St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.
Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan.
Int Breastfeed J. 2020 May 6;15(1):36. doi: 10.1186/s13006-020-00280-1.
The total neonatal mortality in Tanzania remains high reaching as much as 44,900 deaths per year, particularly among low birthweight (LBW) babies. This makes Tanzania the fourth African country with the highest number of annual neonatal deaths. Studies have shown the advantages of breast milk for LBW babies and the effectiveness of interventions from healthcare workers (HCWs) to encourage mothers to achieve exclusive breastfeeding (EBF). Although these interventions can substantially reduce mortality in this vulnerable group, they remain insufficient in practice particularly in resource-limited countries. Therefore, there is an urgent need to establish the most appropriate interventions for mothers with LBW babies, particularly in these countries. To help address this need, we evaluated the breastfeeding care and education given to mothers with LBW babies by HCWs during hospitalization in Tanzania.
A qualitative study using semi-structured interviews with mothers of LBW babies at an urban hospital in Tanzania was conducted. We assessed their understanding of breastfeeding at discharge. All the interviews were conducted in local Swahili and then translated to English. Data were analyzed using content analysis.
Among the 19 mothers interviewed, only four breastfed their baby within an hour after birth. Nine mothers received no support from HCWs when they breastfeed their baby for the first time. Ten mothers received no education on EBF, and there were mothers who misunderstood the EBF definition. Eight answered that they had difficulty breastfeeding their baby at discharge. Four mothers were dissatisfied with the care and education given by HCWs, and six mothers provided suggestions for improvements. Although six mothers had a high reliance on HCWs, they had difficulty asking HCWs questions because of their authoritative attitude and behavior.
Mothers with LBW babies need special support to increase their ability to breastfeed and ensure EBF continuance. To address the gaps between the currently provided breastfeeding interventions and the ideal breastfeeding interventions, improvements in the quality and quantity of breastfeeding care and education are required. Training HCWs to systematize standard interventions, confirming mothers' understanding, and ensuring a comfortable environment for mothers are absolutely needed.
坦桑尼亚的新生儿总死亡率仍然很高，每年达到 44900 人死亡，尤其是在低出生体重（LBW）婴儿中。这使得坦桑尼亚成为非洲新生儿死亡人数第四高的国家。研究表明，母乳对 LBW 婴儿有优势，卫生保健工作者（HCWs）的干预措施鼓励母亲实现纯母乳喂养（EBF）也非常有效。尽管这些干预措施可以大大降低这个脆弱群体的死亡率，但在实践中，特别是在资源有限的国家，这些措施仍然不足。因此，迫切需要为 LBW 婴儿的母亲确定最合适的干预措施，特别是在这些国家。为了帮助满足这一需求，我们评估了坦桑尼亚一家城市医院的 HCWs 对 LBW 婴儿母亲在住院期间提供的母乳喂养护理和教育。
在坦桑尼亚的一家城市医院，我们对 LBW 婴儿的母亲进行了一项使用半结构化访谈的定性研究。我们评估了她们在出院时对母乳喂养的理解。所有访谈均用当地斯瓦希里语进行，然后翻译成英语。使用内容分析法分析数据。
在接受采访的 19 位母亲中，只有 4 位在婴儿出生后 1 小时内进行母乳喂养。9 位母亲第一次给婴儿喂奶时没有得到 HCWs 的支持。10 位母亲没有接受关于 EBF 的教育，并且有一些母亲对 EBF 的定义存在误解。有 8 位母亲在出院时回答说她们在给婴儿喂奶方面有困难。4 位母亲对 HCWs 的护理和教育不满意，有 6 位母亲提出了改进建议。尽管有 6 位母亲非常依赖 HCWs，但由于 HCWs 的权威态度和行为，她们很难向 HCWs 提问。
LBW 婴儿的母亲需要特别的支持来提高母乳喂养能力并确保 EBF 的持续进行。为了解决目前提供的母乳喂养干预措施与理想母乳喂养干预措施之间的差距，需要提高母乳喂养护理和教育的质量和数量。培训 HCWs 以系统化标准干预措施、确认母亲的理解并确保母亲有舒适的环境是绝对必要的。
