الفهرس 
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Abstract
First years of an infant’s life are very important. This period is called golden age, the window of opportunity and critical period. The golden age is the period in which the growth of nerve cells and synapses occurs so rapidly that complex brain tissue (±80%) forms and absorbs information fastest. It is the period with opportunity to maximize all potential of the infant, where adequate nutrition; good health status, proper parenting, and appropriate stimulation help the infants achieve optimal ability. It is also called a vulnerable period where underweight in this period will have long-term and even permanent effects (MOH Indonesia, 2016; Are, 2018).
The adequate knowledge and practice of application of nutritional requirement must be the basis of infant feeding. The health and nutritional status of an infant and subsequent growth and development through child hood depend upon successful feeding practices, the socioeconomic status, education of mother, and family members have been known to influence infant’s feeding behavior, nutritional education is the important responsibility of the nurse to promote the nutritional status of the infants and to prevent nutritional deficiency diseases (Datta, 2018).
The aim of this study is to evaluate educational intervention for mothers having underweight infants through. Assessing knowledge and practices of mothers pre and post implementation of educational intervention program and assessing the improvement in growth of underweight infants post implementation of educational intervention program.
Research hypothesis: Educational intervention program will improve knowledge and practices of mothers having underweight infants resulting in improvement growth of infants
Research Design:
Aquasi-experimental research design (Pre/Posttest) was used in the current study.
Study setting: This study was conducted at south Giza Script which consists of three villages were Esaff, Atfeh and Alaiat that include 90 mother and child health centers (MCH) and distributed as follow Essaf included 28 MCH, Atfeh included 30 MCH and Alaiat included 32 MCH, So systematic sample was used to choose the numbers of MCH after every ten MCH as follow, from Esaff were taken three MCH were namely Shorfa village, Dicmy village and Esaff MCH. Atfeh were taken three MCH were Atfeh MCH, Ekebabat MCH and korimat MCH. Alaiat were taken three MCH were Alaiat MCH, Kafer ElRafaai MCH and ElRika MCH, where 9 MCH compromise this study.
Sampling: A purposive sample used in this study and their numbers were 200 mothers where these having underweight infant who their age were from two month to 12 months, full term, breastfeeding, and their weight were about 3.5 Kg to 8.5 Kg, and time allowed for carrying out the study program were twice per week for three months.
Three tools were used for data collection: Tools
The first tool: Interviewing questionnaires were used for assessing the following portions.
The first part was socio demography data about
- Underweight infants such as age, gender, and infant‘s number of family.
- Mothers of underweight infant such as level of education, job, period of work, Place of infants during work.
- Infant’s nutrition during work, Numbers of siblings, Month’s income of family, and the marital status.
The second part was knowledge of mothers having underweight infants about
Underweight such as definition, normal weight of infant at birth, normal weight of infant at 6 months, normal weight of infant at 12 months, follow the weight of infant, period of following, site of following, factors of underweight, signs of underweight, complication of underweight and prevention of underweight.
- Breast feeding such as definition, advantages, number of breastfeeding daily, periods of breast feeding without any addition, causes of artificial feeding, artificial feeding order, and determining the required amount of artificial feeding.
- Weaning such as definition, foods of infant during weaning, the principals of weaning, and causes of early weaning.
The second tool:
Check list were used to determine practices of mother about personal hygiene, breast feeding practices, and so weaning.
The third Tool: body infant assessment was used to determine underweight by taking weight, height, head circumference, and chest circumference.
Tools were used as the same before and after educational intervention program except socio demographic part.
Results:
1- Socio demography characteristics about underweight infant& mothers:
This table shows that 26% and 27% of underweight infants’ age were about from4 to 6 months and from10 to12 months, 64.0% were female and 33.5% were the fourth number at their family. 51.5% of underweight infants’ mothers were illiterate, 62.5% were work and 95.2% worked about 6 hours daily, while 84.8% leaved their underweight infants at their home, and 52.0% complementary foods were infants’ nutrition during their work, 64.5% of underweight infants had from 3 or 4siblings, 69.0% of month’s family income was about 1200, and 98.5% of underweight infants’ mothers were married.
2- Knowledge of mothers having underweight infants:
All the mothers didn’t define underweight infant, didn’t stated that normal range of infant weight, did not know that the infant is doubled weight at 6 months of age, didn’t know that the infant is doubled weight at 6 months of age, mentioned that gastro enteritis is the most factor causing underweight, stated that muscle weakness & delay teething are the most signs of underweight, stated that complication of underweight infants is physical and mental defects, and mentioned that the prevention of underweight was breast feeding continuously, while mothers ’knowledge about underweight improved post educational program. Defined breast feeding only as feeds the infant from the mother’s breast milk, stated that advantages of breast feeding helped infant’s growth, remembered that feed the infant when infant cried, while stated that breast feeding is not enough for infant growth during first year of life, gave breast feeding only for 4months of age, introduced fluids or foods during the first six months, gave fluids e.g peppermint and soft foods e.g boiled cereals, stated that causes of artificial feeding were work, remembered that doctor described artificial feeding and the required amount. While mothers ’knowledge about breast feeding improved post educational program. Defined weaning only as addition of other foods, fluids, semisolid or solid bedside to breast feeding, introduced soft foods at six months, stated that principals of weaning were feed the infant with carefully, and remembered that causes of early weaning were work while mothers ’knowledge about weaning improved post educational program.
3- Practices of mothers having underweight infants:
The majority of mothers didn’t practice hand washing before breastfeeding, breast washing, made special equipment for infant while mothers improved practices post educational program where their infants had special equipment, interested with their hygiene, washed vegetable and cooked food well. The mothers didn’t practice breastfeeding at first hour after delivery, didn’t give numbers of breast feeding are about 8-12feeds per day,, did not put the infant in semi-sitting position, didn’t put the nipple and aureole in the mouth of infant, didn’t exchange the two breasts in the one feeding, and didn’t rube the infant after breastfeeding while mothers improved practices post educational program where mothers always observed for putting their infants in semi-sitting position, put the nipple and aureole in the mouth of infant, exchanged the two breasts in the one feeding, and rube the infant after breastfeeding. The mothers didn’t practice weaning with starting with one juice glass instead of one breast feeding, didn’t exchange one meal with another every week, didn’t serve semisolid meal, didn’t stop meal when infant suffer from vomiting or diarrhea & didn’t give breast feeding only, didn’t increase numbers of meals with increasing of age and didn’t serve any additional meals rich with vegetables and fruits, while mothers improved practices post educational program where mothers always observed that starting with one juice glass instead of one breast feeding, exchanged one meal with another every week, serve semisolid meal, stopped meal when infant suffer from vomiting or diarrhea& didn’t give breast feeding only, and increased numbers of meals with increasing of age.
4- Physical assessment of underweight infants;
There is increment in weight of infant, height of infant, head circumference and chest circumference post program implementation with a highly significant statistical difference between pre and post program at p= 0.000.
5-Total scoring:
98% of the study sample were having unsatisfactory total knowledge about underweight pre - program while, 71.5 % of them were having satisfactory knowledge about underweight post program with highly significant statistical difference between pre and post program implementation at X2 = 243.3 at p= 0.000. majority of the study sample were having subtotal and total poor practices regarding personal hygiene, breast feeding and weaning pre-program while more than half of them were having good practices post program with highly significant statistical difference between pre and post program with X2= 148.4, 209.9, 209.2 and 212.9 at p= 0.000 for all. There are highly significant statistically positive correlation in pre and post intervention education program between total knowledge and total practices at r= 0.51 and 0.94 at p = 0.000 respectively. there are statistically insignificant differences related to age, gender, numbers of children, infant’s nutrition during work and total knowledge (P>0.05), while there are significant relation between job, numbers of siblings and total knowledge (P<0.05), and finally there are highly significant between mothers ‘educational level, family monthly income and total knowledge (P<0.001). There are statistically insignificant differences related to age, gender, numbers of children, infant’s nutrition during work and total practices ( P>0.05), while there are significant relation between job, numbers of siblings and total practices (P<0.05), and finally there are highly significant between mothers ‘educational level, family monthly income and total practices (P<0.001).