Personal breast-feeding behaviors of female physicians in Mississippi. (Original Article).Background: In this study, we examined the personal breast-feeding breast-feeding /breast-feed·ing/ (brest´fed?ing) nursing; the feeding of an infant at the mother's breast. behaviors of female physicians in Mississippi Mississippi, state, United States Mississippi (mĭs'əsĭp`ē), one of the Deep South states of the United States. It is bordered by Alabama (E), the Gulf of Mexico (S), Arkansas and Louisiana, with most of the border formed by . Method: Two hundred fifteen of 350 female physicians responded to a survey inquiring inquiring, v to draw information from a client—whether by verbal questioning or physical examination—to assess the person's state of health. of their personal breast-feeding behaviors. Results: One hundred fifty-five Adj. 1. one hundred fifty-five - being five more than one hundred fifty 155, clv cardinal - being or denoting a numerical quantity but not order; "cardinal numbers" mothers (74%) reported having biologic children, and 146 (94.2%) breast-fed breast·feed or breast-feed v. breast-fed , breast-feed·ing, breast-feeds v.tr. To feed (a baby) mother's milk from the breast; suckle. v.intr. To breastfeed a baby. at least 1 child. Approximately 21% of the responding mothers breast-fed their first-born children for at least 6 months. There was a positive relationship between the duration of breast-feeding of older children and the breast-feeding duration for younger children. The major reasons for weaning weaning, n the period of transition from breast feeding to eating solid foods. weaning the act of separating the young from the dam that it has been sucking, or receiving a milk diet provided by the dam or from artificial sources. were return to work, diminishing di·min·ish v. di·min·ished, di·min·ish·ing, di·min·ish·es v.tr. 1. a. To make smaller or less or to cause to appear so. b. milk supply, and lack of time to pump breast milk. Conclusion: The breast-feeding initiation rates among female physicians surpassed those of women in the general population, yet duration rates were comparable. Their own breast-feeding success might enhance the potential of female physicians as advocates and sources of credible information regarding breast-feeding; however, physicians need to be better educated regarding the management of breast-feeding. ********** Several studies that have examined the breast-feeding practices of physicians have found that the quality and quantity of counseling and support that they provide is related to their self-perceptions regarding their effectiveness in breastfeeding. (1-4) Freed et al (1) reported that primary care physicians (specifically those specializing in family medicine, internal medicine, pediatrics pediatrics (pēdēă`trĭks), branch of medicine dedicated to the attainment of the best physical, emotional, and social health for infants, children, and young people generally. , obstetrics-gynecology) with personal or spousal spou·sal adj. 1. Of or relating to marriage; nuptial. 2. Of or relating to a spouse. n. Marriage; nuptials. Often used in the plural. experience were more self-confident in providing breast-feeding promotion and support. Two national surveys of pediatricians found that personal experience with breastfeeding contributed to physicians' confidence, effectiveness, and willingness to participate in breast-feeding promotion, counseling, and advocacy. (2) Freed et a1 (4) also reported that practicing obstetrician-gynecologists who breast-fed their own children were more likely to perceive themselves as effective in providing education and support to patients, as compared with their colleagues who had not. Male and female physicians are more likely than the general population to adopt healthy lifestyles and are more effective as health advocates when their advice to patients is congruent con·gru·ent adj. 1. Corresponding; congruous. 2. Mathematics a. Coinciding exactly when superimposed: congruent triangles. b. with their own healthy choices. (5,6) Furthermore, physicians who have healthy lifestyles are more likely to provide preventive care Preventive care is a set of measures taken in advance of symptoms to prevent illness or injury. This type of care is best exemplified by routine physical examinations and immunizations. The emphasis is on preventing illnesses before they occur. See also
In 1997 and 1998, Mississippi ranked 50th in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. in both breast-feeding initiation and duration to 6 or 12 months. (8,9) Although the state moved up to the 48th position in 2000, the Healthy People 2000 goals of 75% for breastfeeding initiation and 50% duration to 6 months were not achieved. (10,11) Statewide efforts are under way in Mississippi to achieve the Healthy People 2010 goal of 25% duration to 12 months. (12) Disparities between white and black women regarding breast-feeding rates exist in the general population, where race is likely to be a predictor of initiation and duration. (13,14) A study of breast-feeding initiation in rural Mississippi, however, found no difference in initiation and duration between the white and black women, even when socioeconomic status socioeconomic status, n the position of an individual on a socio-economic scale that measures such factors as education, income, type of occupation, place of residence, and in some populations, ethnicity and religion. was taken into consideration. In the same study, the women who breast-fed received the majority of their support from nonphsicians. (15) Female physicians represent a high-income, well-educated population with great potential for the adoption of healthy behaviors. They are also uniquely positioned to contribute to the health of their communities through direct patient care and as models for healthy behavior. (16) Within that context, in this study, we examined the following personal breast-feeding behaviors of female physicians in Mississippi: 1) initiation rate; 2) 6- and 12-month duration rates; 3) initiation and duration rates across ethnic groups; 4) supplementation with formula; 5) problems and obstacles; 6) personal influences, support, and resources; and 7) self-perception of their own breast-feeding experience. Materials and Methods We developed the instrument used in this study, which was tested among female physician-faculty members (n = 13) in the Department of Family Medicine of the University of Mississippi Medical Center University of Mississippi Medical Center (UMC) is the health sciences campus of the University of Mississippi (Ole Miss). Located in Jackson, Mississippi (USA), it houses the Schools of Medicine, Dentistry, Nursing, Health Related Professions, and Graduate Studies in the Health . A draft of the survey and a cover letter stating the purpose of the study were sent to each faculty member. Faculty members were asked to complete the survey and provide feedback regarding the form and content of the instrument. Their comments and suggestions were reviewed and incorporated selectively into the final instrument, referred to as the Female Physicians' Breast-feeding Practice Assessment. The Female Physicians' Breast-feeding Practice Assessment was divided into two major sections. The first section addressed professional practices related to breast-feeding. It was to be answered by all respondents In the context of marketing research, a representative sample drawn from a larger population of people from whom information is collected and used to develop or confirm marketing strategy. , regardless of whether they had biologic children or whether they had breast-fed their children. The second section was to be completed by mothers who had breast-fed at least one of their children, no matter how briefly. All children were to be listed according to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. birth order, with information provided regarding the year of birth and the mother's breast-feeding experience with each child (ie, initiation, duration, supplementation, weaning). Other items focused on the workplace (ie, maternity leave maternity leave n → baja por maternidad maternity leave maternity n → congé m de maternité maternity leave maternity n , breast milk expression or pumping), the resources used for advice and support, and personal perceptions (ie, problems encountered). On the first page of each questionnaire, a number corresponding to a name on the master list was written in the upper right corner to track nonrespondents and to facilitate follow-up follow-up, n the process of monitoring the progress of a patient after a period of active treatment. follow-up subsequent. follow-up plan mailings. The Institutional Review Board of the University of Mississippi Medical Center approved the survey. In October 1999, a 5-page, 30-item, self-administered questionnaire was mailed to 350 female physicians across the state of Mississippi. The mailing included female members of the Mississippi State Medical Association who had addresses within the state and female physicians who were employed by the Mississippi State Department of Health. A cover letter accompanied the survey to explain the purpose of the research and to assure respondents that they would not be identified in the reporting of data. Second and third mailings were sent to nonrespondents to the previous queries in February and April 2000. Two hundred fifteen (61%) female physicians returned completed surveys; of these respondents, the answers of the 155 who had one or more biologic children were used in this study. A [chi square chi square (kī), n a nonparametric statistic used with discrete data in the form of frequency count (nominal data) or percentages or proportions that can be reduced to frequencies. ] test was used to test for association between nominal variables. A t test was used to test for differences between the means of the two groups. Variables were determined to be statistically significant if [alpha] [less t han or equal to] 0.05. Results Demographics The attributes of people in a particular geographic area. Used for marketing purposes, population, ethnic origins, religion, spoken language, income and age range are examples of demographic data. Including every questionnaire for which there was a valid indication of age, the median age of the respondents was 40 years (range, 29-86 yr) at the time the survey was conducted. Approximately 88% of the respondents were born in the United States. The respondents' dates of graduation Graduation is the action of receiving or conferring an academic degree or the associated ceremony. The date of event is often called degree day. The event itself is also called commencement, convocation or invocation. from medical school ranged from 1940 to 1996. Demographically, 86% of the respondents classified themselves as white, 5.2% as black, 7.7% as Asian American A·sian A·mer·i·can also A·sian-A·mer·i·can n. A U.S. citizen or resident of Asian descent. See Usage Note at Amerasian. A , 0.6% as Hispanic, and 0.6% were of unknown race or ethnicity ethnicity Vox populi Racial status–ie, African American, Asian, Caucasian, Hispanic . Table 1 presents selected demographic variables, and Table 2 lists the specialties represented. One hundred fifty-five women reported having at least one biologic child, including 31(20%) with one child, 75 (48.4%) with two children, 37 (23.9%) with three children, 10 (6.5%) with four children, and 2 (1.3%) with five or more children. The aggregate number of children reported was 343, and the median number of children per respondent In Equity practice, the party who answers a bill or other proceeding in equity. The party against whom an appeal or motion, an application for a court order, is instituted and who is required to answer in order to protect his or her interests. was 2.0. Initiation of Breast-feeding One hundred forty-six (94.2%) of the 155 women who reported having biologic children breast-fed at least one child. Thirty-seven (24%) of the physician-mothers had breast-fed one child, 72 (46.5%) had breast-fed two children, 27 (17.4%) had breast-fed three children, 9 (5.8%) had breast-fed four children, and 1 (0.6%) had breast-fed six children. Only 8 (5.2%) of the women reported that they had breast-fed none of their children. The reasons given for not initiating breastfeeding included return to work (n = 3), maternal MATERNAL. That which belongs to, or comes from the mother: as, maternal authority, maternal relation, maternal estate, maternal line. Vide Line. illness (n = 2), thought that breast milk was not important (n = 2), and infant illness (n = 1). Eight (5.2%) of the mothers reported that they were breast-feeding a child during the survey period. When the rates of breast-feeding initiation of white, black, and Asian women were compared, no significant association was found between race and initiation rate. Hispanic and Latino women were not included in the analysis, because there was only one respondent in this category (Table 1). Among the primary care physicians, 93.8% as compared with 96.6% of the non-primary care physicians reported breast-feeding one child. [chi square] analysis indicated no significant association between the proportion of primary care and nonprimary care physician-mothers who breast-fed their children. Duration of Breast-feeding Approximately 21% of the responding mothers breastfed their first-born children for at least 6 months, with 7.6% of first-born children being breast-fed for 1 year or longer. The mean duration among the physician-mothers was 14.5 weeks, with a range of 1.5 to 112 weeks. The duration of breast-feeding was calculated in weeks and is reported according to birth order in Table 3. The duration of breastfeeding was divided into two categories--6 weeks or less arid ar·id adj. 1. Lacking moisture, especially having insufficient rainfall to support trees or woody plants: an arid climate. 2. more than 6 weeks--for the first, second, and third children. A [chi square] test indicated a significant association between the duration of breast-feeding with the first child and the duration of breast-feeding with the second child ([chi square] = 29.4; P < 0.01). Seventy-five percent of the mothers who breast-fed for 6 weeks or less with the first child also breast-fed for 6 weeks or less with the second child. Conversely con·verse 1 intr.v. con·versed, con·vers·ing, con·vers·es 1. To engage in a spoken exchange of thoughts, ideas, or feelings; talk. See Synonyms at speak. 2. , 85.5% of those physician-mothers who breast-fed for more than 6 weeks with the first child breast-fed for more than 6 weeks with t he second child. In addition, a [chi square] test indicated a significant association between the duration of breast-feeding with the second child and the duration of breast-feeding with the third child ([chi square] 18.4; P < 0.01). One hundred percent of those mothers who breast-fed for 6 weeks or less with the second child also breast-fed for 6 weeks or less with the third child. Conversely, 84% of those who breast-fed for more than 6 weeks with the second child breast-fed for more than 6 weeks with the third child. The duration of breast-feeding did not differ statistically on the basis of ethnicity. The white physician-mothers were found to breast-feed breast-feed v. To feed a baby mother's milk from the breast; suckle. an average of 20.1 weeks. Among the black physician-mothers, the duration was 24.3 weeks, and for Asian and East Indian East In·dies Indonesia. The term is sometimes used to refer to all of Southeast Asia. Historically, it referred chiefly to India. East Indian adj. & n. Noun 1. physician-mothers, the duration was 11.5 weeks. The factors most frequently cited as contributing to the physician-mothers' decision to wean wean (wen) to discontinue breast feeding and substitute other feeding habits. wean v. 1. To deprive permanently of breast milk and begin to nourish with other food. 2. their children completely from breast-feeding were return to work (45%), diminishing milk supply (31%), and lack of time to pump breast milk (18%) (Table 4). Supplementation Sixty-nine percent of the mothers reported using formula supplements at some point while breast-feeding their firstborn first·born adj. First in order of birth; born first. n. The child in a family who is born first. Noun 1. firstborn - the offspring who came first in the order of birth eldest children. Eight weeks was the median age of the baby at the time of first supplemental feeding. For the second, third, and fourth children, approximately 70% of the mothers used formula, with supplementation initiated at 5, 7, and 1.5 weeks, respectively (Table 5). Problems and Obstacles The mothers were asked if they had experienced breastfeeding problems with any of their children. They were provided with a list of breast-feeding-related problems and instructed to check all items that reflected their difficulties with any of their children. A total of 67.9% of the mothers experienced problems with breast-feeding. Table 6 illustrates the ranking and percentage of problems reported. The three most frequent breast-feeding problems among physician-mothers were sore nipples (43%), low milk supply (25%), and mastitis mastitis (măstī`tĭs), inflammation of the breast. Mastitis most commonly occurs in nursing mothers between the first and third weeks after childbirth, usually of the first child. (20%). Influences and Resources The mothers were asked to indicate the influences that contributed to their decision to breast-feed their children. Sixty-two percent of the mothers credited personal research, and 58.2% indicated their medical training as major influences. Yet, only 31.9% indicated that they had received training in lactation lactation Production of milk by female mammals after giving birth. The milk is discharged by the mammary glands in the breasts. Hormones triggered by delivery of the placenta and by nursing stimulate milk production. management in medical school or during their residency A duration of stay required by state and local laws that entitles a person to the legal protection and benefits provided by applicable statutes. States have required state residency for a variety of rights, including the right to vote, the right to run for public office, the training. Furthermore, when asked whether their training was sufficient for them to breast-feed their children without problems, only 31 (21.2%) of the 146 who breast-fed responded affirmatively af·fir·ma·tive adj. 1. Asserting that something is true or correct, as with the answer "yes": an affirmative reply. 2. . Their sources of advice regarding breast-feeding were books (34.2%), lactation consultants A lactation consultant is a healthcare provider recognized as an expert in the fields of human lactation and breastfeeding. The USLCA, United States Lactation Consultant Association, is the presiding organization in the United States of America and the International Lactation (27.4%), and a nurse at the hospital (25.3%). Eighty-seven percent of breast-feeding mothers indicated that their breastfeeding experience was positive, 8.7% reported a neutral experience, and 4.3% reported a negative experience. Discussion Knowledge, attitude, and a willingness to be actively involved in breast-feeding promotion and advocacy have been found to be associated with physicians' experiences with breast-feeding, whether personal or spousal. (1-4) Although the percentage of female physicians in Mississippi who initiated breast-feeding exceeded the Healthy People 2000 goal of 75%, the statistics for the duration of breast-feeding were far less than the goals of 50% for 6 months and 25% for 1 year. As a group, female physicians in Mississippi fell short of the Healthy People 2010 goals, with fewer than half of the mothers continuing to breast-feed for 6 months and fewer than 10% for 12 months, even when birth order was taken into consideration. Despite their awareness of the evidence of the benefits of breast-feeding, physician-mothers in Mississippi seem to succumb suc·cumb intr.v. suc·cumbed, suc·cumb·ing, suc·cumbs 1. To submit to an overpowering force or yield to an overwhelming desire; give up or give in. See Synonyms at yield. 2. To die. to the same pressure as mothers in the general population to supplement with formula when they face personal breast-feeding problems. Disparities in breast-feeding rates between white and black women exist in the general population. (13,14) We found no difference, however, in the initiation and duration rates of black and white women in this study population of high-income, highly educated professionals. This finding is consistent with an earlier study of breast-feeding initiation and duration among women in rural Mississippi, in which there were no significant differences even when race and income were taken into consideration. (15) Physician-mothers consistently reported their most commonly encountered problems to be sore nipples, low milk supply, and mastitis. We did not request information from the respondents regarding the initial point in the lactation process at which sore nipples occurred. Sore nipples can be related to poor infant latch-on early in the lactation process, whereas later in the course of lactation, sore nipples can be related to infection or other medical problems. It is therefore difficult to reach substantive conclusions regarding the causes of the problems in this group. The physician-mothers in this study reported return to work and diminishing milk supply as reasons for the early cessation cessation Vox populi The stopping of a thing. See Smoking cessation. of breast-feeding. Although these two reasons are frequently cited, duration is also affected by a number of other influences. (17, 18) In one study, previous breast-feeding experience was found to have greater predictive value pre·dic·tive value n. The likelihood that a positive test result indicates disease or that a negative test result excludes disease. predictive value a measure used by clinicians to interpret diagnostic test results. for duration than either income or education. (19) Investigators who have examined the relationship between duration and previous breast-feeding experience have found that women tend to breast-feed younger children for at least as long as they breastfed older children. (17-19) Consistent with the findings of these previous studies, the duration of breast-feeding in our group of physician-mothers was relatively consistent across children for individual respondents. The impact of mothers' experiential ex·pe·ri·en·tial adj. Relating to or derived from experience. ex·pe  ri·en learning on future breast-feeding behavior has been offered as an
explanation for this trend.
The majority of the physicians who participated in this study reported receiving no training in the area of breastfeeding management in medical school or during their residency training. Less than one-fourth of the physician-mothers in this study who breast-fed their children thought that their medical training had informed them adequately as they attempted to breast-feed their own children. Neither their physician colleagues nor the physicians from whom they received health care were major influences in their decision to breastfeed breast·feed or breast-feed v. breast-fed , breast-feed·ing, breast-feeds v.tr. To feed (a baby) mother's milk from the breast; suckle. v.intr. To breastfeed a baby. . Furthermore, they did not seek advice from their colleagues or from health care providers when they encountered personal breast-feeding problems. Their primary sources of information were books, lactation consultants, and nurses. Perhaps they recognized the absence of formal medical education in this subject during their training and presumed that other physicians were equally uninformed. In spite of in opposition to all efforts of; in defiance or contempt of; notwithstanding. See also: Spite the absence of training, it is notable that the majority of the physician-mother s considered their medical training to be a primary influence in their decision to breast-feed and indicated that their breast-feeding experience was positive. Conclusions The female physicians' breast-feeding initiation rates exceeded the recommendations of both the American Academy of Pediatrics The American Academy of Pediatrics ("AAP") is an organization of pediatricians, physicians trained to deal with the medical care of infants, children, and adolescents. Its motto is: "Dedicated to the Health of All Children. and Healthy People 2010. The high rate of initiation of breast-feeding among physician-mothers in Mississippi indicates a general understanding among this group that breast-feeding is best for the baby; however, the recommended percentages of women who continued to breast-feed at 6 and 12 months postpartum postpartum /post·par·tum/ (post-pahr´tum) occurring after childbirth, with reference to the mother. post·par·tum adj. Of or occurring in the period shortly after childbirth. were not attained at·tain v. at·tained, at·tain·ing, at·tains v.tr. 1. To gain as an objective; achieve: attain a diploma by hard work. 2. . It seems that despite the evidence of the benefits of breast-feeding, physician-mothers succumb to the same pressure as mothers in the general population to discontinue dis·con·tin·ue v. dis·con·tin·ued, dis·con·tin·u·ing, dis·con·tin·ues v.tr. 1. To stop doing or providing (something); end or abandon: breast-feeding when they have breast-feeding problems. Few physician-mothers could recall receiving any training regarding lactation during their medical school or residency experiences. Education in the basics of breast-feeding may minimize the difficulties that physician-mothers currently experience and contribute to increased duration, greater self-perceived effectiveness, more active involvemen t, and increased comfort in providing counseling and support to their patients regarding breast-feeding. Furthermore, personal success may also enhance their potential as breast-feeding advocates, as sources of credible information for their patients, and as role models for healthy behavior in their communities.
Table 1
Demographic data regarding the physician-mothers in Mississippi who
responded to the survey (a)
Median year of
No. with Breast-feeding Median medical school
Ethnicity children rate (%) age (yr) graduation
White 133 94.0 42 1985
Black 8 87.5 40 1986
Asian/East Indian 12 100 38 1986
Hispanic (a) -- -- -- --
Primary care
Ethnicity specialists (%)
White 57.9
Black 100
Asian/East Indian 83.3
Hispanic (a) --
(a)--, because there was only one Hispanic respondent, information was
omitted to preserve her anonymity.
Table 2
Specialty areas of the Mississippi physician-mothers
Specialty No. (%)
Pediatrics (a) 35 (24.0%)
Neonatology 3 (2.1%)
Family medicine (a) 23 (15.8%)
Obstetrics and gynecology (a) 18 (12.3%)
General internal medicine (a) 14 (9.6%)
Medicine subspecialties 24 (16.4%)
Anesthesiology 8 (5.5%)
Radiology 5 (3.4%)
Psychiatry 7 (4.8%)
Pathology 2 (1.4%)
Preventive medicine 1 (0.7%)
Emergency medicine 2 (1.4%)
Surgery 1 (0.7%)
Ophthalmology 3 (2.1%)
Total 146 (100%)
(a)Primary care specialties.
Table 3
Duration of breast-feeding, according to birth order
Birth order
Child 1 Child 2 Child 3 Child 4
Parameter (n = 130) (n = 96) (n = 35) (n = 9)
Median no. of weeks of 20 16 12 11
breast-feeding
Breast-feeding [greater than or 20% 19.9% 17.1% 25%
equal to]26 wk (%)
Breast-feeding [greater than or 6.9% 5.2% 5.7% 12.5%
equal to]52 wk (%)
Median age of mother at birth 29 32 33 35
of child (yr)
Table 4
Factors associated with weaning
No. (%)
Reason for weaning (n = 146)
Return to work 66 (45.2%)
Diminishing milk supply 44 (30.0%)
Lack of time to pump milk 27 (18.5%)
Infant-related factors 24 (16.4%)
Other reasons 23 (15.8%)
Call schedule 18 (12.3%)
Fatigue 18 (12.3%)
Husband's preference 4 (2.7%)
Intimacy compromised 3 (2.1%)
Table 5
Supplementation and weaning according to birth order
Birth Order
Child Child Child Child
Parameter 1 2 3 4
Mothers who supplemented breast- 69.2% 70.5% 70% 75%
feeding with formula (%)
Median age of baby when formula- 8 5 7 1.5
feeding was initiated (wk)
Babies weaned to formula before 65.6% 63.9% 77.1% 62.5%
age 6 mo (%)
Table 6
Breast-feeding problems experienced by physician-mothers
No. (%)
Problem (n = 91)
Sore nipples 58 (63.7%)
Low milk supply 36 (39.6%)
Mastitis 30 (33.0%)
Baby's low weight gain 20 (22.0%)
Problems with pumping milk 19 (20.9%)
Poor latch-on by baby 17 (18.7%)
Plugged duct 12 (13.2%)
Nipple infection 8 (8.8%)
Accepted May 16, 2002. References (1.) Freed GL, Clark SJ, Sorenson J, Lohr JA, Cefalo R, Curtis P. National assessment of physicians' breast-feeding knowledge, attitudes, training, and experience. JAMA JAMA abbr. Journal of the American Medical Association 1995;273:472-476. (2.) Schanler RJ, O'Connor KG, Lawrence RA. Pediatricians' practices and attitudes regarding breastfeeding promotion. Pediatrics 1999;103:E35. (3.) Freed GL, Clark SJ, Lohr JA, Sorenson JR. Pediatrician pe·di·a·tri·cian or pe·di·at·rist n. A specialist in pediatrics. involvement in breast-feeding promotion: A national study of residents and practitioners. Pediatrics 1995;96:490-494. (4.) Freed GL, Clark SJ, Cefalo RC, Sorenson JR. Breast-feeding education of obstetrics-gynecology residents and practitioners. Am J Obstet Gynecol 1995;173:1607-1613. (5.) Frank E, Brogan DJ, Mokdad AH, Simoes EJ, Kahn HS, Greenberg RS. Health-related behaviors of women physicians vs other women in the United States. Arch Intern intern /in·tern/ (in´tern) a medical graduate serving in a hospital preparatory to being licensed to practice medicine. in·tern or in·terne n. Med 1998;158:342-348. (6.) Frank E, Breyan J, Elon L. Physician disclosure of healthy personal behaviors improves credibility and ability to motivate. Arch Fam Med 2000;9:287-290. (7.) Frank E, Rothenberg R, Lewis C, Belodoff BF. Correlates of physicians' prevention-related practices: Findings from the Women Physicians' Health Study. Arch Fam Med 2000;9:359-367. (8.) Ross Mothers' Survey, Ross Products Division, Abbott Laboratories Abbott Laboratories (NYSE: ABT) is a diversified pharmaceuticals and health care company. It has over 65,000 employees and operates in 130 countries. The corporate headquarters are in Abbott Park, Illinois, a neighborhood of North Chicago, Illinois. , Abbott Park, IL, 1997. (9.) Ross Mothers' Survey, Ross Products Division, Abbott Laboratories, Abbott Park, IL, 1998. (10.) Ross Mothers' Survey, Ross Products Division, Abbott Laboratories, Abbott Park, IL, 2000. (11.) United States Department of Health and Human Services United States Department of Health and Human Services (USDHHS), n.pr a cabinet-level government organization comprising 12 agencies, including the Food and Drug Administration and the Centers for Disease Control and Prevention. : Healthy People 2000. Washington, DC, U.S. Government Printing Office, 1991. (12.) United States Department of Health and Human Services: Healthy People 2010. Washington, DC, U.S. Government Printing Office, 2000. (13.) Bevan ML, Mosley D, Solimano OR. Factors influencing breast feeding breast feeding Pediatrics The provision of a neonate and infant with liquified lacteal products 'on tap'; lactation and BF–≥ 6 months before age 20 is associated with a relative risk of 0. in an urban WIC WIC - WAN Interface Card program. J Am Diet Assoc 1984;84:563-567. (14.) Forste R, Weiss J, Lippincott E. Thc decision to breastfeed in the United States: Does race matter? Pediatrics 2001;108:291-296. (15.) Kum-Nji P, Mangrem CL, Wells PJ, White P, Herrod HG. Breastfeeding initiation: predictors, attitudes, and practices among blacks and whites in rural Mississippi. South Med J 1999;92:l183-1188. (16.) Frank E. The Women Physicians' Health Study: Background, objectives, and methods. J Am Med Womens Assoc 1995;50:64-66. (17.) Hill P, Humenick SS, Argubright TM, Aldag JC. Effects of parity parity or space parity, in physics, quantity that refers to the relationship between an object or process and the image that it can produce in a mirror. and weaning practices on breastfeeding duration. Public Health Nurs 1997; 14:227-34. (18.) Nagy E, Orvos H, Pal A, Kovacs L, Loveland K. Breastfeeding duration and previous breastfeeding experience. Acta Paediatr 2001;90:51-56. (19.) Meyerink RO, Marquis GS. Breastfeeding initiation and duration among low-income women in Alabama: The importance of personal and familial familial /fa·mil·i·al/ (fah-mil´e-il) occurring in more members of a family than would be expected by chance. fa·mil·ial adj. experiences in making infant-feeding choices. J Hum hum (hum) a low, steady, prolonged sound. venous hum a continuous blowing, singing, or humming murmur heard on auscultation over the right jugular vein in the sitting or erect position; it is Lact 2002;18:38-45. RELATED ARTICLE: Key Points * The breast-feeding initiation rate of physician-mothers was greater than that of the general public; however, the duration of breast-feeding was comparable. * Breast-feeding duration for younger children was related to the duration for older children. * Successful experience with breast-feeding their own children may contribute to female physicians' self-perceived effectiveness as well as their more active involvement and increased comfort in providing counseling and support to their patients regarding breastfeeding. From the Department of Family Medicine, University of Mississippi Medical Center, Jackson, MS. Reprint reprint An individually bound copy of an article in a journal or science communication requests to Chris Rodgers Chris Rodgers (born 5 March, 1976) is an English golfer who turned professional in 1996. He currently plays mainly on the Asian Tour and in 2005 he moved to Bangkok. His first Asian Tour win came at the 2006 Pakistan Open. Arthur, PhD, Department of Family Medicine, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216-4505. Email: carthur@familymed.umsmed.edu Copyright [c] 2003 by The Southern Medical Association 0038-4348/03/9602-0130 |
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