Surveying the knowledge, attitudes, and practices of District of Columbia ACOG members related to breastfeeding

Although the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists (ACOG) recommend exclusive breastfeeding for the first 6 months, only 14.6% of babies born in the District of Columbia (DC) reached this goal. Breastfeeding support from providers has been shown to increase exclusive breastfeeding. We aim (1) to describe breastfeeding knowledge and attitudes, (2) to determine the presence of breastfeeding in routine prenatal discussions, and (3) to determine the knowledge of facility adoption of the Perinatal Care (PC) Core Measure Set among DC ACOG members. A survey sent to DC ACOG members assessed knowledge, attitudes, and practices related to breastfeeding and evaluated participants' barriers to breastfeeding counseling, management of breastfeeding challenges, and awareness of facility adoption of the PC Core Measure Set. All 29 respondents reported breastfeeding as the best infant nutrition and that physicians should encourage breastfeeding. However, despite 75% reporting counseling most of their patients regarding breastfeeding, only 27% reported that most of their patients were breastfeeding at the postpartum visit. Participants scored 83% correct on knowledge-based questions. Perceived barriers to breastfeeding counseling included lack of time (66%), reimbursement (10%), and competence in managing breastfeeding problems (7%). Most respondents were unsure of both adoption of, and breastfeeding data collection for, the PC Core Measure Set (52% and 55%, respectively). Participants had knowledge gaps and identified barriers to discussing breastfeeding. There was limited awareness of hospital data collection about breastfeeding. These results indicate a need for more breastfeeding education among DC obstetricians-gynecologists and better outreach about the PC Core Measure Set.