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The Importance of Breastfeeding for a Baby’s Growth and Development

Question:

Discuss about the Problems Associated With Breast-Feeding In Maldives.

The first food of life is immensely important for a baby’s growth and development. Mother’s milk plays as important role after the birth and helps the baby to survive the postnatal world (Victora et al., 2016). Through the breast milk, the baby can acquire nutrients in proper proportions, gets protection against allergies, diseases, obesity, ear infection and pneumonia. The breast milk is easily digested and helps the baby to grow with healthier weights (Allen, 2012).

Maldives stands in a better place than the world with 64 percent of newborns having breastfed within 24 hour of their birth. However, the problem arises afterwards where only 48 percent of the children are breastfed up to six months.  Therefore, the amount of babies growing with proper amount of macro and micronutrients decreases with time in Maldives (MINISTRY OF HEALTH, 2017). According to the nurses of a local hospital, the prime reason behind lack of breast milk in mothers are introduction of C-section. Mothers are unable to generate milk after the caesarian and hence, newborns develop complications. To overcome these problems, previous assignments has discussed a research proposal with specific aims, objectives and evaluation strategies. An interim report on the benefits of the technology, learning activities, tools, framework of the guideline, success and barriers to attain success has also been discussed (Binns et al., 2012).

This final assignment is going to discuss the complete plan of activities, which was prepared in the previous assignment and will compare it to the activities, which was performed on the ground. The success to get the product with potential barriers to achieve those will be discussed. Finally, recommendations to achieve the success in the health promotional campaign with strategies to remove the barriers will be discussed thoroughly.

According to the World Health Organization (WHO), newborns should receive only breast milk up to 6 months of their age. During that period, they are not allowed to feed with any other solid or liquid other than drops of minerals, vitamins and medicines (Lutsiv et al., 2013). This is very important for the optimal growth, development and health. This process is termed as ‘Exclusive Breastfeeding’, which is important to provide the baby with adequate nutrition and elements to create a shield of immunity.


The statistics of Maldives shows that exclusive breastfeeding is not so much practices, when it comes to the long-term procedure of breastfeeding. Only 10.4 percent of mothers fed their babies for a period of six months. According to an unofficial interview conducted with 10 women, shows that only 30 percent of them are able to follow the exclusive breast-feeding program for 6 months. The prime reasons, which was extracted from the conversation with them, are influence of a senior member of family (20 percent), misconception of mothers about the lack of milk in their body (30 percent). The third reason found was working women, who are unable to continue the breastfeeding program (20 percent) and finally mothers, who thinks formula milk will help to increase the weight of baby optimally (Setegn et al., 2012).

Breastfeeding Situation in Maldives

According to Joseph (2013), the reason behind non-practice of exclusive breastfeed is stressful conditions, lack of the knowledge about the importance of breastfeeding and refusal from the mother. Different studies have been conducted all around the world to understand the fact that hinders mothers to breastfeed their children. Lack of knowledge about this important issue, absence of supportive environment to influence this infant feeding practice and different myths and misconceptions are the prime reason found from all those studies (Cai, Wardlaw & Brown, 2012). In a similar study done in Ethiopia reveals that employed mother are unable to feed their infants and their reason behind it was workplace barriers that contributes in the lowered rate of breast feeding practices. Hence, it is evident from all studies that lack of awareness is the main reason for the ignorance or refusal of mothers towards the breastfeeding process and it can only be achieved through sustained education, personal interviews and support (Sankar et al., 2015).

The prime aim of the proposal for the promotional and awareness campaign was to increase the awareness about the importance of exclusive breastfeeding program (EBFP) and spread awareness about it among mothers attending IGMH reproduction health unit. Further, the secondary aim was to help them to overcome the barriers of EBFP (Smith-Gagen et al., 2014).

The objectives to achieve the aim was –

  • Identify the attitude and knowledge of mothers who are continuously feeding their babies under exclusive breast feeding program
  • Identify the problems and challenges nursing mothers have to face while feeding their babies
  • Educate the mothers about those barriers and provide them the ways to overcome that.
  • Find four techniques to manage the breastfeeding practice despite of the barriers.
  • To create awareness, use leaflets to educate the population about the importance of breast milk in growth and development of newborn babies.

According to the studies done by Thet et al. (2016), Myanmar is one of the several countries where rates of breast-feeding is comparatively lower than other parts of the world. The government of Myanmar is working properly to spread the information about the importance of breast-feeding among newly born however; the population is not following the procedure. The researchers carried out a semi –structured interviews with mothers of 6-12 month old kids, their husbands, their mother or mother in laws in different rural or urban places of Laputta, Myanmar. The results from the study revealed that, it was the influence of the families who thought that breast-feeding is not important for the babies. In spite of the breast milk, they started feeding babies with rice and water. On the other hand, maximum respondents accepted the fact that, it was their lack of knowledge that stopped them to feed their children with breast milk.

Another research done by Ugboaja et al. (2013) revealed that it is the lack in care settings that affects the postnatal care for the newborn as well as the mother in Nigeria. To identify the potential barriers, they conducted a survey with 400 mothers and used semi-structured questionnaire for discussion. The results revealed that 42 percent of women were unaware about the benefits of breast milk, whereas, 36 percent women did not even went to hospitals for their delivery.

Reasons behind Breastfeeding Hurdles in Maldives


Another research focused on the barrier, which is one of the effective barrier to hinder the breast feeding process for infants, employed mothers. In Ethiopia, more than half of the children are not fed with breast milk in their first six months and to promote that, socio-demographics, health related behavioral and economic factors are important to be spread amongst the population (Chekol et al., 2017). To understand the barriers, a community based comparative cross-sectional study they conducted in which 649 mothers were selected randomly and a preselected questionnaire were used to collect the data from those women. Within this, 333 mothers were unemployed and 316 mothers were employed. The results revealed that, the mean duration of the mother feeding their children was 4.77 months. The main finding of the experiment was the fact that breast-feeding was higher in the unemployed mothers with 48 percent than employed mothers with 20.9 percent were. Poor knowledge was 16 percent and most of the women who were unaware about it, fed their children with rice or water, which can be dangerous to those children.

Another evidence was collected from a research study done by Abuidhail et al. (2014) about the problems regarding decrease in the rates of breast-feeding in both developed and developing countries. They found that in both the developed and developing countries the common problems were breast engorgement, insufficient production of milk, soreness and other breast related problems (Keely et al., 2015). In developing countries where, the employment rules for pregnant and mother of newborns are not properly structures, faces the problems regarding the breast-feeding processes. They are not provided with the maternal leave for 6 months and hence, their work culture prevents them to feed their baby with breast milk. Another factor according to this factor focuses on the social aspect for the reason of refusal by mothers. The cultural and social mindset of several countries objectifies women body as the epitome of pride and respect and if someone watches the women breastfeeding her child, the associated family will lose its respect in the society. For example, in India, full time employed women are not been able to breastfeed their children as breasts are sexualized in their culture (Radhakrishna & Balamuruga, 2012). The husbands of such women also discourages their wife to breastfed because of the social factors. this research also points out several psychosocial barriers of breast-feeding in which, women opt out of the breast feeding process because it hampers their physical structure, less freedom or inability to supply ample amount of milk to the baby. This occurs due to the lack of knowledge about the beneficiary effect of breast milk, poor upbringing and less cultural approach among mothers (Mulready-Ward & Hackett, 2014).

Identifying Barriers around the World

To assess the problem regarding breast-feeding among the women in Maldives, a plan of action was prepared, in which the time was divided into weeks and the research proposal was need to be submitted by the fourth week. The first priority was to decide a bunch of topics on which the proposal was needed to be prepared. Then with the help of the tutor, one topic has to be finalized. In this case, it was the barriers related to breast-feeding in Maldives. Furthermore, it was necessary to submit the proposal by the fourth week of the month (Hine, 2013). After receiving clearance, the second step was to prepare an interim report. It was done with the help of interviews conducted with a group of nursing mothers in the reproductive health unit. The deadline to submit the interim report was 9th week of that month. The final report is overdue on the 10th week and finally the leaflet regarding the project to raise the awareness will be distributed among the people of Maldives (Mackenzie et al., 2012).

This was the expected plan of action, whereas, the actual plan was little slow while implementation. The team was able to arrange few important topics for the promotional campaign research proposal however; at the end, it took few more time to select the final topic for the assignment. Consequently, the submission of the proposal was done by 5th week. However, once the peer review was collected, interim report was prepared within the deadline and the interim report was submitted within 8th week.

The following Gantt chart describes the modified timeline.

Month

Week

1

2

3

4

5

6

7

8

9

10

11

12

13

14       

Exam week

1. choose the topic

Finalize the topic after meeting the tutor

Decide the aims and objectives

Prepare the proposal

Submit the proposal

Receive the peer review

Receive tutorial for interim report

Start working on interim report

Conducted unofficial interview to the nurses from gynea ward and reproductive health unit.

Send the report for feedback

Submit the interim report

Write the final report

Prepare the end product that is leaflets

This is the revised period for proposal and interim report and based on this, the final report will be submitted by 11th week of the course and the leaflet will be distributed among the population.

The biggest success of this assignment was to achieve the completion within the deadline. The fact that the research was completed within deadline was inspiring to compile the entire document as a final document and distribute the leaflet among the population. Problems regarding breast-feeding in Maldives is increasing day by day hence; the project was very complicated to proceed with, however it was achieved successfully (Pérez-Escamilla et al., 2012).

The first and second objective, which was to identify the knowledge about the exclusive breast-feeding practice was achieved with the conducting an interview with 20 feeding mothers. These mothers describes their potential barriers in feeding their babies. The interview was successful as each and every mother was vocal during it. Another reason for the success of the interview was the open-ended questionnaire prepared for the interview. The third objective was to identify techniques that will help to manage the breast-feeding practices in deeding mothers.  This was made successful with the help of research journals and authenticated databases. Further, different unofficial interviews were conducted to identify different techniques to enhance this important practice among the feeding women. Finally, the biggest success was the change in the personal perspective, which occurred while searching for evidences or conducting interviews regarding breast-feeding. Objectifying women body was one of the biggest trauma, that is affecting the society and the consequences are suffered by those newborns. Exploring different journal while working for the assignment was inspirational and motivational to conduct more research like this, which can initiate a change in the point of view of the society (Reinhard & Hassmiller, 2012).

Plan of Action to Promote Awareness in Maldives

There were numerous barriers while achieving success for the assignment. The first difficult situation was associated with the selection of the topic and it took an entire week to decide about the topic, as there were numerous topics present in the society, which was very important to raise at that time. Further, from the top three selected topics, it was again a difficult task to decide one appropriate task to conduct this important assignment, which is important not just for us, but also for the society as no one talks about it.

The second biggest barrier was to cope up with the minimal time, left for the completion of the assignment. It was difficult as there were seminars present in those weeks when the assignment was needed to be completed. The interim report was more challenging as the deadline for the proposal was missed by a week and the challenge was to submit the interim report on time. However, the later was successfully achieved (Yuosoff & Kardooni, 2012).

The third barrier was group assignment. This group assignment was important to submit on time, as a complete group was involved and it was the responsibility of the every group member to complete he allotted task on time for everyone. However, this barrier was successfully dodged as well.

Conclusion

Maldives, being a small nation, without any resources and natural support, bears a literacy percentage of 96, which is bigger than so many first and second world countries. However, it is happening in a literal nation, where newborns are unable to get the much-needed breast milk, which is very important for their growth and development. Hence, this topic was chosen for the important assignment to identify the barriers and the techniques to outcome those barriers that influences mothers to refuse the need of their newborns. There were different barriers while progressing with the topic; however, each barriers was overcome with the help of teamwork and support. Every member of the team performed under pressure and hence, the completion of this difficult research was made possible. After this assignment, the final part f the assignment will be left which is generation of leaflets to spread the knowledge obtained from the assignment to the people of Maldives so that they can promote breast-feeding on their own in the society. This needs breaking stereotypes and misconception, scientific thinking and positive approach. If people starts thinking positively and neglects the misconceptions regarding breastfeeding, it will be easier for the women to change their mindset and feed their babies with breast milk. Furthermore, the government should also start campaigns so that the awareness can be spread starting from the basal level

References

Abuidhail, J., Al-Modallal, H., Yousif, R., & Almresi, N. (2014). Exclusive breast feeding (EBF) in Jordan: Prevalence, duration, practices, and barriers. Midwifery, 30(3), 331-337.

Allen, L. H. (2012). B vitamins in breast milk: relative importance of maternal status and intake, and effects on infant status and function. Advances in Nutrition: An International Review Journal, 3(3), 362-369.

Cai, X., Wardlaw, T., & Brown, D. W. (2012). Global trends in exclusive breastfeeding. International breastfeeding journal, 7(1), 12.

Chekol, D. A., Biks, G. A., Gelaw, Y. A., & Melsew, Y. A. (2017). Exclusive breastfeeding and mothers’ employment status in Gondar town, Northwest Ethiopia: a comparative cross-sectional study. International Breastfeeding Journal, 12(1). https://doi.org/10.1186/s13006-017-0118-9 retrieved  from: https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-017-0118-9.

Hine, G. S. (2013). The importance of action research in teacher education programs. Issues in Educational Research, 23(2), 151-163.

Keely, A., Lawton, J., Swanson, V., & Denison, F. C. (2015). Barriers to breast-feeding in obese women: a qualitative exploration. Midwifery, 31(5), 532-539.

Lutsiv, O., Giglia, L., Pullenayegum, E., Foster, G., Vera, C., Chapman, B., ... & McDonald, S. D. (2013). A population-based cohort study of breastfeeding according to gestational age at term delivery. The Journal of pediatrics, 163(5), 1283-1288.

Mackenzie, J., Tan, P. L., Hoverman, S., & Baldwin, C. (2012). The value and limitations of Participatory Action Research methodology. Journal of hydrology, 474, 11-21.

Ministry Of Health. (2017). Cite a Website - Cite This For Me. Health.gov.mv. Retrieved from https://www.health.gov.mv/Uploads/Downloads//Informations/Informations(73).pdf

Mulready-Ward, C., & Hackett, M. (2014). Perception and attitudes: breastfeeding in public in New York City. Journal of Human Lactation, 30(2), 195-200.

Pérez-Escamilla, R., Curry, L., Minhas, D., Taylor, L., & Bradley, E. (2012). Scaling up of breastfeeding promotion programs in low-and middle-income countries: the “breastfeeding gear” model. Advances in Nutrition: An International Review Journal, 3(6), 790-800.

Radhakrishnan, S., & Balamuruga, S. S. (2012). Prevalence of exclusive breastfeeding practices among rural women in Tamil Nadu. International Journal of Health & Allied Sciences, 1(2), 64.

Reinhard, S., & Hassmiller, S. (2012). The future of nursing: Transforming health care. The Journal AARP International.

Sankar, M. J., Sinha, B., Chowdhury, R., Bhandari, N., Taneja, S., Martines, J., & Bahl, R. (2015). Optimal breastfeeding practices and infant and child mortality: a systematic review and meta?analysis. Acta paediatrica, 104(S467), 3-13.

Setegn, T., Belachew, T., Gerbaba, M., Deribe, K., Deribew, A., & Biadgilign, S. (2012). Factors associated with exclusive breastfeeding practices among mothers in Goba district, south east Ethiopia: a cross-sectional study. International breastfeeding journal, 7(1), 17.

Smith-Gagen, J., Hollen, R., Walker, M., Cook, D. M., & Yang, W. (2014). Breastfeeding laws and breastfeeding practices by race and ethnicity. Women's Health Issues, 24(1), e11-e19.

Thet, M. M., Khaing, E. E., Diamond-Smith, N., Sudhinaraset, M., Oo, S., & Aung, T. (2016). Barriers to exclusive breastfeeding in the Ayeyarwaddy Region in Myanmar: Qualitative findings from mothers, grandmothers, and husbands. Appetite, 96, 62–69.

Ugboaja, J., Berthrand, N., Igwegbe, A., & OBI-Nwosu, A. (2013). Barriers to postnatal care and exclusive breastfeeding among urban women in southeastern Nigeria. Nigerian Medical Journal, 54(1), 45.

Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., ... & Group, T. L. B. S. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475-490.

Yuosoff, S., & Kardooni, R. (2012). Barriers and challenges for developing RE policy in Malaysia. In International Conference on Future Environment and Energy IPCBEE (Vol. 28).

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