title: Pediatricians and the promotion and support of breastfeeding.
abstract: OBJECTIVE
  To survey pediatricians on their breastfeeding knowledge, attitudes, and practices and to compare these results with those of a 1995 study.
  
  
  METHODS
  Cross-sectional follow-up survey.
  
  
  METHODS
  The Periodic Survey of Fellows survey conducted by the American Academy of Pediatrics.
  
  
  METHODS
  The survey was completed by 875 pediatrician members of the American Academy of Pediatrics from November 1, 2003, through May 21, 2004.
  
  
  METHODS
  Pediatricians' recommendations on management, opinions about the benefits and promotion of breastfeeding, and relationship to personal breastfeeding experience were compared with the results of the 1995 survey.
  
  
  RESULTS
  Compared with the results of the 1995 survey, in 2004, pediatricians were less likely to believe that the benefits of breastfeeding outweigh the difficulties or inconvenience (adjusted odds ratio, 0.60; 95% confidence interval, 0.47-0.76), and fewer believed that almost all mothers are able to succeed. More pediatricians in 2004 reported reasons to recommend against breastfeeding. Pediatricians in 2004 were more likely to recommend exclusive breastfeeding (adjusted odds ratio, 1.55; 95% confidence interval, 1.23-1.94) and follow supportive hospital policies. Respondents with personal breastfeeding experience were 2.3 times more likely to recommend supportive policies (adjusted odds ratio, 2.3; 95% confidence interval,1.74-3.08) in 2004 than in 1995. Those with no personal breastfeeding experience were also slightly more likely in 2004 to recommend these policies (adjusted odds ratio, 1.49; 95% confidence interval, 1.09-2.03).
  
  
  CONCLUSIONS
  Although pediatricians seem better prepared to support breastfeeding, their attitudes and commitment have deteriorated. Personal experience mitigates poor attitudes and seems to enhance breastfeeding practices among those surveyed.
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, Cooper University Hospital, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Camden, NJ 08103, USA. winterlb@umdnj.edu
authors.forename: Lori B
authors.initials: LB
authors.lastname: Feldman-Winter
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Schanler
authors.forename: Karen G
authors.initials: KG
authors.lastname: O'Connor
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Lawrence
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D002983:Clinical Competence; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States