Assessment of Mother's Knowledge about Newborn Breast-Feeding

A descriptive study was conducted on the mother's knowledge about the newborn breast feeding, for the period of Dec. 11 th (2010) to March 21 st (2011), at Al. Zahra Najaf-Teaching hospital, to identify the knowledge of the mother about the newborn health and breast feeding. Thirty mothers (30) with their newborns were interviewed randomly at the hospital using questionnaire formats to collect the fulfillment data of the involved sample at age grouped from (19 to 42 years). The study showed that the most age-group affected was (19-26) years (36.7%); (93.3%) of mothers were occupied; most of them (66.7%) were rural residents with primary level of education (40%). The mother's knowledge were rare about the newborn's breast feeding (66.7%); and most of them were yo ung. A mass media survey must be hold in Iraq as a teaching program for mothers during the prenatal and postnatal periods.


Introduction
Breast-feeding is the first fundamental right of the child.It is greatly improves quality of life by providing unique nutritional, immunological, economic, ecological, psychological, and child spacing benefits.Breastfeeding also enhances maternal health 1 .Exclusive breastfeeding for first 6 months of life is the most effective child survival intervention in developing countries 1. Scientific evidence has proved beyond any doubt that breastfeeding is the ideal form of feeding the newborn 2 .It estimates that exclusive breastfeeding can reduce 13% of childhood deaths, the largest contribution in comparison to any other child survival intervention.Breastfeeding is advantageous for all-the baby, the mother and the society 3 .Initiate breastfeeding immediately after birth and positively within 30 minutes after normal delivery and within 4 hours after cesarean section for successful breastfeeding, it is essential to keep the baby with the mother all the time.The first feed should always be of mother's milk.No prelacteal feeds should ٢ be allowed as this inhibits the establishment of successful lactation 4 .Nerve impulses travel from the nipple to the hypothalamus to stimulate the production of prolactin-releasing factor.This factor stimulates further active production of prolactin.Other anterior pituitary hormones such as adrenocorticotropic hormones, thyroid-stimulating hormone, and growth hormone, probably also play a role in growth of the mammary glands and their ability to secrete milk 5 .Breastfeeding is the preferred method of feeding a newborn because it provides numerous health benefits to both, the mother and the infant; it remains the ideal nutritional source for infant through the first year of life 6 .Colostrums, is the first nutrition that baby takes.It is called first vaccine characterized by a thin, watery, yellow fluid composed of protein, sugar, fat, water, minerals, vitamins and maternal antibodies, secreted by the laminar breast cells starting in the 4 th month of pregnancy.For the first 3 or 4 days after birth, it provides adequate nutrition for the newborn and easy to digest 7 .Breast milk provides the best nutrition for the infant 8 ; the American Academy of Pediatrics(AAP) and the American Dietetic Association recommended breast-feeding exclusively for the first 4 to 6 months of life and then in combination with infant foods until age 1 9 .Breast-feeding right after birth helps the uterus to contract and return to its former size and position 10 .Breast milk contains the perfect balance of carbohydrates, proteins, and fats.It supplies essential nutrients in an easily digestible form.It is a rich source of linoleic acid (an essential fatty acid) and cholesterol, which are needed for brain development.It contains immune factors that protect infants from infection, such as antibodies (especially immunoglobulin A) and white blood cells.With exclusive breast-feeding, the mother has no bottles or nipples to wash and sterilize and no formula to buy 11 .An allergic reaction is less likely, and milk is always available.Night feedings are more convenient because there's no bottle to prepare.The infant benefits from the frequent direct physical contact, and the mother may feel that she has a More intimate bond with her baby 12 .Breast milk reduces anemia due to reduction in postpartum bleeding and reduced blood loss because of delayed menstruation 13 .Breastfeeding is convenient, need no preparation and is available at right temperature 14 .It helps the mother to regain figure, promotes early uterine involution 15 .Breastfeeding has a protective effect against breast and ovarian cancer.Breastfeeding helps in delaying another pregnancy 16 .

Benefits of breast feeding to the newborn
Lactoferrin is an iron binding protein in breast milk that interferes with growth of pathogenic bacteria.The enzyme lysozyme in breast milk apparently actively destroys bacteria by lysine dissolving their cell membranes.Leukocytes in breast milk provide protection against common respiratory infection invaders.The bifidus factor is specific growth promoting factor for bacteria lactobacillus bifid us.The presence of L. bifidus in breast milk interferes with colonization of pathogenic bacteria in the gastrointestinal tract, reducing the incidence of diarrhea.Breast milk is higher than cows milk in lactose, and easily digested.Sugar that provides ready glucose for rapid brain growth, contains the ideal electrolyte and mineral composition for human infant growth.The ratio of cysteine to methionine in breast milk also appears to favor rapid brain growth in early month.Breast milk is more readily digested and thus infant actually may receive more protein.It contains nitrogen in compounds with other protein so that the infant receives cells building materials from sources rather than just protein (this can result in better mental development), it contains more linoleic acid, an essential amino acid for skin integrity does cow's milk 1 .It contains less sodium, calcium, and phosphorus than do many formulas.It has a better balance of trace elements such as zinc than formulas do.Babies who receive breast milk appear to have less difficulty regulating calcium-phosphorus levels than those who are bottle feed, and the formation of the dental arch 3 .

Steps to successful breast-feeding
Have a written breast feeding policy, that is routinely communicated to all health care staff.Train all health care staff in skills necessary to implement this policy.Inform all pregnant women about the benefits and management of feeding.Help mothers initiate breast feeding within a half-hour of birth.Show mothers how breast feed, and how to maintain lactation even if they should be separated from their infant.Give newborn infant no feed or drink other than breast milk, unless medically indicated.Practice rooming allows mother and infant to remain together throughout the day.Encourage breast feeding on demand.Give no artificial teats pacifiers ( also called dummies or so others ) to breast feeding infant.Faster the establishment of breast feeding support groups and refer mothers to them on discharge from the hospital or clinic 1,6 .

Materials and methods
A descriptive study design was applied on December 11 th ( 2010)-to March 21st (2011), at Al-Zahra-teaching hospital in Najaf Province.A non-purposive sample of 30 adult females at age of ( 19-40 ) years, consuming breast-feeding were randomly selected.Data were collected through interviewing and questionnaire format to mothers with breast feeding.The relevant format consisted of two parts.Part one includes ( age, number or order of child, mother's education and occupation, and home address).While, part two was included the benefits of breast feeding to the mother, and to the newborn.The data were computerized and analyzed through the application of a descriptive method of data analysis.
Breast feeding is economical and hardly costs the family anything extra.It lowers health care costs to the society by reducing illness among children.It is ecofridly and does not cause any environment pollution, ready used, sterile, and highly nutritional values 1, 2 .