Breastfeeding Practices: Attachment and Positioning, a Health Center Level Study in Sinazongwe District, Zambia

Sunday, 30 July 2017

Jerry John Nutor, MSN, BSN1
Shannon Marquez, PhD2
Jaime C. Slaughter-Acey, PhD, MPH1
(1)College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
(2)Environmental and Occupational Health, Dornsife School of Public Health, Philadelphia, PA, USA

Purpose:  Breastfeeding has been accepted as one of the most important intervention to enhance growth and development of a child. It satisfies an infant's nutritional and emotional needs better than any other methods of infant feeding (Haga et al., 2012). At the Innocenti Declaration in 1990, the World Health Organization (WHO) in collaboration with United Nations Children’s Fund (UNICEF) recommended exclusive breastfeeding, this recommendation encourages mothers to feed their infants the first 6 months of life with breastmilk alone and then up to 2 years of age and beyond (World Health Organization, 1991). In order to achieve maximum benefit of breastfeeding for both mother and infant, there is a need for good attachment and adequate positioning. Positioning an infant appropriately is one of the easiest ways to ensure postural support that has impact on both the infant and the mother’s comfort. It could also affect the infant’s neurobehavioral and neuromotor development temporally or permanently (Waitzman, 2007). Attachment is defined as the connection from infant to the mother and it is the initiation of the bond that exit between them. Effective breastfeeding means adequate positioning of mother and baby and attachment of child to the mother's breast (Dongre et al 2010). Positioning of the infant’s body is essential for good attachment, comfortable and successful breastfeeding. Good attachment during infant breastfeeding could also prevent many emotional and psychological problems for both mother and the infant (Goyal et al 2011). The purpose of this project was to educate mothers on good attachment during breastfeeding and important of breastfeeding to the mother, infant and the society.

Methods:  In commemoration of the 2016 world breastfeeding day, the Sinazongwe district health center and the Sinazongwe Area Development Project of World Vision joined the rest of world from August 1st to August 7th to celebrate world breastfeeding day on the theme “Raising Awareness of the Links between Breastfeeding and the Sustainable Development Goals”. In all forty-eight breastfeeding mothers were selected from Sinazongwe district hospital postnatal clinic to undergo a day’s workshop on the importance of breastfeeding, attachment and position during breastfeeding. Three mothers were randomly selected to demonstrate how they usually breastfeed their infants. After every demonstration, other participants were given the opportunity to debrief the sessions.

Results:  None of the three mothers was able to demonstrate infant breastfeeding with good attachment and positioning. In addition, majority of the women could not identify what their colleagues did wrong while demonstrating the breastfeeding. Workshop facilitators including nurses and midwives educated the mothers on proper breastfeeding position and attachment. The mothers were also taught proper hygiene technics such as hand washing before and after breastfeeding and oral hygiene for infants. Other topics including benefits of breastfeeding to the mother, infants, community and the nation were also covered.

Conclusion: Good attachment and positioning during breastfeeding make the difference between a happy, comfortable and successful breastfeeding and one that is painful for mothers and frustrating for the baby. Given that none of the three mothers could not demonstrate proper positioning and attachment during the demonstration, a need exists to develop breastfeeding education program and also use culturally appropriate methods to disseminate this program among postpartum women in the Sinagongwe district.