Objectives: Understanding the factors influencing mothers' decision to breastfeed their infants is essential to formulate effective breastfeeding interventions. This study explored the determinants of optimal breastfeeding indicators in Indonesia. Methods: We used the 2017 Indonesia Demographic and Health Survey to analyze factors associated with early initiation of breastfeeding, exclusive breastfeeding (EBF), and continued breastfeeding at 1 year (CBF-1) and 2 years (CBF-2). Multivariate logistic regression models were used to examine bio-demographic, socio-cultural, and behavioral characteristics associated with breastfeeding after considering the survey design effect. Results: The risk of delayed breastfeeding initiation was higher among infants who were born smaller, first-born children, were delivered via cesarean delivery, and did not have immediate skin-to-skin contact (p<0.01). Infant's age, birth pattern, household wealth index, and the mother's occupation and smoking status were predictors of EBF (p<0.05). CBF-1 was less common among first-time mothers and those working in the non-agricultural sector, mothers from wealthier families, and mothers who had cesarean deliveries (p<0.01). Infant's age was negatively associated with CBF-2 (adjusted odds ratio [aOR], 0.85; 95% confidence interval [CI], 0.74 to 0.99). Mothers attending college were less likely to practice CBF-2 than those with no education or primary education (aOR, 0.45; 95% CI, 0.26 to 0.77). The absence of postnatal visits was a risk factor for CBF-1 and CBF-2 (p<0.05). Conclusions: Breastfeeding interventions in Indonesia should pay particular attention to at-risk groups such as women from wealthier families, working outside the agricultural sector, and with a higher education level. Nutrition-sensitive programs (e.g., postnatal care and smoking cessation) should also be encouraged.
Purpose: To investigate factors that may affect the method of feeding among preterm infants at 4 weeks after discharge. Methods: This study included 222 mother-infant dyads born before a gestational age of 37 weeks. The feeding method and general medical characteristics of the participants were assessed at 4 weeks after discharge using a structured questionnaire. Multinomial logistic regression analysis was used to examine which factors were associated with breastfeeding at home. Results: Of the 222 infants who qualified for the study, 71 (32.9%) continued to receive breastmilk at 4 weeks post-discharge. Multinomial logistic regression analysis showed that breastfeeding at 4 weeks post-discharge was associated with higher breastfeeding self-efficacy, vaginal delivery (experience), direct breastfeeding in the neonatal intensive care unit (NICU), gestational age between 30 and 34 weeks, and breastmilk consumption in the NICU. The following factors were associated with mixed feeding at 4 weeks post-discharge: being employed, having higher breastfeeding self-efficacy, and direct breastfeeding in the NICU. Conclusion: NICU nurses should provide opportunities for direct breastfeeding during hospitalization and support breastfeeding to enhance breastfeeding self-efficacy. These factors may help to ensure the continuation of breastfeeding after discharge. Moreover, factors that affect breastfeeding should be considered when providing interventions.
Purpose: This study examined the effects of breastfeeding education among preterm mothers. Methods: A nonequivalent control group, repeated measure, quasi-experimental study design was used. The participants comprised 46 preterm mothers recruited from the neonatal intensive care unit of a university hospital who were divided into two groups: 23 in the control group and 22 in the experimental group. The breastfeeding education program intervention to promote preterm mothers' self-efficacy used was devised based on the self-efficacy theory. The intervention program consisted of individual breastfeeding education with demonstrations and discharge education, and telephone follow-up education within one week after being discharged. The participants were surveyed before and after the intervention, and four weeks after being discharged from the newborn intensive care unit. Results: The intervention group showed a significant increase in breastfeeding self-efficacy compared with the control group (F=6.92, p=.003) and showed a significant increase in their breastfeeding attitude score (F=3.49, p=.039). Four weeks after discharge, the breastmilk volume of the intervention group increased significantly (t=-2.87, p=.006), and the same group continued to breastfeed more compared with the control group (χ2=4.50, p=.049). Conclusion: This study suggests that the preterm breastfeeding program had a positive effect on breastfeeding self-efficacy, breastfeeding attitude, and extending the breastfeeding period among preterm mothers.
Purpose: This study was done to identify the effects of self-breast pumping on breastfeeding rates and, the degree of breast milk fullness among primiparous women giving birth by cesarean section. Methods: The study design was a non-synchronized posttest control group experiment with repeated measures. The participants were 60 women, 31 in the experimental group who used a manual pump 5 times a day after exclusive breastfeeding and 29 in the control group who breastfed exclusively with no other interventions. Results: While self-breast pumping did not improve breastfeeding rates or the degree of breast milk fullness at any of the time points studied, breastfeeding rates continued to remain high till 12 weeks postpartum in both groups. Conclusion: Although some modifications in research methods will be required to identify the effects of breast pumping and exclusive breastfeeding, both these approaches can be used as interventions to improve breastfeeding rates and breast milk quantity.
This descriptive study aimed to determine the effects of community based health education program for pregnant women on their confidence in labor and breastfeeding. Data were obtained using several questionnaires and administered to 174 pregnant women who have participated (n=49) and have not participated(n=125) in health education program, and 244 mothers of infants who lived in one city in Kyunggi province. Summaries of finding were as follows; First, pregnant women who have participated in health education program showed significantly higher score in confidence in labor than those who have not. Also, confidence in labor was different according to the level of education. Second, pregnant women participated in health education program showed higher score in knowledge and attitude on breastfeeding, but the differences were not significant. Knowledge on breastfeeding was higher in multipara. More positive attitude on breastfeeding was found in working mothers and highly educated mothers. Third, $54.1\%$ of mothers continued breastfeeding over six months. Main reasons for discontinuing breastfeeding were lack of breast milk amount, and health problems in infants and mothers. In this study, we could identify the positive effects of health education program for pregnant women provided by public health center, and find the related factors of confidence in labor and breastfeeding. Community based health education program for pregnant women, especially for vulnerable group should be expanded.
The purpose of this study was to find the effects of an educational program for primiparas on maternal confidence and continuity of breastfeeding. The subjects of this study were the healthy mothers, and the healthy infants whose weight was more than 2.500gm and gestational age was more than 37 weeks. The final targets were thirty seven mothers-19 of intervention group and 18 of control group. Data were collected from 15th of March to 3rd of September, 1999. To the intervention group, education on infant care and breast feeding were provided before discharge. And that, telephone advice was provided within one week after discharge, and at 2 months postpartum. And that, reeducation and counsel were provided at one month and three months postpartum by home-visiting care for the intervention group. For the control group. home visiting was also conducted only for data collection. Data were analyzed by chi-square test and t-test. The results were as follows: 1. The maternal confidence of the experimental group was higher than that of control group at one month postpartum. but the difference of confidence of these two groups were not significant at three months postpartum. 2. For both of experimental and control groups, maternal confidence significantly increased at three months postpartum than one month postpartum. 3. The rate of breastfeeding of the experimental group was higher than that of control group at one month and two months postpartum (p=.050, p=.049). But the difference was not significant at three months, although experimental group continued breastfeeding more(47.4%) than control group(27.8%). In conclusion, educational program for primiparas of this study was effective in the promotion of maternal confidence and breastfeeding.
Purpose: To study whether breastfeeding and breastfeeding status during gluten introduction influences the age at diagnosis of celiac disease (CD). In addition to study, whether the timing of gluten introduction influences the age at diagnosis of CD. Methods: It was a hospital based observational study. Total 198 patients diagnosed with CD as per modified European Society of Pediatric Gastroenterology, Hepatology and Nutrition (2012) criteria, aged between 6 months to 6 years were included. Detail history taken with special emphasis on breastfeeding and age of gluten introduction. Standard statistical methods used to analyze the data. Results: $Mean{\pm}standard$ deviation age of onset and diagnosis of CD in breastfed cases was $2.81{\pm}1.42$ years and $3.68{\pm}1.55$ years respectively as compared to $1.84{\pm}1.36$ years and $2.70{\pm}1.65$ years respectively in not breastfed cases (p<0.05). Those who had continued breastfeeding during gluten introduction and of longer duration had significantly delayed onset of disease. The age at onset of CD was under one year in 40.42% of the cases, who had started gluten before 6 months of age compared to only 12.58% of those who had started gluten later (p<0.001). The proposed statistical model showed that two variables, i.e., breast feeding status during gluten introduction and age at gluten introduction positively influencing the age at diagnosis of CD. Conclusion: Delayed gluten introduction to infant's diet along with continuing breastfeeding, delays symptomatic CD. However, it is not clear from our study that these infant feeding practices provide permanent protection against the disease or merely delays the symptoms.
Purpose: The objective of this study was to identify the effectiveness of continued breast feeding and maternal identity between rooming-in and not rooming-in groups of mothers in post partum care. Method: The subjects were selected by convenient sampling, with 95 women in childbirth completing a questionnaire. The data were collected on the 2nd day after delivery by questionnaire, and after the 4th and 8th weeks by telephone interview. Measures used in this study included general characteristics, breast feeding related characteristics, and the maternal identity scale revised by Koh(1996). The data were analyzed with the SPSS program, and the Chi-test and t-test were used to identify the effect on breast feeding and maternal identity. Results: Continued breast feeding up to 4 weeks after deliverly was not statistically significant between rooming-in and not rooming-in group, but beyond 8 weeks of deliverly, it was significantly different in rooming-in group(p<.01). Maternal identity was significantly higher in rooming-in group than in not rooming-in group(<.01). Conclusion: Mothers preferred rooming-in system because it helped breast feeding and baby care. Rooming-in system provides self confidence in taking care of baby, knowledge about breast feeding and stimulates early phase lactation. We recommend rooming-in system in hospitals to promote breast feeding and maternal identity. Nurses are encouraged to discuss prenatal breast feeding before delivery and rooming-in care should be planned individually for continuation of breast feeding and formation of maternal identity.
In recent days, most of mothers prefer bottle feeding to breast feeding. Even mothers who started with breast feeding, change to bottle feeding in a short period. Many factors were reported causing the trend, but a significant influencing latter was revealed the mothers' perception that their breast milk wasn't enough for their babies. The purpose of this study were to identify how mothers of 30 years ago kept breastfeeding longer period for their child, and what were the diet they used in order to keep adequate breast milk secretion. The subjects of this study were 95 women who are over 60 years or older. Data were gathered by 13 authors by interview using structured questionnare. There were 16 questions related to subject's demographic informations and the specific recipe which they used, and 7 questions related to breast feeding techniques they used. Data were analyzed by SPSS/PC and content analysis. Results were as follows. 1. The subjects reflected that their milk secretion was enough to feed their tables. 2. More than half of the subject started breast feeding on the 3rd day after delivery and had continued breast feeding until they were pregnant again. 3. The subjects tried to eat as much rice and seaweed (MiYuk) soup as possible and didn't take any other specific diet during the breast feeding period. 4. The subjects didn't pay specific attention to the breast, general health. emotion, home environment. The only thing they did was being careful not to press breast when not feed. 5. Many subjects perceived that breast feeding made them healthy, and only 7% of subjects responded that they had some health problem during the breast feeding period.
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