الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 287 |  |  |
| | | from | 287 | | |
Abstract
Summary
Breastfeeding is feeding of an infant or a young child from the mother’s breast milk. The decision to breastfeed is influenced by both the knowledge and attitude of mothers toward breastfeeding. Some mothers have inadequate knowledge regarding the benefits and importance of breastfeeding that result in not practicing. Furthermore, positivematernal attitudes toward breastfeeding are associated with continuing longer breastfeeding and have a higher chance of success. On the contrary, negative views of women toward breastfeeding are considered to be a significant barrier to initiate and continue breastfeeding. The knowledge of mothers about breastfeeding is very important. During the pregnancy, a mother should get ready to breastfeed her baby, and this is a critical time to acquire information and to increase knowledge about breastfeeding. Authorities, physicians, and other sections of the health-care departments are responsible for providing information for pregnant mothers about all breastfeeding aspects and prepare them to make a decision (Ahmed & Piro, 2019)
The aim of this study was to evaluate the effect of instructional guideline for pregnant woman on breastfeeding in the early postpartum period through:
1- Assessment of knowledge of pregnant woman regarding breastfeeding in the early postpartum period.
2- Designing and implementing instructional guideline for pregnant woman regarding breastfeeding in the early postpartum period.
3- Evaluating the effect of the instructional guideline on knowledge regarding breastfeeding in the early postpartum period.
4- Evaluating the effect of the instructional guideline on practice regarding breastfeeding in the early postpartum period.
Research hypothesis:
Instructional guideline for pregnant woman will improve breastfeeding in the early postpartum period.
Research Design:
Experimental research design was used to conduct the study.
Research setting:
The study was conducted at antenatal care clinic of Obstetrics and Gynecology Hospital affiliated to Ain Shams University.
Subjects:
A simple random sample of 72 pregnant women who were admitted at the previously mentioned setting were involved in this study.
Tools of data collection:
The following two tools will be used
Tool I: Structured interviewing questionnaire:
It was designed by the researcher after reviewing the related literature (Piro and Ahmed 2020), consisted of 58 questions. Data was collected by using the self-administered questionnaire after obtaining informed consent. It was written in an Arabic language for gathering data and was used pre and post guideline. It included three parts to assess the following:
Part 1: It was designed to assess personal characteristics of the pregnant women such as age, place of residence, level of education and job. It included 5 questions from 1-5.
Part 2: It was designed to assess pregnant women’s obstetric history such as previous pregnancy, previous abortions, follow up during pregnancy, breast self-examination during pregnancy and breast care during pregnancy. It included 9 questions from 6-14.
Part 3: It was designed to assess pregnant women’s knowledge about breastfeeding such as definition, benefits…...…. etc. It included 44 questions from 15-58.
Scoring system:
The scoring system ranging from (1-3) in which (1) denotes incorrect answer, (2) denotes incomplete correct answer and (3) denotes complete correct answer the total knowledge score was categorized into three categories from total knowledge equal 100%: A score below 60.0 % denotes poor knowledge, A score from 60.0% to 75.0 % denotes average knowledge and score above 75.0 % denotes good knowledge.
Tool II: Observational checklist for breastfeeding practices
It was adopted from Abd El Hamid (2000) and was modified by the researcher including 29 statements to evaluate postpartum women’s practice regarding breastfeeding such as breast massage, hand expression, breastfeeding technique……. etc. It was utilized post guideline.
Scoring system:
The scoring system ranging from (1-2) in which (1) denotes not done practice and (2) denotes done practice. These scores were summed up and were converted into a percentage score. It was classified into two categories as the following:
- Satisfactory if score ≥ 80%.
- Unsatisfactory if score < 80%.
In addition, supportive material which is instructional guideline regarding breastfeeding was used.
Results:
• The current study result showed that, 81.9% of the studied women were in age group20-35years with mean age 23.24 ±4.52 years and 68.1% of them were from rural residence. Also, 75.0% of them had secondary level of education and 81.9% of them were housewives.
• Regarding obstetric and gynecological history of studied pregnant women, 94.4% of the studied women had no previous pregnancy and no previous abortion. Also, 100.0% of them committed to regular follow up during pregnancy. Additionally, 86.1% of them didn’t perform self-breast examination during pregnancy while 100.0% of them performed breast care during pregnancy where the most common style of breast care among 44.4% of them was wash it with soap and water. Moreover, 100.0% of them reported that breastfeeding is their preferred infant feeding method.
• 6.9% of the studied pregnant woman had good level of knowledge regarding breastfeeding at pre instructional guidelines which improved post instructional guidelines to 80.6%. with highly statistically significant difference with p-value =0.000.
• The most common source of information among the studied pregnant women was social media as reported by 59.7% of them followed by doctors by 20.8% of them. Also, 15.3% was from mother while only 4.2% of them was from books and magazines and 2.8% was from nurses.
• Moreover, 87.5% of the studied pregnant women demonstrated satisfactory total level of practice regarding breastfeeding in the early postpartum period.
• Furthermore, there was a significant statically relationship between total level of knowledge pre and post instructional guidelines among the studied pregnant women and their age and educational level
• Additionally, there was a significant statically relationship between total level of practice post instructional guidelines among the studied pregnant women and their educational level at P-Value =0.028. While, there was no significant statically relationship between total level of practice post instructional guidelines among the studied pregnant women and their age, residence, occupation and previous pregnancy at P-value =0.173, 0.924, 0.132 and 0.074 respectively.
• Finally, there was a significant statistical positive correlation between total level of knowledge and total level of practice post instructional guideline among the studied pregnant woman at P- value=0.005.
Conclusion
In the light of the current study findings, it can be concluded that,
Minority of the studied pregnant woman had good level of knowledge regarding breastfeeding at pre instructional guideline which improved post instructional guideline to most of them. Additionally, there was a significant statistical difference in total level of knowledge regarding breastfeeding among the studied pregnant woman between pre and post instructional guideline implementation at P value =0.000 and most of the studied pregnant women demonstrated satisfactory total level of practice regarding breastfeeding in the early postpartum period post instructional guideline. additionally, there was a significant statistical positive correlation between total level of knowledge and total level of practice post instructional guideline among the studied pregnant woman at P- value=0.005.
Recommendations
Based on the current study finding the following recommendations were proposed:
Conduct workshops regarding breastfeeding for women at third trimester during antenatal follow up.
Booklets, posters and brochures should be available and distributed in all MCH and health centers to all women about breastfeeding.
Further research should repeat the study in a different geographic location for maternity setting in Egypt.