• Women's Health Nursing
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• v.22 no.4
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• pp.264-274
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• 2016

Purpose: The purpose of this study was to develop and evaluate breastfeeding effectiveness scale to measure effectiveness of breastfeeding for mothers in the early postpartum period. Methods: A conceptual framework was constructed from properties of effective breastfeeding (Yang and Seo, 2011), and item construction was derived from literature review and analysis of the data along with interviews with breastfeeding mothers. Content validity was tested by experts. Each item was scored on a five-point Likert scale. The preliminary questionnaire was administered to 248 breastfeeding mothers. Data were analyzed using item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's ${\alpha}$. Results: From the factor analysis, 20 items in seven factors were derived. The factors were identified as mother's satisfaction, suckling, assurance of milk quantity, infant's satisfaction, latching on, infant's feeding desire, and breastfeeding positioning. The seven factors explained 65.1% of total variance, Cronbach's ${\alpha}$ of the total items was .83 and the factors ranged from .44 to .75. Conclusion: Results of this study suggest that breastfeeding effectiveness scale is a reliable and valid instrument to measure breastfeeding effectiveness of mothers in the early postpartum period.

• Child Health Nursing Research
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• v.22 no.2
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• pp.79-86
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• 2016

Purpose: The purpose of this study was to identify breastfeeding practice with late preterm infants (LPIs), and to determine predictors of exclusive breastfeeding at the 12th week after discharge. Methods: The participants were 106 mothers of LPIs hospitalized in neonatal intensive care units at two university hospitals. Data were collected between February and October, 2013. Questionnaires included characteristics of LPIs, their mothers, and feeding-related characteristics. Feeding methods were exclusive breastfeeding, mixed feeding, and formula feeding. Results: Exclusive breastfeeding steadily increased from 5.7% at the 1st week to 19.8% at the 12th week, as did formula feeding from 27.3% to 67.9%. Contrarily, mixed feeding decreased from 67.0% at the 1st week to 12.3% at the 12th week. The ratio of formula feeding was higher than that of exclusive breastfeeding over time. Predictors for exclusive breastfeeding were the following: type of delivery (OR=2.96, 95%CI=1.07-8.14), feeding intolerance (OR=3.03, 95%CI=1.26-7.25) and feeding method during hospitalization (OR=7.84, 95%CI=3.15-19.53). Conclusion: In order to increase breastfeeding opportunities for LPIs, educational programs for gestational age-appropriate breastfeeding should be developed. The focus of breastfeeding education needs to be on mothers who delivered their LPIs through Cesarean-section and LPIs who had feeding intolerance or were fed only formula during hospitalization.

• Women's Health Nursing
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• v.21 no.4
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• pp.262-271
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• 2015

Purpose: This study was to explore association of maternal role adjustments, parenting stresses, and demographic factors to breastfeeding adaptation. Methods: A correlational survey design was used to recruit 183 mothers who breastfeed or breastfed their babies. Participants' visited outpatient departments and were admitted to pediatric ward at 2 hospitals in metropolitan city of Korea. Inclusion criteria for subjects were mothers whose babies were from 1 month to 24 months old. Data were collected using a self-report questionnaire for mothers' and babies' demographic variables, maternal role adjustments, parenting stresses, and maternal breastfeeding adaptations. Results: Higher levels of maternal adaptations and low levels of parenting stresses were associated with greater maternal breastfeeding adaptations. Types of feeding during hospital stays and baby's health status at birth were also associated with maternal breastfeeding adaptation. Conclusion: Results showed that a higher level of mothers' adjustment to breastfeeding; indicated lesser parenting stresses with higher levels of maternal adaptation. Nursing interventions for breastfeeding should be applied for appropriate breastfeeding adaptation during mothers' hospital stay. As baby's poor health status at birth medical team should provide a proper breastfeeding education.

• Journal of Korean Academy of Nursing
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• v.46 no.3
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• pp.409-419
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• 2016

Purpose: The purpose of this study was to develop a breastfeeding empowerment program and to investigate the effects of the breastfeeding empowerment program on self-efficacy, adaptation and continuation of breastfeeding for primiparous women. Methods: The 5 session breastfeeding empowerment program was developed and a non-equivalent control group non-synchronized quasi-experiment design was used. Fifty-five participants were assigned to either the experimental group (n=27) or the control group (n=28). Effects were tested using repeated measures ANOVA and $x^2-test$. Results: Scores for self-efficacy, adaptation and continuation of breastfeeding of in the experimental group after program were significantly higher than 1week, 4weeks, 8weeks scores in control group. Conclusion: The effects of the breastfeeding empowerment program for elevating self-efficacy, adaptation and continuation of breastfeeding in primiparous women were validated. Therefore, this program can be recommended for vigorous use in clinical practice.

• Korean Parent-Child Health Journal
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• v.22 no.1
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• pp.30-42
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• 2019

Purpose: This study was a systematic review and meta-analysis designed to evaluate the effects of breastfeeding individual visit program. Methods: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a systematic search was conducted using four core electronic databases from October 28, 2018 to November 14, 2018. The topics of breastfeeding individual visit program were analyzed using descriptive analysis and the effects of intervention were meta-analyzed using the Review Manager 5.3 software. Results: A total of 13 studies were included in the review and 12 were included for meta-analysis. Breastfeeding individual visit programs were found to be more effective in breastfeeding rates, attitude, skill and self-efficacy compared to group education or non-education. Conclusion: Effective breastfeeding education can help mothers to start and sustain breastfeeding. Breastfeeding individual visits programs that are more effective than group education to maintain breastfeeding for pregnant women should be developed and applied.

• Journal of Preventive Medicine and Public Health
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• v.32 no.1
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• pp.95-100
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• 1999

Objectives. This study surveyed medical students attending clerkship to assess their attitude toward and knowledge about breastfeeding, and self-confidence to manage common breastfeeding problems. Methods. A self-report questionnaire was administered to the 323 medical students at four medical colleges in Taegu in May 1997. The response rate was 92.9%, but the respondents used in the final data analysis were 245 (75.8%) due to missing variables. Results. Overall, respondents showed equivocal attitudes toward breastfeeding (mean score 2.9 on a 6-point scale). Knowledge about breastfeeding was substantially low with the median % correct 39.2%. Of nine knowledge areas, weak areas were especially 'contraindications and barriers to breastfeeding', 'use of breastfeeding aids', 'expression and storage of breast milk'. Those reported to be confident to manage common breastfeeding problems were only 25.7%. Correlations between knowledge and self-confidence were not statistically significant except in college A (r=0.35, p<0.05). Correlations between knowledge and attitude were not significant. Conclusions. These results suggest that medical students attending clerkship in Taegu show equivocal attitudes toward breastfeeding, low self-confidence to manage common breastfeeding problems and have substantially limited level of knowledge. There should be more concerted efforts to improve this situation on the part of those involved in breastfeeding education.

• The Korean Journal of Community Living Science
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• v.23 no.4
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• pp.523-535
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• 2012

This study was conducted to investigate and improve experiences regarding breastfeeding education. Questionnaires were distributed to 185 women with children 24 months of age and younger. The period of breastfeeding was about 7.2 months and showed significant differences (p<0.01) according to women's age. About 56% of the respondents participated in breastfeeding education. Women with 3 or more children showed the highest rates of participation compared to the women in other groups(p<0.05). The reason for nonparticipation showed significant differences (p<0.05) according to women's occupation. The biggest reason for nonparticipation was 'lack of time' for housewives and 'no information' for working women. The subjects of education were benefits(20%) and techniques(19%) of breastfeeding, breast care before and after delivery(15%), nutrition care for breastfeeding mothers(11%), etc. The teaching method used most frequently was lecturing(32%). Around 81% of women were not satisfied with their breastfeeding education. The most useful subject was breastfeeding techniques(59%). Thirty percent of women pointed out that 'assessing mother's milk quantity' was the subject which women wanted to learn but were not taught enough about. Around 76% of women wanted more education and preferred personalized education such as home visitation(35%) and personal counselling(27%). Desired education methods showed significant differences(p<0.05) according to women's occupations. 'Home visitation' was the most preferred method for housewives and 'personal counselling' for working women. These results showed breastfeeding education was not helpful for practical life. Therefore, breastfeeding education should reflect women's individual needs to heighten its effectiveness.

• Korean Parent-Child Health Journal
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• v.20 no.1
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• pp.18-27
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• 2017

Purpose: This study aimed to verify the effects of prenatal breast self-massage education on first-time mothers' breastfeeding self-efficacy, breastfeeding adaptation, and breastfeeding practice. Method: The experimental group (n=26) received prenatal breast self-massage education focused on self mamma care (SMC) at 34-36 weeks gestation and 2 weeks later face-to-face. The control group (n=25) was recruited immediately following birth and received usual care. Breastfeeding self-efficacy was measured 4 hours after childbirth and 3 days later, and breastfeeding practice, breastfeeding adaptation, and breastfeeding-related characteristics were measured 2 weeks and 4 weeks after childbirth through online survey. The data were analyzed by $x^2$ test and t-test using SPSS/WIN 24.0. Results: There was no significant difference in breastfeeding self-efficacy of the experimental group at 4 hours after childbirth (t=0.83, p=.410) whereas it was statistically significantly higher at 3 days postpartum (t=2.86, p=.006). There were no significant differences in breastfeeding adaptation between the two groups at both 2 weeks (t=1.76, p=.084) and 4 weeks postpartum (t=0.87, p=.388). For breastfeeding practice a statistically significant difference was found at 4 weeks for the experimental group ($x^2=4.77$, p=.036). Conclusion: This antenatal SMC intervention was found to be a feasible intervention for use in clinical practice.

• Women's Health Nursing
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• v.23 no.4
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• pp.233-242
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• 2017

Purpose: This study investigated the relationships among parenting stress, husband's support, and breastfeeding adaptation in mothers. Methods: A correlational survey design was utilized in this study. Data were collected from 181 breastfeeding mothers with infants under 12 months of age. Participants were recruited from the outpatient clinic, a child photo studio, or from the kid's cafe from July 22 to September 13, 2016. Instruments for collecting data included Childcare Stress Inventory (CSI), Husband's Support scale, and the Breastfeeding Adaptation scale. Data were analyzed using SPSS 21.0 by frequency, descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient and multiple regression. Results: Of the 181 subjects, 54.7% responded they only breastfed with 75.7% who received breastfeeding education. Seventy-two percent of mothers made a decision to breastfeed by themselves. The mean score was $2.39{\pm}0.53$ for parenting stress, $3.07{\pm}0.43$ for husband's support, and $3.85{\pm}0.49$ for breastfeeding adaptation. Factors influencing breastfeeding adaptation were identified as lower parenting stress (${\beta}=-.54$), greater husband's support (${\beta}=.31$), breastfeeding (${\beta}=.31$), and older age of baby (${\beta}=.14$), with 56.0% that explained variance. Conclusion: This study reports that parenting stress has negative effect on breastfeeding adaptation, while husband's support has positive effect. Results may be useful in developing new strategies for enhancing breastfeeding adaptation.

• Journal of Korean Academy of Nursing
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• v.47 no.6
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• pp.713-730
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• 2017

Purpose: This study was a systematic review and meta-analysis designed to evaluate the effects of breastfeeding intervention on breastfeeding rates. Methods: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a systematic search was conducted using eight core electronic databases and other sources including gray literature from January 9 to 19, 2017. Two reviewers independently select the studies and assessed methodological risk of bias of studies using the Cochrane criteria. The topics of breastfeeding interventions were analyzed using descriptive analysis and the effects of intervention were meta-analyzed using the Review Manager 5.2 software. Results: A total of 16 studies were included in the review and 15 were included for meta-analysis. The most frequently used intervention topics were the importance of good latch-on and frequency of feeding and determining adequate intake followed. The pooled total effect of breastfeeding intervention was 1.08 (95% CI 1.03~1.13). In the subgroup analysis, neither pre-nor post-childbirth intervention was effective on the breastfeeding rates at 1, 3, and 6 months, and neither group nor individual interventions had an effect. Only the 1 month breastfeeding rate was found to be affected by the individual intervention with the persistent strategies 1.21 (95% CI 1.04~1.40). Conclusion: Effective breastfeeding interventions are needed to help the mother to start breastfeeding after childbirth and continue for at least six months. It should be programmed such that individuals can acquire information and specific breastfeeding skills. After returning home, there should be continuous support strategies for breastfeeding as well as managing various difficulties related to childcare.