Survey on medical practitioners’ knowledge, attitudes and practices in promoting and supporting breastfeeding
Thank you for your support. Please respond the following items with reference to your clinical practices. The
data collected will be solely used by the investigators for medical research. All the data collected will be kept in
strict confidence.
Please tick  box(es) as appropriate or complete the answer.
1.
Does your practice provide antenatal care to pregnant women?
Yes
No
2.
Does your practice provide postnatal care to mothers of young babies (0 - 2months)?
Yes
No
If all responses for Q1- Q2 are “No”, there is no need to complete the questionnaire.
Otherwise, please proceed with reference to your clinical practice in previous 12 months.
3.
During the past 12 months, what proportion of the newborns under your care (including the
attended labour) was also cared by paediatrician?
4.
%
During the past 12 months, what proportion of the women under your care were breastfeeding (any
form) at hospital discharge?
Over 75%
51-75%
25-50%
<25%
Not Known
5.
During the past 12 months, what proportion of the women in your practice had undergone the
following mode of delivery? (Tick one response for each item)
0-<20%
20-<40%
40-<60%
60-<80%
80-100%
Normal vaginal delivery
(Proportion with episiotomy done:)
Nulliparous women
Multiparous women
Elective Caesarian section
Emergency Caesarian section
Instrumental assisted delivery
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Please indicate your usual recommendations in advising the expectant mothers under your care.
6.
How often do you actively discuss infant feeding options with expectant mothers?
(Tick one response for each item)
Never
Sometimes
Frequently
Always
Women planning for pregnancy (Preconception care)
Pregnant women (Antenatal care)
7.
When discussing feeding options with expectant mothers, what do you usually recommend:
(Tick one category only)
Formula feeding (go to Q10)
Breastfeeding exclusively (go to Q8)
Any form of breastfeeding (go to Q9)
Make no specific recommendation / support mother's choice (go to Q10)
8.
How long do you usually recommend mothers to breastfeed exclusively:
9.
6 long do you usually recommend mothers to continue breastfeeding (any form)?
How
for
months
(Tick
one category only)
.
For
months
Till mother returns to work
Continue as long as the baby / mother wants
Others:
10. When discussing the mode of delivery, what do you usually advise pregnant women who wish to
breastfeed?
(Can tick more than one response)
Advise normal vaginal delivery unless there is medical indication for Caesarian delivery
Explain that Caesarian delivery may reduce the chance and duration of breastfeeding
If Caesarian delivery is unavoidable, advise regional anesthesia over general anesthesia
Make no specific recommendation
Others:
Please indicate your usual recommendations regarding birthing practices and early postnatal care.
11. When discussing pain relief during labour and after delivery, what do you usually recommend
pregnant women who wish to breastfeed? (Tick one response only)
Prescribe drugs to achieve maximum pain control
Avoid drugs that might interfere initiation of breastfeeding (e.g. Meperidine, general anesthesia)
Follow hospital practices
Make no specific recommendation / on mother's request
Others:
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12. What do you usually recommend regarding episiotomy in vaginal births?
(Tick one response only)
Routine episiotomy for all women
Routine episiotomy for nulliparous and selective episiotomy for multiparous women
Selective episiotomy for all women
Others:
13. Do you actively recommend breastfed infants be put to mother’s chest for skin-to-skin contact within 1
hour after delivery? (Tick one response only)
Yes
No
( reasons :
)
Make no specific recommendation /
follow the routine hospital practices
Not applicable to my practice
14. How would you usually recommend infants be breastfed during the first week of life?
(Tick one category only)
Every hour
Every 2-3 hours
Whenever the baby seems hungry or fussy (ie, on demand)
Others:
15. Do you routinely recommend breastfed newborns in the hospital be supplemented by:
(Tick one response only)
(a)
water /
glucose water /
(If tick (a), recommend:
formula:
before initiating breastfeeding /
after feeding /
others:
)
(b)
formula /
water as requested by the mother
(c)
I do not recommend any supplementation
(d)
Not applicable to my practice
(e)
Others:
16. What is your usual recommendation regarding rooming- in during the hospital stay?
(Tick one response only)
Keep the newborn in mother's room
Keep the newborn in nursery (mother visits baby for feedings)
Keep the newborn in mother's room in daytime and nursery at night
Follow the routine hospital practices
Others:
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17. What is your usual recommendation regarding the use of pacifiers?”
(Tick one category only)
Advise against the use at any age
Advise against the use until breastfeeding is well established
Make no specific recommendations / support mother’s choice
What would you recommend for mothers with full-term infants in the following circumstances?
Tick one response for each item.
Circumstances
Continue BF /
Recommend
BF
Discontinue BF /
Not Recommend
BF
Remarks
18. Mother has Caesarean Section
19. Mother has multiple births
20. Mother has inverted nipples
21. Mother has history of breast surgery
22. Mother has cracked nipples
23. Mother has breast infection e.g. mastitis / abscess
24. Mothers' milk supply seems inadequate
25. Mother back to work
26. Mother is too young or immature e.g. teens
27. Mother is HIV-positive
28. Mother is a methadone user
29. Mother is a social drinker
30. Mother taking traditional/ non-selective NSAIDs
(e.g. ibuprofen) for pain control
31. Mother is a strict vegetarian and consumes no animal
products
32. Infant has slow weight gain
33. An otherwise healthy infant jaundiced at Day 3 postnatal
Please indicate your viewpoint regarding the following statements.
(Tick one response for each item)
Agree Neutral Disagree
34. Obstetricians should directly facilitate breastfeeding by him/herself or involve other
members of the team to:
(a)
recommend breastfeeding actively to all expectant mothers
(b)
assist post-delivery mothers with breastfeeding in hospital
(c)
follow up mothers for breastfeeding after hospital discharge
35. Obstetricians have little influence on whether mothers initiate breastfeeding.
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36. Obstetricians should help to protect breastfeeding by stop passing free formula milk
samples and information materials from formula milk companies to expectant
mothers and mothers
37. In the long run, formula fed babies are just as healthy as breastfed babies
38. Formula-feeding and breastfeeding are equally acceptable methods for feeding
infants
39. Formula feeding is more reliable and easier for both the mother and the baby
40. Almost any mother can be successful at breastfeeding if she is given appropriate
support
Regarding education on breastfeeding: (Tick one response for each item)
Yes
No
41. Do you think the training / education on breastfeeding management you received in
medical school is adequate?
42. Do you think in-service training / education on breastfeeding management you received is
adequate?
43. Do you think current CME programs related to breastfeeding management is adequate?
44. During the past three years, have you attended any CME programs that focused on
breastfeeding management?
45. Would you like to attend further training / CME programs focus on breastfeeding
management?
How confident are you regarding your ability of the following?
(Please tick the box that comes closest to your feeling of confidence.)
Not at all
confident
(1)
(4)
Very
confident
(5)
(Tick one response for each item)
Never < 5 times 5-10 times
(1)
(2)
(3)
> 10 times
(4)
(2)
Neutral
(3)
46. Adequately addressing parents’ concerns about
breastfeeding.
47. Competently managing common breastfeeding problems.
During the previous 12 months, how often have you:
48. Assessed a mother breastfeeding in a hospital or clinic
setting
49. Counseled an expectant or newly delivered mother about
infant feeding choices
50. Taught a new mother breastfeeding techniques (e.g.,
positioning and attaching infant at breast)
51. Counseled a breastfeeding mother about lactation
problems (eg, mastitis, cracked nipples, low milk supply)
52. Referred breastfeeding mothers for lactation support
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53. In your opinion, what may be the reason(s) why some obstetricians do not routinely give advice on
breastfeeding? (May choose more than one category)
Limited skills
Time constraints
Hospital policy / environment (Please specify
)
Limited availability of breastfeeding support (e.g. lack of lactation consultant)
Other health professionals (e.g. nurses, paediatricians etc.) are in a better position to advise on
breastfeeding
No such requests from clients/patients
Others (Please specify
)
During the previous 12 months, how often have you:
(Tick one response for each item)
Never
(1)
Sometimes
(2)
Often
(3)
54. Received free milk samples, gifts or information materials from formula milk
companies?
55. Given gift packs or information materials from formula milk companies to
pregnant women / mothers?
56. Passed free milk samples (including maternal and infant formula) to
pregnant women/ mothers?
57. Displayed equipment, posters or other materials with formula milk brand or
company logos /name in your workplace?
58. Allowed staff of formula milk companies approaching mothers while they are
in your hospital / clinic e.g., distributing invitations to join mother-baby clubs,
etc?
59. Attended training activities (e.g. CME activities) sponsored by formula milk
company?
60. Received sponsorship from formula milk companies to attend oversea
conference?
Please indicate your viewpoint regarding the following:
(Tick one response for each item)
Minimum
Mild
Significant
(2)
(3)
/ no
(1)
61. Do you think the following will have adverse impacts on your practice?
(a)
Stop receiving and passing free milk samples (including maternal and
infant formula) to pregnant women/ mothers?
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(b)
Stop giving gift packs or information materials from formula milk
companies to pregnant women / mothers?
(c)
Stop displaying equipment, posters or other materials with formula milk
brand in your workplace?
(d)
Stop receiving sponsorship from formula milk companies to attend
conference / training?
Please tick  against the suitable column.
62.
What is your practicing organization?
Hospital Authority (Please specify the hospital and department:
Private practice
(Setting:
Hospital
Department of Health (Service:
)
Solo practice
Group practice)
)
Others:
63.
64.
What is your specialty?
Paediatrics
Obstetrics & gynaecology
Non-specialist
Others:
What is the status of your specialty qualification?
Fellowship
65.
Family medicine
Higher trainee
Basic trainee
Have you received any breastfeeding-related education in your training?
Yes
No
66.
Number of years practicing in obstetrics & gynaecology :
67.
What is your age?
25-34
35-44
68.
Sex
Male
Female
69.
Personal / spouse experience on breastfeeding?
Yes
70.
Not applicable
(Go to Q70)
45-54
years
55 or above
No, reason:
How many of your children have been breastfed (If applicable)?
(for < 6 months)
(for > 6 months)
< The End. Thank You >
Please send the completed questionnaire to the Research Team, Family Health Service either by e-mail:
som_fhs@dh.gov.hk, fax: 2574 8977 or post: Rm. 1308, Guardian House, 32 Oi Kwan Road, Wan Chai.
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