Volume 32, Issue 119 (August 2019)                   IJN 2019, 32(119): 64-75 | Back to browse issues page

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Gharaei T, Amiri Farahani L, Haghani S, Hasanpoor-Azghady S. The Effect of Breastfeeding Training of Grandmothers on Their Attitude toward Breastfeeding. IJN 2019; 32 (119) :64-75
URL: http://ijn.iums.ac.ir/article-1-2990-en.html
1- MS Student in Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
2- Assistant Professor, Nursing Care Research Center (NCRC), Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Corresponding author) Tel: +98.2143651139 Email: amirifarahani.l@iums.ac.ir
3- MS. in Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
4- Assistant Professor, Nursing Care Research Center (NCRC), Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
Abstract:   (3795 Views)
Background & Aim: Breastfeeding has many benefits for both babies and their mothers, including scoring higher on IQ tests as adults and reduced chance of diabetes type 2, high serum lipid levels, and hypertension in adulthood (for the former), and decreased chance of breast and ovarian cancer, reduced postpartum hemorrhage by causing uterine contractions and reduced anemia (for the latter). Attitude toward breastfeeding is one of the strong predictors of breastfeeding intention, initiation, and continuation. A positive attitude toward breastfeeding leads to more belief about the benefits of breastfeeding. In addition, a person’s attitude toward this issue has a stronger impact on choosing to breastfeed (as a feeding method), compared to other demographic and social factors. Moreover, attitude toward breastfeeding is the first step toward increased breastfeeding duration and amount and can be affected by maternal, cultural, and environmental factors. Several identification factors affect attitude toward breastfeeding positively, which include high maternal age, high socioeconomic status, high level of education, and the decision to breastfeed. On the other hand, return to work was associated with a negative attitude toward breastfeeding. In addition, family members’ beliefs and opinions played an important role in mothers’ decision to breastfeed. Meanwhile, grandmothers are the key to success in breastfeeding since they affect mothers’ intention to initiate and continue breastfeeding using their knowledge and experience. Evaluation of grandmothers’ attitude toward breastfeeding can ensure that feeding with breastmilk is the natural feeding approach. Therefore, the present study aimed to determine the effect of the education of grandmothers on their attitude toward breastfeeding. 
Materials and Methods: This was a clinical trial with a pretest-posttest design and a control group, which was performed on 64 maternal grandmothers referred to Amir al Momenin Hospital in Tehran in 2018. Eligible individuals were selected by continuous sampling until the desired number of subjects was achieved. The next stage included the non-random allocation of the participants to the groups. The inclusion criteria were being literate, ability to understand and speak Persian, and gestational age of 31-34 weeks reported for their daughters. The subjects were allocated to two intervention (n=32) and control (n=32) groups weekly. In the intervention group, maternal grandmothers of infants participated in two one-hour breastfeeding training sessions along with their primiparous daughters at gestational ages of 31-34 weeks and 35-37 weeks. However, maternal grandmothers in the control group received no training, and the educational content was provided to these individuals at the end of the training sessions of the intervention group. In this study, the Iowa Infant Feeding Attitude Scale was completed by all participants before and after education, which evaluates attitude toward different feeding approaches in a valid and reliable manner. The items are scored based on a five-point Likert scale from one (completely disagree) to five (completely agree), and the score range was 17-85. In this regard, a higher score was indicative of a positive attitude toward breastfeeding. In addition, data analysis was carried out using descriptive and inferential statistics. 
Results: In this study, there was no significant difference between the two groups after the statistical analysis of the participants in terms of demographic characteristics. All grandmothers had breastfeeding experience, and, according to the independent t-test results, there was no significant difference between the groups regarding the mean score of the attitude toward breastfeeding before the intervention (P=0.24). Immediately after the intervention, however, we detected a significant difference between the groups in this regard (P<0.001), in a way that the mean score of the intervention group was higher, compared to the control group. Paired t-test also showed that the mean score of breastfeeding attitude of mothers in the intervention and control groups was significantly higher immediately after the intervention, compared to the beginning of the study (P<0.05). In addition, the mean changes in the control and intervention groups were 0.46 and 12.5, respectively. Moreover, the results were indicative of a higher increase in the score of the intervention group, compared to the control group (P<0.001). In other words, the education of grandmothers significantly improved their attitude toward breastfeeding in the intervention group.
Conclusion: According to the results of the present study, raising grandmothers’ knowledge of breastfeeding led to an improvement in their attitude toward breastfeeding. In addition, grandmothers’ attitude toward breastfeeding more increased in the intervention group immediately after the intervention, compared to the control group. During the training sessions, grandmothers had the chance to share information and experiences and exchange opinions, and ask questions to more effectively understand the topic. After the intervention, some of the participants concluded that they have had false beliefs about breastfeeding, changing their opinions based on the facts presented by the researcher during the training sessions. According to the results, the prenatal breastfeeding training program had a positive effect on mothers' and grandmothers’ attitudes toward breastfeeding immediately and one week after the intervention. Grandmothers have little information about breastfeeding, and some of them have a negative attitude toward breastfeeding or have misconceptions about it. Therefore, it is recommended that breastfeeding training classes be held for these individuals to correct these beliefs. The topics presented to the participants in the intervention group included breastfeeding, breastfeeding misconceptions and correction of these beliefs, which increased the mean score of attitude towards breast milk in the grandmothers of the intervention group, compared to the control group. In addition, maternal grandmothers’ breastfeeding experience was a predictor of their positive attitude toward breastfeeding. Attitudes toward continued breastfeeding depend on family support, and grandmothers are one of the most important sources of maternal support. Grandmothers' participation in prenatal and postpartum breastfeeding training sessions can encourage mothers to breastfeed and correct their breastfeeding attitudes and misconceptions, and create a positive attitude toward breastfeeding and continued breastfeeding for up to two years. The main goal of breastfeeding training for grandmothers is not only to increase their knowledge and information but also to improve their attitude towards breastfeeding.
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Type of Study: Research | Subject: Midwifery
Received: 2019/05/15 | Accepted: 2019/08/15 | Published: 2019/08/15

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