Impact of breast feeding on Females' body image

Abstract

Breastfeeding is a natural process but it does not always come without a learning curve for many mothers. It is rare that mothers do not have any difficulties breastfeeding. The key is to stick with it, get support and guidance from a lactation consultant and be careful to not introduce bottles or formula unless you have tried everything else first. The World Health Organization (WHO) recommends that all infants be exclusively breastfed from birth to 6 months of age, followed by the gradual introduction of other forms of nutrition and continued breastfeeding into the second year and beyond. Body image can basically be defined as the mind's picture of the personal body and accompanying thoughts, feelings, and perceptions. In relation to breastfeeding, body image disturbance traits may influence a woman's initial decision to breastfeed, as well as possibly promote discomfort within the breastfeeding relationship, causing early cessation.

Aim of the study:- The aim of this study was to assess impact of breast feeding concept on mothers' body image and initiation and continuity of breast feeding in Riyadh city. The study was conducted at (antenatal clinic & well baby clinic) Primary Health Care Centers at East & West Riyadh city. A systematic random sample used to choose these centers. The five regions of Riyadh city were subjected to equal chance in order to select two regions out of five (East & west) regions were randomly elicited. Form the two regions also centers were randomly selected from each two regions out of regions. Hence the four centers were selected for data collection were PHC centers (Al-Soli & East Nasseim ) East region, PHC centers (Erijah C & Badiah ) West region. A total population of this study 200 woman, including 100 pregnant women who at the third trimester of their pregnancy and 100 women who are breast fed their infants at the first 3 months of their life. A convenient sample technique was used for selecting participants. At each four clinics 25 pregnant women from ante natal clinics & 25 lactating woman were selected with the following Inclusive criteria.

Inclusive criteria for selection of the population subjects was as follows: 1- Mothers age from 18-30 years. 2- Mothers either first pregnancy or with maximum 3 children. 3- Mothers who has normal physical condition without chronic illness. 4- Non-Saudi mothers were excluded from the sample. 5- Mothers who are willing to participate in this study. A pilot study was conducted on 10 women to test the validity and reliability of the tools and to estimate the time required for filling the sheets and to establish the research modification procedures. Any required modification was done. Data was collected from the period of (Rajab , 1429 / July, 2008) to Duo-Quad a, 1429 / December 2008) for duration of six months.

A structured questionnaire composed of two parts was utilized to collect the required data; I - Structured interviewing questionnaire was constructed by the researcher after consulting the experts in maternity & pioneers health care field, the questionnaire consists of two parts: ÞFirst part of the questionnaire included: A. Socio-demographic data such as (age, educational level, occupation status, income/ month, etc…). B. Obstetrical History such as ( Number Previous pregnancies &months, Number of live children & Type of delivery, etc. ) Þ Second part of the interview was aimed at assessing the Factor that encouraging and hindering initiation of breast feeding ,twenty-nine questions was developed by the researcher review of literature, it was formed as Likert scale answers ranging from strongly accept (4 grades) to strongly not accept (1 grade) II - The Body Image Disturbance Scale ( Al- Dousky, 2004). It is a 34 likert-scale (5 answers) ranging from always (4 grades) to never (0 grade) with maximum total score 136 and minimum score 34. The highest scores indicates that woman is satisfied with her body image while lowest scores indicates that woman is not satisfied with her body image. Total scores of Body Image Disturbance Scale was divided as follows: 1- > 50 scores is totally not satisfied with body image. 2- 50 >100 scores moderately satisfied with her body image. 3- Above 100 scores is totally satisfied with her body image.

The results of the study revealed that:- 1. Near half and above two thirds the pregnant and lactating mothers aged (25 > 30 years ) (51% & 67%) respectively. Concerning educational level of the studied samples, that more than half of the pregnant mothers (59%) and (48%) of the lactating mothers had secondary school education. 2. Most of the pregnant and lactating mothers are working (81% & 73%), among who had rented house were (55% & 57%) and of the population who had a present of made (75% & 67%) respectively. And above two-third of the pregnant and lactating mothers (65% & 63%) belonged to low and moderate socio-economic level. 3. Wither the of pregnant and lactating mothers (21% & 38%) initiate breast feeding at the second day after delivery respectively, as regards the previous breast feeding duration takes a period of three months after delivery (34% & 73%) respectively for present pregnant mothers. 4. There is a statistically significant relationship between factors that encourage /hinder initiating & continuity of breast feeding among both studied sample (p = < 0.001). In relation to total scores of body image between pregnant and lactating mothers, a statistically significant relation was found (p = 0.01). 5. The lactating mothers are more active in initiating breast feeding than the pregnant mothers during, days of the newborn’s age (37% & 32% ) (23% & 16%) respectively, but (there was no significant difference between the two groups regarding the time of initiation of breast feeding. 6. The percent (70% & 40%) wither the lactating and pregnant mothers were continues breast feeding their infants for the first three months of their infants’ age respectively ,while the minority (2% & 37%) were not lactating their infants and still pregnant for the first time. There is a significant relationship in relation to continuity of breast feeding among lactating mothers (p = 0.001). 7. A considerable percent of the pregnant and lactating mothers (74% & 77% ) considered that colostrums in the first three days after delivery is important for the newborn while (37% & 35%) of both groups accept and strongly accept that bottle feeding is better than breast feeding because it helps infant to grow healthy respectively. 8. The two-third of the pregnant (61%) and near half (54%) lactating mothers & did not take the decision to breast feed their infant during their pregnancy respectively. 9. The (41% ) of the pregnant and (50%) of the lactating mothers, regarding who is responsible to decide to breast feed the new coming body; both groups strongly not accept that they are only the one who is responsible to take the decision of breast feeding. In relation to feeling of happiness during breast feeding among pregnant and lactating mothers (36%& 83%) strongly accept and strongly not accept respectively. 10. Near two third of the pregnant (59%) and (43%) lactating mothers were strongly not accept the fact that breast feeding will protects the mothers from having breast cancer or protect their body from having gastroenteritis respectively. 11. (44%) of the pregnant mothers accept the idea that their work interfering with their readiness to breast feed their babies, while (30%) of lactating mothers not accept the same proposed idea. . 12. Among the pregnant (45%) and with lactating mothers (48%) accept that breast feeding sessions are given only two times per day and continue with artificial feeding In relation to the importance of breast feeding, (37%) of the pregnant mothers accept that breast feeding is important only for the first three months of the kids age and then they can stop it , while (34%) of lactating mothers are not accepting this idea. 13. Occupation of lactating mothers is significant to the factors hindering breast feeding (p= 0.000) and is not significant in relation to factors hindering breast feeding and body image among pregnant mothers (Mean = 74.4 & SD = 7.04) (Mean = 95.05 & SD = 15.4) respectively. 14. The presence of made in the house pregnant and lactating mothers is not significant to their factors hindering breast feeding and their body image (Mean = 74.7 & SD = 6.6) (Mean = 97.5 & SD = 13.4) (pregnant mothers ) and (Mean = 80.3 & SD = 10.8 ) (Mean = 94.2 & SD = 11.2) (lactating mothers )respectively. Conclusion: The results of this study folded that regardless of the personal hindering or encouraging initiation factors characteristics a positive body image was proved to be relatively high among lactating mothers regardless initiating or hindering factors or knowledge that positively encourage breast feeding.

Recommendation: 1. Integrating self-efficacy Maternal breastfeeding self-efficacy is a significant predictor of breastfeeding duration and level. Integrating self-efficacy enhancing strategies may improve the quality of healthcare that healthcare professionals deliver & may increase a new mother's confidence in her ability to breastfeed, & to persevere if she dose encounter difficulties. 2. Address mothers' self confidence The individual mother is responsible for the success of breastfeeding and the discourses are hiding that general perceptions of breastfeeding undermines the mothers' confidence in breastfeeding should be addressed. 3. Dissemination of information and education The study suggests a need for dissemination of information and education regarding optimal breastfeeding practices and for protecting and promoting healthy traditional practices. 4. Involvement of pregnant and lactating mothers, in various activities Involvement of pregnant and lactating mothers, in various activities is desirable as they all have an important role in initiation of breast-feeding and other healthy feeding practices at the community level. 5. Promoting institutional deliveries They should be made aware of advantages and psychological implications of optimal breast-feeding practices. Efforts should also be made for promoting institutional deliveries for providing them better opportunities of health education for early initiation of breast-feeding. 6. Conduct research Conduct research that identifies the social, cultural, economic, and psychological factors that influence infant feeding behaviors. 7. Educational programs While the educational programs launched to convey the benefits of breastfeeding often focus on the health of the baby, the focus needs to shift to the decision-making process that mothers go through in making infant feeding choices, including the effect of body image on breastfeeding initiation and duration. 8. Promoting & improvement mothers need information Before any increases in breastfeeding rates can occur, true underlying causes of breastfeeding practices, as well as barriers to breastfeeding initiation, must be identified and addressed to best meet the needs of mothers and to best provide for the health of future generations. 9. Family and peer support A universal service for initiation of breast feeding using peer support and family assistance provided within antenatal clinics is required. 10.Outreach services A policy for attending breastfeeding sessions during antenatal period is a must for all pregnant mothers especially during the third pregnancy trimester and especially for those living in relatively deprived areas and initiation and implementation of home visits for postpartum women to assess and encourage women to continue breast feeding is necessary. 11.Paid maternity vacation Community health team should encourages and advocates women to have postpartum maternity leave with full salary for the first 6 months of the child's age for exclusive lactation and flexibility in working conditions for breastfeeding women. 12. The role of healthcare providers The healthcare providers must focuses on the benefits of breastfed versus formula-fed infants across time and Nurses & Pediatricians have significant role in initiation and support mothers to start breastfeeding early especially if the hospital rules is to keep woman who delivered normally for at least 12 hours post delivery.