Neurologists' and obstetricians' perspectives and current practices in breastfeeding counseling in women with epilepsy.

Autor: Al-Faraj AO; Boston Medical Center, Boston University School of Medicine, 85 E Concord Street, Boston, MA 02118, USA. Electronic address: alfaraj@bu.edu., Messina I; Boston University College of Health and Rehabilitation Sciences, Boston, MA, USA., Summit R; Boston University College of Arts and Sciences, Boston, MA, USA., Modhwadiya D; Boston University College of Arts and Sciences, Boston, MA, USA., Ukonu N; Boston University, School of Public Health, Department of Biostatistics, 801 Mass Avenue, Boston, MA, USA., Pang TD; Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, West Campus, Baker 515, Boston, MA 02215, USA. Electronic address: tpang@bidmc.harvard.edu.
Jazyk: angličtina
Zdroj: Epilepsy & behavior : E&B [Epilepsy Behav] 2024 Jul; Vol. 156, pp. 109773. Date of Electronic Publication: 2024 May 23.
DOI: 10.1016/j.yebeh.2024.109773
Abstrakt: Objectives: In this study, we aimed to characterize practice patterns of neurologists and obstetricians in breastfeeding (BF) counseling in women with epilepsy (WWE) and explore factors that may influence physician counseling behaviors.
Methods: We conducted a cross-sectional study of neurologists and obstetricians via an anonymous survey from September 2021 until November 2021. A survey was developed to explore the following areas in WWE: current physicians' BF counseling patterns, physician-specific factors affecting BF counseling, and patient-specific factors and their impact on BF counseling. Descriptive statistics were generated for each survey question. Responses from neurologists and obstetricians were compared. Odds ratios (OR) and confidence intervals (CI) were calculated to assess factors that influence BF counseling in WWE.
Results: A total of 185 physicians participated in the study and consisted of 91 (49.2 %) neurologists, 83 (44.8 %) obstetricians, and 11 (6 %) participants from other specialties. Ninety-four percent (94 %) of neurologists and 92 % of obstetricians indicated that they provide BF safety counseling to WWE primarily during preconception and occasionally during pregnancy. Fifty-six percent of obstetricians reported being very comfortable with BF counseling in WWE, compared to 68 % of neurologists. Both groups rated research and clinical practice guidelines as two factors that have major impact on BF counseling; however, less than half (45 %) of neurologists are very familiar with the current literature and only a quarter (24 %) of obstetricians are very familiar with current literature regarding safety of BF in WWE. Regarding barriers to BF counseling, relative to neurologists, obstetricians believe that delivery of conflicting opinions among medical specialists about BF safety is a barrier that may impede effective BF counseling in WWE [OR = 2.78 (95 % CI: 1.30,5.95), adjusted p value (P = 0.008)].
Significance: Variable knowledge of current literature in BF in WWE and low comfort levels in BF counseling among various specialists, as well as perceived inadequate data and clinical practice guidelines, may contribute to suboptimal BF counseling and impact health outcomes in WWE and their children.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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