• Journal of East-West Nursing Research
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• v.20 no.2
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• pp.112-120
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• 2014

Purpose: The purpose of this study was to compare the differences in characteristics, lactation problems, knowledge, and adaptation of breastfeeding between users and non-users of a lactation clinic. Methods: The descriptive study design was utilized using self-report questionnaires. 446 breastfeeding mothers participated in this study. Data were collected from lactation clinics, postpartum care centers, mother's culture centers, public health centers, pediatrics and obstetrics & gynaecology outpatient clinics in Seoul, Gyeonggi province, and Chungcheongnam province from August 20 to September 30, 2011. The questionnaires to measure lactation problems, knowledge and adaptation of breastfeeding were used. Data were analyzed using SPSS ver. 18.0 for Windows. Results: There was statistically significant differences in the breast feeding problems(t=5.71, p<.001) and breastfeeding knowledge(t=2.87, p=.004) between users and non-users of a lactation clinic. Conclusion: The results of this study may provide a foundation to develop nursing intervention for mothers in breastfeeding, and an evidence to expand the role of nurses as breastfeeding specialists.

• Korean Parent-Child Health Journal
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• v.20 no.1
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• pp.18-27
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• 2017

Purpose: This study aimed to verify the effects of prenatal breast self-massage education on first-time mothers' breastfeeding self-efficacy, breastfeeding adaptation, and breastfeeding practice. Method: The experimental group (n=26) received prenatal breast self-massage education focused on self mamma care (SMC) at 34-36 weeks gestation and 2 weeks later face-to-face. The control group (n=25) was recruited immediately following birth and received usual care. Breastfeeding self-efficacy was measured 4 hours after childbirth and 3 days later, and breastfeeding practice, breastfeeding adaptation, and breastfeeding-related characteristics were measured 2 weeks and 4 weeks after childbirth through online survey. The data were analyzed by $x^2$ test and t-test using SPSS/WIN 24.0. Results: There was no significant difference in breastfeeding self-efficacy of the experimental group at 4 hours after childbirth (t=0.83, p=.410) whereas it was statistically significantly higher at 3 days postpartum (t=2.86, p=.006). There were no significant differences in breastfeeding adaptation between the two groups at both 2 weeks (t=1.76, p=.084) and 4 weeks postpartum (t=0.87, p=.388). For breastfeeding practice a statistically significant difference was found at 4 weeks for the experimental group ($x^2=4.77$, p=.036). Conclusion: This antenatal SMC intervention was found to be a feasible intervention for use in clinical practice.

• Women's Health Nursing
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• v.21 no.4
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• pp.262-271
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• 2015

Purpose: This study was to explore association of maternal role adjustments, parenting stresses, and demographic factors to breastfeeding adaptation. Methods: A correlational survey design was used to recruit 183 mothers who breastfeed or breastfed their babies. Participants' visited outpatient departments and were admitted to pediatric ward at 2 hospitals in metropolitan city of Korea. Inclusion criteria for subjects were mothers whose babies were from 1 month to 24 months old. Data were collected using a self-report questionnaire for mothers' and babies' demographic variables, maternal role adjustments, parenting stresses, and maternal breastfeeding adaptations. Results: Higher levels of maternal adaptations and low levels of parenting stresses were associated with greater maternal breastfeeding adaptations. Types of feeding during hospital stays and baby's health status at birth were also associated with maternal breastfeeding adaptation. Conclusion: Results showed that a higher level of mothers' adjustment to breastfeeding; indicated lesser parenting stresses with higher levels of maternal adaptation. Nursing interventions for breastfeeding should be applied for appropriate breastfeeding adaptation during mothers' hospital stay. As baby's poor health status at birth medical team should provide a proper breastfeeding education.

• Women's Health Nursing
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• v.18 no.2
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• pp.75-84
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• 2012

Purpose: This study was done to identify the effects of individual postpartum breast-feeding education on adaptation, attitude and practice of breast-feeding in primiparas. Methods: A quasi-experimental nonequivalent design was used to examine the effects of individual postpartum breast-feeding education among primiparas. The data were analyzed using $x^2$-test, Fisher's exact test and paired t-test. Results: There was a significant difference in breast-feeding adaptation (t=-12.94, p<.001), breast-feeding attitude (t=-2.71, p=.011) and breast-feeding practice ($x^2$=16.47, p<.001) between the group education (experimental group I) and individual education after group education (experimental group II). Conclusion: The results indicate that individual education on breast-feeding compared to group education has more positive effects on increasing breast-feeding adaptation, attitude and practice in primiparas. This result also indicates that many primiparas should be given opportunities of various types of education to improve breast-feeding practice such as individual approaches and postpartum breast-feeding education programs.

• Journal of Korean Academy of Nursing
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• v.46 no.3
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• pp.409-419
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• 2016

Purpose: The purpose of this study was to develop a breastfeeding empowerment program and to investigate the effects of the breastfeeding empowerment program on self-efficacy, adaptation and continuation of breastfeeding for primiparous women. Methods: The 5 session breastfeeding empowerment program was developed and a non-equivalent control group non-synchronized quasi-experiment design was used. Fifty-five participants were assigned to either the experimental group (n=27) or the control group (n=28). Effects were tested using repeated measures ANOVA and $x^2-test$. Results: Scores for self-efficacy, adaptation and continuation of breastfeeding of in the experimental group after program were significantly higher than 1week, 4weeks, 8weeks scores in control group. Conclusion: The effects of the breastfeeding empowerment program for elevating self-efficacy, adaptation and continuation of breastfeeding in primiparous women were validated. Therefore, this program can be recommended for vigorous use in clinical practice.

• Women's Health Nursing
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• v.23 no.4
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• pp.233-242
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• 2017

Purpose: This study investigated the relationships among parenting stress, husband's support, and breastfeeding adaptation in mothers. Methods: A correlational survey design was utilized in this study. Data were collected from 181 breastfeeding mothers with infants under 12 months of age. Participants were recruited from the outpatient clinic, a child photo studio, or from the kid's cafe from July 22 to September 13, 2016. Instruments for collecting data included Childcare Stress Inventory (CSI), Husband's Support scale, and the Breastfeeding Adaptation scale. Data were analyzed using SPSS 21.0 by frequency, descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient and multiple regression. Results: Of the 181 subjects, 54.7% responded they only breastfed with 75.7% who received breastfeeding education. Seventy-two percent of mothers made a decision to breastfeed by themselves. The mean score was $2.39{\pm}0.53$ for parenting stress, $3.07{\pm}0.43$ for husband's support, and $3.85{\pm}0.49$ for breastfeeding adaptation. Factors influencing breastfeeding adaptation were identified as lower parenting stress (${\beta}=-.54$), greater husband's support (${\beta}=.31$), breastfeeding (${\beta}=.31$), and older age of baby (${\beta}=.14$), with 56.0% that explained variance. Conclusion: This study reports that parenting stress has negative effect on breastfeeding adaptation, while husband's support has positive effect. Results may be useful in developing new strategies for enhancing breastfeeding adaptation.

• Journal of Korean Academy of Nursing
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• v.39 no.2
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• pp.259-269
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• 2009

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.

• Journal of Korean Academy of Nursing
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• v.40 no.2
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• pp.225-235
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• 2010

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.

• Journal of Korean Public Health Nursing
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• v.32 no.3
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• pp.376-387
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• 2018

Purpose: This study was conducted to assess the breast feeding rate and maternal adaptation of mothers with infants and children in early childhood in a community. Methods: This descriptive study was conducted from November to December 2015, and included a total of 283 mothers of infants and children in early childhood. The data were analyzed using descriptive analysis, the ${\chi}^2-test$, and one way ANOVA. Results: The rates of breast feeding after birth were 76.3% (1 month postpartum), 69.3% (3 months postpartum), 53.4% (6 months postpartum), 32.2% (9 months postpartum), and 22.6% (12 months postpartum). The level of maternal adaptation of subjects was $3.78{\pm}0.54$. Subjects who were breastfed until 9 months postpartum had a higher level of maternal adaptation than those who stopped breast feeding at 1 month postpartum (F=3.926, p<.002). The breast feeding rate of subjects who were educated about breast feeding after childbirth was significantly higher than that of those who did not receive breast feeding education after delivery. Conclusion: To increase the breast feeding rate and maternal adaptation, community health nurses should develop and provide breast feeding programs to mothers soon after childbirth.

• Women's Health Nursing
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• v.20 no.1
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• pp.14-28
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• 2014

Purpose: This study was to identify relationships of maternal psychosocial factors including mother's mood state, childcare stress, social support and sleep satisfaction with breastfeeding adaptation and immune substances in breast milk, especially secretory immunoglobulin A (sIgA) and transforming growth factor-beta 2 (TGF-${\beta}2$). Methods: Data were collected from 84 mothers who delivered full-term infants by natural childbirth. Structured questionnaires and breast milk were collected at 2~4 days and 6 weeks postpartum. Data were analyzed using descriptive statistics, Pearson's correlation, multiple linear regression, and generalized estimating equation (GEE). Results: Scores for the breastfeeding adaptation scale were significantly related with child care stress, mood state and social support. Mother's anger was positively correlated with the level of sIgA in colostrum (p<.01). Immune substances of breastmilk was significantly influenced by time for milk collection (p<.001) and the type of breastfeeding (sIgA, p<.001, TGF-${\beta}2$, p=.003). Regression analysis showed that breastfeeding adaptation could be explained 59.1% by the type of breastfeeding, childcare stress, the Profile of Mood States, emotional support and sleep quality (F=16.67, p<.001). Conclusion: The findings from this study provide important concepts of breastfeeding adaptation program and explanation of psychosocial factors by immune substances in breast milk. Future research, specially, bio-maker research on breast milk should focus on the ways to improve breastfeeding adaptation.