Factors Influencing Exclusive Breastfeeding at Discharge Among First-Time Mothers Undergoing Cesarean Section

Authors

  • อริสรา สวัสดิ์พาณิชย์ Registered Nurse, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University
  • สุสัณหา ยิ้มแย้ม Correspondent author, Professor, Faculty of Nursing, Chiang Mai University, Thailand
  • นงลักษณ์ เฉลิมสุข Instructor, Faculty of Nursing, Chiang Mai University

Keywords:

exclusive breastfeeding, perceived benefits of breastfeeding, perceived barriers to breastfeeding, breastfeeding self-efficacy, maternity care practices, mothers undergoing cesarean section

Abstract

Breastfeeding is considerably beneficial to infants, mothers, and society. Nevertheless, mothers who have undergone cesarean section are a risk group for lower rates of exclusive breastfeeding as well as shortened breastfeeding duration. The purpose of this descriptive correlational research was to describe breastfeeding among first-time mothers who have undergone cesarean section, and to examine the relationships between exclusive breastfeeding and selected factors including perceived benefits of breastfeeding, perceived barriers to breastfeeding, breastfeeding self-efficacy, and maternity care practices. The participants were 144 first-time mothers who underwent cesarean section at two tertiary hospitals in Bangkok, Thailand. Purposive sampling was used to recruit the participants on the basis of inclusion criteria. Data were collected from July 2017 to January 2018 by using questionnaires consisting of the Demographic Data Recording Form; the Perceived Breastfeeding Benefits Questionnaire; the Perceived Breastfeeding Barriers Questionnaire; Dennis’s Breastfeeding Self-Efficacy Short-Form Scale (BSES-SF); the Questionnaire of Maternity Care Practice, and the Breastfeeding Practices Questionnaire. The measures of reliability among the instruments were .87, .95, .93, .80 and 1, respectively. Data were collected by the researcher and analyzed using descriptive statistics and Point-Biserial correlation.

          Results of the study revealed that exclusive breastfeeding rates were 33.3% at hospital discharge and 39.1% at the first month postpartum among first-time mothers who had undergone cesarean section. The primary reason for feeding formula to the infants was insufficient milk supply. Furthermore, there was a significantly positive relationship between maternity care practices and exclusive breastfeeding at hospital discharge (rpb=.359, p<.01). The findings suggest that nurse-midwives and other health care professionals should protect, promote, and support exclusive breastfeeding, especially among new mothers who undergo cesarean sections. Intervention and strategies should be implemented focusing on maternity care practices aligned with the Ten Steps to Successful Breastfeeding of the BFHI and on the basis of the health care sphere across the perinatal continuum in order to encourage those mothers to successfully exclusive breastfeed.

References

Albokhary, A. A., & James, J. P. (2014). Does cesarean section have an impact on the successful initiation of breastfeeding in Saudi Arabia?. Saudi Medical Journal, 35(11), 1400-1403.

Asole, S., Spinelli, A., Antinucci, L. E., & Di Lallo, D. (2009). Effect of hospital practices on breastfeeding: a survey in the Italian Region of Lazio. Journal of Human Lactation, 25(3), 333-340. DOI:10.1177/0890334409333849

Bai, Y, Middlestadt, S. E., Peng, C.-Y. P., & Fly, A. D. (2010). Predictors of continuation of exclusive breastfeeding for the first six months of life. Journal of Human Lactation, 26(1), 26-34. DOI:10.117 7/0890334409350168

Bartick, M., & Reinhold, A. (2010). The burden of suboptimal breastfeeding in the United States: A pediatric cost analysis. Pediatrics, e1048-e1056. DOI:10.1542/peds.2009-1616

Battersby, S. (2016). Supporting mothers to sustain breastfeeding. British Journal of Midwifery, 24(Sup1), 1-7.

Chalmers, B., Kaczorowski, J., Darling, E., Heaman, M., Fell, D. B., O’Brien, B., & Lee, L. (2010). Cesarean and vaginal birth in Canadian women: A comparison of experiences. Birth, 37(1), 44-49. DOI:10.1111/j.1523-536X.2009.00377.x

Childbirth Connection (2012). Vaginal or cesarean birth: What is at stake for women and babies? New York: Childbirth Connection. Retrieved from http://transform.childbirthconnection.org/reports/ cesarean/.

Cordero, L., Bajwa, A., Prasad, M., Oza-Frank, R., Landon, M., & Nankervis, C. (2016). Breastfeeding at hospital discharge among high risk obstetrical patients. International Journal of Women’S Health and Wellness, 2(4), 2-6. DOI:10.23937/2474-1353/1510031

Dennis, C. L. (2003). The breastfeeding self‐efficacy scale: Psychometric assessment of the short form. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 32(6), 734-744. DOI:10.1177/0884217503 258459

American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827-e841. DOI:10.1542/peds.2011-3552

Gatti, L. (2008). Maternal perceptions of insufficient milk supply in breastfeeding. Journal of Nursing Scholarship, 40(4): 355–363. DOI:10.1111/j.1547-5069.2008.00234.x

Grove, S. K., Burns, N., & Gray, J. R. (2013). The practice of nursing research: Appraisal, synthesis, and generation of evidence (7th ed.). St. Louise, MO: Saunders Elsevier.

Hobbs, A. J., Mannion, C. A., McDonald, S. W., Brockway, M., & Tough, S. C. (2016). The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy and Childbirth, 16, 90. DOI:10.1186/s12884-016-0876-1

Horta, B. L., & Victora, C. G. (2013a). Long-term effects of breastfeeding: a systematic review. Retrieved from World Health Organization: http://apps.who.int/iris/bitstream/10665/79198/1/9789 241505307_eng.pdf.

Horta, B. L., & Victora, C. G. (2013b). Short-term effects of breastfeeding: a systematic review on the benefits of breastfeeding on diarrhoea and pneumonia mortality. Retrieved from World Health Organization: http://apps.who.int/iris/bitstream/10665/95585/1/9789241506120_eng.pdf

Ip, W. Y., Gao, L. L., Choi, K. C., Chau, J. P. C., & Xiao, Y. (2016). The Short Form of the Breastfeeding Self-Efficacy Scale as a prognostic factor of exclusive breastfeeding among Mandarin-Speaking Chinese mothers. Journal of Human Lactation, 32(4), 711-720. DOI:10.1177/0890334416658014

Jager, E., Skouteris, H., Broadbent, J., Amir, L., & Mellor, K. (2013). Psychosocial correlates of exclusive breastfeeding: A systematic review. Midwifery, 29, 506–518. DOI:10.1016/j.midw.2012.04.009

Kramer, M. S., & Kakuma, R. (2012). Optimal duration of exclusive breastfeeding. The Cochrane Database of Systematic Reviews, 8(Art. No. CD003517). DOI:10.1002/14651858.CD003517.pub2

Linnecar, A., Gupta, A., Dadhich, J., & Bidla, N. (2014). Formula for disaster: weighing the impact of formula feeding vs. breastfeeding on environment. Retrieved from http://ibfan.org/docs/Formula ForDisaster.pdf.

Ma, P., Brewer-Asling, M., & Magnus, J. H. (2013). A case study on the economic impact of optimal breastfeeding. Maternal and Child Health Journal, 17(1), 9-13. DOI:10.1007/s10995-011-0942-2

National Statistical Office, & United Nations Children’s Fund. (2016). Thailand Multiple Indicator Cluster Survey 2015-2016. Retrieved from https://www.unicef.org/thailand/Thailand_MICS_Full_ Report_EN.pdf.

Nuampa, S., Sinsuksai, N., Phahuwatanakorn, W., & Chanprapaph, P. (2013). Personal Factors, First Feeding Time and Nurse Support in Predicting Successful Exclusive Breastfeeding at Discharge in Mothers with Cesarean Section. Journal of Nursing Science, 31(2):49-59.

Pérez-Escamilla, R., Martinez, J. L., & Segura‐Pérez, S. (2016). Impact of the Baby-Friendly Hospital Initiative on breastfeeding and child health outcomes: A systematic review. Maternal & Child Nutrition, 12, 402–417. DOI:10.1111/mcn.12294

Pérez-Ríos, N., Ramos-Valencia, G., & Ortiz, A. P. (2008). Cesarean delivery as a barrier for breastfeeding initiation: The Puerto Rican experience. Journal of Human Lactation, 24(3), 293-302. DOI:10.1177/0890334408316078

Prior, E., Santhakumaran, S., Gale, C., Philipps, L. H., Modi, N., & Hyde, M. J. (2012). Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. The American journal of Clinical Nutrition, 95, 1113–1135. DOI: 10.3945/ajcn.111.030254

Qiu, L., Zhao, Y., Binns, C. W., Lee, A. H., & Xie, X. (2009). Initiation of breastfeeding and prevalence of exclusive breastfeeding at hospital discharge in urban, suburban and rural areas of Zhejiang China. International Breastfeeding Journal, 4(1), 1-7. DOI:10.1186/1746-4358-4-1

Sakha, K., & Behbahan, A. G. G. (2005). The onset time of lactation after delivery. Medical Journal of the Islamic Republic of Iran, 19(2), 135-139.

Scott, J. A., Binns, C. W., & Oddy, W. H. (2007). Predictors of delayed onset of lactation. Maternal & Child Nutrition, 3(3), 186-193. DOI: 10.1111/j.1740-8709.2007.00096.x

Sinsuksai, N., Nuampa, S., & Chanprapaph, P. (2017). Factors predicting 6-month-exclusive breastfeeding in mothers with cesarean section. Journal of Nursing science, 35(1), 14-22.

Tarrant, M., Wu, K. M., Fong, D. Y., Lee, I. L., Wong, E. M., Sham, A., . . . & Dodgson, J. E. (2011). Impact of Baby-Friendly hospital practices on breastfeeding in Hong Kong. Birth, 38(3), 238-245. DOI:10.1111/j.1523-536X.2011.00483.x

Tully, K. P., & Ball, H. L. (2014). Maternal accounts of their breast-feeding intent and early challenges after caesarean childbirth. Midwifery, 30(6), 712-719. DOI:10.1016/j.midw.2013.10.014

Uchendu, U. O., Ikefuna, A. N., & Emodi, I. J. (2009). Exclusive breastfeeding-the relationship between maternal perception and practice. Nigerian Journal of Clinical Practice, 12(4).

Vieira, G. O., Martins, C. C., Vieira, T. O., Oliveira, N. F., & Silva, L. R. (2010). Factors predicting early discontinuation of exclusive breastfeeding in the first month of life. Jornal De Pediatria, 86(5), 441-444. DOI:10.2223/JPED.2010

Walker, M. (2007). Breast-feeding: Good start, good outcomes. Journal of perinatal & neonatal nursing, 21(3), 191-197. DOI:10.1097/01.JPN.0000285807.28775.ee

World Health Organization. (2009b). Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. Retrieved from http://apps.who.int/iris/bitstream/ 10665/44117/1/9789241597494_eng.pdf?ua=1.

Yimyam, S. (2013). Breastfeeding experiences among employed mothers. In Tanya M. Cassidy (Editor). Breastfeeding: Global Practices, Challenges, Maternal and Infant Health Outcomes (pp. 181-200). New York: Nova Science.

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Published

2019-09-27

How to Cite

สวัสดิ์พาณิชย์ อ., ยิ้มแย้ม ส., & เฉลิมสุข น. (2019). Factors Influencing Exclusive Breastfeeding at Discharge Among First-Time Mothers Undergoing Cesarean Section. Nursing Journal CMU, 46(3), 219–231. Retrieved from https://he02.tci-thaijo.org/index.php/cmunursing/article/view/218567

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Research Article