for this study to give a richer, more inclusive and wider reaching understanding of the issues involved than could be obtained by using one method alone. Therefore, to meet the aims of the study, a three phase mixed-method project with triangulation of data was designed. Phase 1 had three distinct data-collection arms: a quantitative survey of medical school curricula; focus groups with medical students from two Queensland medical schools; and interviews with eight GP registrars. Data from Phase 1 provided information about breastfeeding attitudes, knowledge needs and learning opportunities, and informed the development of a questionnaire sent to final-year GP registrars Australia-wide (Phase 2). The aim of this phase was to ascertain the GP registrars’ breastfeeding attitudes and knowledge gaps. Phase 3 used the outcomes of Phases 1 and 2 to design an educational resource that would meet the needs of GP registrars. Results Breastfeeding was included in the curricula of most of the Australian medical schools surveyed (n = 10). Many medical schools relied on contact between the student and patients to provide clinical experience and practical knowledge. Medical students and GP registrars reported marked variability in breastfeeding learning opportunities. Although both groups had positive breastfeeding attitudes, participants had differing opinions regarding doctors’ involvement in infant feeding decisions and the type of support and information offered to women. Overall, the breastfeeding attitudes of the 161 GP registrars who returned the questionnaire were positive (mean 3.99, 1 = least positive, 5 = most positive). However, while the mean breastfeeding knowledge score was 3.40, (1 = minimum score, 5 = maximum score) 40 percent of the knowledge items were incorrectly answered by more than half the cohort. Approximately 40 percent of the registrars were confident and thought they were effective assisting breastfeeding women. Nevertheless, only 23 percent thought they had had sufficient breastfeeding training. Registrars who thought their previous training was inadequate had lower knowledge scores, were less confident and perceived that they were less effective than the remainder of the cohort. A new finding from this study was that Australian-born registrars had more positive breastfeeding attitudes and higher knowledge scores than their overseas-born counterparts. In addition, while parents with more than 26 weeks’ personal breastfeeding experience (self or partner) had more positive breastfeeding attitudes and higher breastfeeding knowledge, confidence and perceived effectiveness scores, parents with less experience had less positive attitudes and poorer knowledge than non-parent participants. Similar to previous studies, gender had no effect on breastfeeding knowledge or attitudes. Using adult learning principles, a five-session, case-based breastfeeding educational resource addressing the knowledge deficits identified in the previous phases of the study was developed. Evaluation activities before and after each session, as well as exercises designed for reflection and critical thinking, were an integral part of the resource. Conclusion This study found that the breastfeeding training of Australian medical students and GP registrars was inadequate and, regardless of their positive breastfeeding attitudes, resulted in registrars being ill-prepared to assist breastfeeding women. Based on the training needs identified in the study and in the literature, an educational resource was developed that presented information within real-life case-based scenarios. Additional background information provided logic and rationale for diagnosis, management and treatment. While the implementation of the resource is outside the scope of this thesis (but will be the focus of post-doctoral work), it is believed that the resource has the potential to provide GP registrars with training opportunities to improve their breastfeeding knowledge and skills, thus better meeting the needs of breastfeeding women