ABSTRACT

Jon Thomas V. Epino, Marlee E. Estipona, Kathryn V. Futalan, Ronald A. Lladones, "BREASTFEEDING COMPLIANCE OF LACTATING MOTHERS IN BARANGAY SAGMIN, LEGAZPI CITY", (An undergraduate thesis, Aquinas University College of Nursing and Health Sciences, Rawis, Legazpi City, 2012)

Breastfeeding is the preferred method of feeding a newborn because it promotes numerous benefits to both the mother and the infant. It remains to be the ideal nutritional source for infants through their first year of life. Breast milk is the widely acknowledged form of complete nutrition with a range of benefits geared towards the infants' health, growth, immunity, and development because of the presence of maternal antibodies. Young as they are and susceptible to illness, infection and all other harm, babies must be treated with special care and given the adequate nourishment they need. Amidst all these benefits there is still an increasing incompliance to this healthy, nutritive and yet economic act of feeding.

For that matter this study aimed to determine the breastfeeding compliance of the lactating mothers in the community in the vicinity of Barangay Sagmin, Legazpi City. Specifically, the study sought to answer the following questions: 1.) what is the demographic profile of the respondents in terms of: A. Lactating Mothers aage, b. Educational attainment, c. Occupation. D. family monthly income and B. Barangay Health Worker A. age B. educational attainment C. family-monthly income C. Number of Years in Service D. Trainings attended related to Breastfeeding.2.) Are the Lactating Mothers and the Barangay Health Workers knowledgeable in terms of: breastfeeding, stoppage of breastfeeding, bottle feeding (milk formula and, mixed feeding, 3.) What is
the level of performance of the Barangay Health Workers in the breastfeeding promotion?4.) What factors affect the breastfeeding compliance as perceived by the lactating mothers and the barangay health workers? And5.) What measures may be proposed to effectively promote breastfeeding compliance among lactating mothers?

This study utilized a descriptive type of research to obtain information concerning the current status of the phenomena to describe "what exists" with respect to variables or condition in a situation. The respondents are composed of 20 lactating mothers and five
(5) Barangay Health Workers where total enumeration method was used. To gather needed information, a semi-structured questionnaire was used. The descriptive method of research was used in this study. The questionnaire was utilized as the main instrument to gather data in order for the research to find out the compliance in the breastfeeding practice in Barangay Sagmin, Legazpi City. The respondents were the lactating mothers who are residents of the said barangay with the total number of 20.

The data gathering material used was a questionnaire written in both in English and Tagalog for further understanding. Using statistical stools such as frequency, percentage/ranking and weighted mean the data was tabulated and analyzed based on previous studies and correlation of related literature. The findings were presented in a tabular and textual form to facilitate understanding and organization of data.

Based on the data that were gathered, the following were the findings of the study with regards to the demographic profile of the lactating mothers most of the 1 mothers came from the age group of 27-31 with a frequency of 9 or 45%. In terms of educational level, most of them were high school graduates with the frequency of 10 or 50%. In terms of occupation, 16 or 80% did not have any jobs and stays as a plain housewife Or housekeeper. Lastly, 15 or 75% of the lactating mothers had a family monthly income ranging from 1,000-5,000 Php.While on the demographic profile of the Barangay Health Workers, most of them were in the age group of 20-30 years by having a frequency of 3 or 60%. 3 or 60% were high school undergraduate and having a family monthly income ranging from 1,000-5,000 Php. It had a frequency of 3 or 60%. In term of years in service, 3 or 60% have spent 6-10 years of being a BHW. All of them or 100% had the basic training of Barangay Health Worker.

Regarding breastfeeding, it was emphasized that among all the indicators the ones with the highest level of awareness are the ninth indicator which discussed that breast milk is the natural milk that protects baby from illnesses received an awareness rating of 20 or 100%. The tenth indicator which centers on the fact that breast milk possesses the right amount of nutrients to an infant of 4-6 months is also known by 20 or 100% of the totality of respondents. The third of the three highest indicators with the most knowledge is the first indicator. Majority of the respondents with 19 or 95% of the totality knows that breastfeeding has the ability to form strong bonds between the mother and child only 1 or 5% believes otherwise. Among the information which needs further teaching the fifth indicator which discusses that women who breastfeed for six months can lose all of the weight gained during pregnancy and with this 12 or 60% had no idea of such fact while the other 8 respondents which comprises 40% of the totality knew of this fact. 10 or only 50% of the respondents knew that women who breastfeed for six months can lose all of the weight gained during pregnancy as well as the fact that breastfeeding reduce the risk to breast cancer. Regarding stoppage of breastfeeding, the highest problem encountered was some mothers have trouble getting the milk flow to start and having a frequency of 16 or 80%. It was followed by the reason that the baby has started biting the mother's nipples causing pain on the part of the mother and this indicator had a frequency of 15 or 75%. On the other hand, those mothers that find breastfeeding is too tiring got the least concern as a problem and having a frequency of 2 or 10%.Regarding bottle feeding, majority of the respondents were highly knowledgeable about bottle feeding. 20 or 100% states that bottle feeding produce more gas and air swallowing problems with artificial nipples than mother's nipple. On the second rank were varied indicators in which the respondent shad a great awareness on as evidenced by a "yes" response by 90% of the population. Among these information was, first, that there are high chances that the baby may develop infections in bottle feeding. Second is that when making formula milk, it is possible to get the mixture wrong and make it too strong, too weak, or too hot. Third is that bottle feeding can be more expensive than breast feeding. Fourth is that the nutritional contents of the milk formula depend on proper preparation. It was deduced that once you have decided not to breastfeed your baby, it is difficult to reverse the decision and begin breastfeeding and this indicator got the lowest frequency of 9 or 45%.

This is the area of concern for the education of mothers regarding bottle feeding. Regarding mixed feeding, Most of the lactating mothers knew that combining bottle feeding with breastfeeding, bottle feeding should not be introduced during the first six weeks of life, it got a frequency of 20 or 100% and the item that states that the difference between nipples can confuse the baby, causing feeding problems, and interfering with the establishment of breastfeeding got a frequency of 13 or 65%. With regards to the Level of Performance of the Barangay Health Workers in the Promotion of Breastfeeding Programs the overall-mean rating was 2.53 with a verbal interpretation of "always". The top actions that barangay health workers perform to be of help to the increase in encouragement of lactating mother to comply to breastfeeding are as follows. On the first rank was that the BHW's provides information on breastfeeding, given the mean of 2.8, the rating was "always" based on the Likert's scale The second in rank is that the BHW's prohibits manufacturers and distributors from distributing to pregnant women or mothers of infants any gifts or articles or utensils which may promote the use of breast milk substitutes or bottle feeding with the mean of 2.75 this was performed on a frequent to always basis. On rank three was BHW's emphasize the hazards and risks of the improper use of breast milk substitutes were emphasized in the health education sessions with a mean of 2.6 this was performed on an always basis. In general, the BHW's perform functionally and prove to be visible and knowledgeable in the community setting of health promotion especially with regards to breast feeding. The least practiced by the BHW's was their role to explain the difficulty of revering the decision not to breastfeed the encouragement and promotion of breastfeeding and the explanation of the negative effects on breastfeeding of introducing partial bottle feeding.
On the Factors that Affect the Breastfeeding Compliance the main factors that affected breastfeeding compliance were divided into three general factors. On rank one was influenced by the busyness towards a mother's daily tasks. The second in rank were the lack of knowledge on the importance of breastfeeding, and, third, was the maintenance of body physique/figure. The least of factors that could affect breastfeeding compliance is the negative attitude towards breast feeding.

Based on the findings of the study, the following conclusions were formulated the respondents have varied demographic profiles. The dominant age of the lactating mothers are from 27-31 years of age. The surfacing educational attainment is being high school graduates and the common occupation was being a housewife and a vendor. The income range was from 1,000- 5,000 Php.1.2 The barangay health workers currently working in the community of Brgy. Sagmin have an age range of 20-30 years of age. Most are high school graduates and they receive an income of 1,000-5,000 Php. The range of service to the community is 5-10 years with numerous training attended to improve their knowledge and skills which could be of greater assistance to the community.2.1 The lactating mothers have a high level of awareness of the information regarding breastfeeding, bottle feeding and mixed feeding With regards to the knowledge of the respondents on breastfeeding, mothers know that breast milk is the natural milk that protects baby from illnesses and breast milk has the right amount of nutrients to your baby until she is four to six months old.2.2In terms of the respondent's knowledge about bottle feeding, most of mothers have a high awareness that bottle feeding produce more gas and air swallowing problems with artificial nipples rather than with the mother's nipple.2.3When it comes to mixed feeding, majority of the lactating mothers know that if they decide to employ bottle feeding with breastfeeding, bottle feeding is not to be introduced during the first six weeks of life.3 The primary reasons for the stoppage of Breastfeeding by the lactating mothers of Brgy. Sagmin, Legazpi City were the following. First is the trouble of getting the milk to flow and to start and the second is the fact that the baby starts to bite the nipples causing pain on the part of the mother.4.In the level of performance of the Barangay Health Workers in Breastfeeding promotion, the over-all mean of 2.53 with an interpretation of sometimes, it shows that the majority of the Barangay Health Workers needs further promotion to the lactating mothers with regards to breastfeeding.5.Factors affecting the Breastfeeding Compliance. For most of the lactating mothers, the factors affecting their breastfeeding compliance were first, they are too busy with the household chores, next is the lack of knowledge on the importance of breastfeeding the least of factors that could affect breastfeeding is the negative attitude towards breastfeeding. In conclusion the lactating mothers of Brgy. Sagmin have a positive regard and attitude towards breast feeding. This is evidenced by the factor that they have least results in the negative attitude towards breastfeeding as being a factor for non-compliance. With regards to recommendations:1.The Department of health through the rural health units should have a check-up of the skills and level of knowledge of BHW's regarding health promotion and augment it through trainings to be attended both by mothers and BHW's regarding maternal and child health especially on the importance of breast feeding. Emphasis on the importance of prenatal and post natal consultation is encouraged.2 The institutions such as hospitals and lying-in centers should actively participate in the promotion of breast feeding compliance and must delve more on the giving of health teachings to mothers on varied subjects related to the maternal and child's well-being beginning from the prevention of illness of both the mother and the baby and down to the proper breastfeeding measures.3 Barangay Health Workers must be true to their call of service of health promotion and must update themselves with information salient to their health promotion in the community and they must be readily available to attend to the needs of the community and most importantly of women in the process of lactation and must serve as an advocate of health for the community. 4 Women who are pregnant are encouraged to involve themselves in their pregnancy by the early attendance to prenatal check-ups for in these classes and consultations all the needed information regarding pregnancy and the care of the child is given. 5 The barangay health workers should conduct mother's "BUNTIS seminars which will discuss on varied topics ranging from the proper nutrition of the mother while pregnant, hygienic measures and the importance of breast feeding and the stress of its benefits for pregnant and lactating mothers to comply with breastfeeding. 6 Home visits should be conducted to the far flung areas to monitor mothers of their breast feeding practices and to guide them about proper breast feeding.6 The lactating mothers must develop a positive attitude towards the help that the barangay is extending and a way to practice this is that they must participate and support the programs that the Barangay Health Workers and the Rural Health Unit are implementing.