Publication: Yapılandırılmış emzirme eğitiminin sadece anne sütünü erken bırakma üzerine etkisi
Abstract
Giriş: Dünya Sağlık Örgütü tarafından önerilen, bebeğin ilk 6 boyunca hiçbir ek gıda almaksızın sadece anne sütüyle (SAS) beslenmesidir. Amaç: Çalışmamızda doğum öncesi ve sonrasında verilen emzirme eğitiminin SAS verme süresi üzerine etkisini belirlemek amaçlanmıştır Materyal-metot: Katılımcılar coğrafik ulaşılabilirlik göz önünde bulundurularak dört Aile Sağlığı Merkezinden (ASM) seçilmiştir. Bir ASM’ye kayıtlı gebeler kontrol diğerleri müdahale grubu olarak alınmıştır. Seçilen bütün ASM’ler Sağlık Bakanlığı tarafından verilen “Bebek Dostu ASM” sertifikasına sahiptir. Eğitim modülü ve doğum sonrası müdahale grubunun ikinci ay viziti Marmara Üniversitesi Hastanesi Aile Hekimliği bölümünde yapılmıştır. Müdahale grubuna emzirme ve anne sütü ile ilgili bilgileri ölçmek amacıyla eğitim öncesi ve sonrası test uygulanmıştır. Anneler, meme başıyla ilgili herhangi bir problem yaşayıp yaşamadıklarını öğrenmek amacıyla doğum sonrası 2. haftada aranmıştır. Müdahale grubunun anneleri 4. ayda telefon görüşmesi yapılan ve rutin izlenen olmak üzere randomizasyonla ikiye ayrılmıştır. Altıncı ayda kontrol grubu dahil bütün anneler sadece anne sütü verme sıklığını belirlenmesi amacıyla aranmıştır. Bulgular: Müdahale grubunda 82, kontrol grubunda 50 anne çalışmaya dâhil edilmiştir. Eğitim modülünün etkinliğini gösteren SAS verme sıklığı müdahale grubunda istatistiksel açıdan anlamlı yüksek bulunmuştur (%42,9 vs %22,2, p=0,001). Ek gıdaya başlama haftası ortalamaları kontrol grubunda daha erkendir (18,5±8 vs 15±9,5 hafta, p=0,03). Anneler ek gıdaya erken başlama sebebi olarak en sık “anne sütünün yetersizliğini” göstermişlerdir. SAS verilmesinde; ailenin gelir durumunun yüksek olması, annenin daha önceki bebeğindeki olumlu deneyimleri, gebeliğin planlı olması, hastaneden erken taburculuk ve babanın yüksek eğitim seviyesinin etkili olduğu saptanmıştır. Biberon kullanmanın ise emzirmeyi negatif etkileyen bağımsız bir faktör olduğu bulunmuştur. Dördüncü ay telefon görüşmeleri 12 yapılan grupla yapılmayan grup arasında SAS vermek açısından istatistiksel anlamda fark saptanmamıştır. Sonuç: Doğum öncesi yapılan eğitim modülü ve doğum sonrası 6. aya kadar izlem yapılarak SAS verme süreleri uzatılabilir. Benzeri grup eğitimlerinin birinci basamakta uygulanması etkili bir yöntem olarak işleri kolaylaştırabilir. anne sütü, emzirme, eğitim
Background: “Exclusive Breastfeeding” (EBF) means that the infant receives only breastmilk during the first 6 months of life and is suggested by the WHO Aim:The purpose of this study,was to determine the effects of an antenatal and postnatal breastfeeding education module on EBF duration. Materials methods:The participants of the study were pregnant women registered to a total of four family health centers selected based on their geographical accessibility.Pregnant women of one center formed the control group while others formed the intervention one.All of them were certified as “Baby Friendly” by the“Initiative” of Turkish Ministry of Health. The education module and postpartum second month’s visit have been run in the Marmara University Hospital Family Medicine department. A pretest and posttest were used to measure breastfeeding knowledge in the intevention group. Phone calls have been made on the second week after delivery to learn if any nipple problem had occurred. The mothers of the intervention group have been randomized into two groups to determine one group for reminder call and the other for routine follow up. All the participants including control group were called at the end of the postpartum 6th month to determine the rates of EBF. Results:A total of 132 mothers, 82 in intervention group and 50 in the control group were included in study. Statistically significant increase in the rates of EBF at the end of 6 months showed the effectiveness of the education module (%42,9 vs, %22,2,p=0,001). Suplemantary food taking time was early in the control group.(18,5±8 , vs, 15±9,5 week, p=0,03). The main reason of early weaning that reported by the mothers were “the insufficiency of the mother’s milk”.EBF were significantly associated with higher family income, previous positive breastfeeding experience, planned pregnancy, earlier discharge after delivery and high education 14 level of the father. Bottlefeeding was the only independent factor that affected breastfeeding negatively. Fourth month recalls did not changed EBF rates. Conclusion: Antenatal educational programme and follow up since postpartum 6. Months can be effective on exclusivebreastfeeding duration. Similar group educations can be an effective method to facilitate rather work in primary care. Key words: breast milk, breastfeeding, education
Background: “Exclusive Breastfeeding” (EBF) means that the infant receives only breastmilk during the first 6 months of life and is suggested by the WHO Aim:The purpose of this study,was to determine the effects of an antenatal and postnatal breastfeeding education module on EBF duration. Materials methods:The participants of the study were pregnant women registered to a total of four family health centers selected based on their geographical accessibility.Pregnant women of one center formed the control group while others formed the intervention one.All of them were certified as “Baby Friendly” by the“Initiative” of Turkish Ministry of Health. The education module and postpartum second month’s visit have been run in the Marmara University Hospital Family Medicine department. A pretest and posttest were used to measure breastfeeding knowledge in the intevention group. Phone calls have been made on the second week after delivery to learn if any nipple problem had occurred. The mothers of the intervention group have been randomized into two groups to determine one group for reminder call and the other for routine follow up. All the participants including control group were called at the end of the postpartum 6th month to determine the rates of EBF. Results:A total of 132 mothers, 82 in intervention group and 50 in the control group were included in study. Statistically significant increase in the rates of EBF at the end of 6 months showed the effectiveness of the education module (%42,9 vs, %22,2,p=0,001). Suplemantary food taking time was early in the control group.(18,5±8 , vs, 15±9,5 week, p=0,03). The main reason of early weaning that reported by the mothers were “the insufficiency of the mother’s milk”.EBF were significantly associated with higher family income, previous positive breastfeeding experience, planned pregnancy, earlier discharge after delivery and high education 14 level of the father. Bottlefeeding was the only independent factor that affected breastfeeding negatively. Fourth month recalls did not changed EBF rates. Conclusion: Antenatal educational programme and follow up since postpartum 6. Months can be effective on exclusivebreastfeeding duration. Similar group educations can be an effective method to facilitate rather work in primary care. Key words: breast milk, breastfeeding, education