Effects of a Model-based Intervention on Breast-feeding Attrition

摘要

Many infants are weaned prematurely within the first 2 weeks of life because of ineffective management of breast-feeding problems unrelated to any physiological deficit in lactogenesis. Objective assessment tools, in conjunction with theory-based interventions, are needed to evaluate the breast-feeding process. The primary purpose of this study was to determine whether a model-based intervention was effective in decreasing breast-feeding attrition. A research-based intervention, grounded in the Theory of Planned Behavior, was used to determine whether a postpartum visit in the hospital, a home visit 2 to 4 days after discharge, plus a phone call at 10 to 14 days had a positive effect on decreasing breast-feeding attrition. The study had a two-group, quasi-experimental design that measured variables of breast-feeding attrition, maternal attitudes about breast-feeding, maternal social norms influencing breastfeeding, and maternal perceived behavioral control regarding breast-feeding. Breast-feeding procedures and protocols were developed based on the Theory of Planned Behaviors three components: attitudes, subjective norms, and perceived behavioral control. The breast-feeding procedures and protocols were used to guide the researchers interactions with the intervention group. The effectiveness of the research-based intervention was evaluated using three tools: (1) Breastfeeding Attrition Assessment, (2) H & H Lactation Scale (attitude, satisfaction, control), and (3) the Hughes Breastfeeding Support Scale (social norm). These instruments measured the variables described by the Theory of Planned Behavior. Because measuring the rate of milk maturation was a relatively new concept, a study comparing the creamatocrit and the Maturation Index of Colostrum and Milk (MICAM) was done to validate use of the latter in early lactogenesis. The Theory of Planned Behavior was found to be an acceptable model by which to predict breast-feeding behavior. Although this study supported the theory, the results suggest that the influential impact of social norms on breast-feeding behavior requires further study.