Effectiveness of STP on Knowledge of Postnatal Mothers RegardingBreastmilk Expression and Its Storage

INTRODUCTION

Breast milk is accepted as unique, natural and nutritious food, provided by the nature for newborn¹. The preterm baby should be fed with unboiled milk obtained from their mothers. There are logistic difficulties to ensure feeding of babies with human milk every second 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 separated.³

There are two methods for expression of breast milk. Manual expression of milk and expressing with a breast pump. The manual expression of milk costs nothing and can be practiced anywhere 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 colostrum. Expressing with a breast pump can be done by either electrical or manually controlled breast pumps.⁴

One common reason for manually expressing or pumping the breast milk is to store breast milk which can be fed later in case of working mothers or mothers who do not have own milk. 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 case it will last up to 4 months.⁵

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 hour.⁶

OBJECTIVES

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

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

3. To find out the association between the post-test knowledge score with demographic variables.

METHODOLOGY

The study adopted an evaluative approachand preexperimental one group pre-test post-test research design. Thesample 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 were admitted in NICU, willing to participate in the study, who were present during time of data collection and able to speak Kannada or English were included. The data collection tool was developed by the researcher and it included, demographic characteristics of postnatal mothers such asage, educational status, religion, monthly income, area, parity, type of delivery. A multiple choice questionnaires was used to assess the knowledge of postnatal mothers regarding breast milk expression and its storage. The total score of knowledge questionnaires are catagorizedas adequate( score>75%), moderate (50-75%) and inadequate (<50%). The content validity was done. Reliability was established by split half method by using Spearman Brown Prophesyformula. The reliability co-efficient of the tool obtained wasr = 0.80.Prior to the data collection ethical permission was obtained. Consent was taken from postnatal mothers.

RESULTS

I. Description of demographic characteristics of postnatal mothers.

The majority of the postnatal mothers (65%) belonged to the age group of 26-30 years, 50% of the postnatal mothers had completed degree education, 41.6% of the mothers belonged to Hindu religion, 63.3% of postnatal mothers had monthly income of more than 7000 Rupees, 60% of the mothers were living in urban area, 65% of the mothers were primi mothers, 50% of the mothers had normal delivery.

II. 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 was in adequate in 61.7% of postnatal and moderate in 31.7% subjects, and adequate in 6.6% of subjects in pre-test. Over all mean was 18.06 with SD 3.23 and Mean percentage 45.16 in pre-test. In post-test 10% postnatal mothers had in adequate knowledge and 23.3% postnatal mothers had moderate knowledge and 66.7% postnatal mothers had adequate knowledge on breast-milk expression and its storage inpost-test.

III. Effectiveness of STP on knowledge of postnatal mothers regarding breastmilk expression and its storage

Table 1, shows that the pre-test overall mean score was 18.06 and standard deviation is 3.23, in post test overall mean was 31.93 with a SD 1.69. The paired t test value was 29.67 which was higher than the table value of 6.68. Hence the teaching program was effecting in terms of enhancing the knowledge of postnatal mothers regarding breastmilk expression and its storage.

IV. 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-testknowledge of postnatal mothers regarding breastmilk expression and its storage was analysed using chi-square test. The results showed that there was an association between the demographic variables such as, educational status (x2 =9.59, tab value=7.82).

DISCUSSION 

Present study evaluated the effectiveness of structured teaching program on knowledge regarding breast milk expression and its storage among postnatal mothers in selected hospitals at Tumkur. The pre-test findings of the study revealed The findings of the study showed that, thelevelof knowledge regarding breast-milk expression and its storage was in adequate in 61.7% of postnatal mothers. The pre-test overall mean score was 18.06 and standard deviation is 3.23, in post-test overall mean was 31.93 with a SD 1.69. The paired t test value was 29.67 which was higher than the table value of 6.68. Hence the teaching program was effecting in terms of enhancing the knowledge of postnatal mothers regarding breastmilk expression and its storage. 

The findings of study depicted a real evidence of significance between pre-test and post-test knowledge scores.

CONCLUSION  

The study concludes 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. 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, neonatal deaths could be saved if all infants were breastfed from day one and if breast feeding started within the first hour.