Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Jessica Illuzzi


Breastfeeding initiation rates in the United States remain below the Healthy People 2010 goals. Research indicates patient interaction with health care providers may play an important role in womens ultimate feeding choice. This study sought to examine the impact of provider counseling regarding breastfeeding during the prenatal period on feeding outcome by evaluating: 1) if providers addressed womens concerns regarding breastfeeding; and 2) how providers responded to a womans feeding choice. We also sought to examine whether the type of counseling provided by providers regarding infant feeding is influenced by patient socio-demographics and stated feeding plans. This study is cross-sectional with convenience sampling of all English or Spanish speaking women on the postpartum floor at Yale-New Haven Hospital. A total of 130 women participated. Overall, 95.4% of women identified a concern they had about breastfeeding during the prenatal period, and one quarter of patients had their concerns about breastfeeding addressed. The majority of patients (74.6%) were asked about their feeding plans, and 50.5% were encouraged to breastfeed. Unlike the majority of studies that indicate young, African American, poorly educated, unmarried and low income women are less likely to receive counseling from providers to breastfeed, providers in our study area focused their efforts on this population. In multivariate analysis, neither having concerns addressed nor being encouraged to breastfeed were associated with increased likelihood of breastfeeding. Addressing patients concerns may be most relevant in the small subset of patients who make their feeding choice during pregnancy. Finally, women who were asked about their plans and had their concerns addressed (p=.010) or were encouraged to breastfeed (p=.040) were more likely to make their decision during pregnancy compared to before pregnancy than women whose providers did not discuss these issues. Likewise, mixed feeders were more likely to make their decision regarding infant feeding during rather than before pregnancy. This data suggests providers may be encouraging women to think more thoroughly about the possibility of breastfeeding, thus delaying their decision. In conclusion, many women are not being encouraged to breastfeed or having their concerns about breastfeeding addressed. All women would benefit from prenatal discussion of these topics; however, the effect may be most profound in women who make their decision regarding feeding during pregnancy.


This is an Open Access Thesis.

Open Access

This Article is Open Access