A new study by trainee doctor Kirsty Biggs and senior colleagues has shown that 97% of the 411 medical students who responded to a survey are uncertain of their practical skills to support new mothers with breastfeeding, such as helping with latch issues, although the overall benefits of breastfeeding were moderately well-known. Yet most students (93%) perceived doctors to have an important role in supporting breastfeeding and the same percentage requested further breastfeeding education.

Over 80% of the respondents had a career interest in obstetric and gynaecology, paediatrics and/or general. While the sample was only around 1% of UK medical students, and only one-quarter of the students responding were male, it’s a very clear message that breastfeeding education overall is not adequate. 

Around 80% of the 32 UK medical schools eligible responded to their part of the survey and results indicate that only 70% of medical schools provide compulsory breastfeeding education. 

WBTI’s findings and vision

The WBTi UK report in 2016 indicated that medical curricula have many gaps with regard to breastfeeding, and Biggs’ study confirms that the students themselves find it inadequate. WBTi UK’s vision is that all doctors have sufficient training in infant feeding to protect the decisions of mothers who want to breastfeed.

UK Health Professional training standards mapped against WHO educational checklist. From the WBTI UK report. See also Part 2 for details of individual specialisms

How can the situation be improved? 
High level standards and Unicef BFI learning outcomes

The General Medical Council provides broad guidelines for undergraduate curricula in its Outcomes for Graduates document and each medical school devises its own curriculum to fit the guidelines. For example, the expectation under the Outcomes Health promotion and illness prevention section is: ‘Newly qualified doctors must be able to apply the principles, methods and knowledge of population health and the improvement of health and sustainable healthcare to medical practice’.  Unicef UK Baby Friendly Initiative’s learning outcomes for several professions, including medical students, published in November 2019 are highly relevant to improving curricula and accompanying resources are being developed. 

RCPCH curriculum – an encouraging sign

Medical training is long, with undergraduate, Foundation and then specialty training. The RCPCH (Royal College of Paediatrics and Child Health) states as part of its activity to promote breastfeeding: ‘The RCPCH training curriculum for General Paediatricians and all paediatric subspecialties requires training to understand the importance of breastfeeding and lactation physiology, be able to recognise common breastfeeding problems, have knowledge of formula and complementary feeding, and be able to advise mothers or refer for support.’

Resources available

Qualified doctors also benefit from improving and updating their skills and knowledge. RCGP’s (Royal College of General Practitioners) Breastfeeding Position Statement has a link in the first sentence to its online resource on breastfeeding. 

by Patricia Wise

I’m very pleased that my e-book Supporting Mothers Who Breastfeed: A guide for trainee and qualified doctors, which is particularly aimed at trainers and trainee doctors, has been included in the Postnatal care guidelines of RCGP Learning.

The GP Infant Feeding Network (GPIFN) and Hospital Infant Feeding Network (HIFN) websites contain extensive information for doctors. 

Other resources include Amy Brown and Wendy Jones’ book A guide for the Medical Professionpublished in December 2019.

Guidance to qualified doctors

Mentioning infant feeding in guidance to doctors to encourage including it in consultations is also important. GP Louise Santhanam (founder of GPIFN) is the lead author of Postnatal Maternal and  Infant care during the COVID-19 Pandemic: a Guide for General Practice that was recently added to the RCGP website. This clarifies that 6-8 week checks need to continue despite the Covid-19 pandemic and that infant feeding should be a routine clinical consideration.

Postnatal Maternal and Infant Care during COVID-19: A Guide for GPs by Louise Santhanam

The challenge

Thus plenty of resources are available but doctors are busy people. While some really understand the importance of protecting breastfeeding, and know how to  – such as signposting mothers to local skilled help – the challenge is how to bring this into every medical student’s training.

If you know anyone at medical school, it would be really useful if you can let them know about Kirsty Biggs’ study.

Sign up to our WBTI UK Mailing list HERE

Banner photo from Freepic

Patricia Wise is an NCT Breastfeeding Counsellor, a member of the WBTi UK Steering Group, and the author of Supporting Mothers Who Breastfeed: A guide for trainee and qualified doctors

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