Development and evaluation of a self care program on breastfeeding in Japan: A quasi-experimental study

Masayo Awano,Keiko Shimada

doi:10.1186/1746-4358-5-9

Abstract

BackgroundAlthough the importance of breastfeeding is well known in Japan, in recent years less than 50% of mothers were fully breastfeeding at one month after birth. The purpose of this study was to develop a self-care program for breastfeeding aimed at increasing mothers' breastfeeding confidence and to evaluate its effectiveness.MethodsA quasi-experimental pretest-posttest design was conducted in Japan. The intervention, a breastfeeding self-care program, was created to improve mothers' self-efficacy for breastfeeding. This Breastfeeding Self-Care Program included: information on the advantages and basics of breastfeeding, a breastfeeding checklist to evaluate breastfeeding by mothers and midwives, and a pamphlet and audiovisual materials on breastfeeding. Mothers received this program during their postpartum hospital stay.A convenience sample of 117 primiparous women was recruited at two clinical sites from October 2007 to March 2008. The intervention group (n = 55), who gave birth in three odd-numbered months, received standard care and the Breastfeeding Self-Care Program while the control group (n = 62) gave birth in three even numbered months and received standard breastfeeding care.To evaluate the effectiveness of the Breastfeeding Self-Care Program, breastfeeding self-efficacy and breastfeeding rate were measured early postpartum, before the intervention, and after the intervention at one month postpartum. The study used the Japanese version of The Breastfeeding Self-Efficacy Scale Short Form (BSES-SF) to measure self-efficacy.ResultsThe BSES-SF score of the intervention group rose significantly from 34.8 at early postpartum to 49.9 at one month after birth (p < 0.01). For the control group, the score rose from 39.5 at early postpartum to 46.5 at one month after birth (p = 0.03). The early postpartum fully breastfeeding rate was 90% for the intervention group and 89% for the control group. At one month postpartum, the fully breastfeeding rate declined significantly to 65% for the control group compared to 90% for the intervention group (p = 0.02).ConclusionResults indicate that the Breastfeeding Self-Care Program increased mothers' self-efficacy for breastfeeding and had a positive effect on the continuation of breastfeeding.Trial Registration NumberUMIN000003517

Highlights

The importance of breastfeeding is well known in Japan, in recent years less than 50% of mothers were fully breastfeeding at one month after birth
It is highly desirable that an infant is fully breastfed for the first six months after birth, and that breastfeeding continues for as long as possible after six months [1]
In 2007, the Ministry of Health, Labor and Welfare Japan reported that 96% of women prior to childbirth wanted to breastfeed, and after childbirth almost all women started breastfeeding [3]

Summary

Introduction

The importance of breastfeeding is well known in Japan, in recent years less than 50% of mothers were fully breastfeeding at one month after birth. According to the same survey, only 42.8% of mothers were fully breastfeeding at one month after birth. The mean hospitalization period after normal childbirth in Japan is usually five to seven days. This period is rather long and unique to Japan. It is hypothesised that if mothers were supported appropriately and effectively during hospitalization, the breastfeeding rate in Japan would be higher. It is thought that during this period of care and post childbirth guidance by midwives the breastfeeding period would more closely match mothers’ earlier intentions. The present situation has raised questions about support measures and efficacy of care by health professionals

Objectives

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Results

Conclusion