Knowledge of Mothers Towards Exclusive Breastfeeding in Erbil's Maternity Hospital

Background: Exclusive breastfeeding (EBF) is defined as “an infant’s consumption of human milk with no supplementation of any type (no water, no nonhuman milk, and no foods) except for vitamins, minerals, and medications until six months. Mothers’ lack of knowledge and experience often results in difficulties in feeding especially when feeding the first time and it may result in the most frustrating experience for the mothers. The main aim of the study was to assess knowledge, towards breastfeeding among mothers attending Maternity Teaching Hospital in Erbil city. Subjects and methods: A cross-sectional design was used to achieve study objectives in Erbil Maternity Teaching Hospital in Erbil city, a non-random consecutive sampling method was adopted and the researcher was planned to involve one thousand mothers those were undergoing delivery regardless the type of delivery . Results: 73.7% of mothers have Knowledge about the benefits of BF for mothers and her baby but they don’t have good information about EBF about, and 74.1% of mothers thought EBF meaning feeding baby with breast milk and water and 13.7 were EBF. Up to 62% of mothers know that first breastfeeding has to be initiated after 1 hour of child life, half of the mothers know that child needs 6 months of exclusive breastfeeding. There was a relation between mother occupation and education level . Conclusion: Mothers have positive knowledge concerning breastfeeding initiation, knowledge regarding the exclusivity of breastfeeding, and duration of breastfeeding. There was a significant statistical association between occupation status and educational level of mothers


23.2%
was distributed from less than one week to even more than six months.Table 5. Family members had important role to give information to mothers regarding BF among more than three quarter of mothers 76.2% followed by mass media 10.6%, health staff 7.2% and 0.3% others subsequently .
Table 6 shows that the mothers' knowledge regarding the time of weaning BF varied and the answers were 1-2 years among 59% of mothers, more than two years among 32.3% and the least was less than 6 months 3.8% .
are as follows: start of breastfeeding within the first hour after birth; Exclusive Breastfeeding (EBF) for the first six months; and nonstop breastfeeding for 24 months or more, together with harmless, nutritionally adequate, age appropriate, responsive matching feeding starting from the sixth month Worldwide (90%) reportage of coverage of exclusive breast feeding reported to avoid in low and middle income countries approximately 13 % of all deaths among under five year-age [1.] Internationally, sub-optimal breastfeeding still accounts for an assessed 1.4 million deaths in children under five years annually.On average, only around 45% of infants under 6 months are exclusively breastfed globally, and only 38% of children less than six months of age in the developing world are exclusively breastfed and just 39% of those 20-23 months old benefit from the practice of continued breastfeeding [2].The advanced of international breastfeeding rates in the last decade about 39 percent of children <6 months of age in the developing world are exclusively breastfed [2.]According to the general characteristics of early breast-feeding, it is exposed higher in central and southern Iraq, the highest percentage than in the Kurdistan region and also higher in rural compared to urban areas is higher when natural childbirth compared to caesarean birth and is reduced with high education all mothers [3].While the number of children receiving the smallest amount of food diversity increases with the increase in the education mothers the old rages, especially 18 months and above, as well as in urban associated with the countryside [3].Many studies conducted on EBF in the last years have shown progressive improvement in maternal knowledge in EBF among mothers.A study by Oche et al recorded a rate of 54 % of knowledge in EBF among mothers [4].A a study conducted by Mogre et al. among lactating mothers in rural areas in Ghana noted that 74 % of mothers who participated in the study study was used to study the knowledge, attitude and practices of mothers towards exclusive Breastfeeding in Erbil's Maternity Teaching Hospital (EMTH).This hospital is the unique public hospital inside Erbil city and it provide obstetrical and gynecological services for the population inside the city and to the rural areas around the city.The majority deliveries in Erbil city occurred in EMTH and the minority were taken place either at homes by Trained Birth Attendance or at few private hospitals [7].A non-random consecutive sampling method was adopted and the researcher was planned to involve (1000) mothers those were undergoing delivery at EMTH regardless the type of delivery ( whether normal vaginal delivery or by caesarean section) , and the mothers were interviewed at post-delivery care wards , and all mothers who were accepted to participate in the study were included .Response rate The response rate was 81% as about 190 mothers refused to participate in the study (all of them are undergoing cesarean section), the acceptable response rate for survey studies is 80-85%[8.]Data collection and interventional phase Data were collected by interviewing the involved mothers through face to face (direct interview).The researcher visited the EMTH at different times per day (in the morning, noon, evening and at night times).The researcher before establishing each interview a prior verbal consent was obtained from each mother, and the interview was done by using a structured questionnaire prepared by the researchers .Pilot Study A pilot study was run to test the preliminary prepared questionnaire.It was conducted at the beginning of January 2019 in EMTH, and the researcher chosen sample of 30 mothers at post-delivery care ward, and after the pilot study the questionnaire was modified.The enrolled sample was excluded from original sample of the study .Instrument of data collection Data collection was done through a structured questionnaire prepared by the researchers and it consists of two sections.A list of (9) items consists of Sociodemographic variables which include (mother's age, occupation, educational level, residency, obstetrical history, Antenatal care type of delivery, ethnicity and monthly family income) , the second section consist of list of (10) items testing mothers knowledge regarding infant and young child feeding and includes (first food that should be given for newborn, when should mother start Bf after delivery, benefits of BF for baby and for the mother, the time start the BF after delivery, the meaning of EBF, the duration of EBF, source of information regarding EBF, right time of stating complementary foods, whether the BF enough for newborn feed.)Descriptive and inferential statistics used through the Microsoft Excel data base jointly with the statistical package for social sciences (SPSS version 23).Chi square test and P-value used to determine the significant relationships between the variables.The P-value ≤ 0.05 considered as statistically significant .Ethical consideration Prior to data collection, the study was approved by the ethical committee in the Shekhan Technical College of Health and an official authorization was obtained from the Erbil General Directorate of Health Erbil and EMTH.A prior verbal consent was obtained from each mother before conducting the interview .Limitations of the study Some mothers were undergoing caesarean sections and because they complained from the surgery and some of their babies were admitted to Neonatal care units (in incubators) so many of them are refuse to participated in the study.

Table 1 :
Association between educational level and occupation

Table 2 :
First Baby Food

Figure 2: Benefits of BF for mothers
Table4:

Table 6 :
Distribution of mothers accordingto their knowledge on BF weaning