My breastfeeding rates are horrible. Just horrible.
I'm only a family doc, so I don't do a ton of peds. Maybe 20% of my practice. And this last 2 weeks there was an anomaly - I got three newborns, two of whom were breastfeeding. Unheard of for me.
Because of my practice situation, I don't often see my babies till the decision has been made. I don't hospital round, and I don't do OB (shudder), so my newborns usually hit my office at about 2 weeks. And I would estimate that 80% are bottle fed. It may be closer to 90%. I wonder if I would be able to intervene a bit if I did newborn nursery rounding, but my feeling is that the decision to nurse or not is made far in advance of the trip to the hospital.
My patient population is predominantly white, lower income. There is a TERRIBLE stigma against using the female breast as anything other than a sexual object. There's lots of "He doesn't want me to", with "he" being the unsupportive, unemployed sperm donor. The most common response I get from our staff regarding breastfeeding is "Ewww." Fortunately, they don't say this to patients, but I'm quite certain that gets communicated at some level.
Patients often won't consider trying. Those that do cave (understandably) the first time that newly-christened Meemaw (that's "grandma" out in the sticks) says "That baby ain't getting enough milk", which also seems to happen before I see the kid. Any potential confidence new mom had is shot, and baby gets enfamil lipil, formula of choice for our local WIC office.
But, this week, I had two new nursing moms. Two slightly yellow babies. One is going to do great, she's got a great grandma (who adopted her so never nursed), and one who I think is only going to make it another week. Just a gut feeling.