Training needs survey of midwives, health visitors and voluntary-sector breastfeeding support staff in England.

This study, which was part of a learning needs assessment of health professionals in England, reports a survey of the training needs of healthcare practitioners in breastfeeding support skills. Respondents rated their competence on 26 breastfeeding support skills, importance of update, actual and potential helpfulness of training, and accessibility in the next 2 years. Perception of organizational barriers to breastfeeding support and practitioners' knowledge of policies and guidance on breastfeeding were measured. Data are reported on 549 healthcare practitioners, mostly midwives and health visitors working for public health services, and some voluntary-sector practitioners, 58% had worked with women and their infants for more than 10 years, and 56% were currently spending at least 25% of their working time providing direct care to breastfeeding women. Those already competent were most likely to want more updating. Those with longer experience of breastfeeding support were more competent on three of the four competence subscales. Relationships between self-assessed competence and current intensity of breastfeeding experience were inconsistent. Respondents preferred training with a practical component. Respondents had poor knowledge of evidence-based policy, and only 51% had access to a breastfeeding policy. Organizational barriers to breastfeeding support were experienced by all, and especially by those with fewer years of experience (t = -2.32, d.f. = 547; P = 0.02) and those currently spending less time supporting breastfeeding women (t = -10.35, d.f. = 547; P < 0.0001). Core training is relevant to all practitioners, and practice-based training with access to evidence-based policies is required.