An educational intervention on promotion of breast feeding

Abstract

This study was designed to search for an effective method to promote exclusive breast feeding among Turkish city women delivering in hospitals. Four hundred and forty-two primiparae with uncomplicated deliveries and with healthy infants with birthweights of greater than 2500 g were exposed to a group educational session on breast feeding after birth, followed by one repeat session at home. Four hundred and ninety-nine women served as controls. All homes were visited monthly for 6 months by independent observers and data relevant to the feeding of the infants were collected. Weight measurements of 176 infants were taken at age 4 months. The study and control mothers were similar in sociodemographic characteristics which reflected a low socio-economic/educational background but relatively good housing conditions. Although significant differences in frequency of exclusive breast feeding were found between the study and control groups, the impact of the intervention was much lower than our expectations and short-lived. Type of feeding was not related to sex or birthweight of the infant, nor to maternal variables. Weight at age 4 months was within normal limits and similar in the study and control groups. It was concluded that lack of up-to-date information on infant feeding was the main obstacle to breast feeding in urban groups in Turkey, and that the impact of an educational intervention limited to the first week after delivery was lost within the first 2 months.

PIP: Between August 1986-December 1988, researchers enrolled at least 941 primiparous women infant pairs at a social security obstetric hospital in Instanbul, Turkey into a study intended to examine an educational model to promote exclusive breast feeding. Neither changes in hospital routine nor a continuing support program accompanied the short term intervention. Cases watched a video on oral rehydration therapy and domestic hygiene geared toward diarrhea prevention while in the hospital. They also watched a video on breast feeding followed by a discussion on breast feeding. On days 5-7, health students made home visits to discuss breast feeding and left a booklet on breast feeding. The controls only watched the film on diarrhea. Their home visits on days 5-7 centered on domestic hygiene and baby care. Health students visited each subject once a month for 6 months. Most mothers intended to breast feed (83.2%). More educated mothers (88%) originally planned to breast feed their infants than mothers with limited (81.5%) or no education (69.7%; p.01). By the end of the 1st week, only 47.1% of the cases and 12.4% of the controls were exclusively breast feeding. Supplements consisted on nonmilk liquids. Many mothers stated that they did not produce enough milk so they had to supplement. MOreover the number of cases exclusively breast feeding fell dramatically so that by the 3rd month almost no mother infant pairs practiced exclusive breast feeding. Still cases were significantly more likely to breast feed in the 1st 2 months than controls. Despite little change in behavior, most case mothers felt that the educational session influenced them and they learned the breast is best. In conclusion, the main obstacle was insufficient up to date information available to mothers, relatives, and health personnel.