| ObjectiveIn this study, we conducted a survey on the current status of breast feeding,analysed the related factors affecting breast feeding and found out possiblereasons for the failure of breastfeeding, in order to provide theoretical guidancefor improving breastfeeding. And then went a step further to study on what isthe best time for the implementation of postpartum breast massage by groupintervention. The effects of breast massage on maternal lactation andbreastfeeding were analysed in each group, so that it can guide pregnant womenand their family members doing the proper breast massage and scientificbreast-feed, thus promoting the establishment and transformation of the roles ofmother, improving and extending the follow-up breastfeeding rate.Methods1. Descriptive research: This study selected300cases of maternal, who werehospitalized in the first affiliated hospital of Guangxi Medical UniversityObstetrics department during September to November,2012, as subjects. Using the self-made questionnaire, the perception and attitude ofbreastfeeding in postpartum maternal was investigated, and then theirbreastfeeding aspirations and the influential factors were analysed. Asummary of the current status of breast feeding was made and its influencingfactors were analysed for the purpose of finding out the reason/s for thefailure of breastfeeding.2. Intervention study: Hospitalized in the first affiliated hospital of GuangxiMedical University Obstetrics department during December,2012to July,2013,200cases of primipara who had undergone spontaneous delivery wereselected. Of which were then divided into four groups with50cases each,and according to the convenience sampling method, the four groups included3observation groups and1control group. The control group did not includebreast massage but only included the routine nursing care and givenpostpartum health education. Apart from the nursing care and healtheducation, the observation groups included breast massage but at differenttime intervals. Breast massage given2h after postpartum was madeobservation group1, while observation group2contained breast massagegiven12h after postpartum, and observation group3had breast massagegiven24h after postpartum. Massage this stretch15-20min on each side ofthe breast, for2consecutive days. The differences in the first time oflactation,48h lactation amount, breast distending pain, postpartumdepression and postpartum42days breastfeeding were observed andrecorded into these four groups. Thereafter the best time for postpartumbreast massage and their effects on breastfeeding was analysed. 3. The SPSS16.0statistical software was used to process the data. The mainstatistical analysis methods included the Descriptive analysis test, analysis ofvariance and chi-square.ResultsResults of the questionnaire1. The maternal women had a high awareness about the benefits ofbreastfeeding, it accounted for as high as87.3％in the puerperal, but theydid not fully understand the relevant skills of breastfeeding. Only few ofthem could sufficiently master those skills such as the lactation nursing skills(79.3%), breast-feed at night (73.6%) and others. The results also show thatmaternal women had a lower rate of understanding of breastfeedingknowledge in some special cases, such as whether maternal women with thehepatitis B carriers can breast-feed or not, or if they could continue to breastfeed when having a fever themselves, the correct rate being62.6%and58.7%respectively.2. The maternal women had a positive attitude toward breastfeeding.91.7%women were willing to breast feed.75.7%of the women will actively takethe initiative to find out ways to solve the problems arising during theprocess of breastfeeding.61.3%of the maternal were very confident towardsbreastfeeding.3. The lack of milk secretion was the main factor contributing to the failure ofearly maternal breastfeeding; it made up the highest rate of74.6%. And thenthe other influencing factors ranging from high to low successively werecesarean section(51.7%), the lack of breastfeeding knowledge(49.3%), lackof confidence(38.7%), affect the body physique(18.7%), and cracked nipplepain(15.6%) amongst others. Results of breast massage intervention1. Comparing the maternal women’s first lactation time from all four groups, itis found that the first lactation time was earlier in the observation group thanin the control group, and that the observation group1had a shorter firstlactation time than the observation groups2and3. The comparison betweenthese groups were statistically significant, two two comparison was ofP<0.01.2. The number of cases of maternal women having reached the adequateamount of lactation in48h after postpartum from more to less were in theorder of observation group1, observation group2, observation group3andthen the control group. There was a statistically significant differencebetween these four groups (P<0.05).3. The incidence rate of breast distending pain in the maternal women in theobservation group was lower than that of the control group. The observationgroup1had the lowest probability, and then second to it were the observationgroup2and group3. Differences between these groups were statisticallysignificant (p<0.05).4. Comparing the maternal women’s breastfeeding situation42days afterpostpartum, it is observed that the observation group was better than thecontrol group, and the observation group1had the highest success rate.There was statistically significant difference between these groups (P<0.01).Conclusion1. Mothers had a relatively good grasp of the breastfeeding knowledge, butsome also had a shortcoming regarding to the feeding techniques and feedingknowledge in special circumstances. We should thus strengthen the study ofthe correct feeding posture method and popularize the breastfeeding knowledge with respect to the special circumstances.2. Mothers had a positive attitude for breastfeeding. Most of them would mostlikely insist on breastfeeding and will actively find ways to solve problemsduring the feeding process. They also had a lot of confidence inbreast-feeding. But to the maternal who lacked confidence or was not willingto breast feed, it was necessary for the medical staffs to find out the reasonsand thereby gave them targeted health education.3. The reasons responsible for the failure of early breastfeeding could bedivided into three aspects, mainly personal factors, family and social factorsand obstetric factors.4. The best time for breast massage was in postpartum2h. When mothers werein the adjustment period, given breast massage could promote early lactationand multiple lactation, and at the same time it would reduce the incidence ofbreast pain. Moreover it could support and sustain any subsequentbreastfeeding. On the whole, the success rate of breast-feeding wasimproved.5. Breast feeding is a social problem. Many different aspects have to beconsidered and brought together when it comes to the improvement of thebreastfeeding rate. As professionals and institutions, we should summarizeand analyse the influencing factors, therefore, provide professional solutionsfor mothers by transmitting the correct breastfeeding knowledge, sharing theexperience of breastfeeding and introducing the latest technology andproducts. |
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