Sources of education about breastfeeding and breast pump use: what effect do they have on breastfeeding duration? An analysis of the Infant Feeding Practices Survey II.

To examine the association between breastfeeding duration and sources of education about breastfeeding and breast pumps. We analyzed data from the Infant Feeding Practices Survey II (n = 2,586), a national longitudinal consumer-based study. We used χ(2) and ANOVA to contrast categorical and continuous variables, respectively, and logistic regression to model the association between breastfeeding duration and sources of education about breastfeeding and breast pump use. In unadjusted results, multiple sources of breastfeeding and breast pump education were significantly associated with breastfeeding duration. However, in multivariable logistic regression models, there was a negative association between longer breastfeeding duration and receiving breast pump education from a physician/physician assistant (OR 0.58, 95% CI 0.36-0.93); and a positive association between longer breastfeeding duration and receiving breastfeeding education from classes/support group (OR: 1.85, 95% CI: 1.24-2.76) and receiving breast pump education from friends/relatives (OR: 1.70, 95% CI: 1.13-2.55). Although healthcare providers such as physicians and nurses have regular contact with women, the only statistically significant association between breastfeeding and breast pump education from healthcare providers and longer breastfeeding duration was a negative one. This likely reflects time and resource limitations of clinical practice, but may also indicate a need for more consistent training for healthcare providers who provide breastfeeding and breast pump education. Social supports, such as education from classes/support groups and friends/relatives demonstrated positive associations with longer breastfeeding duration. This emphasizes the importance of fostering a positive sphere of influence around breastfeeding women. Future work should also investigate alternative levers of action, such as policies affecting insurance coverage of breast pumps.