Journal of Taiwan Occupational Therapy Research and Practice
Objective: Breastfeeding provides diverse and compelling advantages to infants, mothers, families, society, and the environment. Many health authorities have taken actions to build up mother and-baby-friendly environment to protect, promote, and support breastfeeding in order to increase breastfeeding initiation rate and duration. Health care providers' breastfeeding attitudes and knowledge are critical indicators for such an environment. Many studies have addressed the breastfeeding cognition among obstetricians, pediatricians, nurses, and midwives. However, breastfeeding knowledge and attitudes among occupational therapists, who manage breastfeeding difficulties at a later stage, have never been examined. Methods: This study surveyed and analyzed 1,266 Taiwanese occupational therapists' breastfeeding cognition through questionnaire, the content validity of which was reviewed by experts. The questionnaire, which consisted of 9 attitude and 50 knowledge questions, was also tested by 20 pre-testers. Results: Five hundred eighty-five occupational therapists responded to the questionnaire (response rate: 47%), including 406 from Taiwan Province, 136 from Taipei City, and 43 from Kaohsiung City. The mean attitude score was 4.73 (SD=0.68), and the mean knowledge score was 14.83 (SD=4.30). The full score for Attitude subscale was 6 and 50 for Knowledge. The correct answer rate of subscales of breastfeeding benefits to mothers, breast problems, infant problems, and breastfeeding taboo was between 10% to 20%, whereas the correct answer rate of 28%, 33%, and 53% was found for subscales of breastfeeding mechanism, human milk's nutrition, and breastfeeding skills, respectively. Further stepwise linear regression analyses revealed that significant predictors for the score of Attitude subscale, ranked by importance, were knowledge scores, high school diplomas, gender, breastfeeding education, master or above degrees, and breastfeeding during infancy. Significant predictors for the score of Knowledge subscale, ranked by importance, were parenthood, attitude scores, gender, 28-38 year-old age group, and occupational therapy assistants. However, those variables could only account for 9.5% and 15.6% of the variances of the attitude and knowledge scores, respectively. This revealed that there could be other important factors, such as long-term societal and cultural effects. Conclusion: This study concluded that Taiwanese occupational therapists had positive attitude toward breastfeeding although they showed poor knowledge. The results showed that breastfeeding education and the score of Knowledge subscale were main significant predictors for the score of Attitude subscale, and that the score of Attitude subscale was a significant predictor for the score of Knowledge subscale. Though the predictors could account for only a small part of the variances, this study still suggested that providing more breastfeeding education for occupational therapists could help them offer adequate services for clients with breastfeeding difficulties.