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13 "Breast Feeding"
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Research Papers
Development and Effectiveness Evaluation of Comprehensive Mobile-Based, Breastfeeding Promotion Program for Mothers with Gestational Diabetes
Kwak, Eunju , Park, Seungmi
J Korean Acad Nurs 2024;54(2):224-236.   Published online May 31, 2024
DOI: https://doi.org/10.4040/jkan.23098
AbstractAbstract PDF
Purpose
This study aimed to evaluate the effects of a mobile-based breastfeeding promotion program (M-BFGDM) that helps mothers with gestational diabetes.
Methods
Forty-seven mothers participated in the study, of whom 22 were in the experimental group and 25 in the control group. To verify the effects, a lag design before and after the non-equivalence control group was used. The data collection for the experimental group was done before and after the intervention.
Results
In the results, breastfeeding knowledge showed a significant difference in the interaction between measurement period and group (χ2 = 8.14, p = .017), whereas breastfeeding intention did not show a significant difference in the interaction (χ2 = 4.73, p = .094). There was no difference in self-efficacy interaction (F = 0.13, p = .856). The breastfeeding method showed no difference in interaction (F = 0.04, p = .952), whereas cross-analysis showed a significant difference in breastfeeding practice rate between the experimental group and the control group at 1 month postpartum (χ2 = 7.59, p = .006).
Conclusion
A mobile-based breastfeeding promotion program was developed and applied for gestational diabetic mothers, resulting in an increase in breastfeeding knowledge and an improvement in breastfeeding practice rate one month after childbirth. In addition, M-BFGDM managed to create a breastfeeding practice environment with fewer time and place restrictions. A program study that complements motivation is needed to improve breastfeeding in pregnant diabetic mothers in the future.
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Information Resource Network Analysis of Factors Influencing Breastfeeding Planning and Duration
Lee, Eunyoung , Cho, Insook , Cho, Seong Jin , Lee, Eunju
J Korean Acad Nurs 2021;51(2):232-244.   Published online April 30, 2021
DOI: https://doi.org/10.4040/jkan.20280
AbstractAbstract PDF
Purpose
This study aimed to identify the modifiable factors affecting breastfeeding planning and duration among healthy mothers and their use of breastfeeding information resources.
Methods
A cross-sectional survey was conducted in a community setting. Four hundreds participants were recruited at five pediatric clinics and three community health centers located in Paju-si and Goyang-si, Gyeonggi-do, between January and May 2019. Based on the breastfeeding decision-making model, driven by Martens and Young’s work, the survey items consisted of demographics, childbirth and breastfeeding characteristics, and breastfeeding information resources. In the analysis, 389 responses were used in the t-test, ANOVA, and logistic regression. Information resource networks were compared before and after childbirth including a subgroup analysis depending on the breastfeeding duration.
Results
The modifiable factors affecting breastfeeding planning and duration were antenatal and postpartum breastfeeding education and the provision of information in the hospital. The frequency of Internet use and websites visited were notable and potentially modifiable factors, which were also observed in the networks showing different relationship patterns according to participant subgroups and times. The childbirth event increased the centralization of the network in the planned group, while the network of the non-planned group was more diffused after childbirth. The network of the short-term breastfeeding group was characterized by a more centralized pattern and the resources of high betweenness centrality than the long-term group.
Conclusion
Breastfeeding education is a consistent factor that affects breastfeeding behavior. A well-designed internet-based approach would be an effective nursing intervention to meet the needs of women seeking breastfeeding information and changing their behaviors.
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Effect of Direct Breastfeeding Program for Premature Infants in Neonatal Intensive Care Unit
Kang, Ji Hyun , Son, Hyunmi , Byun, Shin Yun , Han, Gyumin
J Korean Acad Nurs 2021;51(1):119-132.   Published online February 28, 2021
DOI: https://doi.org/10.4040/jkan.20240
AbstractAbstract PDF
Purpose
This study aimed to identify the effects of a direct breastfeeding program for premature infants in neonatal intensive care units (NICUs).
Methods
This quasi-experimental study was conducted during August 2016 to April 2017. Sixty mothers of premature infants were assigned to the experimental (n = 31) or control groups (n = 29). The program was comprised of breastfeeding education and direct breastfeeding support. The experimental and control groups were provided with education and counseling on breastfeeding at the time of admission and discharge. In the experimental group, the mothers initiated oral feeding with direct breastfeeding and engaged in breastfeeding at least seven times during the NICU stay. The collected data were analyzed by the χ2 -test and repeated measures ANOVA using an SPSS program.
Results
The experimental group showed a higher direct breastfeeding practice rate (χ2 = 19.29, p < .001), breastfeeding continuation rate (χ2 = 3.76, p < .001), and self-efficacy (F = 25.37, p < .001) than the control group except for maternal attachment.
Conclusion
The direct breastfeeding program in the NICU has significant effects on the practice and continuation rate of breastfeeding and breastfeeding self-efficacy. Therefore, this program can be applied in the NICU settings where direct breastfeeding is limited.
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Original Articles
The Relationship of Bone Mineral Densities and Period of Breast feeding in Premenopausal Women
Eun Nam Lee, Eun Ok Lee, Gwang Hae Lee
Journal of Korean Academy of Nursing 2000;30(1):29-38.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.1.29
AbstractAbstract PDF

To determine whether personal history of lactation in premenopausal women influence bone mineral density, a cross-sectional study was conducted. One hundred eighty-four premenopausal women were selected from women who had been checked for bone mineral density by dual energy x-ray absortiometry in lumbar spine, femoral neck, Ward's triangle, and trochanteric site at general hospitals in Seoul and Pusan. They completed a questionnaire including life style factors and reproductive history. In the data analysis, Pearson correlation coefficients were used to test any association between individual variables and bone mineral density and a statistical comparisons between long term lactation(>24 months) and short term lactation(<24 months) were made by one way analysis of covariance. The results were summarized as follows: 1) There was no significant difference in the bone mineral density of the lumbar vertebrae in premenopausal women between the long term lactation group(>24months) and the short term lactation group(<24months). 2) There was no significant difference in the bone mineral density of the femur neck, Ward's triangle, and trochanteric site in premenopausal women between the long term lactation group (>24months) and the short term lactation group (<24months). Considering these results, we suggest prospective studies that measure bone mineral density before and after, in addition to those during lactation. We also suggest the further study with premenopausal women less than 35 who have achieved peak adult bone mass.

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Attitudes of Pregnant women's husbands to Breast Feeding
Hae Kyung Chung, Kyung Hee Kim
Journal of Korean Academy of Nursing 1998;28(2):392-402.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.2.392
AbstractAbstract PDF

By using Q-methodology, this study examines the attitudes of pregnant womens' husbands toward breastfeeding. Also, the research provides basic data necessary to develop a strategy for recommending breastfeeding. A total of 112 items for the Q-population were collected from related literature and interviews with the general public, specialists, pregnant women and the general public, specialists, pregnant women and their husbands. Finally, 38 statements were selected. Twenty one husbands of pregnant women classified these statements on each card on a 1 to 9 point scale(forced normal distribution) and wrote the reasons for both the most supported and the mos resisted statements. The materials collected were analyzed by using pc QUANL program. The analysis drew down following fact that even though the attitudes of the husbands of pregnant were very similar, they could be classified to three types according to the motivation and recognition the degree of choosing breastfeeding. Type 1 is the mother's duty supporter, who insists that breastfeeding is completely natural and the proper duty of the mother. Type 2 is the emotional value supporter, who thinks that breastfeeding emotionally affects both the baby and the mother in a positive way. Type 3 is the conditional choice supporter, who chooses the most proper suckling way of feeding according to given conditions.

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Effects of a Workbook Program on the Perceived Stress Level, Maternal Role Confidence and Breast Feeding Practice of Mothers of Premature Infants
Yung Sook Jang
Journal of Korean Academy of Nursing 2005;35(2):419-427.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.2.419
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the effects of a workbook program on percieved stress levels, maternal role confidence and breastfeeding practices of mothers of premature infants.

Method

This study employed a quasi-experimental non-equivalent pre-and-post test to compare the two groups. Data was collected from 32 subjects from March 10. to September 5, 2003 at an NICU located in S. city. In the sample, fifteen mothers were in the experimental group and seventeen were in the control group. A workbook program was provided twice during a period from two-three days after the baby's admission to one week after the first intervention. The instruments used were the PSS and self confidence scale. Data was analyzed by means of frequency, SD, χ2-test, Fisher's exact test, Mann-Whitney test, and the Wilcoxon signed rank test.

Result

There was a significant difference in perceived stress levels between the experimental and control group (U=2.366, p=.018). There was not a significant difference in maternal role confidence between the two groups (U=1.002, p=.316). There was a significant difference in breastfeeding practice between the two groups (χ2= 4.910, p=.035).

Conclusion

It is concluded that a program using a workbook has a positive effect on decreasing the perceived stress level and increasing breastfeeding practice.

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Review Article
Effects of Breastfeeding Interventions on Breastfeeding Rates at 1, 3 and 6 Months Postpartum: A Systematic Review and Meta-Analysis
Seol Hui Park, Seang Ryu
J Korean Acad Nurs 2017;47(6):713-730.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.6.713
AbstractAbstract PDF
Abstract Purpose

This study was a systematic review and meta-analysis designed to evaluate the effects of breastfeeding intervention on breastfeeding rates.

Methods

Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a systematic search was conducted using eight core electronic databases and other sources including gray literature from January 9 to 19, 2017. Two reviewers independently select the studies and assessed methodological risk of bias of studies using the Cochrane criteria. The topics of breastfeeding interventions were analyzed using descriptive analysis and the effects of intervention were meta-analyzed using the Review Manager 5.2 software.

Results

A total of 16 studies were included in the review and 15 were included for meta-analysis. The most frequently used intervention topics were the importance of good latch-on and frequency of feeding and determining adequate intake followed. The pooled total effect of breastfeeding intervention was 1.08 (95% CI 1.03~1.13). In the subgroup analysis, neither pre-nor post-childbirth intervention was effective on the breastfeeding rates at 1, 3, and 6 months, and neither group nor individual interventions had an effect. Only the 1 month breastfeeding rate was found to be affected by the individual intervention with the persistent strategies 1.21 (95% CI 1.04~1.40).

Conclusion

Effective breastfeeding interventions are needed to help the mother to start breastfeeding after childbirth and continue for at least six months. It should be programmed such that individuals can acquire information and specific breastfeeding skills. After returning home, there should be continuous support strategies for breastfeeding as well as managing various difficulties related to childcare.

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Original Articles
Breast Feeding Rates and Factors Influencing Breast Feeding Practice in Late Preterm Infants: Comparison with Preterm Born at Less than 34 Weeks of Gestational Age
Gun Ja Jang, Sang Lak Lee, Hyeon Mi Kim
J Korean Acad Nurs 2012;42(2):181-189.   Published online April 30, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.2.181
AbstractAbstract PDF
Purpose

This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm (34≤GA<37) and preterm infants (GA<34).

Methods

A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits.

Results

Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score.

Conclusion

Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.

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Effects of Breast Massage on Breast Pain, Breast-milk Sodium, and Newborn Suckling in Early Postpartum Mothers
Sukhee Ahn, Jinhee Kim, Jungsuk Cho
J Korean Acad Nurs 2011;41(4):451-459.   Published online August 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.4.451
AbstractAbstract PDF
Purpose

In this study the effects of breast massage on breast pain, breast-milk sodium, and newborn suckling in early postpartum mothers were investigated.

Methods

The design was a non-synchronized nonequivalent control group pretest-posttest design. Sixty postpartum mothers who were admitted to a postpartum care center and had problems with breastfeeding were recruited. Of these mothers, 44 were assigned to the intervention group and received two 30-minute breast massages within 10 days of postpartum period. The others were assigned control group and received only routine care. Breast pain was measured using a numeric pain scale and number of times newborns suckled was observed throughout breastfeeding. Breast milk was self-collected to evaluate breast-milk sodium.

Results

Mean age of postpartum mothers was 30 years old. Compared to the control group, women in the intervention group reported significant decreases in breast pain (p<.001), increases in number of times newborns suckled after the first and second massage (p<.001), and a decrease in breast-milk sodium after the first massage (p=.034).

Conclusion

Breast massage may have effects on relieving breast pain, decreasing breast-milk sodium, and improving newborn suckling. Breast massage can be used to solve breast problems. Further research is needed to validate our findings.

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Effects of Breast-feeding Education and Support Services on Breast-feeding Rates and Infant's Growth
Gun-Ja Jang, Sun-Hee Kim
J Korean Acad Nurs 2010;40(2):277-286.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.277
AbstractAbstract PDF
Purpose

This study was done to investigate the effects of breast-feeding education and support services on rate of breast-feeding three and six months after birth, and the effect on infant's growth (weight, height, body mass index [BMI]). The experimental group which had both education and support services was compared with the control group which had only breast-feeding education.

Methods

This study was a quasi-experimental study with a time-series design. The participants were 39 mothers who were hospitalized for childbirth. Twenty mother were assigned to the experimental group and 19 mothers, to the control group. The breast feeding education was done during hospitalization, and support services were provided once a week after discharge for a month (a total 4 times) by a maternity ward nurse. Data regarding breastfeeding rate at one month after childbirth was collected by phone call; the breast-feeding rates at three and six months after childbirth were collected in a visit to the families. The child's weight and height were also measured during the visit.

Results

The experimental group had a statistically significant higher rate for frequency of breast-feeding at one, three and six months after childbirth than the control group. However, there was no meaningful difference between the two groups for infant growth.

Conclusion

The results of this study suggest that breast-feeding education is helpful for a start, but support services are also necessary to sustain breast-feeding.

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Factors Affecting Mother's Adaptation to Breastfeeding
Sun Hee Kim
J Korean Acad Nurs 2010;40(2):225-235.   Published online April 30, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.2.225
AbstractAbstract PDF
Purpose

The aim of this study was to identify factors which influence breastfeeding adaptation from among the following: parity and feeding behavior, social support, psychological, and demographic factors.

Methods

The respondents were 179 breastfeeding mothers. Data were collected from June 2 to 19, 2009 at two community health centers and one pediatric outpatient department. Data were analyzed using the SPSS program and included descriptive statistics, t-test, ANOVA, correlation, and multiple regression.

Results

The major findings of this study were: 1) Significant differences in the level of breastfeeding adaptation were related to number of children, current problems related to breastfeeding, and lay supporters. 2) Level of breastfeeding adaptation was significantly related to marriage satisfaction, proportion of breastfeeding, length of previous breastfeeding, planned length of breastfeeding, parenting stress, and encouragement to breastfeed given by medical personnel. 3) Regression analysis showed that parenting stress, marriage satisfaction, current problems related to breastfeeding, and proportion of breastfeeding explained 44.3% of variance for breastfeeding adaptation. Length of previous breastfeeding also explained 9.7% of breastfeeding adaptation among mothers who had breastfed an elder child.

Conclusion

Mothers with lower marriage satisfaction, breastfeeding problems, and higher parenting stress require more help from their family and nurses for breastfeeding adaptation. Future research should include variables, such as mother's and baby's behavior related to breastfeeding, knowledge about breastfeeding, and attitude toward breastfeeding.

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Development of a Breast Feeding Adaptation Scale (BFAS)
Sun Hee Kim
J Korean Acad Nurs 2009;39(2):259-269.   Published online April 28, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.2.259
AbstractAbstract PDF
Purpose

The aim of this study was to develop a breast feeding adaptation scale (BFAS) to evaluate adaptation to breastfeeding for breastfeeding mothers and their infants and to test the validity and reliability of the instrument.

Methods

The study was conducted as follows: application of the conceptual framework, identification of the content domains, items generation, and test of validity and reliability. In order to test validity and reliability, two panels of experts reviewed items and subcategories of the preliminary questionnaire and then data were collected from 329 mothers who were up to 4 weeks postpartum and breastfeeding. Descriptive statistics, t-test, factor analysis, and Cronbach's alpha were used to analyze the data.

Results

The conceptual framework was based on the Roy adaptation model. The content domains were developed via literature review, review of instruments, and data acquired from the interviews of breastfeeding mothers and nurses. A total of 69 items belonging to 8 domains were generated. A reduction to 44 preliminary items was accomplished through content validity analysis. Factor analysis extracted 8 factors with a total of 27 items on a 5-point Likert scale. Content validity, construct validity, criterion validity, and reliability of the BFAS were established.

Conclusion

The newly developed BFAS is a reliable and valid instrument with which the adaptation of breastfeeding mothers and their infants to the breastfeeding behavior can be evaluated.

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Effects of a Breast Feeding Promotion Program for Working Women
Ji-Won Yoon, Young-Joo Park
J Korean Acad Nurs 2008;38(6):843-852.   Published online December 31, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.6.843
AbstractAbstract PDF
Purpose

The purpose of this study was to measure the effects of a breast feeding promotion program for working women on breast feeding continuation, mother-infant attachment, and maternal sensitivity.

Methods

The design of this study is nonequivalent control group design with repeated measures.

Results

There were significant differences in breast feeding continuation between two groups at each time point except 2 days and 1 week after delivery. The scores of mother-infant attachment and maternal sensitivity of experimental group were higher than those of the control group, but there were no significant differences between two groups.

Conclusion

Although some modifications in contents and administration will be required to increase the effectiveness of the program, breast feeding promotion program for working women can be an effective nursing intervention which can facilitate breast feeding continuation and mother-infant relationships.

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