Throughout the World, mother’s seems to discontinue breastfeeding their child and do not seem to understand the importance of it. Some mother’s may become impatient to feed the child or may find it rather inconvenient. They may also not know the benefits of breastfeeding and consider that commercial alternatives may be equally beneficial. One of the reasons why mothers should continue breastfeeding the child is because breastfed babies are healthier, have a better immune system, develop illnesses less often and survive better than bottle-feed babies.
Sudden stoppage of this healthy habit may later prove to be disastrous for the child’s growth and development. In Brazil, there was a decrease in the frequency of breastfeeding, which had its effect on the infant mortality rates. In an endeavor to promote breastfeeding, a program was launched across Brazil, known as the “Brazilian Breastfeeding Promotion Programme” (BBPP) in March, 1981. Some of the activities that were a part of the program included mass media campaigns, training health professionals and reorganizing the health services structure.
Before the program was launched a surveys were conducted in Sao Paulo before (1981) and after the implementation of the program (1987). To be a part of the study, infants below the age of 8 months, receiving some type of milk and acquiring the healthcare services in metropolitan Sao Paula were chosen (criteria for selection). From this representative sample, 300 children were selected randomly in the first survey (1981) and 380 children randomly selected in the second survey (1987). Data was collected using interviews. The mother was being asked questions on the type of milk being consumed.
This was a comparative study in which the participants of one group were being compared to that of the other group. The study is a controlled experiment as the effect of certain variable is being studied after altering them. As the study is being carried out to review and analyze previously published literature, it is a systematic review. The results of previous observational case-control studies conducted in similar urban population were utilized. These included 2 Southern Brazilian cities (namely Port Alegre and Pelotas).
It was being used to gather data regarding the child’s relative risk to develop diarrhea, respiratory infections and other infectious diseases. Details of child’s mortality were acquired through examination of the state records. Further data was obtained through interview with the mother and examination of the hospital case-sheets. Children who were born with below normal birth weights, twins, birth abnormalities, and birth problems were excluded from these studies. Babies were also being excluded if they died before the eighth day of life. The control group was also selected from the same neighborhood.
The study included 357 cases and 714 controls. Specific details regarding the feeding pattern were obtained just before the baby’s death in the cases. The relative risks were adjusted for several associated factors such as socio-economic status, water and sanitation, birth weight, etc. The study was conducted on 2 representative samples who utilized the health services. They may not have clearly represented the children of Sao Paulo. However, since health services are widely being utilized by all groups, the study may have tried to represent the whole population.
Some of the details were acquired from the state department which could be inaccurate. The study derives the infant mortality rates from a case-control study. In determining the impact, the effects are said to be responsible for the cause. The study can be generalized to some extent (external validity) because the results show that one in every three infant deaths due to diarrhea and one in every five infant deaths due to respiratory and other infections can be prevented by having breastfeeding awareness programs.
Breastfeeding awareness should be incorporated before during the pregnancy period itself, and the program did not make any contribution in that regard. The studies conducted in Sao Paulo in 1981 and 1987 show that they is a reduction in the infant mortality rates, particularly due to diarrhea and to a certain extent in respiratory infections and other infections. This may be due to increased breastfeed rates observed in the age groups (0 to 2 months, 2 to 4 months, 4 to 6 months and 6 to 8 months) from the BBPP awareness.
Full breastfeeding gave better protection compared to partial breastfeeding in the first two months. The finding obtained through the study does prove the hypothesis to some extent. Mortality was reduced through breastfeeding awareness programs especially in deaths arising from diarrhea. The study goes on to prove previous studies that breast feeding is important for the health of the child and development of its immune system. In nursing practice, mothers stopping breast feeding of the child may be observed often.
It may develop due to several reasons such as breast pain, reduced latch and a feeling that the quantity of milk has decreased. Even social, lifestyle (such as impatience from workload) and environmental factors can be attributed. The nurse may find it difficult to educate the mother and motivate her to restart feeding. However, the evidence gained through the study (in which infant mortality arising diarrhea, respiratory and other infections reduced following breast feeding) can be utilized to educate and motivate the mother to continue breastfeeding.
Mothers can be demonstrated that breastfeeding helps improve the immune system and provides better resistance against infection. Abstract – In Brazil, in 1981, a project was implemented in order to create breastfeeding awareness in the population through the mass media, health workers training and re-organizing the health services. In 1981 and 1987, two surveys were being conducted in Sao Paulo, showing that the mean duration for breast feeding was 84 days (in 1981) and improved to 146 days (in 1087).
The effect of the awareness program on the infant mortality rates was determined using a case-control study in an urban population having similar variables. The infant mortality rate decreased by 49%, and better breastfeeding practices created by the program results in 12 % of the 49% reduction (a quarter of the deaths). The reductions was most significant for infant moralities arising from diarrhea (32%), respiratory infections (22%), followed by other infections (17%).
References: Monteiro, Carlos (1990). Can infant mortality be reduced by promoting breastfeeding? Evidence from Sao Paulo city. Health Policy and Planning, 5(1). http://heapol. oxfordjournals. org/cgi/reprint/5/1/23? ijkey=bf35795e6529613b6fec03e6b8d55a32ca8a1f75 WHO Fact sheet (1997). Reducing Mortality from Major Childhood Killer Diseases. Retrieved December 03, 2006, from WHO Web site: http://www. who. int/child-adolescent-health/New_Publications/IMCI/fs_180. htm.