APGO

Alicia Wenberg
White Memorial Medical Center, Los Angeles, California

Study Objective: Breast milk provides unique nutrition and immunologic protection, promotes psychological maternal bonding, and may bring economic benefits. An important determinant of whether women will breastfeed is their confidence and skills to successfully initiate and continue breastfeeding. OB residents who are better prepared by a lactation specialist to handle the clinical encounters with women who want to discuss the correct management of lactation issues feel more confident about their ability to promote and support breastfeeding and feel they have a better chance of helping women initiate breastfeeding than those that only completed a self-paced module on breastfeeding.

Methods: A breastfeeding instructional experimental-control design was used to test the value of supplementing a comprehensive self-paced 4-6 hour study module with a 1-hour shadowing of lactation expert experience. A total of 12 female only OB residents participated in this study. None had previous personal experience with breastfeeding. The control group consisted of six OB residents who completed only the self-paced instructional module and the experimental group consisted of six OB residents who completed the self-paced instructional module and received a 1 hour shadowing experience with a lactation specialist. The control group consisted of one PGY1, two PGY2, two PGY3, and one PGY4 residents. The experimental group consisted of three PGY1, two PGY2, and one PGY 3 residents.

Results: OB residents who completed the self-paced instructional module on breastfeeding and then subsequently shadowed a lactation specialist, compared to those who only completed the self-paced instructional module without subsequent shadowing, felt more confident, were better prepared for clinical encounters with woman attempting to initiate breastfeeding, and demonstrated an increase in the frequency with which they counseled patients about breastfeeding.

Conclusion: These results indicate that while OB residents recognize the important role they have in promoting and supporting breastfeeding, supplemental clinical instruction of residents by a lactation specialist better prepares them to handle antepartum and postpartum clinical encounters with women who want to discuss signs of adequacy of breastfeeding and correct management of lactation issues, than does a 4-6 hour self-paced module on breastfeeding.