P0333 - Increasing the Supply of Breastfeeding Knowledge

Background:
Numerous studies have shown the need and interest for effective instruction in breastfeeding principles for pediatric residents. This study highlights the process and outcomes of implementing an in depth breastfeeding education program. This study may serve as a framework for implementing breastfeeding curriculum across a pediatric residency.

Objective:
To evaluate the effectiveness of breastfeeding curriculum on a single pediatric residency cohort by measuring knowledge, clinical practice, and perceived confidence in providing breastfeeding support following a one year curriculum.

Methods:
Residency cohorts were categorized by post graduate year, with all consenting to study inclusion. Pre and post data was collected using the available AAP BRC (American Academy of Pediatrics Breastfeeding Resident Curriculum) evaluation measures. A yearlong curriculum was implemented including didactics, shadowing experiences, and clinical instruction.

At the time of analysis, Cohort 2 has paired observations before and after training. Each participant’s aggregate total of correct responses within the Breastfeeding Knowledge and Clinical Practice instrument was calculated as a percentage of total items. Each participant’s sum of Likert-type responses out of the maximum subscale total was calculated as a percentage for the Experience and Confidence instrument subscales.

Univariate summary statistics were calculated within and across participant cohorts. Non-parametric methods were employed given limited sample size and non-normal distribution of responses. Alpha was preset at 5% for all testing of significance.

Results:
Analysis showed a statistically significant improvement across both the Knowledge (Z = 2.809, p = 0.005) and Clinical Practice (Z = 2.636, p = 0.008), domains., as shown in Figure 1. Multiple subset items within the Cohort 2 Experience subscale also showed statistically significant improvement as displayed in Figure 2.

Conclusions:
The significant improvement across all domains following implementation of a breastfeeding curriculum shows a valuable model for ongoing training of pediatric residents. Additional subset analysis of current cohorts will yield further data, allowing curriculum to be further refined.