Health Education Regarding Breast Feeding
Benefits of Breast Feeding
Breast-feeding continues to be the gold standard for feeding infants, as it provides nutritional, immunological, cognitive, and psychological benefits for young children.
Recently, a burgeoning body of research in the immunological and biochemical sciences has continued to identify the unique properties and unreplaceable living tissue transferred to infants and children through breast-feeding.
Breast And Medical Issues
These studies have made the connection between breast-feeding and a decreased risk of illness and health problems in infants and children, supporting its importance and necessity to the health of humans ( Heinig , 2001).
Once seen as a personal lifestyle choice, documentation of the superiority of breast-feeding to the health and well-being of infants, children, and women, has led to the recognition that breast-feeding is a health care behavior.
There continues to be a large discrepancy in the United States between breast-feeding rates, especially according to income, education, race, and ethnicity (Ahluwalia , Morrow, Hsia, & Grummer - Strawn , 2003).
When breast-feeding is examined as a health care behavior, nurses have an opportunity for health promotion and disease prevention among mother-child dyads which can affect all of society.
The Healthy People 2010 (2000) national health objectives target, 75% initiation of breast-feeding, 50% breast-feeding at 6 months, and 25% breast-feeding children until 1 year of age.
Breast Feeding And Role Of Health Care Providers
Breast-feeding has an international and interdisciplinary focus. Many professionals from various arenas of health care and the sciences are interested in lactation and the field continues to grow; however, experts, especially lactation consultants, are still underutilized.
Nurses have intimate contact with women at key times to make a difference in their breast-feeding experiences. The majority of nursing breast-feeding research relates to promotion, protection, and support of breast-feeding.
Breast Feeding Ans Nursing Research
Breast-feeding researchers in nursing examined the policies and practices that impact breast-feeding initiation. Nurse scientists continue to develop instruments to assess breast-feeding (Dennis, 2002; Riordan, Bibb, Miller, & Rawlins, 2001).
More research is needed into nurses' influence on the decision to breast-feed and their roles in promoting and reinforcing women's decision. Researchers have demonstrated the importance of health care professionals' recommendations to mothers (Ahluwalia et al., 2003).
Nurses need updated education based on research to provide this support at critical times, and to identify women at risk for complications carly on, so that interventions can be initiated and referrals made in a timely fashion to preserve the breast-feeding relationship. They need to be aware of new research on breast- feeding in areas such as: breast reduction/ augmentation surgery, HIV status, medical conditions, and drugs.
Careful assessment of the benefits and risks of not breast-feeding should be in the forefront in nursing research.
Role Of Health Care Institutes Or Hospitals In Promotion Of Breast Feeding
The advent of the Breastfeeding-Friendly Hospital Initiative in 1997 in the United States by United Nations Children's Fund (UNICEF) encouraged the identification of practices that impact breast-feeding duration.
Studies have demonstrated the negative effect on breast-feeding initiation and duration of: labor medications, vigorous sucking, foreing baby to breast, ineffective positioning, early introduction of pacifiers, delayed feedings, routine separation of mother and baby, failure of nurses to frequently assess
Breastfeeding encounters, use of supplements, and provision of gift packs with promotional materials for artificial infant milk (Auerbach, 2000). In contrast, a meta-analysis of over 35 studies demonstrated that breast-feeding educational programs had the greatest single effect on initiation and short term duration of breast-feeding, although support programs did increase both short and long-term duration (Guise et al. al., 2003).
Duration of Breast Feeding
In a thorough review of the literature from 1990-2000, Dennis (2002) examined breast-feeding initiation and duration and concluded that mothers who weaned prior to 6 months postpartum experienced perceived difficulties with breast-feeding.
These studies identified those least likely to breast-feed as: young, low income, ethnic minority, a supported, full-time employed women with a negative attitude toward breast-feeding and low confidence in their ability to breast-feed.
Partners and nonprofessionals were most supportive, hospital routines were often detrimental to breast-feeding, and health care professionals who lacked knowledge related to breast-feeding were seen as negative sources of support providing inaccurate and inconsistent advice (Dennis).
These results provide a target population for intervention and indicate that even as knowledge has grown, the shift from knowledge to practice is painful and takes time (Hong, Callister, & Schwartz, 2003).
A major population needing attention focused on breast-feeding are low-income women, especially women of color within this group. African-American women have among the lowest rates of breast-feeding in the United States (Ahluwalia et al., 2003). 45% report ever breastfeeding (compared to 66% and 68% of Hispanic and white women) (Bentley, Dee, & Jensen, 2003).
Reasons given by women for not breast-feeding include: embarrassment, a lack of social acceptability of breast-feeding (both public and private), work or school, the difficulty keeping the infant close, and lack of support.
Nursing Scientists Role In Promotion of Breast Feeding
Nurse scientists are using different methodologies to study breast-feeding, including: ethnographies
, phenomenological studies, historical-cultural approaches, and ecological perspectives. Theoretical frameworks used to explore the health behavior of breast-feeding include the theory of planned behavior, the health belief model, social cognitive theory using the concept of self-efficacy, and the social ecological framework.
Nurses are exhibiting a stronger role in publishing studies examining breast-feeding education, support, and prenatal and postnatal interventions to support the mother and infant, Researchers have demonstrated the importance of peer and social support, the effect of hospital interventions.
The need for comprehensive breast feeding education and support, communication-related barriers, socioeconomic issues, the effect of values and practice, and most importantly the culturally relevant issues that influence breast feeding choices.
Clinical issues being explored by nurse scientists include: biological benefits of breast-feeding to the mother, breast-feeding and circumcision, HIV and breast-feeding, lactation mastitis, and positioning and attachment. The influence of the health care delivery system, community, and society/culture cannot be ignored.
Challenges related to the study of breast-feeding include three major areas: the lack of consistency in the definition of breast-feeding (eg, exclusivity), making comparison of studies tedious if not impossible; the difficulty measuring cross-cultural effects (lack of reliability and validity studies of major breast-feeding instruments with various cultures); and the development of prospective designs and randomized controlled trials.
Long Term Effects Of Breast Feeding
Although breast-feeding is now recognized as a right of mothers, a health care behavior contributing to the reduction of infant and maternal morbidity and mortality rates, less expensive than artificial milk supplementation and m
ore environmentally friendly, the national breast-feeding goals are far from being met. Federal funding for breast-feeding research in the United States demonstrates an inconsistency with the national priorities for breast-feeding.
Only 13.7% ($5.6 million out of $40.4 million available) of federal research funds from 1994 to 1996 were awarded to projects having an impact on the Healthy People 2000 goals for increasing the incidence and duration of breast-feeding. In contrast, 27 projects (7.5% or $4.1 million) involved the use of human milk composition and technologies to improve artificial milks (Brown, Bair, & Meier, 2003).
Nurses need to be at the forefront in
protecting, promoting, and supporting breast-feeding for the health of society.
This will require exploring the ways that cultural norms and structures at all
levels support or interfere with breast-feeding for all women and ways in which
nursing can make a difference.
Give your opinion if have any.