Changes in maternal conception about breastfeeding

An intervention study type pretest/posttest was conducted for 113 women attended at a public health service. An adapted cross-cultural questionnaire was applied to identify the conceptions of pregnant women about the conditions of stimulating and discouraging breastfeeding. The effect of the intervention was verified by assessing the Decisional Balance scores before and after the intervention.

Results:

there was a reduction in the overall score of the discouraging conditions and an increase of the overall score of the stimulating conditions (p<0.001). In evaluating each discouraging condition, a significant reduction in the affirmative scores was observed as "breastfeeding makes the breasts saggy" (p=0.003), "I think my breasts are too small to have enough breast milk for my baby" (p=0.001). Regarding to the stimulating conditions, it showed a significant increase in the affirmative score for "breastfeeding is good for me" (p=0.006), "breastfeeding can help me lose weight" (p=0.013), "breastfeeding is easy" (p=0.004).

Conclusions:

the intervention resulted in changing maternal conceptions of breastfeeding and can be an interesting strategy on promoting breastfeeding in health services.

Key words
Breastfeeding; Maternal behavior; Intervention studies

Characteristics	N=113	%
Age (years)
<20	39	34.5
≥ 20 to 34	65	57.5
≥ 35	9	8.0
Schooling (years)
0-4	5	4.4
5-8	38	33.6
9-11	61	54.0
≥12	9	8.0
Marital status
With a partner	81	71.7
Without a partner	32	28.3
Does mother work
Yes	48	42.5
No	65	57.5
Income per capita (n=111)
≤ ½ MW	60	54.1
> ½ MW	51	45.9
Parity
Primiparous	63	55.8
Multiparous	50	44.2
Was breastfed
Yes	97	85.8
No	10	8.8
Don't know	6	5.4
Previous experience in breast feeding
< 24 months	32	64.0
≥ 24 months	18	36.0

	Before intervention	After intervention	p ^* * Comparisons of before and after intervention: Wilcoxon Test.
	X̅ ± SD	X̅ ± SD
Discouraging conditions	28.12 ± 3.11	26.84 ± 3.37	<0.001
Stimulating conditions	39.43 ± 2.43	41.19 ± 3.42	<0.001

	Before intervention	After intervention	p ^* * Comparisons of the before and after intervention: Wilcoxon Test; Mean Likert Scale of 5 points (1-strongly disagree; 5-I totally agree).
	X̅ ± SD	X̅ ± SD
Discouraging conditions
To breastfeed is "out of fashion", "tacky"	1.72 ± 0.51	1.71 ± 0.46	0.866
To breastfeed means that nobody else can do it for me, I have to be ready for the child	3.96 ± 0.80	3.99 ± 0.79	0.721
To breastfeed means that i have to change my eating habits	3.68 ± 0.93	3.76 ± 0.82	0.317
I would be embarrassed if someone saw me breastfeeding	2.01 ± 0.83	1.94 ± 0.71	0.334
To breastfeed means the breast will sag	2.94 ± 1.01	2.57 ± 1.00	0.003
I think breast milk is disgusting	2.35 ± 0.91	2.12 ± 0.80	0.022
I think breastfeeding is painful	2.94 ± 1.08	2.90 ± 1.05	0.990
To breastfeed means that I cannot return to work or study	2.18 ± 0.80	2.12 ± 0.84	0.471
I don't even think about that I don't know everything about breastfeeding	3.92 ± 0.75	3.63 ± 0.80	0.008
I think that my breasts are too small to have enough milk for my baby	2.42 ± 1.02	2.10 ± 0.87	0.001

Stimulating conditions
Breast milk is the healthiest food for the baby	4.42 ± 0.50	4.43 ± 0.50	0.853
I think that breastfeeding is good for the baby	4.32 ± 0.47	4.28 ± 0.45	0.480
To breastfeed is good for me	4.00 ± 0.71	4.19 ± 0.41	0.006
If babies are breastfed their diapers don't smell that bad	3.24 ± 0.82	3.65 ± 0.78	<0.001
To breastfeed may help me feel closer to my baby	4.34 ± 0.47	4.30 ± 0.52	0.480
To breastfeed helps protect my baby against diseases and allergies.	4.35 ± 0.53	4.40 ± 0.49	0.336
To breastfeed helps my uterus return to the normal size quickly	3.58 ± 0.67	4.14 ± 0.46	<0.001
To breastfeed may help me lose weight	3.80 ± 0.75	4.00 ± 0.60	0.013
To breastfeed is easy	3.15 ± 0.97	3.42 ± 0.92	0.004
Breast milk is cheaper than the any other milk	4.23 ± 0.64	4.38 ± 0.63	0.021

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil
E-mail: revista@imip.org.br

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[TFN1] MW = minimum wage at the time of the study; MW= R$ 678.00.