Medical Provider Survey on Breastfeeding

Instructions: Hello. The South MS Breastfeeding Coalition and the Mississippi Public Health Institute are gathering information that will help to better promote the practice of breastfeeding. We are contacting you because you provide medical services to women of childbearing age or patients who are pregnant. This survey should take 3 minutes to complete, and we are grateful for your consideration. Even if you are in a group practice, we’d like to hear from you and your colleagues.  

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* 1. Name of practice:

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* 2. Which of the following best describes your role at your health center or medical practice?

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* 3. How many years have you been practicing medicine or working as a healthcare provider?

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* 4. How would you rate the importance of breastfeeding for the health of the baby?

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* 5. Does your practice educate expectant and new mothers on breastfeeding practices?

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* 6. Does your practice offer trainings for staff to help them provide lactation counseling?

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* 7. Do you or your staff ask about the cultural beliefs and practices of a patient before counseling about breastfeeding?

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* 8. How often is prenatal care provided to expectant mothers in your practice?

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* 9. How often are prenatal visits in your practice used to discuss delivery room considerations such as skin-to-skin care and rooming of the mother and newborn?

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* 10. How often do you encounter patient enthusiasm for breastfeeding among expectant or new mothers?

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* 11. How often is an expectant or new mother referred to breastfeeding support groups through your practice?

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* 12. When discussing feeding options with parents of a healthy full-term infant in your practice, which one of the following do you usually recommend for the first month of life?

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* 13. For approximately what length of time do you recommend breastfeeding?

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* 14. How often, if at all, is your office able to provide a quiet and comfortable private space, with appropriate resources (seating, an electric outlet, refrigeration), set aside for mothers to breastfeed or express breast milk?

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* 15. Which of the following describe the availability of brochures, pamphlets, and other resources about breastfeeding in your practice? (Please select all that apply.)

Questions 16-18: Does your practice ever provide information about any of the following to expectant/new mothers or other parents?

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* 16. Lactation specialists

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* 17. Community-based breastfeeding support groups

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* 18. Breastfeeding peer counselors

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* 19. How familiar are you with recommendations from Optimizing Support for Breastfeeding as Part of Obstetric Practice issued by the American College of Obstetricians and Gynecologists (ACOG) or the American Academy of Pediatrics’ (AAP) policy statement on breastfeeding? (Please answer concerning familiarity with either one of these.)

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* 20. What barriers to breastfeeding are commonly faced by your patients? (Please select up to five top barriers.)

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* 21. What factors might most encourage mothers to breastfeed? (Please select up to five top factors.)

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* 22. What might assist your practice in its effort to offer breastfeeding support? (Please select all that apply.)

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* 23. Your email address (will not be shared):

Questions? Contact Tennille Collins, Mississippi Public Health Institute: (601)398-4406; tcollins@msphi.org.

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