BREASTFEEDING DISCOMFORTS EXPERIENCED AND ITS MANAGEMENT BY PRIMIGRAVIDA MOTHERS

NAZRIA G. KAPUSAN

A Thesis Outline Submitted to the College of Health Sciences, University of Southern Mindanao, Kabacan, Cotabato in Partial Fulfillment of Requirement for Degree of

BACHELOR OF SCIENCE IN NURSING

TABLE OF CONTENTS

Titles INTRODUCTION Significance of the Study Objectives of the Study Expected Output Scope and Limitation of the Study Place and Time of the Study Definition of Terms Hypotheses Theoretical Framework Conceptual Framework

Pages

REVIEW OF RELATED LITERATURE METHODOLOGY Research Design Respondents of the Study Sampling Instrument Data Gathering Procedure Statistical Analysis

LITERATURE CITED APPENDICES

INTRODUCTION

Significance of the Study

Human milk is uniquely designed to promote optimum health and growth in the human infant. Breast milk is a living, changing food, with enzymes and living cells that cannot be reproduced in formula and which help prevent or delay allergies, protect from infectious diseases and reduce occurrence of respiratory and digestive infections. Breast milk, unlike formula, promotes the growth and development of the human brain and nervous system. In addition breastfeeding promotes healthy oral development and satisfies the babies sucking needs. The World Health Organization recommends that infants be exclusively breastfed for the first months of life and that breastfeeding be continued into the second year of life or longer. These recommendations are based on studies showing long term benefits in children who receive breast milk in their first year of life. (WHO, 2001) The benefits of breastfeeding include: the reduction of infant mortality and morbidity and decrease risk of infectious disease, like diarrhea, respiratory, ear, and urinary tract infections (American Academy of Pediatrics, 2005, WHO, 2002). Long term benefits include decrease incidence of obesity and chronic illness such as diabetes, allergies and asthma (Baldwin & Friedman, 2006). Less incidences of osteoporosis, ovarian cancer, and premenopausal breast cancer are reported for mothers who have breastfed (Noel-Weiss, Rupp, Cragg, Bassett & Woodend, 2006).

Pre- natal care is indeed a need specifically in pregnant mothers and mostly the primigravida mothers because they do not have sufficient knowledge regarding child bearing and specially how they will breastfed their baby, what will be their proper positioning, the foods they will eat for them to produce more milk and how often they will breastfeed their babies. These were some of the questions encountered by primigravida mothers during their pregnancy stage. When they were able to deliver the child, they often encounter discomforts most especially in breastfeeding, these was the researcher aims to know and also the management done by the mothers to lessen or prevent the discomforts in breastfeeding. Breastfeeding provides ideal infant nutrition and is the physiologic norm for mothers and children. Mothers often make a decision regarding breastfeeding early in prenatal care, and many have already decided whether to breastfeed prior to conception. Encouragement and education from Healthcare providers result in increased breastfeeding initiation and duration. In addition, ongoing educational and support programs can improve initiation and duration of breastfeeding.

Furthermore, through this study, researcher will be able to determine the discomforts experienced by primigravida mothers and how they will manage it. Also, through this study, the researcher can determine the perception of primigravida mothers on breastfeeding during their pregnancy stage and how they perceive breastfeeding after delivery.

Objectives: 1. To determine the socio-demographic profile of the respondents. 2. To determine the perception of the mothers on breastfeeding during their pregnancy stage. 3. To determine the discomforts experienced by primigravida mothers on breastfeeding 4. To determine perception of the mothers on breastfeeding after giving birth. 5. To determine the breastfeeding discomforts management done by the primigravida mothers. 6. To determine the factors which contribute to their discomforts.

Expected Output 1. To determine the socio-demographic profile of the respondents. 2. To determine the perception of the mothers on breastfeeding during their pregnancy stage. 3. To determine the discomforts experienced by primigravida mothers on breastfeeding 4. To determine perception of the mothers on breastfeeding after giving birth. 5. To determine the breastfeeding discomforts management done by the primigravida mothers. 6. To determine the factors which contribute to their discomforts.

Scope and limitation This study will include primigravida mothers residing at Poblacion, Pikit Cotabato,

Place and Time of the Study The study will be conducted at Poblacion, Pikit North, Cotabato, February, 2014.

Definitions of Terms

Breastfeeding- this refers to the sucking or nursing, giving a baby milk from the mothers breast. Specifically the way the primigravida mothers nurse there baby.

Primigravida Mothers- a woman that is pregnant on the first time; the respondents of the study; the first time mothers who encountered breastfeeding discomforts.

Discomforts-unpleasant; uneasy feeling; specifically the unusual feeling that causes pain to the primigravida mothers on breastfeeding.

Management- the way the primigravida breastfeeding mothers handle the breastfeeding discomfort experienced.

Hypotheses:

Theoretical Framework

Self-efficacy has received attention as a predictor of health related behaviors. Described as an individuals confidence in his or her perceived ability to perform a specific task or behavior (Bandura 1977), Dennis Breastfeeding Self-Efficacy framework (1999), is derived from Banduras Social Cognitive Learning Theory (Bandura, 1977). Dennis uses her framework to understand the role self-efficacy plays in relation to breastfeeding behaviors. Breastfeeding self efficacy refers to a mothers perceived ability or confidence to breastfeed her newborn and influences her decisions regarding breastfeeding such as whether to breastfeed or not, how much effort she will expend on the task and how she will deal with the challenges that she will encounter during her experience. The theory of self-efficacy proposes that a persons level of self-efficacy may be influenced by four factors. These factors are: personal accomplishments, vicarious experiences, verbal persuasion, and psychological and affective states. These factors could be influenced by education and healthcare provider intervention (Bandura, 1977, Dennis, 1999). The first source, personal accomplishments, is based on the belief that successes build robust belief in ones personal efficacy. Failures undermine it, especially if failures occur before a sense

of efficacy is firmly established (Bandura (1994). The second source, vicarious experiences, builds a strong sense of efficacy through the vicarious experiences provided by social models. Seeing people similar to oneself succeed by sustained effort raises observers beliefs that they too possess the capabilities to master comparable activities required to succeed (Bandura, 1994). The third source, verbal persuasion, is a way to strengthen peoples beliefs that they have what it takes to succeed. People who are persuaded verbally that they possess the capabilities to master given activities are likely to mobilize greater effort and sustain it than if they harbor selfdoubts and dwell on personal deficiencies when problems arise (Bandura, 1994). The fourth source is psychological and affective states. The final way to enhance efficacy is to reduce peoples stress reactions and alter their negative emotional proclivities and interpretations of their physical states. It is how the emotions are perceived, rather than the sheer intensity of emotional and physical reactions that is important. People with a high sense of efficacy are likely to view their state of affective arousal as an energizing facilitator of performance, whereas those who are plagued by self-doubt regard their arousal as a debilitation (Bandura, 1994).

Conceptual Framework

Independent Variable

Dependent Variable

SOCIO-DEMOGRAPHIC PROFILE -Age -Educational Attainment -Tribe

DISCOMFORTS and MANAGEMENT

Figure 1. A schemic diagram showing the relationship between the respondents sociodemographic profile and their discomforts and management on breastfeeding discomforts.

Review of Related Literature

In the book Immunity of Human Milk that breast milk contains lymphocytes and macrophages, which produce antibodies and other immune factors. It provides Lactobacillus bifidus; the friendly bacteria that helps prevent the growth of dangerous bacteria. Another molecule is breast milk actually kills harmful bacteria. Some components are even directly antiinflammatory. In addition to providing protection against viruses, fungi, and parasites. Long term breastfeeding and natural weaning as far the healthiest thing you can do as positive effect of breast milk remains for years after breast milk is discontinued the larger you breast milk, the stronger your child s immune system (Hanson, 1998). In our society, we all know that breast milk is the best. Unfortunately, many women are led to believe that they cannot or should not breastfed for various reasons, and it is usually just not true. The following are some common reasons that a woman might decide not to try breastfeeding and information dispelling these common myths. (Weekly, 2007). My breast are small. Breast size has nothing to do with the ability or inability to produce milk. Even women with very small breast are able to produce milk. Milk glands lie under the muscle wall, so even if one has extremely small breast, one should still have glands necessary to produce milk. It is actually easier for a small-breasted woman to breastfeed.

METHODOLOGY Research Design This study will utilize a descriptive-comparative ; it will obtain the socio demographic characteristic and the comparative to compare the breastfeeding discomforts of the respondents before and after delivery.

Respondents of the Study The respondents of this study will be ___ primigravida mothers residing at Poblacion, Pikit, Cotabato.

Sampling Procedure

The respondents of this study will be selected through simple random sampling from all puroks in Poblacion, Pikit, Cotabato, there is 10 respondents in each purok that will be selected randomly.

Research Instrument The research instrument will be a self-made questionnaire. The questionnaire has three parts. The first part will generate the socio-demographic profile of the respondents. The second part s the perception of the primigravida mothers towards breastfeeding discomforts, and the third part is the management done by primigravida mothers on breastfeeding discomforts.

Data Gathering Procedure The respondents will be randomly selected in their purok. After identifying the names of the respondents, the questionnaire will be distributed by appointment.

Statistical Analysis

LITERATURE CITED

QUESTIONNAIRES Part I-Socio-demographic Profile Name (optional): _______________________ Tribe:_______________ Age when you first get pregnant:__________ Educational Attainment:_____________

Part II- Perception of Primigravida Mothers on Breastfeeding

1. Are you prepared in having a baby? a.yes b.no 2. do you like to breastfed your baby on the first place? a.yes b.no 3. do you prefer to breastfed your baby? a.yes b.yes 4. are you willing to breastfed your baby? a.yes b.no 5. Who educated you to perform brestfeedig? a. nurse b. midwife or ___________________________ 6. are you educated on the proper positioning of the baby when you breastfeed? a. yes b.no 7. how do you understand breastfeeding?

8. give us some of your preception towards breastfeeding during your pre-natal check up?

9. Your perception on breastfeeding after you have given birth ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

Part III Discomforts Experienced by Primigravida Mothers on Breastfeeding

10. Do you encounter discomforts while you are breastfeeding your baby? a.yes b.no if yes, what are those_________________________________________________________ ___________________________________________________________________________

11. do the health care practisioner oriented you regarding breastfeeding discomforts? a.yes b. no

12. how do you manage those discomforts

13. During your pre-natal check-ups or the time you are still pregnant, how painful do you think is the breastfeeding? a.mild

b.moderate c.severe

14. After you have given birth, and tried breastfeeding, how painful the breastfeeding was? a.mild b.moderate c. severe