Evaluative Study On Knowledge Of Postnatal Mothers Of Their BabiesAdmitted In Nicu Regarding Breastmilk Expression And Its Storage

“Breast milk is the best nothing that money can buy is good for baby as breast feeding”

Breast milk is accepted as unique, natural and nutritious food, provided by the nature for newborn1. The preterm baby should fed with unboiled milk obtained from their mothers. There are logistic difficulties to ensure feeding of babies with human milk every 2 hourly round the clock. To circumvent this difficulty, the neonatal unit should establish facilities to store expressed breast milk (EBM) obtained from the mother whose babies are admitted in NICU2. Expression and storage of breast milk is way to maintain breastfeeding when mother and infant are separated³.

Expression of breast milk having 2 methods. Manual expression of milk and expressing with a breast pump. The manual expression of milk costs nothing and practiced any where by the mother and it causes a higher level of prolactin release which will help to maintain lactation over a long period. It is the most efficient method of obtaining colostrums. Expressing with a breast pump are several types: electrical and manually controlled breast pumps⁴ .

One common reason for manually expressing or pumping the breast milk is to store breast milk for bottle feeding. This can be done safely if some guidelines are followed. First the milk should be expressed in to a container that has been sterilized by immersion in boiling water for 5 minutes. Breast milk can then be poured in to sterilized bottle and refrigerated up to 24 hours or it can be frozen, in which cuse it will last up to 4 months⁵.

Promotion of early initiation of breast feeding has the potential to make a major contribution to the achievement of the child survival millennium development goal, 16% of neonatal deaths could be saved if all infants were breastfed from day one and 22% if breast feeding started within the first hour⁶. 

OBJECTIVES

1. To assess the pretest knowledge of postnatal mothers regarding breast milk expression and its storage at selected hospitals Tumkur.

2. To develop and administer Structured Teaching Programme on breast milk expression and its storage among postnatal mothers of their babies admitted in NICU at selected hospitals Tumkur.

3. To assess the effectiveness of STP by the pre and post test knowledge score of postnatal mothers regarding breast milk expression and its storage.

4. To find out the association between the posttest knowledge score with demographic variables.

METHODOLOGY

The study adopted a Evaluative approach and pre-experimental reserch design. The sample consisted of 50 postnatal mothers of their babies admitted in NICU at selected hospital, Tumkur. Purposive sampling technique was opted to select the samples. The postnatal mothers whose babies are admitted in NICU, Who were willing to participate in the study,Who were present during time of data collection,Who were able to speak Kannada or English were included. The data collection tool was developed by the researcher and it includes, Part-I included Demographic characterstics of postnatal mothers such as age, educational status, religion, monthly income, area, parity, type of delivery. Part-II: Multiple choice questionnaires to assess the knowledge of postnatal mothers regarding breast milk expression and its storage. The total score of knowledge questionnaires are catagorized as adequate in 66.7% of subjects and moderate in 23.3% subjects and inadequate in 10% in post test. The content validity was done. Reliability was established by split half method by using Spearman Brown Prophesy formula. The reliability co-efficient of the tool obtained was r = 0.80. Prior to the data collection ethical permission was obtained. Consent was taken from postnatal mothers. 

RESULTS

1. Description of sample characterstics of postnatal mothers.

The majority of the postnatal mothers (65%) belongs to the age group of 26-30 years, 50% of the postnatal mothers had their education of degree, 41.6% of the mothers were belongs to hindu religion, 63.3% of postnatal mothers had their monthly income of >7000 rs. 60% of the mothers were living in urban area, 65% of the mothers were primi mothers, 50% of the mothers are having normal delivery.

2. To Assess The Existing Knowledge Of Postnatal Mothers Regarding Breastmilk Expression And Its Storage.

The findings of the study showed that, the level of knowledge regarding breast-milk expression and its storage is inadequate in 61.7% of subjects and moderate in 31.7% subjects, and adequate in6.6% of subjects in pre test. Over all mean is 18.06 and Standard deviation is 3.23 and Mean percentage is 45.16 in pre test.

3. To Compare The Significant Differences Between Pre Test & Post Test Knowledge Score Of Postnatal Mothers Regarding Breastmilk Expression And Its Storage. 

The table-1 and figure-1 shows 10% postnatal mothers had inadequate knowledge and 23.3% postnatal mothers had moderate knowledge and 66.7% postnatal mothers had adequate knowledge on breast-milk expression and its storage in post test. 

4. Association Between The Demographic Variables And Post Test Knowledge Of Postnatal Mothers Regarding Breast-Milk Expression And Its Storage. 

Assosiation between the demographic variables and post test knoledge of postnatal mothers regarding breastmilk expression and its storage was analysed using chi-square test. The results showed that the demographic variables such as, age ( x2 =6.89, p<0.05), educational status ( x2 =9.59, p>0.05), religion (x2 =2.26, p<0.05), monthly income (x2=1.33, p<0.05), area (x2=0.32, p<0.05), parity(x2=6.9, p>0.05), type of delivery (x2=9.59, p>0.05). Educational status, Parity, and Type of delivery are significant. The other variables such as age, religion, monthly income, residential area, are not significant. Hence reject null hypothesis and accept research hypothesis that administration of structured teaching program can improve the knowledge of postnatal mothers regarding breast-milk expression and its storage.

DISCUSSION

Here this study evaluates the effectiveness of structured teaching program on knowledge regarding breast milk expression and its storage among postnatal mothers in selected hospitals at Tumkur. A pre-experimental pretest, post-test design was used to assess the effectiveness of structured teaching program on knowledge regarding breast milk expression and its storage among postnatal mothers. A structured knowledge questionnaire used to collect to data. A structured teaching program was implemented to find out effectiveness. Association of post e-test knowledge score with demographic variables was done using chi-square test. Present study showed that educational status, parity, type of delivery, showed a significant association with post-test score where as Age, religion, monthly income, residential area, is not significant. As expected hypothesis of the study the investigator found that there was Significant association between the knowledge on breast milk expression and its storage and Demographic variables of postnatal mothers. Hence hypothesis (H2) is proved.

CONCLUSION

The study conclude that,The pretest showed that knowledge of postnatal mothers regarding breast milk expression and its storage was inadequate in all areas.The structured teaching programme tested in this study was found to be effective in improving the knowledge of postnatal mothers participated in the study. The structured teaching programme is an effective method in improving the knowledge of postnatal mothers.The study proved that educational status, parity, type of delivery, showed a significant association with post-test score where as age, religion, monthly income, residential area, is not significant.