ABSTRACT

Bragais, Gabriel Joseph M., Almine, Joanna Marie V., Andes, Krista Mae A., Bobier, Mario N., BREASTFEEDING COMPLIANCE OF LACTATING MOTHERS IN BARANGAY BUYOAN, LEGAZPI CITY, (An undergraduate thesis, Aquinas University College of Nursing and Health Sciences, Rawis, Legazpi City, 2012)

This study was conducted to determine the level of breastfeeding compliance of lactating mothers and the performance of Barangay Health Workers (BHWs) in the promotion of breastfeeding program in Barangay Buyoan, Legazpi City. Specifically, it sought to answer the following: 1) What is the demographic profile of the respondents in terms of; A. Lactating Mothers'; Age, Educational Attainment, Occupation, Family Monthly Income. B. Barangay Health Workers'; Age, Educational Attainment, Family Monthly Income, Years in Service, Trainings attended. 2) What is the knowledge of lactating mothers and Barangay Health Workers along; Breastfeeding, Stoppage of Breastfeeding, Bottle feeding (Milk Formula), Mixed Feeding. 3)What is the level of
performance of the Barangay Health Workers in the promotion of breastfeeding program, 4)What factors affect the breastfeeding compliance as perceived by the lactating mothers and the Barangay Health Workers, 5) What measures may be proposed to effectively promote breastfeeding compliance among lactating mothers.


The total number of lactating mothers within the target area was 118. By applying stratified sampling utilizing the Slovin formula with a 5% margin of error the researchers computed for a total sample of 84 respondents. For the Barangay Health Workers the researchers utilized total enumeration. The study was limited to lactating mothers and active Barangay Health Workers of Barangay Buyoan, Legazpi City Lactating mothers who are immigrants or transients were excluded in this study. The study used a random active Barangay Health Workers of Barangay Buyoan, Legazpi City. Lactating mothers who are immigrants or transients were excluded in this study. The study used a random sampling method and utilized survey of questionnaires to facilitate gathering of data that were needed.

The following were the findings of the study: Twenty-five or thirty percent of the lactating mothers were 28-32 years old. This was the highest percentage. Two or 2% of the respondents were 43-47 years old, with the lowest percentage. On age group of Barangay Health Workers, three of the age groups had the same percentage of 4 or 27.67% who belonged to ages 48-54 years old, 55-61 years old, and 62-68 years old. Forty eight or 57.14% of the lactating mothers were high school graduates. Two or 2.38% of lactating mothers had the lowest educational attainment. For the Barangay Health Workers, nine or 60% had the highest educational attainment which was elementary graduate. One or 7% had a college degree. Sixty seven or 80% of lactating mothers were housewives; one or 1% each for vendor, teacher, gasoline station employee, and barangay treasurer. Thirty-nine or 46.42% of the lactating mothers had an income of Php 800-2839 while one or 1.2% had a family income of Php 6,920-8,959 and Php 11,000-13,039 per month comprised the
minority. For the Barangay Health Workers (BliWs), eight or 53% had a family monthly income which ranged from Php 3,000-3,999 per month; while only one BHW had an income that ranged from Php 1,000-1,999 comprising the minority. Majority of the barangay health workers had a minimum of 16-year experience as community health workers, while some had only 9-69 months of service. All the barangay health workers had received no training regarding the promotion of breastfeeding and breastfeeding practices. Hence, they rely heavily on common knowledge for their health teachings. Eighty-four or 100% of lactating mothers believed that breastfeeding has the ability to form a strong bond between mother and baby; fourty-four or 52.38% believed that women who had Caesarian sections can breastfeed comfortably by using different positions. Seventy or 83.88% know that some mothers have trouble getting the milk flow to start; thirty or 35.71% agreed with the statement mother wishes to get pregnant again.


Seventy-eight or 92.85% knew of the nutritional contents of milk formula that depended on proper preparation and fifty-two or 61% were aware th at bottle feeding can be much more inconvenient than breastfeeding. Sixty-three or 75% knew that the difference between nipples can confuse the baby, causing feeding problems, and interfering with the establishment of breastfeeding; fourty-nine or 58.33% knew that in combining bottle feeding with breastfeeding; one should not introduce bottle feeding during the first six weeks of life.

The level of performance of the BHWs on Breastfeeding promotion was according to the lactating mothers, encouraging and promoting breastfeeding which had the highest mean of 2.78. Explaining the negative effects on breastfeeding of introducing partial bottle feeding, the difficulty of reversing the decision not to breastfeed, and emphasizing the hazards and risks of the improper use of breast milk substitutes were emphasized in the health education which session had the lowest mean of 2.16. The Barangay Health Workers, perceived that encouraging and promoting breastfeeding, providing information and explaining negative effects on breastfeeding of introducing partial bottle feeding had the highest mean of 2.93 and prohibiting manufacturers and distributors from distributing to pregnant women or mothers of infants any gift of article or utensil which may promote the use of breast milk substitutes or bottle fee ding had the lowest mean of 2.2. According to lactating mothers, the lack of knowledge on the importance of breastfeeding had the highest percentage of 69.04% while the lowest percentage of 27.38% was about the lack of financial support from the government. For the Barangay Health workers, the highest percentage was 93.33% for lack of training on breastfeeding program and lack of financial support from the government. On the other hand the lowest was 0% on maintaining a good body figure.

Based on the findings, the following conclusions were formulated: among the lactating mothers most of them were 28-32 years old, high school graduates, and housewives with a monthly family income of 800-2839. These factors predisposed the lactating mothers to practice breastfeeding. For the barangay health workers, most of them were ages of 48-54 years old, 55-61 years old, and 62-68 years old, elementary graduates with a monthly family income of 3,000-3,999, the age and qualifications suggested that the barangay health workers had a reduced effectiveness as breastfeeding advocates. Also the lack of compensation further reduced their efficiency by limiting the amount of time allotted as community health practitioners. The highest percentage on knowledge of breastfeeding of lactating mothers was on the item that it forms and provides a strong bond between mothers and babies.

However, on the item that a mother who underwent Caesarian section may use different kinds of positions to be comfortable in breastfeeding their babies, had the lowest percentage. Knowledge of "mothers that had trouble in ejecting milk to start where it tends to have insufficient supply of milk" showed the highest percentage. The least they knew of was that "stoppage happens when they thought of being pregnant again." "Mothers knew about what nutrients composes formula milk when it is being prepared through bottle feeding," had the highest percentage. The lowest concern was "mothers had ideas that several disadvantages and inconvenience were experienced in bottle feeding than in breastfeeding." The highest percentage on knowledge on mixed feeding was on "nipples of different size, shape, flat, or inverted may affect the babies having feeding problems and interferes in nursing them." Respondents were concerned about not introducing bottle feeding during the first six weeks of the life of infants. For the level of performance of the barangay health workers on breastfeeding promotion, the lactating mothers showed that encouraging and promoting breastfeeding was "always" implemented by the barangay health workers but they were "sometimes" informed of the negative effects of introducing partial bottle feeding while breastfeeding the infant, having difficulty in deciding whether to breastfeed or not and giving emphasis on the hazards and risks of the improper use of milk substitutes. According to barangay health workers, they "always" encouraged breastfeeding promotion by giving information and explaining such negative effects of introducing partial bottle feeding while practicing breastfeeding. Meanwhile, they "sometimes" prohibit several manufacturers and distributors from giving gifts of articles that promote milk substitutes. "Lactating mothers' insufficient knowledge on the importance of breastfeeding affected their compliance" had the highest impact on their compliance; while "few mothers considered financial support from the government" had the least percentage.
The barangay workers perceived, "insufficient skills due to lack of training regarding breastfeeding compliance of lactating mothers" and "
the lack of financial support" as the primary factors affecting compliance, while "maintenance of body figure" had the least impact on the barangay health workers. They suggested for themselves measures suggested to improve breastfeeding compliance, such a s, supplemental trainings on breastfeeding practices, and better compensations in the form of financial and/or benefits which could increase the level of performance of the barangay health workers.


For the lactating mothers, seminars regarding breastfeeding compliance and breastfeeding practices which are taught at the level of their understanding
would increase awareness thereby increasing compliance. Also livelihood programs aimed at giving mothers extra income can address the problems regarding financial support. Based on the results of the study the following strategies were recommended: The barangay council must promote the efficient performance of duties of Barangay Health Workers in promoting the breastfeeding programs to all lactating mothers by providing a series of supplementary modules focused on the importance and benefits they can get from breastfeeding. Also the proper distribution to all mothers, all the available literature and other information on breastfeeding in order for them to have more knowledge and information especially when it comes to compliance, practices and the proper way of breastfeeding.


It was found out that lactating mothers were less aware that women who have had caesarean sections can breastfeed comfortably by using different positions. It implies that they need more information about the benefits of breastfeeding such as promoting bonding, strengthening the immune system; mother's milk is cheaper than bottled milk, a treasured experience and providing complete nourishment of the baby. It also revealed that mothers who wanted to get pregnant, gave them a reason to stop breastfeeding their baby.

Hence, better seminars regarding family planning and conducting community "mother's classes" could address this problem. Some of the mothers knew that bottle feeding can be much more inconvenient than breastfeeding. Breastfeeding contains some minerals and vitamins needed by the
body to protect it from any form of infection. It showed that some mothers knew that if they decide to combine bottle feeding with breastfeeding, they should not introduce bottle feeding during the first six weeks of life. Mothers should be oriented on the importance of breast milk to the child especially during the first six we eks of life. Since majority of lactating mothers and Barangay Health Workers had problems with the negative effects of breastfeeding as introducing partial bottle feeding to the baby, reversing the decision not to breastfeed their baby becomes difficult because they do not have the capability to produce enough milk. The lack of health education sessions emphasized the hazards and risk of the improper use of breast milk substitutes. This study recommends that the breastfeeding advocates should have clear information regarding the importance and benefits of breastfeeding, also teaching the proper method of doing it, and how to make good choices on their own.


The study found out that they had problems affecting the breastfeeding compliance perceived by both respondents, such as "mothers had lack of knowledge on the importance of breastfeeding," "too busy with their household chores" and "mothers could not breastfeed their babies during work." This study recommends giving them a health related magazine or literature in order for them to know that breastfeeding is the normal way of providing young infants with the nutrients they need for healthy growth and development. A series of health education is advised that serves as an eye opener for them to know the importance of breastfeeding which tackles the right method of feeding a baby during or after household chores/works. All mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society as a whole.