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Biomedical subjects

G L Freed

Publications and source records attributed to G L Freed.

7 recordsLinked to original sources
PubMed1995

Breast-feeding education of obstetrics-gynecology residents and practitioners.

OBJECTIVE: Our purpose was to assess breast-feeding education, knowledge, attitudes, and practices among resident and practicing obstetrician-gynecologists. STUDY DESIGN: A mailed survey was administered to a national sample of resident and practicing obstetrician-gynecologists. RESULTS: Response rates were 64% for residents and 69% for practitioners. Residency training included limited opportunity for direct patient interaction regarding breast-feeding; 60% of practitioners recommended that training devote more time to breast-feeding counseling skills. Only 38% of residents reported that obstetric faculty presented breast-feeding topics; more common sources were nursing staff and other residents. Practitioners rated themselves as more effective in meeting the needs of breast-feeding patients than were residents; prior personal breast-feeding experience was a significant influence on perceived effectiveness. Almost all respondents agreed that obstretician-gynecologists have a role in breast-feeding promotion, but significant deficits in knowledge of breast-feeding benefits and clinical management were found. CONCLUSION: Residency training and continuing education programs should create opportunities to practice breast-feeding promotion skills and emphasize management of common lactation problems.

Breast Feeding↗
PubMed1992

Attitudes and education of pediatric house staff concerning breast-feeding.

Pediatricians are expected to offer information and advice on breast-feeding to expectant and lactating mothers, but the educational experience for pediatric residents may not adequately prepare them for this responsibility. To examine knowledge and confidence regarding breast-feeding gained by pediatric house staff during their residency, a survey was administered to pediatric residents in a large, hospital-based training program. Of 108 program residents, 87 (81%) participated. Forty-one percent of the respondents were postgraduate level I (PL-I), 29% were PL-II, and 30% were PL-III. There was no evidence that PL-III residents were more competent or comfortable with routine breast-feeding counseling or intervention than their PL-I counterparts. Residents who had breast-fed, those with spouses who had breast-fed, and those with children of their own had the greatest knowledge and confidence base in several areas, such as their ability to teach breast-feeding techniques and to treat cracked nipples. They were also more familiar with different types of breastpumps. There were no significant differences among those who were or were not breast-fed as a child nor among men versus women. Residency programs must provide comprehensive education on breast-feeding to prepare future pediatricians to meet the needs of patients and their parents.

Attitude of Health Personnel↗
PubMed1992

Attitudes of expectant fathers regarding breast-feeding.

Fathers participate in choosing the feeding method for their newborns. However they traditionally have not been included in most breast-feeding education programs. To examine expectant fathers' attitudes and knowledge regarding breast-feeding, we surveyed 268 men during the first session of their childbirth education classes at five private hospitals in Houston, Texas. The study population was 81% white, 8% black, and 6% hispanic. Ninety-seven percent (n = 259) of the total were married. Fifty-eight percent (n = 156) reported that their spouses planned to breast-feed exclusively; several significant differences existed between these men and those who reported plans for exclusive formula feeding. The breast-feeding group was more likely to believe breast-feeding is better for the baby (96% vs 62%; P less than .0001), helps with infant bonding (92% vs 53%; P less than .0001), and protects the infant from disease (79% vs 47% P less than .001). The breast-feeding group was also more likely to want their partner to breast-feed (90% vs 13%; P less than .0001) and to have respect for breast-feeding women (57% vs 16%; P less than .0001). Conversely, those in the formula feeding group were more likely to think breast-feeding is bad for breasts (52% vs 22%; P less than .01), makes breasts ugly (44% vs 23%; P less than .05), and interferes with sex (72% vs 24%; P less than .0001). The majority of both groups indicated breast-feeding was not acceptable in public (breast-feeding = 71%, formula feeding = 78%, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude↗
PubMed1992

Lack of agreement of tympanic membrane temperature assessments with conventional methods in a private practice setting.

An infrared tympanic membrane thermometer (FIRST temp) said to approximate core temperature accurately is being marketed as a noninvasive, quick, and easy-to-use clinical instrument. The determination of tympanic membrane temperatures by this device was compared with the determination of oral, rectal, or axillary temperatures by a conventional glass thermometer. Subjects were patients of a pediatric group practice in Houston, Texas. FIRST temp and conventional temperature determinations on individual patients were completed within 5 minutes of each other. The presence or absence of otitis media was noted by the examining physician. Agreement between the two methods of temperature determination was assessed by calculating limits of agreement within which 95% (+/- 2 standard deviations) of individual differences would fall. The location of conventional thermometer (oral, rectal, axillary), time interval between the two separate measures, and the presence or absence of otitis media were entered into a multiple regression analysis to determine whether these factors influenced the observed differences between the two methods. A total of 144 patients were enrolled in the study; oral comparisons were obtained in 92 (57%) patients, rectal in 35 (24%), and axillary in 29 (19%). The upper and lower limits of agreement between temperature methods were 1.12 degrees C and 0.89 degrees C and the mean difference was -0.12 degrees C. Regression analysis revealed that only the site of conventional thermometer location (oral, rectal, axillary) was a significant predictor of FIRST temp/conventional differences. Each site had a range of agreement greater than 1.65% degrees C; axillary temperatures had the greatest range (-0.94 degree C to +1.30 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1991

A practical guide to successful breast-feeding management.

It is often difficult for new mothers to know whom to approach for the necessary guidance and practical problem solving required for successful long-term lactation. Although obstetricians are familiar with the care of the breast, they may not maintain the degree of postpartum follow-up necessary to ensure its proper function nor is it their responsibility to ensure that the infant receives proper nourishment. Pediatricians are expected to offer advice and information regarding not only the advantages and disadvantages of breastfeeding but also practical management of this art. We provide a guide for practitioners who wish to assist breast-feeding mothers and their infants.

Bottle Feeding↗
PubMedDate not supplied

Prenatal determination of demographic and attitudinal factors regarding feeding practice in an indigent population.

Demographic and attitudinal factors influencing the decision to breast- or bottle-feed were evaluated early in pregnancy by survey of 307 women in a low-risk prenatal obstetric clinic at a publicly funded hospital in Houston, Texas. Subjects responded to 17 demographic and 24 attitudinal questions. Racial classification revealed blacks 36.4%, whites 29.2%, and hispanics 30.8%. Twenty-five percent of the completed surveys were in Spanish. Of the total sample, 26.7% planned to breast-feed, 48.2% planned to bottle-feed, and 25.1% planned to do both. Multiple logistic regression analysis revealed six prominent independent risk factors for bottle-feeding. The most significant variable was lack of support for breast-feeding from a significant other (husband, mother, other relative, or friend), which had a odds ratio (OR) of 456.3. Other attitudinal variables achieving independent significance were disagreement with the statements "breastfeeding protects against disease" (OR = 4.0), "breasts were made for breastfeeding" (OR = 8.0), and "I want to know more about breastfeeding" (OR = 120.0). Significant demographic variables identified were completion of less than 12th grade (OR = 32.1), and age less than 35 years (OR = 43.3). These findings indicate the influence of significant others in the decision to breast-feed and suggest that future educational programs should require their inclusion if the prevalence of breast-feeding in this population is to be increased.

Adolescent↗