There after purposive
sampling technique was used to select two primary health care centers among the
twenty PHCS in Kaduna South. Data was collected with the use of a reliable
self-constructed questionnaire before and after the training.Cronbach Alpha was
used to determine the reliability of the questionnaire (r=0.990)The training Programme
consists of four modules and the training lasted for four weeks. The training
comprises of four stages: pre-intervention stage, week 1, week 2, week 3, week
4 and administration of post-test. The study generated four research questions
and the three hypotheses which were tested at 0.05 alpha levels. Data were
analyzed using descriptive statistics, and t-test.
Demographic data of participants showed that majority
of the maternal respondents with children numbering between 1 and 2 were
28(77.75%) had the highest percentage.
The highest educational attainment of the respondent was secondary school
(100%). The Igbo’s 16, (44.4%) had the
highest percentage among the tribes. Majority (52.8%) of the nursing mothers have poor knowledge on adequate breastfeeding positioning, 14 (38.8%) of the participants had moderate
level of knowledge on procedure for breastfeeding. 17 (47.2%) of the
participants had moderate knowledge level of breast engorgement,). Majority 21
(58.4%) of the participants had moderate level of knowledge on sore
nipples. Significant differences were found
between the pre and post intervention in the following areas; on adequate
positioning for effective latch-on (p=0.009), on procedure for breastfeeding (p=0.011),
on breastfeeding problems (p=0.001).
In conclusion, the training was effective in improving the level of knowledge of breastfeeding mothers on breastfeeding related problems and its prevention. Based on the findings, it is recommended that the government should help in minimizing this breastfeeding related problems by organizing seminars, workshop and extension services to enlighten women on breastfeeding problems and early prevention
TABLE
OF CONTENTS
Content Page
Title Page i
Certification ii
Dedication iii
Acknowledgements iv
Abstract v
Table of Contents vi
List of Tables vii
List of Figures ix
Appendices x
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study 1
1.2 Statement of the Problem 2
1.3 Objective of the Study 2
1.4 Research Questions 3
1.5 Hypotheses 3
1.6 Scope of the Study 3
1.7 Significance of the Study 3
1.8 Operational Definition of Terms 4
CHAPTER
TWO: REVIEW OF LITERATURE
2.0 Introduction5
2.1 Importance of breastfeeding to infants and
mothers5
2.2 Implications of knowledge of nursing mothers on breastfeeding techniques 6
2.3 Causes, treatment and remedies for nipple pain 11
2.4 Good techniques and proper positioning for
good latch-on16
2.5 Impact of breastfeeding interventions on breastfeeding related problem 19
2.6Conceptual Model 24
CHAPTER THREE: METHODOLOGY
3.0 Introduction
26
3.1 Research Design 26
3.2Population 27
3.3Sample size and sampling Technique 28
3.4 Instrumentation 28
3.5 Validity and Reliability of the Instrument 28
3.6Method of Data Collection 29
3.7Method of Data Analysis 30
3.8 Ethical Consideration 31
CHAPTER
FOUR: DATA ANALYSIS, RESULTS AND
DISCUSSION
OF FINDINGS
4.0: Introduction 32
4.1: Demographic Data of Participants 33
4.2: Discussion of Research Questions 34
4.3: Discussion of Hypotheses 36
CHARPTER FIVE: SUMMARY CONCLUSION AND RECOMMENDATIONS
5.1: Summary 42
5.2: Conclusion 42
5.3: Recommendations 43
5.4: Limitation of Study 43
5.5: Suggestion for Further Studies 44
REFERENCES 45
APPENDICES 48
LIST
OF TABLES
Table Page
4.1 Demographic data of the maternal respondents 33
4.2 Descriptive statistics showing the existing knowledge of nursing mothers on adequate breastfeeding positioning 34
4.3 Descriptive statistics showing the knowledge level of mothers on procedure for breastfeeding before intervention 35
4.4 Descriptive statistics showing the level of knowledge of mothers on breast engorgement 36
4.5 Descriptive statistics showing the level of knowledge of mothers on sore nipples before intervention 37
4.6 T-test showing differences between the knowledge level of mothers on adequate positioning for effective latch on pre and post intervention 38
4.7T-test showing the differences between the knowledge level of participants on procedure for breastfeeding pre and post intervention 39
4.8T-test showing the difference between the pre and post intervention knowledge of nursing mothers on breastfeeding problems 39
LIST
OF FIGURE
Figure 1 Conceptual model adapted from DoreathyOrem’s theoryself care deficit 24
APPENDICES
- Informed Consent Form
- Questionnaire
- Teaching Modules
- BUHREC Permission to conduct research work
- Introduction Letter to PHC where the research
work was done.
- Reliability
Result
- Picture
taken during the research work with participants.
CHAPTER
ONE
INTRODUCTION
Breastfeeding is the act of milk
transference from mother to baby that is needed for the survival and healthy
growth of the baby into an adult (United Nations Children’s Fund (UNICEF),
2009; Heckman, 2011). Breastfeeding provide infant with essential calories and
nutrients to nourish the baby (National Institute of Child Health & Human
Development, 2009).According to the American Academy of Pediatrics (AAP) policy Statement on Breastfeeding,
women who do not have health problems should exclusively breastfeed their
infants for at least the first six months of life (AAP,2012). The importance of appropriate infant feeding
and the vital role played by breastfeeding in child survival, growth and
development cannot be over-emphasized (AAP,
2012). The World Health Organization (WHO) has recommended two years
breastfeeding; first sixmonths exclusive breastfeeding; more than eight times
breastfeeding per day in the first three months of an infant’s life. The AAP
suggested that a woman should try to breastfeed her infant for the first twelve
months of life.
Despite
the documented value of exclusive breastfeeding during the first months of a
child’s life and struggles for promoting this practice, rates for exclusive
breastfeeding in Nigeria are below those recommended by the World Health
Organization (WHO), which advocates exclusive breastfeeding during the first
six months of baby’s life. Breastfeeding a baby exclusively for the first six
months and then continued breastfeeding in addition to appropriate solid foods
until twelve months and beyond has health benefits for both mother and the child and these
include; reduction of the risk of
mothers from developing gestational diabetes, osteoporosis, and breast cancer.
It can also assist the women to lose weight after delivery, and also help the
uterus of the women to return fast to pre-pregnant state. Advantages to the
babies may also include: reduced risk of development of gastro intestinal
illness, allergies, asthma, diabetes, obesity, some childhood cancer,
respiratory infections and diarrhoea.
Based on the WHO Global data on
infant and young Child Feeding in Nigeria, 22.3% of children were exclusively
breastfed for less than 4 months, while 17.2% were exclusively breastfed for
less than 6 months, in the year 2003. According to the Nigerian Demographic and
Health Survey (NDHS), in 2008 17% of children were exclusively breastfed for
less than 4 months, while 13% were exclusively breastfed for less than 6
months. The median exclusive breastfeeding period in Southwest Nigeria by
months in the year 2003 was 7 months. In the year 2008, it was 6 months. Within
the same period, early initiation of breastfeeding among women in the region
was 12.7% in 2003, but increased to 35.5% in the year 2008. All these figures
are far below the 90% level recommended by the WHO. Child mortality therefore
remains high in low and middle-income countries. Nigeria has the highest
under-five rural mortality rate of 242.7 per 1,000 among selected sub-Saharan
Africa countries. (NDHS, 2008; NPC, 2009; WHO, 2010)
The technique used in
breastfeeding, especially mother-infant positioning and attachment or suckling
by the infant, has been shown to be important for the effective transfer of
milk from the breast to the child as well as for preventing nipple damage.
Heckman (2011) evaluated mother-infant pairs in a maternity ward and observed
that only 2% of pairs achieved optimal latch performance (chin touches the
breast, mouth opens wide, lower lip flared outward ,moderate lip tension, and
infant grasps the areola), and only 0.2% achieved optimal mother-infant
positioning (mother in a comfortable position, C-hold of the breast [leaving
the areola free and making gentle compression of the breast tissue between the
thumb and fingers]. infant’s head and body aligned facing the mother and in
close contact with the mother’s body, infant’s arm not between the mother and
infant, infant’s head and neck supported, infant’s mouth facing the nipple, and
infants nose free for breathing).
1.2 Statement of the Problem
Breastfeeding
is the natural way to feed a baby but that does not always mean it is easy.
Many breastfeeding mothers encounter a few challenges in the course of using
one breastfeeding technique or the other (Finello, 2015). According to National
Health Service U.K (2013), most breastfeeding mothers have experienced variety
of difficulties as a result of some of the techniques used both to the baby and
themselves as mothers. It was observed during the child welfare Clinic that
many of the nursing mothers failed to practice exclusive breastfeeding as a
result of some of the breastfeeding related problems they encountered while
breastfeeding. Considering that breastfeeding technique seems to be important
for maintaining successful breastfeeding, this project will explore effect of
nursing intervention on breastfeeding-related problems among nursing mothers in
selected Primary Health Clinics in Kaduna South, Nigeria.
1.3 Objective of
the Study
The main objective of this study is
to determine the effect of nursing intervention on breastfeeding-related
problems among nursing mothers in selected Primary Health Clinics in Kaduna
State, Nigeria, in the first six months postpartum. The specific objectives are
to:
EFFECT OF NURSING INTERVENTION PROGRAMME ON BREASTFEEDING RELATED PROBLEMS AMONG THE NURSING MOTHERS IN TWO SELECTED PRIMARY HEALTH CARE CENTRES IN KADUNA SOUTH, NIGERIA
