Breastfeeding beyond infancy: Are the barriers too hard to overcome, even for physicians?

INTRODUCTION: The World Health Organization (WHO) recommends continued breastfeeding up to two years of age and beyond. However, breastfeeding beyond infancy remains uncommon and is often hindered by cultural barriers and misconceptions. Physicians play a crucial role in guiding families on infant feeding practices; yet, limited evidence exists regarding their knowledge and attitudes toward breastfeeding beyond two years. This study aimed to evaluate the knowledge and attitudes of physicians from different specialties toward breastfeeding beyond two years and to identify factors influencing their awareness and counseling practices.
METHODS: This multicenter, descriptive, cross-sectional study was conducted in four hospitals among physicians working in pediatrics, family medicine, obstetrics and gynecology, and other clinical specialties. Data were collected using a face-to-face structured questionnaire assessing demographic characteristics, personal breastfeeding experience, knowledge of WHO recommendations, perceived benefits and challenges of extended breastfeeding, and counseling behaviors. Data were analyzed using descriptive statistics and chi-square tests.
RESULTS: Although 95.9% of participants correctly identified the WHO recommendation for exclusive breastfeeding, only 17.9% accurately recognized the total recommended duration of breastfeeding. Knowledge levels were significantly higher among pediatricians and family physicians and among those who frequently provided breastfeeding counseling. While 90% of pedodontists believed that extended breastfeeding could contribute to dental caries, most physicians remained uncertain about its protective effects on maternal health. Only 19.9% reported recommending breastfeeding beyond two years. Both knowledge and attitudes varied significantly across medical specialties.
DISCUSSION AND CONCLUSION: Physicians’ knowledge and attitudes toward breastfeeding beyond two years were limited. Integrating evidence-based breastfeeding education into medical curricula, residency programs, and continuing professional training may strengthen physicians’ ability to support mothers who breastfeed beyond infancy.

Keywords: Baby-friendly hospital initiative, breastfeeding beyond two years, breastfeeding education, extended breastfeeding, maternal and child health.