@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2019;6(1):11-15

Background
Although the body of nursing mothers naturally produces milk, breastfeeding technique should be learned and it needs teaching.
Previous Studies
... [1-16]. In a study, 32% of mothers who breastfeed reported problems with the position and connection of the infants to their breasts [17]. Experts in breastfeeding also believe that the appropriate position and attaching of the infants to the breast reduce breastfeeding problems and increase its duration [18]. Saba et al. concluded that in-person training and facial expressions were effective in enhancing mothers' performance in breastfeeding [19]. Arzani et al. also suggested that using teaching aids, such as pictures, educational videos and pamphlets are effective in breastfeeding training [20].
Aim(s)
This search was performed with the aim of investigating the effect of teaching breastfeeding technique on breastfeeding position in primiparous women.
Research type
This research is a semi-experimental study with pre-test post-test design using control group.
Research society, place and time
This research was conducted on 74 primiparous women referring to comprehensive health centers in Hamadan in 2016.
Sampling method and number
The number of samples was considered 33 subjects for each group, according to the Tafazoli et al. [21] study, with an error of 5% and a power of 90%. On the other hand, in order to avoid possible falling of samples, 10% was added to the sample size and 37 subjects were studied in each group (74 subjects overall). The samples were selected randomly using multi-stage cluster sampling. Inclusion criteria included single delivery, absence of abnormalities in the baby's mouth, including having short frenulum, no feeding with glass baby bottles, exclusive breastfeeding, no abnormalities on the nipple, the ability to making phone calls or presence on checking days. Exclusion criteria included breast infection and mastitis, displacement and the absence for more than once in training sessions.
Used devices&materials
The data collection tool was a demographic questionnaire and a Bristol Breast-feeding Technique (BBAT) checklist. The BBAT checklist is a standard checklist for measuring the breastfeeding technique that examines the four items, including the infant’s position while breastfeeding, infant’s connection to the mother, sucking and swallowing. Each item based on infant’s position while breastfeeding is scored zero (poor), one (average) and 2 (good). The reliability of the questionnaire has been proved by Ingram et al. with a coefficient of agreement of 0.668 [22]. The participants were informed about the study method and objectives and they were assured of confidentiality of information and encoded questionnaires without name and information. The informed consent was also received from the participants. The experimental group was subjected to face-to-face breastfeeding training on the 3-5th day after delivery and also on the tenth and fifteenth days after delivery in 60-min sessions using educational brochure, educational images and clips by the researcher. Then, breastfeeding and the position of mother and child while breastfeeding were checked at each session, individually. The mother was informed about the time of next training sessions, and they were followed up by phone in case of being absent. The control group also received routine breastfeeding training without researcher. Demographic questionnaire was completed for all samples in the experimental and control groups. BBAT was first completed in the experimental group before the first training session, ie on the 3-5th day after delivery, followed by the first stage of training. Also, on the tenth and fifteenth days after delivery, the checklist of the breastfeeding technique was completed again by the researcher at the beginning of the training session. BBAT was completed by the control group on these days. Data were analyzed by SPSS software version 20 using independent T-test.
Findings by Text
The experimental and control groups did not show any significant difference in terms of demographic characteristics, such as mother's age, number of breast-feeding sessions in a day, duration of a breastfeeding session, type of delivery and breastfeeding at birth (Table 1).There was no significant difference between the two groups in the mean scores of dimensions of breastfeeding evaluation before and after the intervention (p>0.05). After the first stage of training (the tenth day after training), there was a significant difference between the two groups in sucking (p<0.05). In the second stage (fifteenth day after training), there was a significant difference in sucking and swallowing dimensions (p<0.05). Also, the total score of the breastfeeding checklist was significantly different between the experimental and control groups both in the first stage and in the second stage of training (p<0.05; Table 2).
Main comparison to the similar studies
Several studies have shown that education is effective in the onset and resistance of breastfeeding [14], but in the present study, the training was not cross-sectional and transient and did not initiate immediately after delivery and was done in several stages and with face-to-face approach. Also, in the mentioned study, films, photos and educational pamphlets were used. The results of this study are consistent with the results of the study by Mirmohammadali et al. [14], entitled “the effect of educational package on the self-efficacy of breastfeeding in the postpartum period”. Their study was a single-blind experimental study and was performed on 300 primiparous women by face-to-face method. In this study, BBAT was used to evaluate the breastfeeding technique. The same questionnaire was used in the study by Ingram et al. study entitled “new tools for measuring breastfeeding and its relationship with breastfeeding self-efficacy [22]. In this study, BBAT was found to be a useful tool for clinical and research use, and it boosts breastfeeding self-efficacy. .... [23-27].
Suggestions
It is suggested that in future studies, the impact of group counseling of women who breastfeed on their breastfeeding position the effect of face-to-face breastfeeding counseling on fissure anale be considered.
Limitations
The lack of supervision on all breastfeeding sessions was one of the limitations of this study.
Conclusions
Teaching breastfeeding technique by standard tools in many steps and face to face can improve mothers’ breastfeeding.
Acknowledgments
We are very grateful to all the respectable officials who helped us in conducting this research.
Conflict of interest
None declared.
Ethical Permissions
The present study was approved by the Ethics Committee of Hamedan University of Medical Sciences (Ethics code: IR.UMSHA.REC.1396.314).
Funding Sources
This research was funded by the Deputy of research and technology of Hamedan University of Medical Sciences.

TABLES and CHARTS

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