TRAINING NEEDS OF HEALTHCARE PROFESSIONALS WORKING WITH BREASTFEEDING MOTHERS IN ENGLAND AND IN POLAND pp. 257-281 )
Authors: (Joanna Kosmala-Anderson, Health & Lifestyles Interventions Research Centre, Coventry Univ., Coventry, UK, Louise Wallace, Health & Lifestyles Interventions Research Centre, Coventry Univ., Coventry, UK, Susan Law, Dept. of Nursing, Midwifery and Health Care, Coventry Univ., Coventry, UK, Orla Dunn, Dept. of Psychology, Coventry Univ., Coventry, UK
Abstract: This article will explore the research literature of the importance of breastfeeding as an essential grounding for human nutrition, and present specific findings in relation to the training needs of healthcare workers who care for breastfeeding women and their infants. Breastfeeding is associated with significant health advantages for infants and mothers. The World Health Organization and UNICEF recommend breastfeeding exclusively for six months, but fewer than 35% of infants worldwide are exclusively breastfed for even the first four months. Expectant and new mothers turn to healthcare professionals for advice and breastfeeding support. Their ability to meet mothers’ expectations often influences the decision about initiating and maintaining breastfeeding; yet staff often do not receive core training on breastfeeding, which results in poor breastfeeding knowledge and competence. We compared the training needs of English and Polish healthcare professionals in breastfeeding support skills. Self assessed competence in 23 skills, and knowledge of policies and guidance on breastfeeding were compared. The sample comprised non-medical (midwives, nurses and health visitors) and medical healthcare professionals (doctors). The results for both sub-samples were analyzed separately. The self-report questionnaire was developed in consultation with experts in breastfeeding practice, pedagogy and psychology, and potential participants. Four hundred and twenty seven English and 131 Polish non-medical healthcare professionals completed our questionnaire. Results showed that Polish respondents were more likely to see themselves as competent in managing specific breastfeeding problems and in clinical practice, while English practitioners more often perceived themselves as competent in regard to socio–cultural aspects of breastfeeding. In both countries breastfeeding knowledge was low. Unsurprisingly, staff who perceived themselves as more competent tended to have better knowledge. One hundred and seventy seven English doctors and 54 of their Polish colleagues took part in the survey. There were no differences in perceived clinical practice competence levels between the two samples although Polish doctors assessed themselves as more competent in regard to educative skills. Unlike the English sample, doctors within the Polish sample who perceived themselves as less competent expressed a greater need for updating. Polish doctors had wider access to policies and guidance on breastfeeding as well as greater breastfeeding knowledge. We conclude that training needs are very similar in both countries. Core training and regular knowledge and practice-based updates are recommended to all practitioners. Even in UNICEF Baby Friendly Initiative-accredited units, more attention should be given to ensuring consistent and evidence-based practice in both countries, by updating breastfeeding policies and guidance on breastfeeding and ensuring that they are used by all healthcare practitioners. We conclude with recommendations for breastfeeding policy and for practice that are relevant to healthcare professionals in all developed countries.