ABSTRACT

Melbert Joseph R., Maquifiana, Kirk Daniel Q., Paja Michelle joy R, BREASTFEEDING COMPLIANCE OF LACTATING MOTHERS IN BARANGAY ILAWOD II, LEGAZPI CITY (Unpublished Undergraduate Thesis, Aquinas University of Legazpi College of Nursing and Health Sciences, October 2011)

This study aimed to determine breastfeeding compliance of lactating mother in Barangay Ilawod I, Legazpi City . Specifically, it sought to answer the following
questions:1. What is the demographic profile of the respondents in terms of: A.Lactating Mothers: a.1 Age, a.2 Educational Attainment, a.3 Occupation, and a.4 Family Monthly Income; B. BHW’s: b.1 Age, b.2 Educational Attainment, b.3 Occupation, b.4 Family Monthly Income, b.5 Years in Service, and b.6 Training Attended?; 2. Are the lactating mothers knowledgeable along: a. Breastfeeding, b. Stoppage of breastfeeding, c. Bottle feeding, and d. Mixed Feeding?; 3. What is the level of performance of the Barangay Health Workers in the Breastfeeding Promotion?; 4. What factors affect the breastfeeding compliance as perceived by the lactating mothers and the Barangay Health Workers?; 5.What measures may be proposed to effectively promote breastfeeding compliance among lactating mothers?

This study used the descriptive type of research design. The data came from lactating mothers with infants from the Iawod Il, Legazpi city and barangay health workers who served as the respondents of the study. The following are the findings of the study: 1. For the lactating mothers, the age bracket of 21-25 had 3 respondents or 13.64%. Those who belonged to the age bracket of 26-30 were 9 or 40.29%, age bracket of 31-35 had 8 respondents or 36.36% and both of the age brackets 36-40 and 41-45 both had 1 respondent or 4.55%. Most of the respondents were college graduates with 8 respondents or 36.36%.7 of the respondents or 22.73% high school graduates. Also, 5 respondents or 31.82% have attained college level. While both vocational and elementary graduate had 1 respondent or 4.55%. Majority of the lactating mothers were housewives with 17 respondents or 77.27%. While “labandera”, crew, sales lady, employee, and vendor all had 1 respondent each or 4.55%. 44.44% of the respondents had a monthly income of Php 3,000-4,00 followed by Php 4,900-6,700 with 27.78% of the total respondents. While brackets of Php 6,800-8,600 and 8,700-10,400 both had 11.11% of the total respondents and, lastly, only 5.56% of the respondents had a monthly income of Php10,500-12,200. Two out of 4 of the BHWs belonged to the age bracket of 27-28 years old while only of them belonged to age bracket of 29-30. Also, one BHW belonged to age bracket of 31-32 years. This implies that only 1 out of the 4 BHWs was above 30 years old or the one who had a much experience working as BHW. Three of the 4 BHWs were college graduates. Only 1 of them was able to graduate from high school. Based on the data, not all BHWs were required to have a college degree with just enough trainings and knowledge one can be a BHW. Two of the BHWs had a family income of Php 7,000-8,000. While in brackets 3.000-4,000 and 5,000-6,000php both had 1 respondent each. This finding shows that BHWs do not have enough income for them to support their families especially those with big families. Three out of the 4 BHWs had served 1-2 years . Only one of the respondents was already in service for 3-4 years. Most of the BHWs have attended barangay training in barangay health while on Basic life support, Basic nutrition seminar and First aid training all had lor 25% of the respondents. 2. All of the lactating mothers knew that breastfeeding has the ability to form a strong bond between mother and baby.

Majority of respondents also knew that they can breastfeed exclusively until about six months, then continue breastfeeding for up to two years or longer while adding
complementary foods (15 or 68.18%); that almost all women, regardless of breast size and even with inverted nipples can breastfeed ( 17 or 77.27 %); that it is often easy for women who breastfed to lose weight after giving birth since their bodies use so much energy to make milk (20 or 90.91%); that women who breastfeed for six months can lose all of the weight gained during pregnancy(15 or 68.18%); and that breastfeeding will not ruin the shape of their breasts (15 or 68.18%). Likewise, majority of them knew that most women with health problems can still breastfeed, except those tested positive for HIV ( 15 or 68.18%); that breast milk is the natural milk that protects baby from illnesses (17 or 77%); that breast milk has the right amount of nutrients for their babies until they are four to six-months old ( 19 or 86.36%); that breastfeeding reduces your risk to breast cancer (15 or 68.18%); that your body will respond to the baby’s sucking and you will produce enough milk (15 or 68.18%); that breastfeeding is protective against allergic conditions, such as asthma and eczema (13 or 59.09%) and that breastfeeding enhances intelligence and mental development (14 or 63.64%). However, 14 or 63.64% of them did not know that women who have had cesarean sections can breastfeed comfortably by using different positions. This finding shows that most of the lactating mothers have knowledge about breastfeeding. Fifteen or 38.18% of the lactating mothers’ main reason to stop breastfeeding was because the baby got sick and could not be breastfed. Also 14 or 63.64% of them knew that breastfeeding could be stopped if the baby had trouble sucking or latching on properly, while 15 or 68.18% of them believed that breast milk alone can satisfy the baby. Fourteen or 63.64% of them knew that breastfeeding is stopped when it is too tiring. Majority of the lactating mothers knew that the nutritional contents of the milk formula depend on proper preparation (20 or 90.91%) and that bottle feeding can be much more inconvenient than breastfeeding (18 or 82%). Likewise, 17 or 77.27% of them knew that bottle feeding produce more gas and air swallowing problems with artificial nipples than mother’s nipple; that there are high chances that the baby may develop infections in bottle feeding; that when making formula milk, it is possible to get the mixture wrong and make it too strong, too weak, or too hot; that the bottle fed babies have an increased risk of obesity at least until six years of age; that bottle feeding can be more expensive than breast feeding and that some babies have difficulty tolerating certain nutrients on milk formula. This implies that the lactating mothers knew the disadvantages of bottle feeding. Also, majority of the lactating mother knew that if they decide to combine bottle feeding with breastfeeding, they should not introduce bottle feeding during the first six weeks of life (17 or 77.27%) and that the difference between nipples can confuse the baby, causing feeding problems, and interfering with the establishment of breastfeeding (15 or 68.18%). This implies that they knew that there are problems that they could encounter in mixed feeding. 3. The lactating mothers perceived that sometimes BHWs emphasized the hazards and risks of the improper use of breast milk substitutes were emphasized in the health education session (22.25). This means that they perceived that the BHWs always encourage and promote breastfeeding (3.00); provide information on breastfeeding (2.27); provide materials; written, audio or visual dealing with the feeding of infant and intended to teach pregnant mothers and mothers of infants (3.00); explain the benefits and superiority of breastfeeding (3.00), the negative effects on breastfeeding of introducing partial bottle feeding (2.50), the difficulty of reversing the decision not to breastfeed (3.00) and the proper use of infant formula, whether manufactured industrially or home-prepared (2.75). They were also observed that they always make sure that the health care facility was not used to promote infant formula or other infant products relative to bottle feeding (3.00);prohibit manufacturers and distributors from distributing to pregnant women or mothers of infants any gifts or articles or utensils which may promote the use of breast milk substitutes or bottle feeding (3.00). The BHWs had the same perception as the lactating mothers. They also perceived that they sometimes emphasized the hazards and risks of the improper use of breast milk substitutes were emphasized in the health education sessions (2.27); prohibit manufacturers and distributors from distributing to pregnant women or mothers of infants any gifts or articles or utensils which may promote the use of breast milk substitutes or bottle feeding (2.27); explains the proper use of infant formula, whether manufactured industrially or home-prepared (2.27), the benefits and superiority of breastfeeding (2.40). They always encourage and promote breastfeeding (2.54); provide information on breastfeeding (2.54), materials; written, audio or visual dealing with the feeding of infant and intended to teach pregnant mothers and mothers of infants (2.59); explain the negative effects on breastfeeding of introducing partial bottle feeding (2.68) and the difficulty of revering the decision not to breastfeed (2.63); and make sure that the health care facility was not used to promote infant formula or other infant products relative to bottle feeding (2.77). In general, both the lactating mothers and the BHWs themselves perceived that the BHWs always perform their role in the promotion of breastfeeding compliance. 4. The lactating mothers identified the following as the top three factors that affect breastfeeding compliance: Too busy on household chores (Rank 1); Lack of knowledge on the importance of breastfeeding (Rank 2); and could not breastfeed while at work (Rank 3). While the BHW’s had also top two factors that affect breastfeeding compliance: Lack of knowledge on the importance of breastfeeding (Rank 1.5); and too busy on household chores (Rank 1.5). 5. Conduct seminars or health teachings regarding the importance and benefits of breastfeeding. The study also found out that lactating mothers do not have much knowledge about breastfeeding. This only shows that the barangay health workers should be more mobile in giving the mothers more information about the importance of breastfeeding. BHWs should do house to house visits to all lactating mothers that are not complying with breastfeeding for them to comply with breastfeeding.

The following are the conclusions derived from the findings of the study:
1. Majority of the lactating mothers are within the age bracket of 25 — 30. Most of them are college graduate but majority of them are housewives belonging to families with monthly income below Php 6,700. Half of the number of BHWs belong to the age bracket of 27- 28 years old and majority of them are college graduates belonging to families with monthly income below Php 8,000. 2. The lactating mothers had knowledge about the importance breastfeeding, the reasons for stoppage of breastfeeding, and the advantages as well the disadvantages of bottle feeding and mixed feeding. 3. The lactating mothers perceived that BHWs perform their role on Breastfeeding Promotion 20 to 79% of the times. Likewise, the BHWs believed that they perform their role on Breastfeeding Promotion 20 to 79% of the times. 4. There are factors affecting breastfeeding compliance that were identified by the lactating mothers and BHWs such as being too busy on household chores and the lack of knowledge on the importance of breastfeeding. 5. There are measures that could be proposed that effectively promote breastfeeding compliance by conducting seminars and giving health teachings regarding the importance and benefits of breastfeeding. The study also found out that lactating mothers don’t have much knowledge about breastfeeding. This only shows that the barangay health workers should be more mobile in giving the mothers more information about the importance of breastfeeding. BHWs should do house to house visits to all lactating mothers that are not
complying with breastfeeding for them to comply with breastfeeding.

The following are the recommendations drawn from the conclusions of the study:
1. The barangay officials especially the barangay health workers should promote
breastfeeding in their own barangay. Because based on the research done in barangay
Ilawod
2, legazpi City, Most of the lactating mothers are not complying with breastfeeding. BHWs must provide seminars and health teachings to all lactating mothers
regarding the importance and benefits of Breastfeeding. Based also on the research done, it was found out that most of the lactating mothers are having difficult time on breastfeeding such as they do not have time to breastfeed their babies. It is recommended that all mothers should be provided with enough knowledge and information particularly when it comes to compliance and proper practice of breastfeeding; and also providing them information that their babies needs the proper nutrients that they need for healthy growth and development. Especially on how they can provide breast milk on their baby even though they are not around.
3. The study also found out that lactating mothers do not have much knowledge about breastfeeding. This only shows that the barangay health workers should be more mobile in giving the mothers more information about the importance of breastfeeding. BHWs should do house to house visits to all lactating mothers that are not complying with breastfeeding for them to comply with breastfeeding.
4. One of the main reasons why BHWs cannot give the proper information is that they do not have enough support coming from the government. This study
recommends that Department of health should make programs and activities that can improve the knowledge of BHWs and lactating mothers for them to improve the
compliance of breastfeeding. They also should provide enough budgets for the barangay health centers to be more accountable to all the BHWs and lactating mothers in providing health teachings to the respondents.The community should also participate in different kinds of activities regarding breastfeeding for them to be more knowledgeable about breastfeeding.