Study design and aims:
A comparative, cross-sectional study was designed to assess the level of mothers’ knowledge and practices, and find out the differences between mothers’ knowledge and practices regarding early colostrum feeding among mothers in three different areas in Erbil Governorate of Iraqi Kurdistan region.
Tim and setting of the study:
This study was carried out during the period was started in 2nd Jan. to the end of May. 2019, in three different areas of Erbil governorate ( Erbil city (inside) Shawlwa city and Koy Sanjaq city.
The following simple formula would be used for calculating the adequate sample size in prevalence study; n=Z2P(1−P)d2 Where n is the sample size, Z is the statistic corresponding to level of confidence, P is expected prevalence, and d is precision (corresponding to effect size) .
Sample size and Data collection
A special simple formula used for calculating and estimate the adequate sample size as follow ; n=Z2P(1−P)d2. Where n. is the sample size, Z. is the statistic corresponding to level of confidence, P. is expected prevalence, and d is precision (corresponding to effect size). The process have been made in three different area ( Erbil city (inside) Shawlwa city and Koy Sanjaq city. Non-probability of 177 mothers in the Maternity Teaching Hospital in Erbil City, with 126 mothers from Shaqlawa and 97 mothers from Koy-Sanjaq Hospital who attended for the same purposes, the total was 400 mothers. Erbil is the capital of the Kurdistan region, Shaqlawa is a district which it is lies 50 km from the north of Erbil city, and Koy-Sanjaq is a third selected district, which it is lies west of Erbil about 75 km.
The official permission was obtained from the Erbil Directorate of Health and the chosen Hospitals for conducting the study. The mothers were asked respectfully to participate in the study. Oral informed consent was obtained from the participants, the researchers confirmed anonymity and confidentiality were considered.
The researchers constructed a special questionnaire, after an extensive review of related literature, and previous studies. The questionnaire categorized into three parts: the first part; was to obtain the sociodemographic characteristics of mothers such as age, level of education, residency areas. The second part was to assess the mother’s knowledge, and it was consisting of 12 related questions, the items were scaled into two answers, 1 for an incorrect answer and 2 for the correct answer, while the third was parted to observe their practices regarding early colostrum feeding after delivery, and it was consisting of 10 related questions, 1 score for not achieved and 2 scores for achieved. For that reason, a female researcher remains with the mother after delivery to observe either she practices breastfeeding or not, depends on her observation the part of practice has been filed out. A panel of experts which was consists of related experts were validated the tool, all expert's comments regarding the items of the questionnaire were taken into consideration.
Characteristics of the samples
Eligible normal vaginal delivered mothers in the hospitals (Hawler teaching Hospital- Erbil, Shaqlawa general Hospital, and Koy-Sanjaq general Hospital) and who were interested to participate in the study were respectfully asked to participate in the study, while tired mothers, cesarean section, episiotomy were excluded. Ten mothers were recruited to the study as a pilot study.
The internal reliability of the tool was computed, and the alpha Cronbach correlation was 0.86, which was statistically adequate. The collected data have been analyzed by using the Statistical Package for Social Science (SPSS, Version 23). Descriptive frequency, Chi-square, was used for determining the association between variables, while an independent t-test was used for identifying the statistically significant differences between the three areas.