An observational study on breast feeding Success among postnatal mothers

Introduction

Breast feeding was the common practice since ancient times and it is practiced even today. With the 18^th and 19^th century industrialisation in the Western world, working mothers in many urban centres began dispensing Breast feeding due to their work requirements. Under modern health care, human breast milk is considered the healthiest form of milk for babies. It also promotes the health of both mother and infant and helps to prevent disease.^{1, 2, 3, 4.}

WHO states that, the vast majority of mothers can and should breast feed, just as the vast majority of infants can and should be breast fed. Only under exceptional circumstances can a mother's milk be considered unsuitable for her infant. WHO also recommends exclusive Breast feeding for the first six months of life.AAP (American Academy of Paediatrics) recommends exclusive breast feeding for the first six months of life and it should be continued for at least the First year of life and beyond for as long as mutually desired by mother and child.^5,6

WHO also states that Breast feeding is the normal way of providing young infants with the nutrients they need for healthy growth and development. Virtually all mothers can Breast feed, provided they have accurate information and the support of their family. The health care system and society at large. Colostrum, the yellowish sticky Breast milk produced at the end of pregnancy, is recommended by WHO as the perfect food for the newborn.⁷ and all mothers should be inculcated to practice giving first feed (colostrum) to the infant

Objectives

1. To determine the breast feeding success among postnatal mothers

2. To find an association on breast feeding success with selected demographic variables

Methods

A descriptive survey was carried out in a selected postnatal unit of a hospital in Mangalore. 50 postnatal mothers who were breast feeding were selected by convenient sampling. Consent was taken from each of the participants who were willing to participate in the study. Two tools were used for data collection.

Tool 1 : Sample characteristics.

Tool 2 : Observational checklist on breastfeeding.

Results

Through descriptive analysis it was found that majority (44%) of mothers were in the age group of 20 – 25 years. Majority (68%) were Hindus. In type of delivery 84% had full term normal delivery. With regards to parity, 44% were multis. In relation to sex of the baby, 68% were females. The condition of the mother and the baby after delivery was good and normal in 100% [Table 1]. An observational checklist on breastfeeding success shows that the success rate on breastfeeding was high. There were 4 items such as getting ready to feed, Latching on, Feed itself and after feed and each item had 4 to 8 specific items on observational checklists on breastfeeding which indicates that in most of the mothers breastfeeding was a success [Table 2]. By inferential statistics it was found that type of delivery is associated with breast feeding (P < 0.05). Since all other p values are more than 0.05 there was no association between those selected demographic variables with breast feeding at 5% level of significance [Table 3].

In the above table, there were 4 items, and each item had 4 to 8 specific items on observational checklists on breastfeeding which indicates that in most of the mothers breastfeeding was a success.

The above shows that, type of delivery is associated with breast feeding (P < 0.05). Since all other P values are more than 0.05 there is no association between those selected demographic variables with breast feeding at 5% level of significance.

A similar study on KAP STUDY OF FACTORS PROMOTING BREASTFEEDING IN NURSING MOTHERS AND PREGNANT WOMEN was conducted at a tertiary teaching hospital of coastal south India on 300 subjects and the results were 36% had primary education and 12% were graduates. Majority (61%) lived in a joint family. Only 52.3% of the subjects received advice on breastfeeding during antenatal visits, out of which only 19.3% had a breast examination. 58.7% knew that breastfeeding should be initiated within 1 hour of child birth but only 48% of the mothers who had delivered initiated breastfeeding within 1 hour. 71.6% of the mothers knew that exclusive breastfeeding should be practised for 6 months. On univariate analysis mothers with more than 1 child, vaginal delivery and an educated partner had awareness of breastfeeding and practiced healthy breastfeeding and this study emphasises the need to counsel mothers regarding breastfeeding practices early during antenatal visits and not postpone till after delivery, include the spouse for support, sensitise the health care giver and improve infrastructure for a successful breastfeeding initiation.¹⁶

A study on ‘Pain and breastfeeding: a prospective observational study’ was conducted on seventy-nine patients regarding satisfaction in breastfeeding, tiredness, uterine pain, nipple and other pain, and analgesic use at day three and at first, second, third, and fourth week after birth. Data regarding the mode of delivery were recorded from medical charts. Milk formula supplements, bottle use, pacifier use, and nipple shields use were considered as variables suggesting unsuccessful breastfeeding. And the results were at the third day after delivery, it appeared that analgesic use was significantly associated with milk formula supplementing, bottle use, less satisfaction in breastfeeding, and more tiredness. At first week after delivery, the presence of pain differing from nipple and uterine pain was more likely associated with milk formula supplementing, bottle use, pacifier use, less satisfaction in breastfeeding, and more tiredness. At third week after delivery, nipple pain was directly related to tiredness, while it increased the odds of adding milk formula and using a bottle.¹⁷

A retrospective study of 1893 mothers on ‘Determinants of successful breastfeeding initiation in healthy term singletons: a Swiss university hospital observational study.’ The results indicated multiparity was associated with nursing exclusively at the breast at discharge (P<0.001), less use of maltodextrin supplement (P<0.05), bottle/cup (both P<0.001), but more pacifier use (P<0.05). Among obese mothers, nursing exclusively at the breast at discharge was less frequent, and use of all feeding aids more frequent, than among normal-weight women (both P<0.001). Neuraxial anesthesia was associated with use of maltodextrin and bottle (both P<0.05) compared to no anesthesia. Delayed first skin-to-skin contact and roomingin for <24 h/day were each associated with maltodextrin and cup (P<0.05). Nursing exclusively at the breast at discharge was less frequent (P<0.001), and bottle use more frequent (P<0.05), in women with sore nipples than in those without.¹⁸

A study on ‘The effectiveness of a hospital-based program to promote exclusive breast-feeding among low-income women in Brazil.’ Was conducted with an active breastfeeding promotion program (n = 236) were compared with women who delivered at a nearby control hospital (n = 206) and the results showed that the two groups had similar demographic characteristics and previous breast-feeding histories. Exposure to breast-feeding activities, assessed by maternal recall prior to discharge, was universally high at the program hospital and universally low at the control hospital. Multivariate survival analysis showed that exclusive breast-feeding lasted 53 days longer among women who delivered at the program hospital.¹⁹

Conclusion

MDG-4 aims to reduce less than five child mortality by 2/3^rd by 2015. The UN secretary Generals global strategy for women's and Children's Health, 2012 has set a specific target for increase in 21.9 million infants who are exclusively breastfed for the first six months of life, by 2015, in 49 developed countries.⁸