This study was conducted at the maternity ward of Peking University People's Hospital in China, which is a comprehensive and teaching hospital for the Peking University Health Center.
This study was aimed to assess the breastfeeding techniques of mothers before discharge and identify its associated factor. We use a cross-sectional design for this descriptive correlational study and conducted questionnaire survey with a convenience sample of mothers before discharge. This study was approved by the institutional review board of Peking University People's Hospital (No. 2019PHB227-01).
The potential participants were recruited through the maternity ward of a metropolitan, general, teaching hospital in the north of china from March 19 to April 27, 2018. Inclusion criteria for mothers were as follows: (a) Come back to the maternity ward after natural childbirth or cesarean section; (b) informed consent and voluntary participation in this study. Exclusion criteria: (a) communication barriers; (b) unclear consciousness or mental disorder; (c) taboos on breast-feeding such as acute phase of hepatitis b, active tuberculosis, taking anticancer drugs, HIV positive, congenital malformations and congenital metabolic diseases of newborns, et al; (d) separation of mother and baby. A total of 166 potential participants were initially recruited; 13 mothers did not fill the questionnaire completely that the final sample size was 153.
The study was conducted by questionnaire survey, which includes the LATCH scoring system, the general information and breastfeeding behavior questionnaire, the breastfeeding knowledge questionnaire, and the Chinese version of maternal breastfeeding evaluation scale (MBFES).
The LATCH scoring system.
Used to assess mothers breastfeeding techniques. The questionnaire was designed by Jensen, which evaluate breastfeeding techniques from five aspects: Latch, Audible swallowing, Type of nipple, Hold and Comfort. Each item gets a score of 0 or 1 or 2, the total score is 10. The higher score means a better breastfeeding techniques. The Cronbach’ s α is 0. 7. The LATCH scoring system is a simple and effective tool to evaluate breastfeeding techniques, which has a good consistency and sensitivity among different ethnic groups so that it can be used in multi-ethnic population.
The general information and breastfeeding behavior questionnaire.
The questionnaire was developed and modified by the researcher after consulting domestic and foreign study. It includes: 1) Sociodemographic characteristics: age, marital status, Level of education, Average monthly family income; 2) Obstetrics and Maternal characteristics: the times of delivery, whether received breastfeeding counseling during pregnancy, gestational complications/complications, gestational weeks, mode of delivery, skin contact time after delivery, number of births, birth weight, satisfaction of the infant’s sex, condition of infant’s neonatal jaundice, length of hospital stay, feeding frequency and sucking duration, whether mastered the way of milking.
Breastfeeding knowledge questionnaire.
Which was developed by Zhao Min and used to measure the breastfeeding knowledge level. It includes 17 items, each item gets 1 point with the correct answer, the total score is 0~17 points. The higher score means a better level of breastfeeding knowledge. The Content Validity Index is 0.9l, Cronbach’ s α is 0.80.
The maternal breastfeeding evaluation scale (MBFES).
To evaluate the satisfaction of breastfeeding. The Chinese version used in this study was translated by Yu. It includes 29 items in 3 dimensions: maternal satisfaction, infant satisfaction, mother’s lifestyle. Each item uses a 5-point Likert scale with a total score of 145 points. The higher score means the better breastfeeding satisfaction. It’ s Cronbach’ s α is 0. 952, content validity index is 0. 896.
All data was collected within 24 hours before the mother discharged. One investigator who had been trained to use the LATCH scoring system evaluated mothers’ breastfeeding techniques. The general information, breastfeeding knowledge questionnaire and the maternal breastfeeding evaluation scale (MBFES) were filled by the mothers. The investigator used unified instruction to explain the question of the mothers, checked the collected data for completeness and corrective measures were taken accordingly. A total of 166 cases of questionnaires were distributed and 153 cases were effectively recovered, with an effective recovery rate of 92.2%.
Double data entry was done by using Epi Data statistical software version 3.1. Entered data exported into statistical package for social science (SPSS) software version 21 for analysis. Descriptive statistics of each variable was determined and the results were presented by percentages, mean and standard deviation. t-test was used for dichotomous variables, ANVOA was used for comparison among multiple groups, and Pearson correlation analysis was used for measurement data. Those variables with a p value < 0.05 were included in the final model (multivariate analysis). Factors associated with breastfeeding techniques before discharge were determined by multiple linear regression analysis. Statistical significance was declared at a p value < 0.05.