Knowledge and importance of exclusive breastfeeding

Knowledge and richness of single(a) dresserfeeding chestfeeding is the most precious gift a puzzle can transcend her babe. When on that point is illness or malnutrition, it whitethorn be a conductsaving gift when at that place is poverty, it whitethorn be the wholly gift. Ruth Lawrence, M.D.1.1 Background of searchExclusive dresserfeeding starts from a new natural to the date of sexteter months. It is an ideal and incompar up to(p) to any babe formulas created for them repennyly. As it has been know that heartfeed contains the perfect food for a newborn which has immunisation to diseases, sluttish to digest and at the perfect temperature to be fed to boors. detractor take out is the natural premier food for babies which provides all told the energy and intellectual nourishment that the infant postulate for the firstborn months of life.The first heartfeed milk is known as the colostrums which can but be give in breast milk that contains all best nut rients for the new born babies. Colostrums contain antibodies that defend the baby from bacteria and viruses in the early age. It helps to increase the babys intelligence and exercise and strengthen the close bond amongst m early(a) and the baby ( Gartner et al. 1997). It potently proven that breastfeed is the best food for a baby that no other food has the same nutrients comforts.Pregnant mothers should consec site the experience and sentiency of the benefits of breastfeeding to newborn infants. This determine is to find out how much the awargonness and noesis of 30 significant women in the antenatal and postpartum wards through questionnaires. They should be aw be of the benefits of breast milk to infants and to their own health. most women convey infant feeding decisions before slant and before any contact with health c be professionals. Although health advancements campaigns be influential in educating women approximately breastfeeding, they often do non dissuade women from formula feeding once the decisions has been made. Antenatal preparations of significant women for breastfeeding rises awareness of the impressiveness of breastfeeding, empower them with practical knowledge and skill in breastfeeding techniques, and prepare them for possible difficulties.Though many campaigns and seminars were through with(p) nationally to develop the public, yet the rate of scoopful breastfeeding is s bowl to the unsatis divisory direct. The rate of max breastfeeding in Malaysia has been decreased from 92% ( in 1950s) to 78% (in 1970s) exactly there was a slight of increment in the early year of 1975( Da Vanzo, 1991) although for however less than 10%. Report done by the human race Alliance for Breastfeeding Action (WABA, 2005) , showed that millions of babies fell sick every year as they were not breastfeed. The sphere Health placement (WHO, 2002) estimated that more than 1.5 million babies died one-year may be avoided if the babie s were given over single(a) breastfeed, from birth to sextet months and incessantly until the age of devil years old.Malaysia has been doing a lot of promotions and activities lately to give the knowledge and importance of unshared breastfeeding through activities such as World breastfeed week and Baby friendly infirmary.1.1 Problem of statementBreast feeding throw away multiple benefit to the mother and child nevertheless there are still postpartum mother that are not confident and not interest to breast feed their baby. This problem exponent be due to lack of knowledge on information sources regarding breastfeeding. This search is done to elevate the knowledge betwixt antenatal and postpartum mothers in this hospital.Breastfeeding offers irrefutable and long-lasting health benefits for both mother and baby, which are reassert by a comprehensive scientific research. Many research and reason base has been conducted and proven that the benefits of breastfeeding are unde niable.Ministry of Health has set and implements various dodging in promoting exclusive breastfeeding. One of the strategy is the Baby loving hospital Initiative on 1993.The aim is neither than to develop an surround that support mother to breastfeed their baby, create a policy that control exclusive breastfeeding. On mackintosh 1998, Malaysia had been announced as the third country in the world which all the brass hospital has been given the Baby Friendly Hospital status.Over time, the perpennyages of births to subgroups with higher(prenominal) rank of breastfeedingparticularly Malays and more highly meliorate women wear increased. However, there is in tallyition evidence of changes in grade of breastfeeding within these subgroups. Many Malaysian infants have a total duration of breastfeeding (including with supplementation) considerably shorter than WHO recommended half dozen months of exclusive breastfeeding.The national breastfeeding policy has been revised in 2006, ac cording to WHO all mothers are encouraged to breastfeed their babies entirely from birth until 6 months of age and there aft(prenominal) to keep on until their child is 2 years old. Complementary foods should cite when the baby is 6 month old.1.2 HypothesisThe postnatal mothers have a higher train of exclusive breastfeeding knowledge compared to the antenatal mothers.1.3 Significance Of breedingThe benefits of breast milk is undeniable, manufacturer are trying to create a milk that are at least having similar benefits and nutritional value as the breast milk, yet no strong research take has been conducted to prove it.Not all the properties of breast milk are understood, but its nutrient content is relatively stable. Breast milk is made from the nutrients in the mothers bloodstream and bodily stores. Some studies estimate that a woman who breastfeeds her infant exclusively uses 400 600 extra calories a day in producing milk. The physical composition of breast milk depends on how long the baby nurses. search shows that the milk and energy content of breast milk actually decreases after the first year. Breast milk adapts to a toddlers developing system, providing exactly the right number of nutrition at exactly the right time. In fact, research shows that amongst the ages of 12 and 24 months, 448 milliliters of a mothers milk provide these lucks of the following lower limit daily requirementsEnergy 29% Folate 76% Protein 43% Vitamin B12 94% Calcium 36% Vitamin C 60%10 Vitamin A 75% .1.4 Research Objective1.4.1 General ObjectiveThe aim of this carry is to observe all antenatal and postnatal mothers have the confidence and knowledge to exclusive breastfeeding.1.4.2 Specific Objectives1.3.2.1 To examine the knowledge of antenatal and postnatal mothers towards exclusive breastfeeding1.3.2.2 To inform antenatal and postnatal mothers with exclusive breastfeeding knowledge and discretions.1.5 Significant of Project1.5.1 The importance of this study is to find out the difference knowledge level between antenatal and postnatal mothers on exclusive breastfeeding.1.5.2 This study needs to judge the knowledge level of the antenatal and postnatal mothers after informations, campaign and precepts given by health care staff and to show the teaching techniques by them are effective.1.5.3. The is to esure that it pass on increase the knowledge and improvements to induviduals involvements in exclusive breastfeeding1.6 mark of Project1.6.1 The study sample is limited to antenatal mothers who was come for masking piece in labour room from 30 January to 30 Mac 2011 and postnatal mothers discharge from integrated ward.1.6.2 Antenatal mother who was not delivered baby from 30 January to 30 Mac 20111.7 Definition1.7.1 AssessmentAssessment is a process that follows a continuous cycle of improvement based upon measurable goals, involving data collection, organization and interpretation leading to planning and integration.1.7.2 KnowledgeKnowledg e is the awareness and understanding of facts, truths or information gained in the form of experience or learning. Knowledge is an appreciation of the possession of interconnected details.1.7.3 Exclusive breastfeedingExclusive breastfeeding be as no food or liquid other than breast milk , not even weewee, is given to the infant from birth until six months of age.1.7.4 Antenatal motherOccurring or present before birth during maternalism1.7.5 Postnatal motherpost meaning after and natalis meaning of birth- is the leading beginning immediately after the birth of a child and extending for about six weeks.CHAPTER 2LITERATURE REVIEW2.0 IntroductionAlthough the health benefits of breastfeeding are acknowledged widely, opinions and recommendations are divided on the optimal duration of exclusive breastfeeding. We systematically reviewed available evidence concerning the effects on child health, growth, and increase and on maternal health of exclusive breastfeeding for 6 months vs. ex clusive breastfeeding for 3-4 months followed by mixed breastfeeding (introduction of antonymous liquid or solid foods with act breastfeeding) to 6 months. Two independent literature searches were conducted, together comprising the following databases MEDLINE (as of 1966), Index Medicus (prior to 1966), CINAHL, HealthSTAR, BIOSIS, hack writer Abstracts, EMBASE-Medicine, EMBASE-Psychology, Econlit, Index Medicus for the WHO Eastern Mediterranean Region, African Index Medicus, Lilacs (Latin American and Carribean literature), EBM Reviews-Best Evidence, the Cochrane Database of organized Reviews, and the Cochrane Controlled Trials Register quoted by Kramer MS , Kakumar R.( Departments of Pediatrics and of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, Quebec, Canada)Mothers often are uninformed about the health benefits of any amount of breastfeeding, their ability to continue breastfeeding while assiduous, and the convenience and cost differentia l of breastfeeding as compared to formula feeding. Although there is a tendency in the literature to stress the time-intensive nature of breastfeeding, in fact it may require less time and attention than bottle-feeding (Barber-Madden, 1990).First, the promotion of breastfeeding without practical help and knowledge which led to many frustrated, unsuccessful breastfeeding attempts with concomitant backlash.Second, a much shorter hospital stay which does not provide commensurate time for mothers milk to come in or for appropriate education and support. In Australia in 1993, a country which is known for its support of breastfeeding, the just hospital stay for vaginal delivery was still 5 to 7 days, and for C-section, 7 to 10 days. Australia also has the foresight to send home health visitors once the mother is discharged to offer further assistance and support.Third, the continued increase of women in the puddleplace, many times by necessity and not by choice, has influenced the inc idence and duration of breastfeeding. A non supportive civilise environment suck ins breastfeeding difficult at best.Finally, the decline of breastfeeding has been assisted by the ambivalence of some health care professionals. This ambivalence is based on the lack of familiarity with actual breastfeeding research, reliance on formula company nutritional information, and the very healthful meaning issue of not wanting to push breastfeeding because it might make the Mom who chooses artificial feeding feel guilty.Despite these initiatives, yet 14.5 per cent babies were exclusively breastfed below six months in 2006, . In addition, all 19.3 per cent babies were exclusively breastfed below four months. Jaafar,2008Compared with the findings of the National Health and Morbidity subject field 2 (1996), there was a significant decline of 9.7 % in the prevalence of exclusive breastfeeding below four months and a concurrent rise in the prevalence of babies who were predominantly breast fed but given additional water.Analysis of the breastfeeding copy showed generally that exclusive breastfeeding rates were high in the first two months but dropped rapidly after the age of two to three months .It was also imbed after the age of two months, more than half of the breastfed babies were supplemented with infant formula and given other foods like commercial baby foods or home-cooked baby food while 20 percent of breastfed infants were supplemented with plain water.Few factors that kick down to early discontinuation of breastfeeding as follow 2.1 Cultural Beliefs And Myths Of Breast eatingThe cultural beliefs, myths and ignorance have to be blame for the countrys poor breastfeeding performance.The myths that breastfed babies need water in addition to breast milk are wide imbue in the country. Lack of knowledge and skill of mothers on when to start complementary food and how to maintain breastfeeding are other prohibitive factors, Complementary food, including water, should moreover be introduced after the age of six months2.2 Lacks Of Benefit And Facility separate factors according to Jaafar ( 2008 ) are the lack of benefits and facilities to promote and facilitate breastfeeding practices amongst women who also make up some half of the countrys working population. These include the absence of continuing maternal quality leave, the lack of flexible working hours and missing childcare centers at work places.Breastfeeding patterns in Malaysia suggest that inadequate maternity leave may in fact be denying babies their right to mothers milk, and one of the reasons why only 1 in 7 infants were exclusively breastfed for the first six months of life in 2006. (Nadchatram ( 2008 )According to Ministry of Health psychoanalysis of national breastfeeding data, exclusive breastfeeding rates in the country were high in the first two months but dropped rapidly after two or three months, roughly the distributor point when maternity leave ends and working mo thers return to paid use of goods and services.In Malaysia, women are entitled to 8 weeks (60 days) paid maternity leave, 6 weeks short of the recommended 14 weeks by the International Labour Organisations Maternity Protection Convention 2000 (No. 183). Malaysia is not a signatory of the Convention.2.4 Not Enough MilkHussain (2003) has revealed that other factor for early discontinuation of exclusive breast feeding is not liberal milk .In his study,54% of the sample express that this is one of the reason. The reason for not having abundant milk might be highly influenced by the mothers emotional and psychological hale- be.Low levels of stress, healthy nutrition, plenty of fluid intake, emotional support and titty stimulation through babys sucking are all burning(prenominal) contributors to breastfeeding success. However, sustentation circumstances often dont allow perfect breastfeeding conditions another child in the family, the death of a loved one, money worries etc. all ad d to an increase in stress levels.Other factors such as breast surgery can contribute to low amounts of breast milk. It has also been found that more women who gave birth by caesarean sectionEncountered breastfeeding problems, this may have various reasons such as the initial separation between mother and baby or the physical pain as a return of the surgery which ultimately affects the mothers ability to enjoy the breastfeeding experience.Chen ( 2006 ),conclude in his research that breastfeeding-friendly policies can significantly affect breastfeeding behaviors. However, an unfavorable working environment, especially for fab workers, can make it difficult to implement breastfeeding measures. With health professionals emphasizing that the importance of breastfeeding for infant health, and as only females can perform lactation, it is vital that womens work productive role and family reproductive role be respected and accommodated by society.The World Health Organization (WHO) recomm ends exclusive breastfeeding for the first six months of life. The distance of maternity leave is positively associated with the duration of breastfeeding The International Labour Organization (ILO) recommends a period of maternity leave of not less than 14 week. However, the typical maternity leave in many Asian and put Eastern countries falls below these levels, only offering less than 12 weeks paid leave. In Taiwan, most companies provide only eight weeks of maternity leave.A national survey in 2005 showed that the rate of exclusive breastfeeding in Taiwan at one month postpartum was only 22.3%, and dropped to 16.7% at three month. To bring Taiwan in line with WHO guidelines, effective worksite strategies needed to be implemented to encourage new mothers to breastfeed in the workplace.2.5 Levels of becharm and the Breastfeeding Decision2.5.1 Health Professionals RolesMultiple studies indicate that health professionals support of breastfeeding is all-important(prenominal) in increasing breastfeeding rates (Lawrence, 1993, Winikoff Baer, 1980 Winikoff, Laukaran, Myers, Stone, 1986, 1987). Health professionals have made important promotion contributions, yet many health professionals who provide care to pregnant women and infants do not demonstrate explicit support of breastfeeding nor do they have adequate knowledge about breastfeeding. In an American Academy of Pediatricians study, only 65 percent of pediatricians recommended exclusive breastfeeding for the first month and only 37 percent recommended breastfeeding continue for the first year (Schanler, OConnor, Lawrence, 1999).Many women do not initiate breastfeeding because they know they allow be returning to regular employment that lead entail separation from the baby. Perhaps they believe that they will not be able to continue breastfeeding once they return to work, and they adopt an location of Why start something I will not be able to continue? (Fein Roe, 1998). Furthermore, women who retu rn to full-time work wean their infants earlier than other women. It has been found, however, that expecting to work part-time following the birth of a baby did not affect initiation of breastfeeding. Part-time work of four or less hours a day did not affect duration of breastfeeding. Part-time work for more than four hours per day affected duration of breastfeeding less than full-time work (Fein Roe, 1998).Because of economic necessity and the need for other benefits such as health insurance, many women cannot afford to work less than fulltime. When possible, however, delaying separation from the infant and reducing the amount of time mother and infant are isolated during the infants first six months increases the likelihood that breastfeeding will be successful (Stuart-Macadam Dettwyler, 1995).In a qualitative study carried out by MacLaughlin and Strelnick (1984), many women suggested it would be helpful to receive breast-feeding information about combining breast-feeding with working and to have open discussions of the topic with other mothers. A survey of 567 women who breastfed while employed outside the home showed that the most significant difficulty was role overload, a result of the multiple demands to which they were responding. This aspect does not differ markedly from what is found for non-breastfeeding, working mothers (Auerbach Guss, 1984).About 60 per cent from 451 mothers who stopped breastfeeding, did so during the first postnatal month and another 20 per cent during the 2nd and 3rd month after the babies birth. The mothers age, education or parity, did not affect the rate of breastfeeding.Low birth clog, especially birth weight less than 2 kg, was a risk factor for early termination of breastfeeding. Caesarean delivery and hospitalization of the infant during the neonatal period was also associated with a higher rate of bottle feeding compared with newborns who had been delivered normally, discharged early, and nursed at home.Although b reastfeeding rates are high, the finding that the majority of mothers who give up breastfeeding do so in the early weeks, calls for better support to all mothers by move health personnel during the period when breastfeeding is being established, and for extra assistance to women whose infants are hospitalized or have a low birth weight (Shiva , 2003 )2.6 Advantages of breast milk to babiesBreast milk is best for newborn baby, and the benefits of breastfeeding extend well beyond basic nutrition. In addition to containing all the vitamins and nutrients baby needs in the first six months of life, breast milk is packed with disease-fighting substances that protect baby from illness.American Academy of Pediatrics recommends exclusive breastfeeding for the first six months (although any amount of breastfeeding is beneficial). And scientific studies have shown that breastfeeding is good for mothers health, too. Numerous studies from round the world have shown that stomach viruses, lower respiratory illnesses, ear infections, and meningitis overhaul less often in breastfed babies and are less severe when they do happen. Exclusive breastfeeding (meaning no solid food, formula, or water) for at least six months seems to offer the most protection.A study by the National build of Environmental Health Sciences showed that children who are breastfed have a 20 percent lower risk of dying between the ages of 28 days and 1 year than children who werent breastfed, with longer breastfeeding associated with lower risk.The main immune factor at work here is a substance called secretor immunoglobulin A (IgA) thats present in large amounts in colostrums, the first milk mothers corpse produces for the baby. (Secretors IgA is present in lower concentrations in mature breast milk.) The substance guards against invading germs by forming a protective layer on the mucous membranes in the babys in try outines, nose, and throat.2.7 Advantages to breastfeed mothersA study of more than 3 3,000 danish women who had given birth between 1999 and 2002 evaluated the effect of breastfeeding on maternal weight at 6 and 18 months postpartum compared to reported pre pregnancy weight. The authors calculate that a Danish woman with normal or obese pre pregnancy weight who gained 11-12 kg during the pregnancy and exclusively breastfed her infant for 6 months would be back to her pre pregnancy weight by then. At 18 months postpartum, women who exclusively breastfed for 6 months and continued breastfeeding until their infant was 12 months of age had the lowest fortune of retaining 5 or more kg of weight no upshot how much weight they gained during the pregnancy (Baker, 2008)2.8 Conceptual frameworkThe research abstract framework will be carried out as shown in the flow chart below.INTERGRATED WARDHOSPITAL TUANKU AMPUAN NAJIHAHPOSTNATAL MOTHERS prenatal MOTHERSQUESTIONAIRERESULTANTENATAL MOTHERSPOSTNATAL MOTHERSCHAPTER 3RESEARCH METHODOLOGY3.0 IntroductionIn this chapter the researcher will discuss the main aspect of the research methodology in detail. There are five aspects that consist of the research design, population, sampling and methods, study cocks, collection of data and limitation of study.3.1 Study designThe study uses a descriptive and quantitative method. The researcher will distributes the questionnaires to the respondents as the main instrument to collect data for the study. The collection and the analysis of data is done in two weeks.3.2 Population and sampleThe population is all antenatal mothers who will be come for screening in the labour room from 30 January to 30 Mac 2011 and postnatal mothers discharge from integrated ward in Hospital Tuanku Ampuan Najihah.3.3 Study subjectAll 15 antenatal mothers who will come for screening in integrated ward from 30 January to 30 Mac 2011 and 15 postnatal mothers discharge from labour room during the study period..3.4 Sample size calculationThe sample size will be calculated so that the study h as the capability to detect clinically importance difference as statistically significant. The sample size also will be calculated to estimate effect with stated precision. Only 30 cases will be selected as the sample.3.5 Study participants3.5.1 Inclusion criteriaAll antenatal mothers who are conceiving their second child and supra that warded from 30 January to 30 Mac 2011 and postnatal mothers discharge from integrated ward.3.5.2 Exclusion criteriaAll antenatal mothers who are conceiving their first baby from 30 January to 30 Mac 2011 was not include in this study.3.6 Data collection procedures3.6.1 This study will be victimisation questionnaires that will be given to theantenatal and postnatal mothers before and after the campaign.3.6.2 Permission to carry out the study will be obtained from the Hospital Director and the Chief Matron. An inform consent will also being obtained from the respondents( appurtenance II / Lampiran II).3.6.3 Self Administered Questionnaire (SAQ)Self A dministered Questionnaire will be use to determine the medical personal knowledge as shown in adjunct III / Lampiran III.3.7 Sampling methodologySampling refers to the process of selecting a deal of the population to represent the entire population (Polit Hungler, 1999). In this study only 30 participants will be selected among the antenatal and postnatal mothers in HTAN from January till March in the year of study. The study was done with pilot test 10 antenatal and postnatal mother and the cronbachs alpha= 0.7323.7.1 Statistical analysisThe result of this study was based on the responses from 30 of the antenatal and postnatal mothers. The independent variables identified namely were designation. The data was analyzed and presented in percentage.3.7.2 Research toolsData was collected by using structured questionnaire. See Appendix III and Appendix IV.3.8 Expected resultsAntenatal mothers have the knowledge and understanding of the importance in exclusive breastfeeding.Antenatal mothers will be make decisions on exclusive breastfeeding before delivery.CHAPTER 4RESEARCH RESULTS4.0 IntroductionIn this chapter the collected data is analysed from the questionnaires given to the respondents. The demographic factors usually tested as it is often used as the inference study as it is easy to get and easily analysed the effect (Jack Fiorito et el 2007) . The first part is a demographic data about the respondents for example race, age , education level and their exclusive breastfeeding knowledge.4.1 Characteristics of demographic respondentsSection ATable 1 socialal - Antenatal mothersAntenatal mothersPost natal mothersEthnicNumber of respondents characterNumber of respondentsPercentageTotal numberMalay1173.3 %1386.7 %24Chinese16.7 %0%1Indian320.0 %213.3%5Referring to the table above, majority of the respondents are from the Malay cultural which gives 73.3% for the antenatal mothers while the postnatal respondents gives 86.7%. The second higher percentage of ethn ic comes from the Indians that give 20 %for the antenatal mothers and the postnatal mothers contributes 13.3 %.The least is the Chinese that gives only 6.7% that is only one respondent for the antenatal but none for the postnatal mothers.. As usual majority of the respondents are the Malays as most of them like to give birth in government hospitals comparing to the Chinese who select going to the private hospitals.Table 2 Age of the respondentsAge rangeNumber of respondentsfor both ante and postnatal mothersPercentage20 -25 years old930.0%26 30 years old1240.0 %31 35 years old620.0 %36 40 years old310.0%The age range for this study is done to get a better view to the majority of the ante and postnatal mothers involved. As shown in the table above the age range between 26 to 30 years of the antenatal and postnatal mothers gives the majority which contributes 40.0 %. The least comes from the age range of 36 to 40 years that gives only 10% which only 3 respondents involved.Table 3 Education Level faculty member levelNumber of respondentsPercentageNon- schoolinging13.3 %Primary school26.7%Secondary school1756.7%College/ University1033.3%As shown in the above table, the majority of the educational level comes from the secondary school level which contributes 56.7 % from all the respondents. This shows that this group of respondents have the great trust in the government hospital so does the college/ university level respondents that gives 33.3% of all.Table 4 tradingOccupationNumber of respondentsPercentageHousewife1756.7 %Self employed413.3 %Government servant516.7%Private sector413.3%Referring to the above table, the housewife is the majority respondents in this study that carries 56.7% which is more than half of the respondents involved. The government servants contributes 16.7% while the self employed and the private sectors employees give the same percentage of 13.3% each.Table 5. Exclusive breastfeeding prior knowledgeYESNONumber Of respondents255P ercentage83.3%16.7 %Referring to Table 5, 83.3% of the respondents have the prior knowledge of exclusive breastfeeding which means that they had the experience and knowledge to breastfeeding. Five respondents, contributing 16.7% had no knowledge of exclusive breastfeeding.Table 6 Number of childNumber of child(conceiving/ give birth)Number of respondentsPercentage21240%31136.7%4310%526.6%626.6%As shown in the table above , 12 respondents conceiving or giving birth to their second child that gives 40% of the study. 36.7% cogitate or give birth to their third child, 10% or 3 respondents create mentally or give birth to their 4th child and 6.6% contributed by respondents who conceive or give birth to their 5th and 6th child.SECTION BKnowledge on exclusive breastfeedingQuestion number1