PhD student Ankara University, Graduate School of Health Sciences Ankara Universitesi Saglik Bilimleri Enstitusu Ankara, Turkey
Background: Exclusive breastfeeding for 6 months (EBF6M) is recommended for every infant. Prevalence of EBF6M has decreased from 42% to 30% during the last 5 years, in Turkey. The physician's maternity ward attitudes, knowledge and skills can affect EBF6M.
Objective: To investigate the effect of a supervised training intervention on maternity ward practices of pediatric residents and maintenance of EBF6M.
Design/Methods: The study consisted of 2 phases lasting 6 months, before and after the intervention. An interactive multimedia curricular intervention was designed for pediatric residents to enhance their knowledge and skills in distinguishing the high-risk newborn, blood glucose monitoring, physiological weight loss, approach to lactation problems at the maternity ward. The maternity ward was visited twice a week by a NICU attending to give feedback. The attitudes of the physicians were deduced from the surveys answered by the mothers at the 6th month immunization visit. Pre (Group 1) and post (Group 2) intervention groups were compared with demographic and birth characteristics, as well as physicians’ maternity ward practices and EBF6M. The parameters that affect EBF6M were evaluated by logistic regression analysis.
Results: Group 1 and Group 2 were consisted of 141 and 131 mother-infant pairs, respectively. The infants were singleton, full-term and appropriate for gestational age at birth. The prevalence of EBF6M increased from 42.6% to 60.3% (p=0.003), initiation of formula before discharge decreased from 30.5% to 19.8% (p=0.044) after the intervention. The frequency of blood glucose monitoring (45.4% vs 33.6%, p=0.047) and early discharge (67.4% vs 19.8%, p<0.001) were lower in Group 2. Mothers in Group 2 were more likely to report satisfaction with their children’s growth at 6 months (92,2% vs 98.5%, p=0.015). In univariate analysis EBF6M was related to maternal anticipation of BF for 12-24 months (OR:2.12 95% CI: 1.15-3.91), a previous history of BF for at least 6 months (OR:2.17, 95% CI:1.34-3.53), BF training during pregnancy (OR:2.13, 95% CI:1.03-4.39) and less blood glucose monitoring (OR:1.65, 95% CI:1.01-2.70). Postpartum negative mood and grand parent support were preventive factors for EBF6M (OR:0.521, 95% CI:0.31-0.88 and OR:0.51, 95% CI:0.31-0.86, respectively). Study intervention was also related to EBF6M in multiple logistic regression. Conclusion(s): Even a brief comprehensive supervised training may change physician attitudes and contribute to recuperate BF outcomes.
Authors/Institutions: Aybike Korkmaz, Ankara Universitesi Saglik Bilimleri Enstitusu, Ankara, Ankara, Turkey; Emel Okulu, Ankara University School of Medicine, Ankara, Türkiye, Turkey; Beyza D. Erdogan, Ankara University, Ankara, , Turkey; Omer Erdeve, Ankara University School of Medicine, Ankara, Türkiye, Turkey; Begum Atasay, Ankara University School of Medicine, Ankara, Türkiye, Turkey; Saadet Arsan, Ankara University School of Medicine, Ankara, Türkiye, Turkey