Percent Of Mothers Research Articles

Determinants of utilization of antenatal care services in rural area of Bangladesh

Appropriate ante-natal care services promote safe motherhood and delivery with improved maternal and neonatal outcome. This population based cross sectional descriptive study was carried out to determine the utilization of antenatal care (ANC) services in a rural community of Bangladesh. Out of the 112 women studied, 63.4% mothers were found to receive antenatal care. Among them one third (32.4%) took it more than 4 occasions, 34(47.8%) pregnant women received antenatal care from government hospitals, 19(27%) from family welfare centre, 6(8.5%) from satellite clinics and around 12(17%) received from private hospitals. Around 71% mothers received ANC service from doctor while 17% mothers received from trained professionals. Seventy four percent mothers received tetanus (TT) injections. Only one fourth (25.3%) mothers had not received it. On an average, 90% mothers received iron tablets during their pregnancy. Regarding have danger signs during pregnancy, it was found that, 58.9% mothers were not aware about the have danger signs and 29.5% respondents knew about all the danger signs. Association between educational status and treatment seeking behaviour for pregnancy complication was found to be statistically significant (p<0.05). However, association between educational status and place of treatment for pregnancy complication was also found significant (p<0.01). Intensive awareness programme, behavioural change interventions and regular pregnancy monitoring may promote antenatal care service utilization in rural Bangladesh.Bangladesh Med J. 2015 May; 44 (2): 67-71

Multi-tiered quality improvement strategy to reduce maternal and neonatal death in complex delivery systems in Ghana

24 www.thelancet.com/lancetgh Published Online April 8, 2016 University of North Carolina, Chapel Hill, NC, USA (R Ramaswamy PhD); Kybele, Winston-Salem, NC, USA (B Kallam MPH); Ridge Regional Hospital, Accra, Ghana (E Srofenyoh MD); Wake Forest University, Winston-Salem, NC, USA( (M Owen MD) Correspondence to: R Ramaswamy, 4107, McGavranGreenberg Hall, 135 Dauer Drive, Chapel Hill, NC 27514, USA ramaswam@email.unc.edu Multi-tiered quality improvement strategy to reduce maternal and neonatal death in complex delivery systems in Ghana Rohit Ramaswamy, Brianne Kallam, Emmanuel Srofenyoh, Medge Owen Abstract Background Referral hospitals see a disproportionate number of maternal and neonatal deaths in low-income settings such in Ghana. In 2013, the maternal mortality ratio in Ghana was 380 per 10 0000 livebirths: in 2015, combined data from three large referral and teaching hospitals showed a rate of 895 maternal deaths per 100 000 livebirths. For these deaths to be reduced, staff capacity needs to be developed to routinely identify problems with service delivery processes, and data-driven approaches will be required. In this study, we describe implementation of a quality improvement programme at Ridge Regional Hospital in Accra, Ghana.Background Referral hospitals see a disproportionate number of maternal and neonatal deaths in low-income settings such in Ghana. In 2013, the maternal mortality ratio in Ghana was 380 per 10 0000 livebirths: in 2015, combined data from three large referral and teaching hospitals showed a rate of 895 maternal deaths per 100 000 livebirths. For these deaths to be reduced, staff capacity needs to be developed to routinely identify problems with service delivery processes, and data-driven approaches will be required. In this study, we describe implementation of a quality improvement programme at Ridge Regional Hospital in Accra, Ghana. Methods Between 2013 and 2015, Ridge Regional Hospital adopted a quality improvement programme in three stages. In the fi rst stage, two senior staff members were selected to serve as QI (quality improvement) leaders and received 4 days of training in Six Sigma methods. In the second stage, two frontline staff from each of the eight departments in obstetric and neonatology were appointed as clinical champions and received 1 day of training in the running of small improvement projects using Lean principles and the Plan-Do-Study-Act approach. In the third stage, two levels of improvement projects—interdepartmental, led by the QI leaders and departmental, led by the clinical champions—were launched. Findings Within 6 months of the introduction of the quality improvement programme, two systems projects and two departmental projects to address waiting time for emergency caesarean sections and hand hygiene in the neonatal intensive care unit had begun. The two department-level projects addressed the triage of sick mothers and cleaning and organising the neonatal intensive care unit to reduce errors. There was a four-fold reduction in the percentage of mothers needing emergency caesarean surgery with unacceptable waiting times, over 93% accuracy in identifi cation of the sickest mothers, and a 37% increase in hand hygiene compliance. Interpretation The multi-level approach taken for quality improvement programmes has had some success in this referral hospital in Ghana. Improvements cannot be achieved without the engagement of all staff across levels, but selected leaders also need the analytical capability to address complex system problems. Each level reinforces the other. The approach at Ridge Regional Hospital is being scaled-up to four other Ghanaian regional hospitals. Furthermore, a learning network is being created to share improvement solutions across the entire system. To engage front line staff in building these capacities, while also increasing capability to address system problems, a multi-tiered approach is needed. Funding Kybele and PATH. Copyright © Ramaswamy et al. Open Access article distributed under the terms of CC BY. Declaration of interests We declare no competing interest.

Infant feeding practices in a diverse group of women: The Healthy Start Study

ObjectiveTo describe infant feeding practices among a diverse group of mother‐offspring pairs and identify demographic factors related to adherence to the American Academy of Pediatrics (AAP) recommendations.MethodsWe analyzed data from 942 mother‐offspring pairs in The Healthy Start Study, an ongoing longitudinal pre‐birth cohort in Colorado. Prospectively obtained maternal self‐report of infant feeding practices (breastfeeding, formula feeding, and complementary foods) were ascertained at 4–6 months and 18–24 months postnatally. Mothers were classified according to the following AAP recommendations: 1) exclusive breastfeeding for first 6 months, 2) continued breastfeeding through 12 months, and 3) introduction of complementary foods after 6 months of age. Mothers who met all three recommendations were categorized as “adherent” and all others were categorized as “not adherent”.ResultsEighty three percent of mothers were not adherent to the AAP guidelines. Of these, 74% did not exclusively breastfeed for the first 6 months, 87% did not continue breastfeeding for 12 months, and 39% introduced complementary foods prior to 6 months. The majority (74%) did not meet two or more of the guidelines (Fig 1). Of the women who did not exclusively breastfeed for 6 months, 75% introduced formula before 3 months of age (Fig 2). The mean age of introduction to complementary foods across the entire cohort was 6 months of age, and the order of introduction of food types was similar (i.e., started with fruits and vegetables at 6 months, at 8–10 months introduced potatoes, dairy products [yogurt, cheese] and meats, and did not offer nuts [including peanut butter], chips, or candy until after 12 months of age).Compared to adherent mothers, non‐adherent mothers were younger (27.9 vs 31.0 years; p<0.0001), more likely to be of a minority racial or ethnic group (49% versus 16%; p<0.0001), more likely to have a pre‐pregnancy BMI≥30 (21% vs 9%; p=0.001), more likely to be unmarried (21% vs 3%; p<0.0001), and less likely to have a college degree (68% versus 94%; p<0.0001). Non‐adherent mothers were also more likely to receive WIC services (26% vs 13%; p=0.0002), more often reported working full‐time jobs (37% vs 28%; p=0.001), and less likely to report “pumping” breastmilk (64% vs 91%; p<0.0001). The strongest predictors of non‐adherence were working a greater number of hours worked after the baby was born (β= 0.42; p = 0.008) and not pumping breastmilk (β= −0.83; p = 0.001).ConclusionsWe found that a substantial proportion of mothers in a large contemporary cohort are not adhering to AAP guidelines on infant feeding. The AAP guideline that is least likely to be adhered to is the recommendation for 6 months of exclusive breastfeeding. Given this, future research should focus on better understanding the determinants of non‐adherence in order to develop effective intervention strategies to improve infant feeding practices.Support or Funding InformationNIH R01DK076648; PI: Dabelea

Role of Social Support in Improving Infant Feeding Practices in Western Kenya: A Quasi-Experimental Study.

We designed and tested an intervention that used dialogue-based groups to engage infants' fathers and grandmothers to support optimal infant feeding practices. The study's aim was to test the effectiveness of increased social support by key household influencers on improving mothers' complementary feeding practices. Using a quasi-experimental design, we enrolled mothers, fathers, and grandmothers from households with infants 6-9 months old in 3 rural communities (1 intervention arm with fathers, 1 intervention arm with grandmothers, and 1 comparison arm) in western Kenya. We engaged 79 grandmothers and 85 fathers in separate dialogue groups for 6 months from January to July 2012. They received information on health and nutrition and were encouraged to provide social support to mothers (defined as specific physical actions in the past 2 weeks or material support actions in the past month). We conducted a baseline household survey in December 2011 in the 3 communities and returned to the same households in July 2012 for an endline survey. We used a difference-in-difference (DiD) approach and logistic regression to evaluate the intervention. We surveyed 554 people at baseline (258 mothers, 165 grandmothers, and 131 fathers) and 509 participants at endline. The percentage of mothers who reported receiving 5 or more social support actions (of a possible 12) ranged from 58% to 66% at baseline in the 3 groups. By endline, the percentage had increased by 25.8 percentage points (P=.002) and 32.7 percentage points (P=.001) more in the father and the grandmother intervention group, respectively, than in the comparison group. As the number of social support actions increased in the 3 groups, the likelihood of a mother reporting that she had fed her infant the minimum number of meals in the past 24 hours also increased between baseline and endline (odds ratio [OR], 1.14; confidence interval [CI], 1.00 to 1.30; P=.047). When taking into account the interaction effects of intervention area and increasing social support over time, we found a significant association in the grandmother intervention area on dietary diversity (OR, 1.19; CI, 1.01 to 1.40; P=.04). No significant effects were found on minimum acceptable diet. Engaging fathers and grandmothers of infants to improve their knowledge of optimal infant feeding practices and to encourage provision of social support to mothers could help improve some feeding practices. Future studies should engage all key household influencers in a family-centered approach to practice and support infant feeding recommendations.

Trends and determinants for early initiation of and exclusive breastfeeding under six months in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000–2011

BackgroundThere is strong evidence that breastfeeding (BF) significantly benefits mothers and infants in various ways. Yet the proportion of breastfed babies in Vietnam is low and continues to decline. This study fills an important evidence gap in BF practices in Vietnam.ObjectiveThis paper examines the trend of early initiation of BF and exclusive BF from 2000 to 2011 in Vietnam and explores the determinants at individual and contextual levels.DesignData from three waves of the Multiple Indicator Cluster Survey were combined to estimate crude and adjusted trends over time for two outcomes – early initiation of BF and exclusive BF. Three-level logistic regressions were fitted to examine the impacts of both individual and contextual characteristics on early initiation of BF and exclusive BF in the 2011 data.ResultsBoth types of BF showed a decreasing trend over time after controlling for individual-level characteristics but this trend was more evident for early initiation of BF. Apart from child's age, individual-level characteristics were not significant predictors of the BF outcomes, but provincial characteristics had a strong association. When controlling for individual-level characteristics, mothers living in provinces with a higher percentage of mothers with more than three children were more likely to have initiated early BF (odds ratio [OR]: 1.06; confidence interval [CI]: 1.02–1.11) but less likely to exclusively breastfeed their babies (OR: 0.94; CI: 0.88–1.01). Mothers living in areas with a higher poverty rate were more likely to breastfeed exclusively (OR: 1.07; CI: 1.02–1.13), and those who delivered by Caesarean section were less likely to initiate early BF.ConclusionsOur results suggest that environmental factors are becoming more important for determining BF practices in Vietnam. Intervention programs should therefore not only consider individual factors, but should also consider the potential impact of contextual factors on BF practices.

The Role of Mother in Informing Girls About Puberty: A Meta-Analysis Study.

ContextFamily, especially the mother, has the most important role in the education, transformation of information, and health behaviors of girls in order for them to have a healthy transition from the critical stage of puberty, but there are different views in this regard.ObjectivesConsidering the various findings about the source of information about puberty, a meta-analysis study was conducted to investigate the extent of the mother’s role in informing girls about puberty.Data SourcesThis meta-analysis study was based on English articles published from 2000 to February 2015 in the Scopus, PubMed, and Science direct databases and on Persian articles in the SID, Magiran, and Iran Medex databases with determined key words and their MeSH equivalent.Study SelectionQuantitative cross-sectional articles were extracted by two independent researchers and finally 46 articles were selected based on inclusion criteria. STROBE list were used for evaluation of studies.Data ExtractionThe percent of mothers as the current and preferred source of gaining information about the process of puberty, menarche, and menstruation from the perspective of adolescent girls was extracted from the articles. The results of studies were analyzed using meta-analysis (random effects model) and the studies’ heterogeneity was analyzed using the I2 calculation index. Variance between studies was analyzed using tau squared (Tau2) and review manager 5 software.ResultsThe results showed that, from the perspective of teenage girls in Iran and other countries, in 56% of cases, the mother was the current source of information about the process of puberty, menarche, and menstruation. The preferred source of information about the process of puberty, menarche, and menstruation was the mother in all studies at 60% (Iran 57%, and other countries 66%).ConclusionsAccording to the findings of this study, it is essential that health professionals and officials of the ministry of health train mothers about the time, trends, and factors affecting the start of puberty using a multi-dimensional approach that involves religious organizations, community groups, and peer groups.

UTILIZATION OF SELF CARE GUIDELINE ON PROMOTING EARLY INITIATION OF BREAST FEEDING AMONG MOTHERS IN THE DELIVERY ROOM

Aim of the study is to investigate the utilization of self care guideline on promoting early initiation of breastfeeding among mothers in the delivery room. Research design Quasi experimental study design was used. Sample: A purposive sample included 100 pregnant mother.Setting: the study was conducted at antenatal and labor units at Benha University Hospital. Tool of data collection; an interviewing questionnaire sheet, observational checklist, follow up card and satisfaction sheet. Results: of the present study revealed that There was highly statistically significant difference in relation to all items concerning mother’s knowledge pre and post intervention Majority of mothers were satisfied about self-care Guideline. There was a highly significant improvement of mother’s practices in all self-care items during the postnatal period. Sixty five percent of mothers were initiated breastfeeding immediately after delivery. There was a highly significant difference between mother’s knowledge and educational levels of mothers in the pre and post intervention period. Also, this study showed that, highly significant difference between mother's selfcare practice regarding initiation of breastfeeding and their residence, correct knowledge pre and post intervention and their satisfaction in the post intervention period. Conclusions: utilizing self-care guideline is significantly improves mother’s knowledge and practices regarding early initiation of breastfeeding during the postnatal period, the majority of mothers were satisfied with utilization of self-care guideline. Recommendations: Integrated self care concept into the maternal and newborn health nursing under and post graduate student faculty of nursing Benha university and distributing brochure about self care for early initiation of breast feeding during antenatal care to all pregnant mothers.

Effect of Health System Transformation on Two Main Public Health Issues: Prenatal Care and Tetanus Toxoid Vaccination

Background: Health care systems in many countries are changing, for a variety of reasons. This brings both opportunities and threats for public health professionals. Monitoring of preventive services becomes more important during these transition periods. Objective: It was aimed to determine tetanus toxoid vaccination and prenatal care coverage of mothers, to establish how routine services are affected by changes in the health care system. Methods: Two descriptive, cross-sectional studies were conducted in the city center of Gaziantep, Turkey by the Lot Quality Assurance Sampling Technique. The first study was applied just before transition, and the second was applied one year after transition to family medicine. Results: While a total of 82.8% mothers received first dose of tetanus toxoid in Gaziantep before the transition, it increased significantly to 90.1% (p<0.005) after the family medicine. Of the mothers, 82.8% received prenatal care before transition, it was 92.5% after family medicine (p<0.005). The percentage of mothers who gave birth in a health facility declined to 98.1% from 99.3%. The number of unacceptable lots dicreased from 22 lots to 10 lots after system change. Conclusion: A relatively high coverage was achieved for the first dose of tetanus toxoid and, prenatal care after family medicine. However, the coverage for booster doses are still under to be desired.

Study of breast feeding practices in rural field practice area of Kakatiya Medical College, Warangal, Telangana state, India

Background: Infant mortality rate (IMR) is considered as one of the most sensitive indicators of health status of a community. Breast feeding in rural areas appears to be influenced by beliefs, social, cultural and educational factors. This study aimed to access awareness and practices towards exclusive breast feeding and awareness towards the nutritional status and assessment and positioning of baby as per IMNCI guidelines in rural area, Warangal. Methods: A community based cross-sectional study conducted on mothers with children aged 0-2 years residing in rural field practising area, Kakatiya Medical College, Warangal. A total of 200 mothers with children aged 0-2 years were interviewed using a pre-tested questionnaire. Statistical analysis: percentages, proportions and chi-square test. Results: A total of 200 mothers with children aged 0-2 years participated in the study; majority (46.2%) belonged to the age group of 21-23 years in which most of the mothers belong to Hindu religion (90%), of which 67% lived in nuclear family. In this study, the percentage of mothers with children 0-2 years belonging to upper class was predominant with 47.5%. Association was found between education and practice of not giving prelacteal feeds and also with initiation of breast feeding (IBF). Association was also found between knowledge and practice. There is a significant awareness between EBF and IBF. About 83.8% mothers feed their child with colostrum, of which 28% mothers said that they don’t know the reason of practising colostrum. Around 70% babies have good suckling and 54.3% babies were born with prematurity. Conclusions: Nearly 76% mothers were lack of awareness regarding health condition of both baby and mother on breast feeding practices. The literacy and age of women has significant association on breast feeding practices.

Knowledge and Practices Regarding Prevention of Anaemia in Pregnant Women

Anaemia is the most frequent maternal complication during of pregnancy which is associated with maternal morbidity, mortality, perinatal morbidity and mortality. Antenatal mothers should equip themselves to prevent anaemia during pregnancy. Cross sectional survey was undertaken to assess the knowledge and practices regarding prevention of Anemia in registered pregnant women at Government Maternity Hospital, Koti Hyderabad. Data was collected from 100 antenatal mothers who were attending antenatal clinic of GMH, koti, Hyderabad, India. The tool used for data collection was interview schedule Reliabllity and validity of the tool was established. Findings are majority (60%) were in the age group of 20–24 years. Three fourth(77%) are educated. Sixty nine percent of mothers registered during 2nd trimester. Most of sample are primigravida(63%). 63% of mothers had mild anaemia(9.1 to 11mg/dl). Nearly half of the mothers (53%) had moderate knowledge regarding anaemia. Most of mothers (65%) are not aware of prevention of Anaemia. 48% of mothers are following diet practices about prevention of anaemia, almost all practicing hygiene, 73% are following treatment practices. Significant association was found between education, occupation of subjects and knowledge regarding anaemia. Significant relationship was found with occupation and practices about prevention of anaemia. Improvement in the knowledge level and dietary practices among the most vulnerable group is very important to decrease the prevalence of anaemia. Awareness programmes should be conducted among the pregnant women for their promotion of health. Anaemia being major contributor to the maternal mortality and morbidity due to its complications in pregnancy, it is the need of the hour to disseminate basic knowledge on prevention of anaemia which can have an impact on our health system.

Assessment of knowledge of mothers regarding benefits of exclusive breast feeding in mother and children: a hospital based study

Background: Breastfeeding, a component of primary health care has been identified world over as greatest protection of child health. Irrespective of the fact that breastfeeding in India is universal, psychological barrier still exist in early breastfeeding. Hence a study was conducted to find benefits of breastfeeding for mothers and for their child . Objectives of the study were to study benefits of breast feeding in mothers and to study benefits of exclusive breast feeding among children Methods: The study was conducted in Geetanjali Medical College and Hospital and its urban and rural health centres. 500 women who had nursed in last 5 years were interviewed using structured questionnaire. Results: 500 mothers were interviewed over a period of 6 months.31% were from semi urban, 52% population was from the urban area, 17% were from rural.72 percent mothers initiated breast feeding on the first day with 83% feeding their new born colostrum . Conclusions: This study emphasises that mother should be educated and motivated for exclusive breastfeeding their babies for 6 months and continue breastfeeding till 2 years. The benefits of breastfeeding for mothers should be explained for this purpose.

EVALUAREA CUNOŞTINŢELOR PĂRINŢILOR PRIVIND PERIAJUL DENTAR LA COPIII PREŞCOLARI

Aim. To assess the knowledge of the preschool children’ parents about their toothbrushing. Material and method. During the first visit to the clinic, a questionnaire about the mother’ education level and children’ dental hygiene was given to the parents of 276 children aged 1 to 5 years, with caries in primary dentition. Results. a) 194 parents (70.29%) filled the questionnaire; b) in 15.46% of children (aged between 1 year 3 months and 3 years 3 months) the toothbrushing has not been yet introduced; most of the mothers with ≤10 classes started the toothbrushing after the age of 2 and mothers with middle and higher education level – in most cases after the age of 1; c) in 41.50% of children the toothbrushing was performed 1 time/day or less; d) 29.37% of children brushed their teeth without a parental surveillance and 48.75% with supervision. Conclusions. 1) Only in 5% of children toothbrushing was started before the age of 1; 2) About 30% of children had no parental supervision during their toothbrushing; 3) In a large percentage of mothers, especially those with lower education level, the knowledge about oral health care of preschool children are scarce.

Factors associated with neonatal deaths in Chitwan district of Nepal.

BackgroundNeonatal mortality has remained unchanged since 2006 in Nepal. Reducing neonatal mortality is indispensable to reduce child mortality. The objective of this study was to investigate the factors associated with neonatal mortality. This study assesses socio-demographic factors, maternal health care and newborn care practices contributing to neonatal deaths in Chitwan district of Central Nepal.MethodsA case–control study was conducted during April–July 2012. The study used a mixed-method approach, in which records of neonatal deaths were obtained from the District Public Health Office and a comparison group, survivors, was obtained from the same community. A total of 198 mothers (of 99 neonatal deaths and 99 survivor neonates) were included in the survey. Focus group discussions, in-depth interviews and case studies were also conducted. Maternal characteristics were analyzed using descriptive statistics, Mc Nemar’s Chi square test and multivariable backward conditional logistic regression analysis. Qualitative data were analyzed by narrative analysis method.ResultsMore than four-fifth of mothers (86 %) had antenatal check-up (ANC) and the proportion of four or more ANC was 64 %. Similarly, the percentage of mothers having institutional delivery was 62 %, and postnatal check-up was received by 65 % of mothers. In multivariable analysis, low birth weight [adjusted odds ratio: 8.49, 95 % CI (3.21–22.47)], applying nothing on cord [adjusted odds ratio: 5.72, 95 % CI (1.01-32.30)], not wrapping of newborn [adjusted odds ratio: 9.54, 95 % CI (2.03–44.73)], and no schooling of mother [adjusted odds ratio: 2.09, 95 % CI (1.07–4.11)] were significantly associated with an increased likelihood of neonatal mortality after adjusting for other confounding variables. Qualitative findings suggested that bathing newborns after 24 h and wrapping in clean clothes were common newborn care practices. The mothers only attended postnatal care services if health problems appeared either in the mother or in the child.ConclusionResults of this study suggest that the current community based newborn survival intervention should provide an even greater focus to essential newborn care practices, low birth weight newborns, and female education.

English

English

Effects of smoking during pregnancy on retinopathy of prematurity

PurposeBackground: Tobacco smoking during pregnancy is the first preventable cause of adverse birth outcomes such as vascular and neurodevelopment disturbation.Aims: To asses how smoking during pregnancy would affect retinal vascularization causing retinopathy of prematurity.Design: An observational cross‐sectional study.MethodsRecords of preterm newborns (n = 293) and tobacco expossure were reviewed. Retinopathy of prematurity (ROP) grading was evaluated in accordance with the International Classification of Retinopathy of Prematurity. Factors were evaluated using a multivariate logistic regression analysisResultsAlthough most children did not develop ROP (74.1%), 10.9% has mild, 9.6% severe and 5.5% aggressive posterior retinopathy. Twenty percent of mothers smoked during pregnancy and 10.2% smoked ≥5 cigarettes per day. Children of smoking mothers showed higher rate of Anterior Progressive ROP (6.9%) than those who were not expossed (5.1%), and as much severe as higher number of cigarettes (10.9% vs 5.1%). However, these results were not statsically significative (p &gt; 0.05).ConclusionsA tendency to higher severity grades of ROP in connection with heavy tobacco exposure during pregnancy was observed.

Bebek Dostu Özel Bir Hastanede Doğum Yapan Annelerin, Emzirmeye İlişkin Bilgi Düzeylerinin ve Bebeklerini Emzirme Durumlarının Değerlendirilmesi

Purpose: Intension of this researchis to determine level of breastfeeding knowledge and breastfeeding conditions of mothers which are breed in private baby friendly hospital. Methods: This research contains 383 mother which are breed in a private hospital maternity service and selected 150 mothers with their babies between the dates 01 November 2011 and 29 February 2012. Data were obtained by Interview and Observation Form which is consist 53 question about demographic and obstetric characteristics of mothers and evaluation for knowledge and practices related to breastfeeding and lactation&Breastfeeding Diagnostic Measurement Tool (LATCH) which has developed by Deborah Jensen, Sheila Wallace at Oregon in 1993 to evaluate breastfeeding. Statistical analysis completed by NCSS (Number Cruncher Statistical System) 2007 Statistical Software (Utah, USA) program. Descriptive statistical methods were used to evaluate the data. The significance of the results was evaluated at p<0,05 level. Results: Observed that average of mothers’ age was 29,12±4,35, 89,3% of mothers were have higher education graduates, 46% of mothers were working, 57,3% of mothers were primipara, 82% of mothers were breed C-section. 88% of mothers were completed breastfeeding in first one hour, 96,6% of mothers’ first food that served first was breast milk but despite this 18% of mothers had breastfeed only each baby wants and 31,3% of mothers had breastfeed until baby stop breastfeeding, 40,7% of mothers hold breast by wrong technique (shearing style). 92% of mothers had knowledge about storage of milked breastfeed but 62,6% of mothers had no knowledge about storage of milked breastfeed, 65,3% of the mothers had no knowledge to serve pacifier and 45,3% of mothers had no knowledge that adverse to the affected by give to use feeding bottle. Mothers’ LATCH point average which is indicating the competence of breastfeeding was detected 8,83±1,46, there was statistically relation between scale scores with spouse’s education level and babies' birth weight in positive direction (p=0,011, p=0,005). Conclusion: Percentage of mothers' who starting to breastfeeding; looks high, ability of breastfeeding's enough. These results set thinking that getting effective support about to get starting breastfeeding. But standart of knowledge is defficient for some issues (breastmilk storage time, indication of less saturation, pacifier and feeding bottle utilization efficacy to breastfeeding.) about breastfeeding success. Therefore, potential of haviwng problems about breastfeeding is seems high in after dicharging period because of this reason

Mothers’ Knowledge Regarding Neonatal Baby Care

Neonatal mortality is a major problem, all over the world especially, in the developing countries. The aim of this study was to determine the knowledge of mothers, who were admitted to the postnatal ward of Teaching Hospital Kurunegala regarding the neonatal baby care. This descriptive cross sectional study was carried out in the post-natal ward, at the Teaching Hospital in Kurunegala (North Western Province), Sri Lanka. The data was collected by interviewing 246 post-natal mothers, aged 15 – 45 years, who were in the post-natal ward, during the period of 18th April to 2nd May 2011. The mean age of the sample was 26 years. Nearly half of mothers (48.4%) completed education up to O/L. The percentage of mothers who completed education up to secondary and higher education level was 41.3%. A considerable proportion of mothers were unemployed (86%). Half of them had one child. The percentage of postnatal mothers, who had two children, is 30%. Others had more than two children. Education level was found to be positively and significantly associated with knowledge regarding neonatal care. Additionally, occupation and age too were found to be significantly associated with knowledge level. Parity did not show a significant association with maternal knowledge regarding neonatal care as expected. The results showed that mothers’ knowledge and practices regarding breast feeding was at a satisfactory level in mothers selected to the sample population. But knowledge of mothers was not at a satisfactory level regarding umbilical cord care. More than half of them were in less than average knowledge level. It was found that mothers’ knowledge of prevention of neonatal hypothermia was poor. A large proportion of them (45.52%) were in the poor knowledge group and 42.27% of them were in very poor knowledge group. The results showed clearly that mothers’ knowledge of prevention of neonatal hypothermia was the most deficient knowledge field of mothers who lived in Kurunegala area. Maternal knowledge of breastfeeding was the only satisfactory knowledge field from these three areas for mother who lived in Kurunegala area. The study showed in majority of mothers, adequate knowledge and practices regarding neonatal care were lacking. Especially, in the field of prevention of neonatal hypothermia and care for the neonatal umbilical cord.

The behavior over time of postnatal depression symptomatology and its early detection via the Edinburgh Postnatal Depression Scale: An Italian longitudinal study

Background: Becoming a mother for the first time is a significant developmental transition and postpartum mood disorders represents the most frequent form of maternal morbidity following delivery.Objective: To investigate the ability of Edinburgh Postnatal Depression Scale (EPDS) to detect, in the first days postpartum, mothers at risk of developing depressive symptomatology over time.Results: The percentage of mothers with an EPDS score ≥10 decreases over time: 23.77% at 2/5 days postpartum, 15.57% at 2 months and 9.02% at 6 months after delivery. Among mothers with a depressive symptomatology after 2/5 days postpartum, 41.38% maintained an EPDS score ≥10 at 2 months too, while 20.69% of them manifested depressive symptoms at 6 months as well. Both correlation and linear regression showed a significant association between EPDS scores in all three administrations of the study but EPDS score at 2/5 days postpartum is more associated and predictive to maternal mood at two months than at six months postpartum.Method: A longitudinal study was conducting on 122 primiparous mothers who filled out EPDS and a General Information Questionnaire at 2/5 days postpartum, at 2/3 and 6/7 months after delivery. Women with high EPDS scores (≥10) were compared to those who had scored &lt;10 in all the three steps and longitudinal analysis were conducted.Conclusion: Implementing EPDS in the first week postpartum allows identifying women at high risk to maintain depressive symptoms over time. These findings could be useful for health care interventions after delivery and for researchers involved in the study of transcultural aspects of postnatal depression.

120. Adolescent mothers and their children: Outcomes of a Tots and Teens program in a Canadian urban setting

sexual, 36% physical and 18% emotional). Thirty percent of mothers had child protection involvement in their own childhoods. The majority of adolescent mothers were living with family (54%), or in a maternity home (28%); 71% resided in lower SES neighborhoods. Forty-four percent of our adolescent mothers reported a history of substance use (tobacco 27%, marijuana 27% and alcohol 19%). Only sixty percent were attending school or had graduated high school prior to the birth of their child. A significant proportion of children in our population experienced expressive speech and language delay (47%) and poor growth (24%) by 18 months of age. Child protection services became involved with 65% of our families, primarily for instrumental support, concerns regarding parenting capacity, or due to intimate partner violence. Conclusions: The Young Families Program is an interprofessional family-centred program acting as the “medical home” for parenting adolescents and their children. This population is challenged by a significant burden of preexisting maternal mental health issues, maternal trauma history, maternal substance use, delayed educational attainment and residing in low SES neighborhoods. A significant number of infants of adolescentmothers in our samplewere at risk for delayed language development and poor growth. Comprehensive programs focusing on the unique needs of this population should endeavor to enhance the overall health and wellbeing of both the adolescent mother and her children, with a specific focus on maternal and infant mental health through both dyad and individual therapy, child growth and development including access to consistent caregiving in a stimulating, structured environment, instrumental support with securing safe, clean housing, educational issues, and effective liaison with child protection services. Sources of Support: Social Pediatrics Research Summer Scholarship (SPReSS) Funding, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada.

Accuracy of low birth weight as perceived by mothers and factors influencing it: a facility based study in Nepal

Introduction: Birth weight is a key predictor for risk of childhood illnesses and chances of survival; however in developing countries less than half of newborns are weighed at birth. In Nepal, only 36% of children born were weighed at birth. Nearly two thirds (63%) of deliveries take place at home and birth weight may not be known for many babies, the mother’s estimate of the baby’s size at birth could be used as an alternative. Aim and Objective: This study assessed the accuracy of low birth weight as perceived by mothers and factors influencing whether their perceptions were accurate. Methods: The study wasa facility based descriptive study carried out in four hospitals with sample size of 1533. Hospital nurses interviewed mothers using a pre-tested tool. Data was entered into EpiData 3.1 and analyzed using SPSS version 17 software package. Results: A total of 1533 mothers were interviewed of which 75 did not respond. An overall 75% mothers accurately identified actual low birth weight; and 25% mother perceived normal for actual low birth weight. Less percent of mothers <20years (sensitivity=0.74), illiterate (sensitivity=0.74), and primigravida (sensitivity=0.74) identified actual low birth weight than mothers ≥20years (sensitivity=0.75), literate (sensitivity=0.75) and multigravida (sensitivity=0.77). Conclusion: The study concluded that 75% mothers recognized actual low birth weight of newborn, and 25% mother’s perceived normal for actually low birth weight. The percentage of women accurately identifying actual low birth weight was slightly lower among mothers <20years, illiterate and primigravida as compared to mothers ≥20years, literate and multigravida.