Before discussing the results, the limitations of the study must be considered. The cases who applied to pediatric policlinics for any reasons in a certain period were included in this study. The research period can be found as short by some. In addition, although a quite close match, the sample was not entirely representative of the Turkish population. The rates of breastfeeding can be found low as this study was carried out before BFHI.
Breastfeeding is the best form of nutrition for infants. Family physicians and healthcare workers can have a significant role on the initiating and maintenance of breastfeeding if they have sufficient knowledge of benefits of breastfeeding and the necessary clinical management skills or habits. More than one million infants worldwide die every year because they are not breastfed or are given other foods too early. Millions of people live in poor health expose to preventable diseases and battle malnutrition. A woman’s ability to feel self confidence and secure with her decision to breastfeed are challenged by her family and friends, the media, and health care providers1,13,15.
The rate of breastfeeding initiating within the first 1-2 hours after delivery was 78.9 % and after two hours it was 21.1 %. The rate of breastfeeding initiation within the first 1-2 hours in normal spontaneous delivery significantly showed higher prevalence than cesarean section (X2=32.653, p=0.000). Cesarean delivery (C/S) has a negative effect on early, successful breastfeeding.16,17 We recommend that an attempt be made to initiate lactation before the end of the first hour (and no longer than two hours) of birth following cesarean delivery. Positioning may be more difficult because of postoperative pain after C/S. The lateral decubitus position for breastfeeding might be preferable. Special pillows may also be used to provide support for breastfeeding.16
The rate of breastfeeding whenever the baby wants was 90.2 %, and the ratio of breastfeeding with certain intervals was 9.8 %. This finding shows similarity to the recommended breastfeeding practices of WHO.11,14
In our study, in the 6 months and older babies group, exclusive breastfeeding rates in the 1st, 3rd and 6th months postpartum were 98.3 %, 81.1 % and 37.7 % respectively. According to Anne Merewood, MA, IBCLC, in 2001, the mean breastfeeding initiation rate at US Baby- Friendly hospitals was 84.8%, compared to a national breastfeeding initiation rate of 69.5%.18 According to Kramer MS. et al, the exclusive breastfeeding rates at 6th month were 7.9% in the Republic of Belarus in 1997.19 Durand M. et al evaluated a training program about breast feeding at the maternity section of Obstetrics, Gynecology and Reproductive Medicine at Grenoble University Hospital Center in 2002. The exclusive breastfeeding rates of a pre-and post sample survey were 14.0% and 28.0% respectively. In the same study, the initiating rate of breastfeeding was 76.0%.1 In our study, this rate was higher. In the older than 1 year of age group (n=131), the ratio of breastfeeding continuing breastfeeding until the 12th month combined with a gradually diversified food intake was 38.9 %. Whereas, breastfeeding education, lactation consultation, and other postpartum supports may improve a woman’s chance of starting and continuing to breast-feed her baby.5,11,15
Breast discomfort or infection was seen in 36.9% of all mothers. If they are sufficiently educated, this negative rate can be decreased.
The rate of using artificial nipple was 46.7 % (n=100). This rate was significantly lower in exclusive breastfeeding until the sixth month than exclusive breastfeeding less than four months (p=0.001). The use of artificial nipple is an unhealthy habit.14,16 Unfortunately, the nonexclusive breastfeeding group has a tendency to use a pacifier.
In our study, most of the mothers were from middle/low education levels. The educational level and working status did not significantly affect the rate of exclusive breastfeeding for at least 6 months.
The rate of smoking during pregnancy and lactation was 8.9 %. This rate was lower than the other countries.20-23 Smoking is an important public health problem. Especially, during the pregnancy and lactation, smoking negatively affects both mother and baby health. To prevent and reduce tobacco use in the young and in pregnancy, further research should be carried out to develop more effective smoking cessation programmes.23,24
In our country, traditional marriages between relatives are common. In this study, the rate of relativity with husband was 21 %. To share the same house with grandparents is also a traditional custom. This rate was 25.7 %. Having a grandparent in the same house positively supports and encourages providing this ideal form of nutrition to their infants.
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