Development of a Self-efficacy in Breast Milk Expression Promoting Program for Cesarean Mothers with Gestational Diabetes Mellitus: A Pilot Study

Abstract

This research aimed to design, determine and evaluate a Self-efficacy in Breast Milk Expression Promoting Program among cesarean mothers with gestational diabetes mellitus (GDM). The research was divided into three phases: 1) program design, 2) determining its quality, and 3) evaluating the practicability of the program. The participants consisted of 10 cesarean mothers with GDM who were selected according to inclusion criteria. The data were analyzed using descriptive statistics, percent, mean and standard deviation. The developed program consists of 2 parts: 1) the self-efficacy promoting in breast milk expression activity, comprising 4 steps and 2 sessions, and taking 30 minutes per session; and 2) the instruments, comprising 2.1) the intervention and control instruments including lesson plan, manual, and visual media, the assessment tool for hand breast milk expression skill, and the hand breast milk expression recording form, and 2.2) the data collecting instruments including a personal data form, and the milk ejection assessment and the onset of lactation questionnaires. This development program was evaluated by experts, its reliability determined, and its practicability verified. After intervention at 72 hours postpartum, 80 percent of participants had milk ejection equal to or more than level 3 (M = 2.80, SD=1.14). Moreover, 90 percent of participants had the onset of lactation earlier than a criterion-referenced standard, (M= 66.89, SD=13.85). The program can be used as a guide for nursing care to promote breastfeeding for cesarean mothers with GDM. However, its effectiveness should be tested with a larger sample size before being applied.