Implementation of early breastfeeding education to enhance breastfeeding success in first 6
months of life
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While exclusive breastfeeding has many benefits to the mother and child, early
termination of breastfeeding is the leading cause of a high mortality rate among children below
the age of five years. Millions of children die annually from diseases that could otherwise have
been prevented. Premature deaths among infants can be averted through breastfeeding. Exclusive
breastfeeding from day one is critical for the endurance of the child; however it is also
responsible for healthy brain development. It forms the basis of good nutrition and safeguards
children against any sickness. In reality, approximately less than the globe’s newborns profit
from early breastfeeding, however a handful of them are exclusively breastfed during their first
six months (Blyth et al .2009). According to World Health Organization (WHO) breastfeeding
should commence one hour after birth to stir milk generation, enhance uterine activity and is also
likely to curtail the danger that comes with excessive bleeding and contagion. In the end, it helps
to foster a strong bond between mother and children while enhancing the period of breast-
Whilst breastfeeding play a pertinent role when it comes to safeguarding the child against
premature death related diseases, the employment of breastfeeding education involvements
developing nations is likely to present challenges and contextual variables that may impact
breastfeeding period. These variables should be based on income disparities, as findings in
Uganda and South America has indicated that white collar women or those that are financially
empowered are more likely to curtail breastfeeding early on than those without. Research has
largely been done developed nations, and yet studies should be scaled up in various settings
across the world, to help document the really issue on the ground. Limited evidence suggests that
it may be possible to scale up even with relatively “low-intensity interventions” as established by
research findings in Mexico City.
Moreover, the obtainability and use of infant formula may equally present an important
challenge, especially in settings with prevalent HIV-contagion. The issue may be multifarious
in setting where global standards of marketing breastfeeding milk alternatives or analogous
policy controlling the promotion of formula has not been approved and infant formula is easily
accessible as existing nutrition schemes. Furthermore, clinical experiments have not been done
adequately especially in low and middle-income nations, when it comes to investigating the
advantages of antenatal breastfeeding training on breastfeeding instigation, limited breastfeeding
rate and period (Taveras et al. 2013). However, implementing breastfeeding education, require
altered modes of delivery, such as one-on-one, cluster and peer-led sessions, in homes and
healthcare unit settings. Ultimately, practitioners ought to receive pre-and in-service coaching on
how to assist mothers with the deterrence and treatment of common breastfeeding issues, that
finally culminate to breastfeeding cessation (Webb et al. 2012).
Impact of the problem
Research shows that breastfeeding has vital benefits for not only the child but also the
mother. A methodical analysis of the impacts of breastfeeding on maternal and infant health
established that breastfeeding cessation enhances the likelihood for perilous pestilence, such as
newborn death syndrome, atopic dermatitis and chronic lower respiratory. The valuable health
impacts of breastfeeding continue beyond breastfeeding time-frame. A review conducted by
World Health Organization (WHO) indicated that children that are not breastfed have the
propensity for higher blood pressure, enhanced risk of type 2 diabetes, enhanced risk of obesity,
and low tests when it comes to intelligence tests. Moreover, children that miss their mother’s
milk are also equally at an increased threat of type one diabetes, asthma, children leukemia.
Further research also demonstrates the significance of six months of exclusive breastfeeding as
the security against gastrointestinal and respiratory tract and pneumonia.
Another research indicates that longer duration of breastfeeding culminated to greater
persistent weight loss. Enhanced risk of postpartum depression is linked to not breastfeeding. On
the long haul, for women in developed nations, type 2 diabetes is linked to the lack of
breastfeeding. Diseases such as breast cancer, ovarian cancer, hypertension as well as
cardiovascular are equally associated with not breastfeeding (Taveras et al. 2013). It also has a
far reaching broader fiscal and social benefit. Early breastfeeding cessation has economic
implications for both children and mothers. It may also safeguard against the maltreatment and
abuse of the child. Optimum breastfeeding of children under the age of two years has the utmost
potential impact on child endurance all deterrent involvements, with the prospects to deter over
Children that are exclusively breastfed have at least 6 times greater chance of survival in
the formative months as opposed to non-breastfed kids. Children that are exclusively breastfed
are fourteen times less likely to die in the first 6 months than a non-breastfed child; breastfeeding
radically lessens deaths from chronic respiratory contagion and diarrhea, as two main child
killers (Lancet 2008). The possible effect of optimal breastfeeding culture is particularly
pertinent in les developed economies with a huge burden of disease and low access to clean
water as well as sanitation.
Nonetheless, non-breastfed kids in developed economies are at a greater threat of dying,
where latest research of post-neonatal death in US established a twenty five percent increase in
mortality among non-breastfed infants. In the United Kingdom for instance, the Millennium Unit
Assessment, indicated that breast feeding is related to a fifty three decrease in hospital
admissions for diarrhea and a twenty seven percent decrease in respiratory tract infections
(Wolfberg et al. 2014).
Whereas breastfeeding rates are no longer decline deteriorating at the global level, with
various nations experiencing pertinent increases in the last 10 years, about thirty nine percent of
kids less than 6 months of age in struggling economies are exclusively on their mothers breast,
however, about fifty eight percent of twenty to twenty three months olds benefit from the culture
of continued breastfeeding (Taveras et al. 2013).
15 Peer Reviewed Articles that discuss Breastfeeding
Two of the articles used recognized racial groups in the investigation of breastfeeding.
For instance, a study by Blyth et al (2009) carried out in central Indiana and New Jersey
investigated non-Hispanic African-America, whites and Latina breastfeeding mothers. In
addition, Britton, et al. (2010) selected women from Bradford which involved white British and
mothers with Asian origin. Much as these studies attempted to integrate racial groups, Taveras et
al. (2013) study never recognized racial groups particularly with UK mothers sampled from
economically deprived regions.
Constructs of planned behavioral theory are assessed with a Likert scale questionnaires,
questions are aimed at this theory. Falceto, Giugliani & Fernandes, (2014) suggest a nine step
technique to develop planned behavioral theory questionnaire. Stage 8 entails questionnaire
testing while stage 9 is basically test-rearrange of consistency. In the reviewed articles, Forster,
McLachlan & Lumley, (2013) and Gist & Mitchell, (2012) demonstrated instrument consistency
evaluating using alpha. With the case of Hector & King, (2009) the study demonstrated alpha for
questionnaire consistency. Additionally, Hector, King and Webb, (2012) reported that the aspect
of elicitation research was utilized in the creation of planned behavioral theory questionnaire.
While Hector, King, Webb & Heywood, (2010) does not recognize the basis of the
questionnaire utilized in the study. Assessing some of the questions offered by a study by Hector,
King, Webb & Heywood, (2010) shows that there is a connection to questions illustrated in
Bronner et al. (2011) study. Generally, planned behavioral theory creation involved social norms,
mind-set and alleged behavioral control as the main concepts to set findings demonstrated in the
studies. These studies demonstrated that the purpose to breastfeed was strongly related to the
breastfeeding behavior. Planned behavioral constructs including mind-set, social norms and
alleged behavioral control were strong parameters of purpose; nevertheless, these differed in
terms of strength.
A study by (Ertem, Votto & Levnthal, 2009) indicated that breastfeeding had a strong
positive correlation with purpose as well as alleged behavioral control. The ability of planned
behavioral when it comes to forecasting the purpose of breastfeeding differed in relative
significance among the respondents (DiGirolamo et al. 2009). On the other hand, Hector, King,
Webb & Heywood, (2010) showed that ethnicity and education were main parameters of the
purpose to breastfeed. Furthermore, Bronner et al. (2011).indicate that for every racial group
finding were considerable intuitive. The components of planned behavioral theory for calculating
the purposes for breastfeeding differed based on the racial group; for instance, among whites and
non-Hispanic African American women attitude and social customs were strong parameters
while for Latino women alleged behavioral control was the primary indicator. Factors not related
to behavioral theory such as age and education were strongly related to breastfeeding, in addition
to purpose to breastfeed and attitude to breastfeed in economically deprived regions.
Social customs, attitude and alleged behavioral control are strongly related to purpose of
breastfeeding in all the articles. As mentioned earlier, Wolfberg et al. (2014) recognized the
differences based on the faced that ethnicity is decreased using the assessment of planned
behavioral theory themes strong in every racial group. In Webb et al. (2012) study alleged
behavioral control was the main indicator. Moreover, they extended their investigation of
participants such as disposed actors, abstainers, opposed abstainers to enhance the intervention of
breastfeeding. No evidence was presented based on this breakdown and no assessment with other
studies was practical.
Effectiveness of Interventions
Breastfeeding awareness has been suggested by a number of previous studies to not only
support but also in the promotion of breastfeeding practice. Nevertheless, educational initiatives
are inadequately identified and differ in accordance with timing pattern, strategies making them
intricate to assess. In nine systematic reviews, regarding initiatives to promote breastfeeding,
educational initiatives that begin from prenatal as well as postnatal are most appropriate (Hector
et al. 2004). For example, the systematic reviews reported that an integration of group awareness
session, home visits that commenced in ante-natal through to postnatal was appropriate
technique in enhancing breastfeeding period. However, these reviews fail to present intervention
details such as information regarding educational technique, learning activities and material,
frequency and time frame for every session, educators’ skills (Falceto, Giugliani & Fernandes,
Educational techniques aimed at enhancing maternal self-effectiveness are appropriate
compared to techniques that concentrate on knowledge transfer. Nonetheless, few techniques
purpose to increase self-effectiveness have been investigated. For example among Canadian
mothers who observed breastfeeding role models through videos considerably enhanced their
breastfeeding effectiveness compared to those who never watched. Australian women,
breastfeeding frequency after postpartum is considerably enhanced among those with knowledge
when it comes to breastfeeding education (Win et al. 2009).
Mothers who get support are not likely to discontinue breastfeeding prior to five months
than other kinds of breastfeeding after 5 months. The function of the mother’s social networking
with family members is not included in the support intervention. A few studies target spouses of
expectant mothers (Falceto, Giugliani & Fernandes, 2014). These studies men are usually
encouraged to support one another with the objective of promoting breastfeeding. They also have
the responsibility of supporting their spouses. Women whose partners participated in these
studies considerably initiated breastfeeding unlike mothers whose partners never took part. But
this support initiative was not effective when it comes to increasing breastfeeding time. These
studies only involve making instead of a couple, therefore for better outcome both male and
female should be included to explore their own techniques while making plans to help one
Blyth, R., Creedy, D., Dennis, C.-L., Moyle, W., Pratt, J., & De Vries, S. (2009). Effect of
maternal confidence on breastfeeding duration: An application of breastfeeding self-
efficacy theory. Birth, 29(4), 278-284.
Britton C, McCormick FM, Renfrew, M., Wade, A., & King, S. (2010). Support for
breastfeeding mothers Cochrane Library, 1-61.
Bronner, Y., Barber, T., Vogelhut, J., & Resnik, A. (2011). Breastfeeding peer counseling:
results from the national WIC survey. Journal of Human Lactation, 17(2), 119-125.
DiGirolamo, A., Thompson, N., Martoel, R., Faden, S., & Grummer-Strawn, L. (209). Intention
or Experience? predictors of continued breastfeeding. Health Education and Behavior,
Ertem, I., Votto, N., & Levnthal, J. (2009). The timing and prediction of the early termination of
breastfeeding Paediatric 107, 543-548.
Falceto, O., Giugliani, E., & Fernandes, C. (2014). Couples’ relationships and breastfeeding: Is
there an association? Journal of Human Lactation, 20(1), 46-55.
Forster, D., McLachlan, H., & Lumley, J. (2013). Factors associated with breastfeeding at six
months postpartum in a group of Australian women. International breastfeeding journal
Gist, M., & Mitchell, T. (2012). Self-efficacy: A theoretical analysis of its determinants and
malleability. The Academy of Management Review, 17(2), 183-210.
Hector, D., & King, L. (2009). Interventins to Encourage and Support Breastfeeding NSW public
Health Bulletin, 16(3-4), 56- 61.
Hector, D., King, L., & Webb, K. (2012). Overview of recent reviews of interventions to
promote and support breastfeeding. . Sydney: NSW Centre for Public Health Nutrition.
Hector, D., King, L., Webb, K., & Heywood, P. (2010). Factors affecting breastfeeding practice:
applying a conceptual framework. NSW Public Health Bulletin, 16(3-4), 52-55.
Win, N., Binns, C., Zhao, Y., Scott, J., & Oddy, W. (2009). Breastfeeding duration in mothers
who express breastmilk : a cohort study International breastfeeding journal, 1(28), 1- 28.
Wolfberg, A., Michels, K., Shields, W., O’campo, P., Bronner, Y., & Bienstock, J. (2014). Dads
as breastfeeding advocates: Results from a randomized controlled trial of an education
intervention. American Journal of Obstetrics and Gynecology, 191, 708-712.
Taveras, E., Capra, A., Braveman, P., Jensvold, N., Escobar, G., & Lieu, T. (2013). Clinician
support and psychosocial risk factors associated with breastfeeding discontinuation.
Pediatrics, 112(1), 108-115.
Webb, K., Marks, K., Lund-Adams, M., & Abraham, B. (2012). Towards a national system for
monitoring breastfeeding in Australia: recommendations for population indicators,
definitions and next steps. Canberra: Australian Food and Nutrition Monitoring Unit,
Commonwealth Department of Health and Aged care.