CHAPTER I

The Problem and Its Background

Introduction

It is well worth spending some time thinking about some of the choices

that parents need to make before the baby is born. Of course the parents may

change their mind later but by considering the options beforehand will be able to

make more informed decisions. Deciding how to feed the baby is a very personal

and understanding the benefits and drawbacks of breastfeeding and bottle

feeding can make an informed decision. There is no question that breast milk is

best, especially in the initial weeks after birth, but there are many good reasons

why women bottle feed. Ultimately, it is important to make sure that both the

mother and the baby are comfortable, healthy, and happy.

There is no other natural substitute for breast milk and there is no doubt

that nature’s way gives the baby the best possible start. Benefits of breastfeeding

may include: breast milk is naturally designed to provide all the nutrients the baby

needs in the right amounts; it contains antibodies and other protective factors

that help fight infection; breastfed infants are known to have decreased risks of

respiratory and ear infections, gastroenteritis, diabetes, Crohn’s disease,

autoimmune diseases, and obesity, among many other problems; It is easily

digested and is less likely to cause stomach upsets, diarrhea or constipation;

Breastmilk is cheap, readily available at the right temperature, and, naturally,

always fresh; Nursing speeds the process of the mother’s uterus returning to its
normal size and can help lose the weight of the mother gained during pregnancy;

and, Nursing can reduce a woman’s risk of developing breast cancer.

Most women can breastfeed, regardless of the size or shape of their

breasts. However, if the mother has flat or inverted nipples may need a little help

in learning to position the baby and may need to use breast shells before birth.

Breastfeeding may be difficult or painful at first, but most women get used to it

within a few weeks with or without the help of their healthcare providers. Some

pregnant women feel uncomfortable about the idea of breastfeeding, but then

take it to quite easily after the birth when the baby is presented to them.

Breastfeeding requires lactating mothers to continue to restrict their diet as they

are providing nutrition for their child. Alcohol and caffeine intake needs to be

regulated. Fathers may feel left out during breastfeeding as they cannot have an

active role in the feeding of the child. It may also be necessary for a working

mother to extend maternity leave.

One of the main benefits that the mother do decide to bottle feed the baby

is that the partner and close family, such as the baby’s grandparents, can easily

share in the feeding of the baby. Bottle feeding also allows the mother to see

how much milk the baby is taking at each session. It is an essential substitute for

those mother’s who are not capable of breastfeeding due to some medications

and conditions, such as HIV, which are not compatible with breastfeeding

because of the risks to the baby.

 Formula companies have produced milk for babies, which at least on

paper, seem to resemble the real thing. What these companies make does not

quite measure up to what a mother makes. And, their primary goal is to make

profit, so marketing and manufacturing issues influence what finally gets into the

can.

Babies who are fed on formula milk are more likely to develop illnesses

such as diarrhoea and stomach upsets, as the mother's immune system is not

passed on through this method of feeding. Formula milk is also costly, as money

needs to be spent on buying formula.

Formula is not as easily digested by babies as breast milk. Thus, allowing

the baby to be full longer and the baby needing fewer feeds throughout the day.

For the first few weeks, the parents probably find that feeding takes

precedence over everything else. It may take awhile to settle into a comfortable

routine, but having some support at home can make the process swifter and

more successful. “Growth Spurts” may take into consideration during five (5) to

six (6) weeks and again at 3 months, but can occur as early as three (3) weeks of

age. This usually happens when the baby was satisfied with the feeding routine,

but suddenly starts to be unsettled or demands milk more frequently.

Our concern is that even though formula fed infants appear to grow

normally, are they really thriving? Thriving means if the baby is gaining weight

steadily; good skin color; lively with bright eyes; contented and seems satisfied

after feeding; has six (6) or more wet diapers in twenty-four (24) hours; and
passing soft stools. One of the best ways to do this is to make sure that the baby

is regularly seen by his healthcare providers. Weighing the baby and plotting his

height on a centile chart.

The researchers decided to focus on a study that aims to compare

the effect on the weight of breastfed and bottle fed infants in the community of

their choice.

Background of the Study

By conducting this study, the researchers would like to know the in-

depth effect on the weight among breastfed and bottle fed infants from 0-3

months, in Baranggay Caingin, Sta. Rosa, Laguna.

Human milk is a live substance containing live white blood cells and

immune-fighting substances, and is a dynamic, changing nutritional source,

which adjusts to meet the individual need of a growing baby. Formulas are

nothing more than a collection of dead nutrients. They do not contain living white

cells, digestive enzymes, or immune factors. in terms of human history, they are

a new experiment.

But with the current trend, bottle feeding shows more patronage rather

than breastfeeding. But does it really show any difference for growing infants?

The researchers raised a few questions in mind on these facts and a few

apprehensive comments as well. The researchers would like to suffice these

inquiries by conducting this study. The researchers feel that it would contribute

greatly in the field of nursing, and as well as providing holistic awareness in the

community.

Theoretical Framework

In meeting the need for evaluation and analysis of the research study, the

social-cognitive theory of Bandura (1997) was considered. This was used for the

easier and cleaner views of the study. It pointed out that both interpersonal socio-

environmental factors influence method of infant feeding: The theory approaches

the explanation in terms of a continues reciprocal interactions between cognitive,

behavioral, the opportunity for people, these actions as well as the limits of self

direction. This conception of human functioning then neither costs people into the

role of powerless object by environmental forces or forces agent who can

become whatever they want to choose. It also offers an explanation of human

behaviour using the concepts of self efficacy, outcome expectations, and

incentives. Self efficacy expectations are focused on people is belief in their own

capacity to carry out particular behaviours. Self efficacy expectations determine

the behaviours a person chooses to perform, their degree of perseverance, and

the quality of the performance.

Conceptual Framework

The types of feeding during the first months of life of an infant can provide

a significant development to them physically and mentally. We know that breast

feeding is best for all babies during infancy and bottle feedings are more typical

to use. However, there are several factors taken into consideration in which

feeding would be chosen. These factors are the mother’s age, educational

attainment, civil status, occupation, monthly income, and number of children.

The independent variable for this study is the demographic profile of the

respondents, the mothers of the infants, in terms of age, educational attainment,

occupation, civil status, monthly income, and The number of children. While

the dependent variable is the weight of the infants, from 0-3 months of age, from

which the researchers are going to compare.

 Demographic Profile of the Mother:

Educational Attainment

Employment

Monthly Income

Number of Children

Monthly Income

Number of children
Preferred feeding
method

Breastfeeding Bottle feeding

Weight of Breastfed Weight of Bottle fed

infants infants

Fig. 01 Schematic Design of Conceptual Framework

Statement of the Problem

1. What is the profile of the respondents in terms of:

1.1 Educational Attainment

1.2 Employment

1.3 Monthly Income

1.4 Number of children?

2. What is the respondents’ preferred feeding method?

3. What is the gain in weight of the breastfed infants from birth to 3 months?

4. What is the gain in weight of the bottle-fed infants from birth to 3 months?

5. Is there a significant relationship between the respondents’ profile and their

preferred feeding method?

6. Is there a significant difference in the gain in weight of the breastfed and

bottle-fed infants?
Hypothesis of the study

The following null hypotheses were proposed.

Ho1: There is no significant difference between the weight of breastfed

compared to bottle fed infants from 0-3 months.

Ho2: There is no significant relationship between the weights of 0-3month

infant and the profile of the respondents in terms of the following personal

variable:

2.1. Educational Attainment

2.2. Employment

2.3. Monthly Income

2.4. Number of Children

Significance of the study

The comparison of breast fed and bottle fed infants, from 0-3 months, in

terms of weight residing in Barangay Caingin, Sta. Rosa, Laguna will benefit the

following:

NURSING STUDENTS. This study will benefits the nursing students to

increases their awareness of the importance of breast feeding compared to bottle

feeding in which they can promote the importance of breast feeding in the

community.

MOTHERS. The information collected will provide mothers and their family

about the importance and effect of breastfeeding or bottle feeding to the infants.

COMMUNITY HEALTH CARE CENTER. The result of this study will

benefit the student nurse by rendering improved health teachings and

interventions. The result of this study will help develop more effective health

teachings for the community regarding knowledge about breast feeding and

bottle feeding.

FUTURE RESEARCHERS. This study would provide reference and guide

who wish to conduct a similar study. Also, this may inspire them to research

further and put in additional information on the said topic.

Scope and Delimitation

This study intends to compare and understand the effects of two different

feeding methods for infants, which are breastfeeding and bottle feeding. The

researchers would like to know how it will affect the infant's weight gain. The

researchers also would like to find out if the breastfed infants and the bottle-fed

infants get the same nourishment.

The researchers will be conducting surveys on infants between 0-3

months. Residing in Barangay Caingin,Southville 4, Sta. Rosa, Laguna. The

respondents of this study are the mothers of infants born on the month of

December. This study was conducted at the month of January 20, 2009.

Definition of terms

To provide clarity and better understanding of this study, the researcher

operationally defined the following key words and terms.

Breast fed - this refers to a baby that feed using mother’s milk that came

from their breast.

Bottle fed this refers to a feed of an infant using a bottle.

Infants (0-3 months) this refers to a baby under one year of age, a

newborn child that age ranges from 0-3 months.

Weight this refers to the measure of the heaviness of an infant ages 0-3

months.

Breast Milk this refers to milk produced by a mother which is usually fed

to infants, toddlers, and young children by breastfeeding

Formula Milk this refers to the substitute for human breast milk.

Mothers this refers to the female parent who breastfed or bottlefed the0-3

month infant. They were the respondents in our research.

 CHAPTER II

Review of Related Literature and Studies

This chapter focuses on the survey of related local and foreign literature

and studies. The materials were scanned from various libraries and collected to

provide understanding of the subject under discussion.

Foreign Literature and Studies

According to Ruth Lawrence MD, (2009) the U.S. Food and Drug

Administration stated that the best first food for babies is breast milk. Many

decades of research have been done to determine that breast milk is perfectly

suited to nourish babies and protect them from illness. Human milk is made for

human infants and it meets all their specific nutrient needs. She also stated that

breast fed babies are healthier and have fewer infections than formula fed

babies.

Formula feeding is the second best option to breast milk. Cow’s milk is not

a good option for babies because it contains a different type of protein than

breast milk. Also, breast fed babies have fewer illnesses because human milk

transfers to the infant the mother’s antibodies to diseases. Breast milk is always

sterile, never contaminated by polluted water or dirty bottles. In addition to the

nutrition that breastfeeding provides the infant, it also aids in their development.

Breastfeeding allows the child to create an emotional attachment to the mother,

as well as providing a sense of security from the warmth and presence of the
mother. The U.S. Food and Drug Administration stated that nursing becomes

more than a way to feed a baby; it’s a source of warmth and comfort.

According to the American Academy of Pediatrics (AAP)( 2008), human

milk is the preferred feeding for all infants, including premature and sick new born

babies, with rare exception. The AAP has continuously promoted breastfeeding

as the foundation of good feeding practices. The AAP states that research has

shown that human milk and breastfeeding of infants provides advantages with

regard to general health, growth, and development, while significantly decreasing

risk for a large number of acute and chronic diseases. The AAP also states that

breastfeeding has also been related to possible enhancement of cognitive

development. The AAP encourages mothers to breast feed and encourages

paediatricians and care givers to become knowledgeable and skilled in both the

physiology and the clinical management of breastfeeding. Overall, the AAP

strongly adheres to the position that breastfeeding ensures the best possible

health as well as the best development and psychosocial outcomes for the infant.

A study published in the October 2009 edition of the American Journal of

Clinical Nutrition (AJCN) by Dr. Michael Kramer et al. of McGill University,

Montreal Canada titled, "Health and development outcomes in 6.5-y-old children

breastfed exclusively for 3 or 6 months" finds no adverse or beneficial effects

associated with exclusive breastfeeding for 6 months.* Part of the PROBIT study

in Belarus, a clinical trial where the promotion of breastfeeding was randomized

and infants were followed forward in time and assessed for various health

outcomes, this study’s objective was to compare health and developmental

outcomes at age 6.5 years in children who were exclusively breastfed for three

months (with continued partial breastfeeding for greater than six months) and

those who were exclusively breastfed for six months.

The authors randomized pregnant women into two groups: one that

received breastfeeding promotion and education and one that did not. They

followed the infants in time and at 6.5 years of age, they examined

anthropometric measurements, systolic and diastolic blood pressure, intelligence

quotient, teachers’ ratings of academic performance, parent- and teacher-rated

behaviour, atopic symptoms, allergen skin-prick test, and dental caries of infants

exclusively breastfed infants for three months (with continued partial

breastfeeding) compared to infants exclusively breastfed for six months. The

authors found that the only significant differences between the two groups were

in mean body mass index, triceps skin fold thickness, and hip circumference, all

of which were higher in infants exclusively breastfed for 6 months.

The study’s authors concluded, "No demonstrable beneficial or adverse

long-term effects on child health or exclusive breastfeeding for 6 months."

Additionally, researches noted that "established benefits appear to be limited to

the period of exclusive breastfeeding."

Another study is made by the Department of Health & Human Services

(HHS) Office on Women's Health entitled “Breastfeeding and Maternal and Infant

Health Outcomes in Developed Countries” of May 2009. The researcher’s main

objective isto review the evidence on the effects of breastfeeding on short- and

long-term infant and maternal health outcomes in developed countries.

They included systematic reviews/meta-analyses, randomized and non-

randomized comparative trials, prospective cohort, and case-control studies on

the effects of breastfeeding and relevant outcomes published in the English

language. Included studies must have a comparative arm of formula feeding or

different durations of breastfeeding. Only studies conducted in developed

countries were included in the updates of previous systematic reviews. The

studies were graded for methodological quality.

The researchers found that a history of breastfeeding was associated with

a reduction in the risk of acute otitis media, non-specific gastroenteritis, severe

lower respiratory tract infections, atopic dermatitis, asthma (young children),

obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death

syndrome (SIDS), and necrotizing enterocolitis. There was no relationship

between breastfeeding in term infants and cognitive performance.

The relationship between breastfeeding and cardiovascular diseases was

unclear. Similarly, it was also unclear concerning the relationship between

breastfeeding and infant mortality in developed countries.

For maternal outcomes, a history of lactation was associated with a

reduced risk of type 2 diabetes, breast, and ovarian cancer. Early cessation of

breastfeeding or not breastfeeding was associated with an increased risk of

maternal postpartum depression. There was no relationship between a history of

lactation and the risk of osteoporosis. The effect of breastfeeding in mothers on

return-to-pre-pregnancy weight was negligible, and the effect of breastfeeding on

postpartum weight loss was unclear.

The study came with a conclusion that a history of breastfeeding is

associated with a reduced risk of many diseases in infants and mothers from

developed countries. Because almost all the data in this review were gathered

from observational studies, one should not infer causality based on these

findings. Also, there is a wide range of quality of the body of evidence across

different health outcomes.

For future studies, clear subject selection criteria and definition of

"exclusive breastfeeding," reliable collection of feeding data, controlling for

important confounders including child-specific factors, and blinded assessment of

the outcome measures will help. Sibling analysis provides a method to control for

hereditary and household factors that are important in certain outcomes. In

addition, cluster randomized controlled studies on the effectiveness of various

breastfeeding promotion interventions will provide further opportunity to

investigate any disparity in health outcomes as a result of the intervention.

The Consumer Research on Infant Formula and Infant Feeding supported

by the Centre for Food Safety and Applied Nutrition conducted several research

studies to provide further information regarding infant feeding.

 The first study made isentitled “Longitudinal Analysis of Infant Morbidity

and the Extent of Breastfeeding in the United States.” By Scariati,Paula

D.,Grummer-Strawn, Laurence M. and Fein,Sara Beck.

This study was about the health benefits of breastfeeding in developed

countries have shown conflicting results. These studies often fail to account for

confounding, reverse causality, and dose-response effects. The

researchersaddressed these issues in analysing longitudinal data to determine if

breastfeeding protects US infants from developing diarrhoea and ear infections.

Mothers participating in a mail panel provided information on their infants

at ages 2, 3, 4, 5, 6, and 7 months. Infants were classified as exclusively

breastfed; high, middle, or low mixed breast-and formula-fed; or exclusively

formula-fed. Diarrhoea and ear infection diagnoses were based on mothers'

reports. Infant age and gender; other liquid and solid intake; maternal education,

occupation, and smoking; household size; family income; and day care use were

adjusted for in the full models.

As a conclusion to their study, breastfeeding protects US infants against

the development of diarrhoea and ear infection. Breastfeeding does not have to

be exclusive to confer this benefit. In fact, protection is afforded in a dose-

response manner. The more breast milk an infant receives in the first 6 months of

life, the less likely that he or she will develop diarrhoea or ear infection.

A study made by Fein,Sara B., PhD.,et al. (2008) entitled “The Effect of

Work Status on Initiation and Duration of Breast-Feeding.” for the American

Journal of Public Health. In this study, longitudinal data are used to examine the

effect of work status on breast-feeding initiation and duration.

Mothers from a mail panel completed questionnaires during late

pregnancy and 10 times in the infant's first year. Mother's work status was

categorized for initiation by hours she expected, before delivery to work and for

duration by hours she worked at month 3. Covariates were demographics, parity,

medical, delivery, and hospital experiences, social support, embarrassment, and

health promotion.

In conclusion, part-time work is an effective strategy to help mothers

combine breast-feeding and employment.

Another question for a study was raised to the Consumer Research on

Infant Formula and Infant Feeding which is “Is There Competition Between

Breast-Feeding and Maternal Employment?” by Sara Beck.,et al. 2006.

Theory suggests that the decision to return to employment after childbirth

and the decision to breast-feed may be jointly determined. They estimate models

of simultaneous equations for two different aspects of the relationship between

maternal employment and breastfeeding using 1993-1994 data from the U.S.

Food and Drug Administration's Infant Feeding Practices Study. The researchers

first explore the simultaneous duration of breast-feeding and work leave following

childbirth. They find that the duration of leave from work significantly affects the

duration of breast-feeding, but the effect of breastfeeding on work leave is

insignificant. They also estimate models of the daily hours of work and breast
feedings at infant ages 3 months and 6 months postpartum. At both times, the

intensity of work effort significantly affects the intensity of breast-feeding, but the

reverse was generally not found. Competition clearly exists between work and

breast-feeding for many women in their sample.

American Academy of Pediatrics has studied and promoted extended and

exclusive breastfeeding of new born for the first six months of life as a method of

reducing the risk of food allergies, and other allergy-related complications, later in

childhood. Breastfeeding is a protective factor against allergies for two reasons.

First, the initial milk of the mother, called the colostrum, is not only nutrient-rich,

but also filled with antibodies. These antibodies are intended to supplement the

infant’s weak immune system and help protect them against foreign cells, such

as allergens. The second reason, breastfeeding is said to be a protective factor

and that it limits the diet of the infant. For as long as the baby is breast fed, they

are only exposed to the allergens that enter the milk through the mother’s diet.

Extending the length of the breastfeeding period will delay the introduction of

solid foods, which could be possible sources of allergens.

Although those who promote breastfeeding as a prevention of allergies

present many statements claiming that it is an effective method, few actually cite

solid numbers or specific studies in support of their claims. They vaguely stated

that when solid foods are added to an infant’s diet within the first four months of

life, the child is more likely to develop atopic dermatitis, an allergic reaction of the

skin, in childhood. These children also show breathing problems more frequently

as an infant. It is also stated that if a child is solely breastfed for at least six
months, they have a decreased risk of atopic dermatitis and asthma. It is also

asserted that when an allergen is removed from a mother’s diet, the infant shows

signs of improvement within a week. This short recovery period was used as

proof of the influence of breastfeeding on the allergic reactions of an infant.

These claims do not specifically show the effectiveness of breastfeeding, but

rather the combined effects of breastfeeding and delaying solid foods in the diet.

Most articles simply support claims in promotion of breastfeeding by citing the

APA recommendations.

Breastfeeding has been recommended by the US Surgeon General for at

least the first six months of an infant’s life. It is not only beneficial for the infant,

but the mother and the family as well. The initial breast milk of a mother,

colostrum, contains vital nutrients and antibodies, which are delivered to the

infant when ingested. The concentrations of nutrients in the breast milk vary over

time to accommodate the changing needs of the developing infant. Breast fed

babies are less likely to develop ear infections, diarrhea, obesity, allergy related

issues, and diabetes, to name a few benefits. Mothers who breastfeed their

infants lose excess weight from pregnancy more rapidly and are at a decreased

risk for type II diabetes, breast and ovarian cancer, and post partum depression.

Breast feeding is also an easier, more natural process, with no need for

measuring formulas or cleaning bottles. Additionally, families who breast feed

their children save large sums of money per year. Over all, the process of

breastfeeding is said to increase the bond between the mother and the infant,

contributing to a healthier relationship initially and later in life.

 As with most practices, there are common drawbacks that deter people

from breastfeeding. Breastfeeding can be painful for the mother, especially on

the nipples, which can become raw, flat, or very large. There are also infections

associated with breastfeeding and continuous contact with the nipple.

Additionally, many women are not able to breastfeed for the full recommended

length of time because they stop producing enough milk. Finally, infants are

much more perceptible to environmental factors, such as alcohol and cigarette

smoke, when being breast fed. However, most organizations, in support of

breastfeeding, claim that these issues can all be resolved, to come to the best

solution for both the mother and the infant.

Local Literature and Studies

Based on an article written by, Christian V. Esguerra (2007) Philippine

government advocates “Breastfeeding campaign not only a lonely battle”. This

was a campaign against giant milk formula companies which is anything but a

lonesome battle.

In this article, it is stated that around 50 non-government organizations

have banded together into a nationwide coalition to help promote breastfeeding

and implement the revised implementing rules and regulations of the new Milk

Code.

Several studies around the world apparently show the inherent efficacy

advantage of breast milk over infant formula products.

Olive, Jean Marc MD., WHO country representative, earlier briefed a

congressional committee on the benefits of breastfeeding. He warned that babies

who are not breast fed were 10 times more likely to die from diarrhea, 3.6 times

likely to die of pneumonia, and 2.5 times more likely to suffer from other

infections.

Breast milk is simply the best food for babies. It provides all the

nourishment they require and builds immunities protecting your baby against

developing certain infections to which they will be exposed.

Breast milk is also economical because a mother can do away with buying

milk bottles, formula milk, and other paraphernalia needed when formula-feeding,

plus of course, there is that solid bond formed between the mother and her child.

An article form a local newspaper entitled “How the Bottle Sabotages

Breastfeeding” stated to if a mother give the bottle feeding in the early hours after

birth, then the mother would be seriously compromising the baby’s chance to a

successful breast feeding.

This is how Silvestre, Maria Asuncion A. MD.,(2007) chair of the

Breastfeeding Committee and member of the Board of Trustees of the Philippine

Society of New born Medicine, describes how feeding bottle gave mothers a

false sense of security.

Silvestre, who recently spoke to members of the media during a PCP

Health Forum, added that the amount of milk from the bottle is also

disproportionate to the feeding capacity if the baby. The size of the newly born

baby’s stomach is like that of a marble that’s not designed to accommodate one

to two ounces of milk formula or water from a feeding bottle. So how come the

baby seems to calm down while taking the entire contents of a feeding bottle? It

is because when you force the bottle’s nipple or even pacifier in the baby’s

mouth, the baby would instinctively starts suckling. The baby would stop crying;

again giving mothers that false sense of security.

After being used to bottle feeding, what comes next is that when the bay is

then finally breast fed by the mother, the latter would most likely feel

uncomfortable about the process. Silvestre explained that as a result of getting

used to artificial nipple, the baby would develop a different way of sucking the

mother’s breast, a way that would most likely be painful, would cause soreness

or even infection of mother’s nipples.

Another article entitled “Why Some Women Don’t Breast Fed” stated why

mother’s chose to bottle feed their infants rather than breast feeding.

First is wrong feeding pattern. Some women think babies should feed only

every two or three hours an only for 10 - 20 minutes. Babies should be fed on
demand because it may take up to 2 – 4 weeks to establish a good milk supply.

Most babies will gain weight if they are fed on demand or at least 1 – 2 hours.

Second, women stated that they did not produce enough milk. So many

women are so insecure and so underpowered to believe that if nature had

allowed them to bear a child, nature would also equip them with the means to

keep their baby alive. It is all based on supply and demand. The moment you

start to fix with formula, the demand of breast milk decreases since the baby is

fuller for a long period of time. Logically, this is because the proteins of formula

milk stay undigested for up to 60 minutes while breast milk digested within 15

minutes.

Next is unrelenting frustration. Women end up with comedy of errors that

can start with a poor latch on, then end up frustrated when she get sore nipples

or the baby reject her. The problem is, the moment mothers get stressed, they

would not release the hormone prolactin whichis released from her pituitary gland

at the base of the brain, which is responsible for the milk let-down reflex.

Another is poor home support. Some of the first people who may

discourage a mother from breastfeeding may be their very own mother, aunt, or

relative who grew up in a generation brainwashed by ads to believe that formula

is superior to breast milk. Some overbearing mothers may find it ridiculous why

you should make life difficult when there is formula milk to free up your body and

time. This may lead one to believe that since your family members did not

breastfed, you would not be able to either, which is so untrue.

 Next is illness and infection. Sometimes a hospitalization from a serious

illness, a fever or infection can prompt their paediatrician to shift to formula

feeding.

Next is work interference. Many women stop breast feeding once they go

back to work 6 – 8 weeks after delivery. Leaking breast can be embarrassing

during a corporate meeting. The stress of work can jeopardize release of

prolactin essential to milk let-down reflex.

Some women, however, whose pregnancy is under adverse

circumstances, like after rape, are not psychologically prepared to breast feed.

Since, they feel further violated. Those who imagine themselves being bitten on

the nipples or have seen the suffering of the women with engorged nipples are

afraid to undergo the experience themselves. Women do not have the

confidence that they have it within them to keep their baby alive through their

natural faculty of breastfeeding. Some women do not want to be tied down at

home because of work or leisure reasons. Breastfeeding just simply cramp their

style.

And last reason, our breastfeeding culture has disappeared. We lived in a

society where we do not see women breastfeeding in public. So, if mothers have

not grown up seeing women around them breastfeeding successfully, if it is

something that is hidden away, then it becomes harder for them to succeed

themselves. Many women feel embarrassment with public exposure.

 Another local study which is “Colostrum: Nature’s first food for babies”

states that the thick yellowish fluid that comes out of a mother’s breast a few

days after giving birth, called colostrum, serves as a child’s perfect first food.

Colostrum has high concentrations of nutrients and antibodies that a new born

needs to develop properly and resist infection.

While in small quantity, it is packed with carbohydrates, proteins, and

antibodies. The size of a new born stomach can only hold 5 – 7 ml of fluids. The

small amount of colostrum from the breast is thus sufficient. Anything in excess is

expelled or spit out by the baby.

Colostrum is low in fat a new born babies have difficulty digesting it. It also

serves as the baby’s first immunization. It contains large numbers of

immunoglobulin that help protect the mucus membranes in the throat lungs, and

intestines of the infant from the germs. Leukocytes are also present to protect

against harmful viruses. Colostrum also has beneficial bacteria that line the

digestive tract to ward off infection.

Colostrum also has a mild laxative effect that encourages the passing of

the baby’s first stool. This allows clearing of excess blood waste product from

their system and prevents jaundice. To ensure that the baby receives the

benefits of colostrum, breastfeeding should be initiated in the first hour of birth.

The sucking reflex of the baby, which is strongest also in the first hour,

establishes proper latching and encourages the production of milk.

 In the article “Why some woman don’t breastfed.” Some women think babies

should feed only every two or three hours and only for 10-20 minutes. Babies

should be fed on demend because it may take up to 2-4 weeks to establish a

good milk supply. Most babies will gain weight if they are fed demand or at least

every 1 1/2 to 2 hours

So many women are so insecure and so underpowered to believe that if

nature had allowed them to bear a child, nature would also equip them with the

means to keep their baby alive but cannot produce enough milk. It is all based on

supply and demand. The moment you start to fix with formula, the demand for

breast milk decreases since the baby is fuller for a long period of time. Logically,

this is because the proteins of formula milk stay undigested for up to 60 minutes

while breast milk digested within 15 minutes. Women end up with comedy of

errors that can start with a poor latch on, then end up frustrated when she gets

sore nipples or the baby reject her. The problem is, the moment Mom gets

stressed, she won't release the hormone prolactin which is released from her

pituitary gland at the base of the brain, which is responsible for the milk let-down

reflex.

Some of the first people who may discourage you from breastfeeding may

be your very own mother, aunt, or relative who grew up in a generation

brainwashed by ads to believe that formula is superior to breast milk. Some

overbearing moms may find it ridiculous why you should make life difficult when

there is formula milk to free up your body and time this may lead one to believe
that since your family members did not breastfed, you would not be able to

either.

Many women stop breastfeeding because it interfere with work after delivery.

Leaking breast can be embarrassing during a corporate meeting. The stress of

work can jeopardize release of prolactin essential to milk let-down reflex. Some

women don't want to be tied down at home because of work or leisure reasons.

Breastfeeding just simply cramp her style.

Some women, however whose pregnancy is under adverse circumstances,

like after rape, are not psychologically prepared to breastfeed, since they feel

further violated. With Fear of pain for those who imagine themselves being bitten

on the nipples or have seen the suffering of the women with engorged nipples

are afraid to undergo the experience themselves.

We lived in a society where we do not see women breastfeeding in

public. Our breastfeeding culture has disappeared. So, if you haven’t grown up

seeing women around you breastfeeding successfully, if it's something that's

hidden away, then it becomes harder for you to succeed yourself. Many women

feel embarrassment with public exposure,. (Phil. Daily Inquirer Sept. 16, 2006).
 CHAPTER III

Methodology and Procedures

This chapter presents the research design used, sample and sampling

technique, instrument of research, validation, data gathering procedure,

statistical treatment, and the decision criteria being used in the research.

Research Method

Having a precise investigation is a must in every research. Hence to

attain his, the researchers will utilize the following methods of research:

The purpose of the study is to measure the effect of an intervention, test a

theory about relationships, or describe a phenomenon with precision. These

studies require measurement so it will ultimately involve the analysis of numbers.

The quantitative research has a goal in describing social reactions and

interactions reader can understand the meaning of the event, even if they have

not experienced.

Descriptive designs are designed to gain more information about a

particular characteristic within a particular field of study. A descriptive study may

be used to, develop theory, identify problems with current practice, justify current

practice, make judgements or use to describe in detail some process, event, or

outcome.
 The research conducted was Comparative in nature. This is a non-

experimental study, in which two groups are selected to compare. Groups are

carefully assessed based on the independent variable.

Respondents of the Study

The respondents are mothers with an infant of 0-3 months residing in

Barangay Caingin, Sta. Rosa, Laguna who were breastfeeding or bottle feeding.

The researchers got a total of thirty mothers. The researchers get their

educational attainment, employment, monthly income and their number of

children.

Sample and Sampling Technique

The researchers used Random sampling. In this study the researchers

listed the name of the first 30 mothers residing in Barangay Caingin, Sta. Rosa,

Laguna with babies born on the month of December that is breastfed or bottle

fed.

Sources of Data

The major source of direct data or empirical data is through a questionnaire

prepared by the researchers.

A Comparison of weight Among Breastfed and Bottle Fed Infant, Ages 0-3
months questionnaire contain two parts:

Part 1: Demographic Profile of the Mother

Part2: Preferred Feeding Method

Part 1 demographic profile of the mother contains age, educational

attainment, employment, monthly income and the number of children

Part 2 Preferred feeding method, it contain what method that the mother
used to fed her baby ages 0-3 months. To determine if it is bottle fed or
breastfed.

Validation of Questionnaire

The question is validated by three experts from the field of nursing and research,
who are asked to evaluate the contents and appropriateness of the items. Their
suggestions and criticism are incorporated before testing the questionnaire.

Statistical Treatment of data

The data that were gathered by the use of the survey questionnaire were

tabulated, analysed, and interpreted with the use of the following statistical

techniques:

1. Percentage, used to describe the profile of the respondents.

The formula for percentage is:

P ═ f X 100
N
 Where: P = percentage

f = frequency

N = total number of respondents

2. Chi-square test, used to determine if there is significant relationship between

the profile variables and the preferred feeding method.

The formula for Chi-square is:

Where: O = observed frequency

E = expected frequency

3. t test for dependent sample, to determine if there is significant difference in

the gain in weight of breastfed and bottle-fed infants from 0-3 months..
Profile of the Respondents

Table 1

Profile of the Respondents According to Educational Attainment

Educational Attainment Frequency Percentage

College 6 20.00

High School 19 63.33

 Elementary 5 16.67

Total 30 100.00

Table 1 shows the frequency and percentage of the respondents

according to educational attainment. The table shows that 19 out of 30 respondents
or 63% are high school graduate, 6 out of 30 respondents or 20% are college
graduate and 5 out of 30 respondents or 16.67% are elementary graduate.

Majority of the respondents are high school graduate rounding of about

63.33% of the total respondents.

Table 2

Profile of the Respondents According to Employment

Employment Frequency Percentage

Employed 15 50.00
 Unemployed 15 50.00

Total 30 100.00

Table 2 shows the frequency and percentage distribution of mothers

according o employment. The table shows an equal percentage of employment,
15 out of 30 respondents or 50% are employed and also 15 out of 30 respondents
or 50% are unemployed

Table 3

Profile of the Respondents According to Monthly Income

Monthly Income Frequency Percentage

P 9001 and above 1 3.33

 P 6001 - P 9000 12 40.00

P 3001 - P 6000 9 30.00

P 3000 and below 8 26.67

Total 30 100.00

Table 3 shows the frequency and percentage distribution of the

respondents according to monthly income. The table shows that 12 out of 30
respondents or 40% have an income of 6,001-9,000 per month, 9 out of 30
respondents or 30% have an income of 3,001-6,000 per month, 8 out of 30
respondents or 26.67% have an income of 3,000 and below per month and 1 out of
30 respondents or 3.33% have an income of 9,001 and above.

Majority of the respondents have an income of 6,001-9,000 per month

rounding of about 40% of the total respondents.

Table 4
 Profile of the Respondents According to Number of Children

Number of Children Frequency Percentage

5-6 6 20.00

3-4 12 40.00

1-2 12 40.00

Total 30 100.00

Table 4 shows the frequency and percentage distribution of the

respondents according to the number of children. The table shows that the
number of 3-4 children and 1-2 children have an equal frequency of 12 or 40%
out of 30 respondents and 6 or 20% out of 30 respondents have a number of 5-6
children.

Majority of the respondents have an equal number of 3-4 children and 1-2
with an equal frequency of 12 or 40% out of 30 respondents.

Respondents’ Preferred Feeding Method

 Table 5

Preferred Feeding Method

Feeding Method Frequency Percentage

Breast Feeding 15 50.00

Bottle Feeding 15 50.00

Total 30 100.00
Gain in Weight of Breastfed Infants from 0-3 Months

Table 6

Gain in Weight of Breastfed Infants from 0-3 months

Infant No. Gain in Weight, kgs

1 2.2

2 1.8

3 2.3

4 2.5

5 2.7

6 2.6

7 2.6

8 2.2

9 2.5

10 2.1

11 2.0

12 2.3

13 2.5

14 2.4

15 2.7

Average 2.36

Gain in Weight of Bottle-fed Infants from 0-3 Months

 Table 7

Gain in Weight of Bottle-fed Infants from 0-3 months

Infant No. Gain in Weight, kgs

1 3.6

2 3.7

3 3.9

4 3.3

5 3.7

6 4.1

7 3.4

8 3.8

9 3.8

10 4.2

11 3.7

12 3.7

13 4.2

14 3.4

15 3.4

Average 3.73
Relationship Between Profile and Preferred Feeding Method

Table 8

Relationship between Profile and Preferred Feeding Method

 Computed Critical

Profile Chi-square Chi-square df Interpretatio

value value n

Educational
Attainment
0.92 5.99 2 Not
Significant

Employment 30.00 3.84 1 Significant

Monthly Income 23.78 5.99 2 Significant

Number of 1.00 5.99 2 Not

Children significant

0.05 level of significance

As shown in Table 8, for the relationship between educational

attainment and preferred feeding method, a computed chi-square value of
0.92 was obtained which is lower than the critical chi-square value of 5.99 at
0.05 level of significance. This shows that there is no significant relationship
between educational attainment and preferred feeding method. This means
that their preference for the type of feeding is not dependent on their
educational attainment.

For the relationship between employment and preferred feeding

method, a computed chi-square value of 30.00 was obtained which is higher
than the critical chi-square value of 5.99 at 0.05 level of significance. This
shows that there is significant relationship between employment and
preferred feeding method. This means that their preference for the type of
feeding is dependent on their employment.
Difference in the Gain in Weight of Breast-fed and Bottle-fed Infants
from 0-3 Months

Table 9

Difference in the Gain in Weight of Breast-fed and Bottle-fed Infants

from 0-3 months

Mean, X1 Mean, X2 Computed

Variable Breast-fed Bottle-fed t value Interpretati

on

Gain in Weight 2.36 3.73 13.58 Significant

0.05 level of significance

Critical t value = 2.048

As shown in Table 9, for the difference in the gain in weight of breast-

fed and bottle-fed infants from 0-3 months, a computed t value of 13.58 was
obtained which is lower than the critical t value of 2.048 at 0.05 level of
significance. This shows that there is significant difference in the gain in
weight of the breast-fed and bottle-fed infants. This means that the bottle-
fed infants had a higher weight gain than the breast-fed infants.