DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20162066

A community based assessment study of positioning, attachment and suckling during breastfeeding among 0-6 months aged infants in rural area of Gandhinagar district, Gujarat, India

Arpit Chelabhai Prajapati, Haresh Chandwani, Bhavik Rana, Kantibhai N. Sonaliya

Abstract


Background: Effective breastfeeding is a function of the proper positioning of mother and baby and attachment of child to the mother's breast. Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy recommended systematic assessment of breastfeeding and emphasized counselling of the mother on proper positioning and attachment of infant to the breast. Objective of the study was to assess the correct position, attachment and effective suckling in the breastfeeding of infants as practiced by mothers in rural community.

Methods: An observational, descriptive study was done at field practice area of rural health training centre, Dabhoda, from January 2013 to December 2013. One hundred twenty mothers of 0-6 months of aged infant were interviewed and observed for baby's position, attachment and effective suckling using pre-tested semi-structured questionnaire through random selection. Grading of positioning, attachment and suckling was done according to the score of various characteristics. Data thus collected were analyzed using MS Excel 2007 and also Epi info.

Results: There was poorer positioning among primipara (41.7%) than multipara (20.9%) mothers. Poorer attachment was also more evident among primipara (45.8%) compared to multipara (10.9%) mothers. Parity was significantly linked with poor positioning of infant (P value = 0.001) and attachment (P value <0.001). Maternal occupation was also significantly associated with attachment (p value = 0.028) and positioning (p value = 0.009). Preterm delivery was significantly associated with poor attachment (P value = 0.023) and poor effective suckling (P value <0.0001).

Conclusions: Primipara mothers require help and support for correct breastfeeding techniques as poor positioning and attachment was found among primipara mothers. 


Keywords


Attachment, Breastfeeding, Effective suckling, Positioning

Full Text:

PDF

References


K Park. Park’s text book of preventive and social medicine, Preventive medicine in obstetrics, paediatrics and geriatrics. 2015:530-8.

National guidelines on infant and young child feeding. www.wcd.nic.in/nationalguidelines.pdf. Accessed on 27/04/2015.

Henderson P. WHO Press 20 Avenue Appia, 1211. Geneva 27, Switzerland: WHO Press, World Health Organization; 2009. Infant and young child feeding: Model chapter for textbooks for medical students and allied health professionals. Session 1- The importance of infant and young child feeding and recommended practices; pp. 5-6. Available at:whqlibdoc.who.int/publications/2009/9789241597494_eng.pdf.

World Bank. Repositioning nutrition as central to development: a strategy for large scale action. Washington DC, The World Bank, 2006 Available at:siteresources.worldbank.org/NUTRITION/./NutritionStrategy.pdf.

Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS. How many child deaths can we prevent this year? Lancet. 2003;362:65-71. Available at:www.who.int/child...health/.../lancet_child_survival_prevent_deaths.pdf accessed on 28.04.2015.

World Health Organization, Infant and young child feeding, Model chapter for textbooks for medical students and allied health professional pp 13. Available at:whqlibdoc.who.int/publications/2009/9789241597494_eng.pdf.

National Rural Health Mission. http://nrhm.gov.in/ nrhm-components/ rmnch-a/ child-health-immunization/ child-health/ guidelines.html. Accessed on 26/04/2015.

Dongre AR, Deshmukh PR, Rawool AP, Garg BS. Where and how breastfeeding promotion initiatives should focus its attention? A study from rural wardha. Indian J Community Med. 2010;35:226-9.

Vinther T, Helsing E. Breastfeeding- how to support success: a practical guide for health workers. Copenhagen: World Health Organization, Regional Office for Europe. 1997:10-2.

Woolridge MW. Aetiology of sore nipples. Midwifery. 1986;2:172-6. Available at:http://www.midwiferyjournal.com/article/S0266-6138%2886%2980042-0/abstract.

Blair A, Cadwell K, Turner-Maffei C, Brimdyr K. The relationship between positioning, the breastfeeding dynamic, the latching process and pain in breastfeeding mothers with sore nipples. Breastfeed Rev. 2003;11:5-10.

Weigert EM, Giugliani ER, França MC, Oliveira LD, Bonilha A, Espírito Santo LC, et al. The influence of breastfeeding technique on the frequencies of exclusive breastfeeding and nipple trauma in the first month of lactation. J Pediatr (Rio J). 2005;81:310-6.

Matthews MK. Experiences of primiparous breast-feeding mothers in the first days following birth. ClinNursRes.1993;2:309-26.

Kronborg H, Vaeth M. How are effective breastfeeding technique and pacifier use related to breastfeeding problems and breastfeeding duration? Birth. 2009;36:34-42.

Gupta M, Aggarwal AK. Feasibility study of IMNCI guidelines on effective breastfeeding in a rural area of North India. Indian J Community Med. 2008;33:201-3.

Santo LC, de Oliveira LD, Giugliani ER. Factors associated with low incidence of exclusive breastfeeding for the first 6 months. Birth. 2007;34:212-9.

Sai M, Kishore S, Kumar P, Aggarwal AK. Breastfeeding knowledge and practices amongst mothers in a rural population of North India: A community-based study. J Trop Pediatr. 2009;55:183-8.

Essa RM, Ebrahim EM. Effect of breast milk versus therapeutic honey (Apicare) on cracked nipples' healing. Life Science Journal. 2013:10(1).

Mannan I, Rahman SM, Sania A, Seraji HR, Arifeen SE, Winch PJ, et al. Can early postpartum home visits by trained community health workers improve breastfeeding of newborns? J Perinatol. 2008;28:632-40.

Thakre SB, Thakre SS, Ughade SM, Golawar S, Thakre AD, Kale P. The breastfeeding practices: the positioning and attachment initiative among the mothers of rural Nagpur. J Clin Diagn Res. 2012;6(7):1215-8.

Shrivastava P, Saha I, Nandy S. A study on feeding practice of under 6 months infants attending the nutrition clinic of a tertiary care hospital of West Bengal, India. Epidemiology Biostatistics and Public Health. 2013;10:2.

Parashar M, Singh S, Kishore J, Patavegar BN. Breastfeeding attachment and positioning technique, practices, and knowledge of related issues among mothers in a resettlement colony of Delhi. ICAN: Infant, Child, and Adolescent. 2015;20(10):1-6.

Rahim F, Muhammad J, Ali S, Amir S. Breastfeeding practices in neonatal units. J Med Sci. (Peshawar, Print) 2014;22(4):159-63.

Costa SD, Engel-Hoek LVD, Bos AF. State of the art, sucking and swallowing in infants and diagnostic tools. J Perinatol. 2008;28:247-57.

Haider R, Rasheed S, Sanghvi TG, Hassan N, Pachon H, Isla S, et al. Available at: http://www.internationalbreastfeedingjournal.com/content/5/1/21.