Assessment of physicians' knowledge, attitudes, and beliefs about breastfeeding and their influence on mothers' breastfeeding practices in Lebanon

Abstract

Background – Breastfeeding is an effective public health intervention that improves infants and mothers’ health worldwide. Exclusive breastfeeding rates in Lebanon are low. The extent to which gynecologists, pediatricians, and family doctors in Lebanon play a role in women’s breastfeeding practices is not well-understood. Lebanese physicians’ perceived and actual knowledge, beliefs about the benefits of breastfeeding, and self-efficacy in supporting breastfeeding are also not fully investigated. Methods – In this pilot cross-sectional study, we used interview-administered questionnaires to describe breastfeeding practices among n=50 Lebanese mothers mostly residing in North Lebanon, as well as their perceived level of physicians’ support and extent of influence on their breastfeeding practices. We also administered a questionnaire to gynecologists, pediatricians and family physicians (n=20 each), who practice within the same geographical areas as the interviewed mothers, to describe their breastfeeding promotion and support practices, as well as their breastfeeding-related actual and perceived knowledge, beliefs, and self-efficacy. Results – 98% of mothers decided during pregnancy to exclusively breastfeed, but around a third only did so at the hospital after delivery and during the first six months postnatally. Mothers commonly reported that their gynecologists and infants’ pediatricians, but not family physicians, were influential on decisions related to their breastfeeding practices. However, the mothers’ social network, primarily their mothers and husbands, were the most influential and not the physicians. Physicians generally reported positive beliefs and self-efficacy about breastfeeding, but had suboptimal scores on tests of knowledge assessment. Conclusion – Improving physicians’ knowledge around breastfeeding may be a potential indirect way to improve influence of physicians on women’s breastfeeding practices and to increasing breastfeeding initiation, continuation and exclusivity among women in North Lebanon.