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South African Medical Journal

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Factors influencing a mother's choice of feeding after discharge of her baby from a neonatal unit

U Hallbauer, M Grobler, I Niemand

Abstract


Objective. To assess feeding methods chosen by mothers of babies who spent time in a neonatal unit.  Factors influencing this decision were investigated.

Design. Descriptive study.

Methods. Mothers were interviewed on the day they took their babies home. Basic demographic data on mother and baby were collected from the hospital records.

Setting. The neonatal unit, Pelonomi Hospital, Bloemfontein from May 1996 to May 1998.

Subjects. Eighty-one mothers of babies admitted to the neonatal unit.

Outcome measures. At discharge 60% of mothers intended to breast-feed their babies exclusively the  next day. The mother's decision to breasHeed her baby at home was significantly associated with her decision before delivery (P = 0.0050). Otherfactors positively associated with the decision to breast-feed exclusively at home were a significantly higher birth weight of the baby (P < 0.0008) and gestational age of the baby (P < 0.0005). The only hospital practice positively associated with this decision was the frequency with which mothers saw their babies during their stay in the unit (P = 0.0153). Mothers' knowledge of how to increase breast-milk supply was very poor.

Conclusions. Infants with a lower weight and gestational age, who stayed in the unit longer, were less  likely to be breast-fed after discharge from the neonatal unit. The mothers' experience in the unit did not seem to alter their choice of feeding method decided upon before delivery. This suggests that efforts to promote breast-feeding in the neonatal unit were either ineffectual or inadequate. In order to remedy this situation it is necessary to keep the motherinfant pair together (lodger mothers) and to promote  breastfeeding before and after delivery. It would also be necessary to train staff in the management of lactation problems.




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