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Rema Ramakrishnan reports on link between medical provider attitudes and breastfeeding outcomes

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Epidemiology doctoral student Rema Ramakrishnan, MD, MPH, is co-author on a publication entitled “The Association between Maternal Perception of Obstetric and Pediatric Care Providers’ Attitudes and Exclusive Breastfeeding Outcomes.”  The study is in the February 2014 issue of the Journal of Human Lactation.

Rema Ramakrishnan

A native of Pune, India, Dr. Ramakrishnan completed her medical training at the University of Pune and earned her MPH from the University of Minnesota—Twin Cities. With an interest in maternal and child health, her dissertation will focus on perinatal epidemiology.

Dr. Ramakrishnan’s academic home is the USF College of Public Health, Department of Epidemiology and Biostatistics.  The department offers concentrations in epidemiology that lead to MPH, MSPH, and PhD degrees, as well several dual degrees, graduate certificates, and special programs. Most recently, the department added an online master of public health degree in epidemiology to its academic offerings.

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Rema Ramakrishnan, MPH1, Charles N. Oberg, MD, MPH2, and Russell S. Kirby, PhD, MS, FACE3

Abstract

Background: Exclusive breastfeeding is recommended for 6 months. Successful breastfeeding requires support from family members, peers, and health care professionals.

Objective: This study aimed to determine the association between maternal perception of the attitudes of obstetric and pediatric care providers about infant feeding during the neonatal period and exclusive breastfeeding at 1, 3, and 6 months.

Methods: The study sample consisted of 1602 women from the Infant Feeding Practices Study II (2005-2007), a longitudinal study of women in the United States. Analyses included chi-square and Fisher’s exact tests and logistic regression models.

Results: Mothers who perceived that the obstetric care provider favored exclusive breastfeeding were significantly more likely to exclusively breastfeed their infants at 1 and 3 months (odds ratio [OR] = 1.73, 95% confidence interval [CI], 1.33-2.24; and OR = 1.41, 95% CI, 1.09-1.80, respectively) as compared to mothers who perceived that the obstetric care provider was neutral about the type of infant feeding. Similarly, mothers who perceived that the pediatric care provider favored exclusive breastfeeding had higher odds of exclusively breastfeeding their infants at 1 and 3 months (OR = 1.53, 95% CI, 1.17-1.99; and OR = 1.51, 95% CI, 1.17-1.95, respectively) as compared to mothers who perceived that the pediatric care provider was neutral about the type of infant feeding. The association was no longer significant at 6 months.

Conclusion: Maternal perception of obstetric and pediatric care providers’ preference for exclusive breastfeeding during the neonatal period is associated with exclusive breastfeeding until 3 months.

Keywords

breastfeeding, breastfeeding attitudes, breastfeeding support, breast milk