The effect of early postpartum home visits by midwife on breastfeeding problems: a clinical trial study

Document Type : Original Article

Authors

1 M.Sc. of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Assistant professor, Department of Midwifery, Psychiatric Care Research Centre, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Instructor, Department of Midwifery, Non-communicable Diseases Research Center, School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran.

4 Assistant professor, Department of Biostatistics, Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

5 Assistant professor, Department of Midwifery, Maternal–Fetal Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Introduction: Postpartum home visits have yielded conflicting results. One of the challenges in this field is the implementation of effective training to support mothers after giving birth to investigate the problems of exclusive breastfeeding. The present study was performed with aim to investigate the impact of home visits by midwives on the amount of breastfeeding problems after delivery.
Methods: This clinical trial study was conducted on 100 mothers who gave birth in Flowerjan Imam Khomeini Hospital in 2018. The subjects were randomly divided into two groups of intervention and control (n=50 in each group). The control group received routine postpartum care through health centers and the intervention group received training in 4 sessions (in the early postpartum period up to 42 days after birth) at home. The data collection tool was a demographic and breast problems questionnaire which was completed in mothers' homes. Data was analyzed by SPSS statistical software (version 22) and independent t-test and paired t-test. P<0.05 was considered statistically significant.
Results: The frequency of engorgement on the third and seventh days was significantly lower in the intervention group than the control group (P<0.05), and there was no significant difference between the two groups on the fourteenth and forty-second days (P>0.05). The frequency of fissure on the third day was significantly lower in the intervention group than the control group (P<0.05), and there was no significant difference between the two groups on the seventh and fourteenth days (P>0.05). There was no fissure in any of the two groups on the forty-second day.
Conclusion: Practical advice and support on breastfeeding techniques by trained midwives may result in greater transfer of skills and reduced fissure and engorgement.

Keywords

References

  1. Jafary gol M, Navipour H, sadooghi asl A. Nurses’ Experiences of Assessment Competency in Home Health Care: A Qualitative content analysis Study. IJNR 2022; 16 (6) :23-32
  2. Amini R, Najafi H, Samari B, Khodaveisi M, Tapak L. Effect of home care program on therapeutic adherence of patients with type 2 diabetes. Journal of Education and Community Health 2020; 7(3):187-93.
  3. Dehestani H, Tayebi N, Moshfeghy Z, Akbarzadeh M. The Role of Spiritual Health Experience with Intensity and Duration of Labor Pain While Childbearing and Postpartum. Current Women's Health Reviews 2022; 18(2):77-84.
  4. Gebuza G, Kaźmierczak M, Mieczkowska E, Gierszewska M, Banaszkiewicz M. Adequacy of social support and satisfaction with life during childbirth. Polish Annals of Medicine 2016; 23(2):135-40.
  5. Naghizadeh S, Sehati F, Atri Barzanjeh S, Ebrahimi H, Eghdampour FA. Comparative study of mothers' satisfaction with physical care provided by laborers, maternal and postpartum carers in Tabriz educational and Non-educational hospitals. Woman Fam Stud 2012; 3(11):129-41.
  6. Sigurdardottir VL, Gamble J, Gudmundsdottir B, Kristjansdottir H, Sveinsdottir H, Gottfredsdottir H. The predictive role of support in the birth experience: A longitudinal cohort study. Women and Birth 2017; 30(6):450-9.
  7. Howarth A, Swain N, Treharne GJ. First-time New Zealand mothers' experience of birth: Importance of relationship and support. New Zealand College of Midwives Journal 2011; (45).
  8. Bick D, Taylor C. Quantitative assessment of birth experience remains elusive. BJOG: An International Journal of Obstetrics & Gynaecology 2015; 123(3):475-.
  9. Badakhsh M, Hastings-Tolsma M, Firouzkohi M, Amirshahi M, Hashemi ZS. The lived experience of women with a high-risk pregnancy: A phenomenology investigation. Midwifery 2020; 82:102625.
  10. Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The lancet 2016; 387(10017):475-90.
  11. Pérez-Escamilla R, Tomori C, Hernández-Cordero S, Baker P, Barros AJ, Bégin F, et al. Breastfeeding: crucially important, but increasingly challenged in a market-driven world. The Lancet 2023; 401(10375):472-85.
  12. Ziaie T, Ghanbari A, Hassanzadeh Rad A, Yazdani MA. Investigating risk factors of failure in exclusive breastfeeding in less than one-year-old children referred to health centers in Rasht city. Iran J Obstet Gynecol Infertil 2012; 15(18):32-9.
  13. Hagos D, Tadesse AW. Prevalence and factors associated with exclusive breastfeeding among rural mothers of infants less than six months of age in Southern Nations, Nationalities, Peoples (SNNP) and Tigray regions, Ethiopia: a cross-sectional study. International breastfeeding journal 2020; 15(1):1-8.
  14. Muluneh MW. Determinants of exclusive breastfeeding practices among mothers in Ethiopia. Plos one 2023; 18(2):e0281576.
  15. Scime NV, Patten SB, Tough SC, Chaput KH. Maternal chronic disease and breastfeeding outcomes: a Canadian population-based study. The Journal of Maternal-Fetal & Neonatal Medicine 2022; 35(6):1148-55.
  16. McDonald SD, Pullenayegum E, Chapman B, Vera C, Giglia L, Fusch C, et al. Prevalence and predictors of exclusive breastfeeding at hospital discharge. Obstetrics & Gynecology 2012; 119(6):1171-9.
  17. Henninger ML, Irving SA, Kauffman TL, Kurosky SK, Rompala K, Thompson MG, et al. Predictors of breastfeeding initiation and maintenance in an integrated healthcare setting. Journal of Human Lactation 2017; 33(2):256-66.
  18. Waiswa P, Pariyo G, Kallander K, Akuze J, Namazzi G, Ekirapa-Kiracho E, et al. Effect of the Uganda Newborn Study on care-seeking and care practices: a cluster-randomised controlled trial. Global health action 2015; 8(1):24584.
  19. Adam MB, Dillmann M, Chen MK, Mbugua S, Ndung’u J, Mumbi P, et al. Improving maternal and newborn health: effectiveness of a community health worker program in rural Kenya. PloS one 2014; 9(8):e104027.
  20. World Health Organization. WHO recommendations on postnatal care of the mother and newborn. World Health Organization; 2014.
  21. Amare Y, Scheelbeek P, Schellenberg J, Berhanu D, Hill Z. Early postnatal home visits: a qualitative study of barriers and facilitators to achieving high coverage. BMC public health 2018; 18(1):1-8.
  22. Gogia S, Sachdev HS. Home visits by community health workers to prevent neonatal deaths in developing countries: a systematic review. Bulletin of the World Health Organization 2010; 88:658-66.
  23. Kirkwood BR, Manu A, ten Asbroek AH, Soremekun S, Weobong B, Gyan T, et al. Effect of the Newhints home-visits intervention on neonatal mortality rate and care practices in Ghana: a cluster randomised controlled trial. The Lancet 2013; 381(9884):2184-92.
  24. McPherson R, Hodgins S. Postnatal home visitation: lessons from country programs operating at scale. Journal of global health 2018; 8(1).
  25. Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane database of systematic reviews 2012(8).
  26. Anatolitou F. Human milk benefits and breastfeeding. Journal of Pediatric and Neonatal Individualized Medicine (JPNIM) 2012; 1(1):11-8.
  27. Scime NV, Metcalfe A, Nettel-Aguirre A, Nerenberg K, Seow CH, Tough SC, et al. Breastfeeding difficulties in the first 6 weeks postpartum among mothers with chronic conditions: a latent class analysis. BMC Pregnancy and Childbirth 2023; 23(1):90.
  28. Brown CR, Dodds L, Legge A, Bryanton J, Semenic S. Factors influencing the reasons why mothers stop breastfeeding. Canadian Journal of Public Health 2014; 105:e179-85.
  29. Laageide L, Radke S, Santillan D, Ten Eyck P, Powers J. Postpartum nipple symptoms: risk factors and dermatologic characterization. Breastfeeding Medicine 2021; 16(3):215-21.
  30. Vieira F, Bachion MM, Mota DD, Munari DB. A systematic review of the interventions for nipple trauma in breastfeeding mothers. Journal of Nursing Scholarship 2013; 45(2):116-25.
  31. Morland‐Schultz K, Hill PD. Prevention of and therapies for nipple pain: a systematic review. Journal of Obstetric, Gynecologic, & Neonatal Nursing 2005; 34(4):428-37.
  32. McCann MF, Baydar N, Williams RL. Breastfeeding attitudes and reported problems in a national sample of WIC participants. Journal of Human Lactation 2007; 23(4):314-24.
  33. Buck ML, Amir LH, Cullinane M, Donath SM, CASTLE Study Team. Nipple pain, damage, and vasospasm in the first 8 weeks postpartum. Breastfeeding Medicine 2014; 9(2):56-62.
  34. Akbari SA, Alamolhoda SH, Baghban AA, Mirabi P. Effects of menthol essence and breast milk on the improvement of nipple fissures in breastfeeding women. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 2014; 19(7):629-33.
  35. Firouzabadi M, Pourramezani N, Balvardi M. Comparing the effects of yarrow, honey, and breast milk for healing nipple fissure. Iranian journal of nursing and midwifery research 2020; 25(4):282-5.
  36. Sheinizadeh-Emadi S, Ehsani P, Dahanzadeh S, Haghighizadeh M. Comparison evaluation of Curcumin (Curcuma longa extract) with the application of expressed breast milk in the treatment of nipple cracks in lactating primiparous women: A randomized clinical trial. Journal of Clinical Nursing and Midwifery 2015; 4(2):11-9.
  37. Morrison AH, Gentry R, Anderson J. Mothers' reasons for early breastfeeding cessation. MCN: The American Journal of Maternal/Child Nursing 2019; 44(6):325-30.
  38. Wilson E, Woodd SL, Benova L. Incidence of and risk factors for lactational mastitis: a systematic review. Journal of Human Lactation 2020; 36(4):673-86.
  39. Tesfau YB, Gebrehiwot TG, Godefay H, Kahsay AB. Effect of health facility linkage with community using postnatal card on postnatal home visit coverage and newborn care practices in rural Ethiopia: A controlled quasi-experimental study design. Plos one 2022; 17(5):e0267686.
  40. Tesfau YB, Kahsay AB, Gebrehiwot TG, Medhanyie AA, Godefay H. Postnatal home visits by health extension workers in rural areas of Ethiopia: a cross-sectional study design. BMC Pregnancy and Childbirth 2020; 20(1):1-9.
  41. Sinha LN, Kaur P, Gupta R, Dalpath S, Goyal V, Murhekar M. Newborn care practices and home-based postnatal newborn care programme–Mewat, Haryana, India, 2013. Western Pacific surveillance and response journal: WPSAR 2014; 5(3):22-9.
  42. Rydström LL, Tavallali A, Sundborg E, Berlin A, Ranheim A. Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications. Qualitative health research 2021; 31(9):1622-31.
  43. Brown A, Rance J, Bennett P. Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties. Journal of advanced nursing 2016; 72(2):273-82.
  44. Williamson I, Leeming D, Lyttle S, Johnson S. ‘It should be the most natural thing in the world’: Exploring first‐time mothers' breastfeeding difficulties in the UK using audio‐diaries and interviews. Maternal & child nutrition 2012; 8(4):434-47.
  45. Palmér L, Carlsson G, Mollberg M, Nyström M. Severe breastfeeding difficulties: Existential lostness as a mother—Women's lived experiences of initiating breastfeeding under severe difficulties. International journal of qualitative studies on health and well-being 2012; 7(1):10846.
  46. Chaput KH, Nettel-Aguirre A, Musto R, Adair CE, Tough SC. Breastfeeding difficulties and supports and risk of postpartum depression in a cohort of womenwho have given birth in Calgary: a prospective cohort study. Canadian Medical Association Open Access Journal 2016; 4(1):E103-9.
  47. Asaadi N, Kariman N, Shahrahmani H, Ghalandari S, Khodakarami N. A systematic review of clinical trials in the treatment of sore nipple and nipple pain in breastfeeding women. Iran J Obstet Gynecol Infertil 2016; 19(6):22-33.
  48. Zakarija-Grkovic I, Stewart F. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev 2020; 9(9):CD006946.
  49. Mokhtari F, Bahadoran P, Baghersad Z. Effectiveness of postpartum homecare program as a new method on mothers’ knowledge about the health of the mother and the infant. Iranian Journal of Nursing and Midwifery Research 2018; 23(4):316-21.
  50. Zarshenas M, Zhao Y, Poorarian S, Binns CW, Scott JA. Incidence and risk factors of mastitis in Shiraz, Iran: Results of a cohort study. Breastfeeding Medicine 2017; 12(5):290-6.
  51. Scott JA, Binns CW, Aroni RA. The influence of reported paternal attitudes on the decision to breast‐feed. Journal of paediatrics and child health 1997; 33(4):305-7.
  52. Scott JA, Binns CW, Graham KI, Oddy WH. Temporal changes in the determinants of breastfeeding initiation. Birth 2006; 33(1):37-45.
  53. Dashti M, Scott JA, Edwards CA, Al-Sughayer M. Determinants of breastfeeding initiation among mothers in Kuwait. International breastfeeding journal 2010; 5:1-9.
  54. Raheem RA, Binns CW, Chih HJ, Sauer K. Determinants of the introduction of prelacteal feeds in the Maldives. Breastfeeding Medicine 2014; 9(9):473-8.
  55. Scott JA, Robertson M, Fitzpatrick J, Knight C, Mulholland S. Occurrence of lactational mastitis and medical management: a prospective cohort study in Glasgow. International breastfeeding journal 2008; 3(1):1-6.
  56. Haute Autorité de Santé (HAS). Sortie de maternité après accouchement: conditions et organisation du retour à domicile des mères et de leurs nouveau-nés. Argumentaire. Mars 2014. Available at: https://www.has-sante.fr/upload/docs/application/pdf/2014-03/argumentaire_scientifique_-_sortie_de_maternite_apres_accouchement.pdf. Accessed July 28, 2021.
  57. Sellwood M, Huertas-Ceballos A. Review of NICE guidelines on routine postnatal infant care. Archives of Disease in Childhood-Fetal and Neonatal Edition 2008; 93(1):F10-3.
  58. Lemyre B, Jefferies AL, O’Flaherty P. Facilitating discharge from hospital of the healthy term infant. Paediatrics & child health 2018; 23(8):515-22.
  59. Jones E, Stewart F, Taylor B, Davis PG, Brown SJ. Early postnatal discharge from hospital for healthy mothers and term infants. Cochrane Database of Systematic Reviews 2021(6).
  60. Chalmers B, Mangiaterra V, Porter R. WHO principles of perinatal care: the essential antenatal, perinatal, and postpartum care course. Birth 2001; 28(3):202-7.
  61. Dutta R, Gowder RO. The prevalence and predisposing factors of mastitis in lactating mothers in puerperium. Indian Journal of OBGYN 2018; 5(1):28-32.
  62. Cullinane M, Amir LH, Donath SM, Garland SM, Tabrizi SN, Payne MS, Bennett CM. Determinants of mastitis in women in the CASTLE study: a cohort study. BMC Family Practice 2015; 16(1):1-8.
  63. Khanal V. Breastfeeding practices and lactation mastitis in Western Nepal: A prospective cohort study (Doctoral dissertation, Curtin University); 2016.
  64. Tang L, Lee AH, Qiu L, Binns CW. Mastitis in Chinese breastfeeding mothers: a prospective cohort study. Breastfeeding Medicine 2014; 9(1):35-8.
  65. Gao H, Wang J, An J, Liu S, Li Y, Ding S, et al. Effects of prenatal professional breastfeeding education for the family. Scientific Reports 2022; 12(1):5577.
  66. Mangesi L, Zakarija‐Grkovic I. Treatments for breast engorgement during lactation. Cochrane Database of Systematic Reviews 2016(6).
  67. Varghese B, Patwa A. Effectiveness of hospital based teaching programme on knowledge regarding home management for breast engorgement among postnatal mothers. Int J Res Rev 2020; 7:486-93.
  68. Yadav N, Vyas H, Goyal M. Effectiveness of prenatal lactation counseling on breastfeeding practices, breast engorgement, and newborn feeding behavior among postnatal mothers at a teaching institution. Journal of Family Medicine and Primary Care 2022; 11(3):1146-51.
  69. Padmasree SR, Varghese L, Krishnan AS. Effectiveness of prenatal teaching on prevention of breast engorgement. Int J Reprod Contracept Obstet Gynecol 2017; 6(9):3927-31.
  70. Chiu JY, Gau ML, Kuo SY, Chang YH, Kuo SC, Tu HC. Effects of Gua-Sha therapy on breast engorgement: a randomized controlled trial. Journal of Nursing Research 2010; 18(1):1-0.
  71. Wong BB, Chan YH, Leow MQ, Lu Y, Chong YS, Koh SS, et al. Application of cabbage leaves compared to gel packs for mothers with breast engorgement: Randomised controlled trial. International journal of nursing studies 2017; 76:92-9.
  72. Alekseev NP. Progesterone-Containing Gel Does Not Eliminate Postpartum Breast Engorgement?. Breastfeeding Medicine 2017; 12(2):122-3.
  73. Douglas P. Re-thinking lactation-related nipple pain and damage. Women's Health 2022; 18:17455057221087865.
  74. Vieira GO, Martins CD, Vieira TD, Oliveira NF, Silva LR. Factors predicting early discontinuation of exclusive breastfeeding in the first month of life. Jornal de pediatria 2010; 86:441-4.
  75. Santos KJ, Santana GS, Vieira TD, Santos CA, Giugliani ER, Vieira GO. Prevalence and factors associated with cracked nipples in the first month postpartum. BMC pregnancy and childbirth 2016; 16:1-8.
  76. Suresh S, Sharma KK, Saksena M, Thukral A, Agarwal R, Vatsa M. Predictors of breastfeeding problems in the first postnatal week and its effect on exclusive breastfeeding rate at six months: experience in a tertiary care centre in Northern India. Indian journal of public health 2014; 58(4):270-3.
  77. Goldfeld S, Price A, Kemp L. Designing, testing, and implementing a sustainable nurse home visiting program: right@ home. Annals of the New York Academy of Sciences 2018; 1419(1):141-59.
  78. Kanda K, Blythe S, Grace R, Kemp L. Parent satisfaction with sustained home visiting care for mothers and children: an integrative review. BMC health services research 2022; 22(1):295.
  79. Fenwick J, Butt J, Dhaliwal S, Hauck Y, Schmied V. Western Australian women's perceptions of the style and quality of midwifery postnatal care in hospital and at home. Women and birth 2010; 23(1):10-21.
  80. Christie J, Bunting B. The effect of health visitors’ postpartum home visit frequency on first-time mothers: cluster randomised trial. International Journal of Nursing Studies 2011; 48(6):689-702.
  81. Baghersad Z, Mokhtari F, Bahadoran P. Effect of postpartum home care on mothers’ health. Iran J Obstet Gynecol Infertil 2020; 23(4):45-53.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 26, Issue 3
May 2023
Pages 53-65

Files

Share

How to cite

Statistics