Paediatric Staff Nurses Knowledge regarding human milk banking working in Kashiben Gordhandas Patel Children Hospital, Baroda, Gujarat

 

Mrs. P. Karthika¹, Mrs. Stella Gracy², Mr. Moses kandula³

¹Associate Professor, Welfare College of Nursing and Midwifery, Bharuch

²Principal, Welfare College of Nursing and Midwifery, Bharuch

³Principal, Welfare School of Nursing and Midwifery, Bharuch

 

ABSTRACT:

Background of the study: WHO and UNICEF state that the use of human milk from other sources should be the first alternative when it is not possible for the mother to breastfeed. Human milk banks should be made available in appropriate situations. A human milk bank is a service established for collecting, screening, processing, storing and distributing donated human milk. Objectives: 1. To assess the level of knowledge regarding human milk banking among paediatric staff nurses. 2. To find out the association between knowledge score with selected demographic variables. Materials and methods: The data were collected from 30 Paediatric staff nurses related to human milk banking by convenient sampling method with the use of dichotomous structured questionnaire method. Result: 52% paediatric Staff nurses having adequate knowledge regarding human milk banking, moderate knowledge 39% and inadequate knowledge 9% regarding human milk banking, and there is a significant association between knowledge score and demographic variables. Conclusion: The major conclusion drawn from this study was that highest percentage 52% paediatric staff nurses had adequate knowledge regarding human milk banking.

 

 

 

 

INTRODUCTION:

The breast milk is the most important source of nutrition for the infants. The developing countries like India are having high infant mortality and malnutrition. The novel concept of human breast milk is absolutely important to solve such grave problems. The human breast milk banks can work efficiently and are cost effective. Besides, not much of human workforce has to be involved into such banks. The various studies from all over the world have emphasized on the importance of human breast milk banks in the management of premature infants. (Dr Carolyn Nash and Dr Lisa Amir – 2000)

 

 

 

This paper highlights the importance of the human breast milk banks and also gives insights about various factors associated with it. When a mother, for some reason, is unable to feed her infant directly, her breast milk should be expressed and fed to the infant. If mother’s own milk is un available or insufficient, the next best option is to use pasteurized donor human milk (PDHM). India faces its own unique challenges, having the highest number of low birth weight babies, and significant mortality and morbidity in very low birth weight (VLBW) population. In our country, the burden of low birth weight babies in various hospitals is about 20% with significant mortality and morbidities. Feeding these babies with breastmilk can significantly reduce the risk of infections. Hence the Government, health experts and the civil society must join hands to propagate the concept of human milk banking for the sake of thousands of low birth weight and preterm babies.

 

The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for 6 months and continued breastfeeding for at least 1 year.¹ Surveillance data from the United States indicate that while 80% of mothers initiate breastfeeding, the percent exclusively breastfeeding at 6 months is much lower (∼22%), and only 31% continue any breastfeeding through 1 year. Approximately 15.5% of all breastfed newborns in the India receive formula supplementation in the first days of life.

 

The first milk bank in Asia under the name of Sneha, founded by Dr. Armeda Fernandez, was started in Dharavi, Mumbai on November 27, 1989. Currently, the number of human milk banks (HMB) has grown to nearly 14 all over India but the growth of human milk banks has been very low as compared to the growth of neonatal intensive care units. One of the major reasons for loss of interest inhuman milk banking was the promotion of formula milk by the industry. Banked human milk is regarded as "the next best" after the biological mother's breast milk. It is used for the treatment of many conditions (mainly in Neonatal Intensive Care Units: NICUs): prematurity, malabsorption, short-gut syndrome, intractable diarrhea, nephrotic syndrome, some congenital anomalies, formula intolerance, failure to thrive, immune deficiencies (IgA). Studies have found that breast milk has a protective effect against necrotizing enterocolitis (NEC).

 

NEED FOR STUDY:

JH Kim and S Unger, 2010, (Nov 15) -A systematic review and meta – analysis comparing donor breast milk with infant formula has recently been published. There were only eight studies that met the criteria for inclusion in the Cochrane review, and only one study compared nutrient-fortified breast milk. There was a reduction in NEC in donor breast milk-fed neonates. The authors concluded, however, that further research was required because most studies did not follow current feeding practices, which may account for the slower growth that was seen in donor breast milk-fed babies. The use of exclusive human breast milk intake that included the mother’s breast milk and/or donor human breast milk plus a novel human-based human milk fortifier has been shown to reduce NEC by 63% and surgical NEC by 92% compared with an intake of the mother’s milk and a standard bovine fortifier in extremely preterm infants weighing less than 1250 g.

 

Margaret G. Parker, Barbara L. Philipp 2008 to 2016,This study was a cross-sectional online survey with two overlapping sampling frames. To determine the prevalence of donor milk use for healthy newborns among MA hospitals, we surveyed all birth hospitals in MA (n = 46 hospitals). To determine the hospital prevalence of donor milk use for healthy newborns among hospitals already using donor milk, we surveyed all birth hospitals that purchased milk from our regional Human Milk Bank Association of North America-certified milk bank (Mother's Milk Bank Northeast), which serves hospitals in 11 states and the District of Columbia (n = 69 hospitals). Due to overlap between sampling frames (n = 15 hospitals in both MA and milk bank sampling frames, the total number of unique hospitals targeted for the survey was 100.

 

Ziegler EE, Moro GE, 2013, Evidence and Recommendations: 

Donor human milk in preterm and infant feeding. In preterm infants, feeding with human milk (HM) is a very effective intervention for the prevention of infections and necrotizing enterocolitis (NEC), and for potentially improved Neuro cognitive and cardiovascular outcomes in the long-term. Hospitals and physicians are advised to recommend HM for preterm and other high-risk infants either by direct breastfeeding and/or using the mother's own expressed milk. Donor HM is the preferred feeding when the mother's own milk is not available in sufficient quantity. While in some countries donor HM has been considered an effective tool in the delivery of health care to infants, skepticism regarding its nutritional and immunological quality has limited its distribution in other countries. The purpose of this paper is to summarize the clinical benefits of donor HM in preterm infants, and to discuss common concerns limiting its distribution as standard care. Clinically, the use of donor HM has been shown to prevent NEC, reduce feeding intolerance and improve long-term outcomes in premature infants. Optimization of banking procedures and of HM fortification is available and should be applied. Banked donor milk should be promoted as standard component of health care for premature infants. (World Association of Perinatal Medicine Working Group On Nutrition- 2013)

Lucas and Cole, 2016 found that NEC was 6-10 times more likely to develop in exclusively formula fed infants than in those fed only breast milk, and that NEC was 3 times more likely when formula-only fed infants were compared to those receiving both breast milk and formula. Other studies have demonstrated that formula fed infants had lower IQ scores than infants fed breast milk. Milk banks vary in their use of banked milk. In some cases, milk is provided for adopted babies or older children with severe food allergies. In 1988, 72% of the milk dispensed from all the milk banks in the USA was prescribed for infants in neonatal intensive care units, 23% went to babies at home, and 2% was used for pediatric inpatients.

 

STATEMENT OF THE PROBLEM:

A descriptive study to assess the paediatric staff nurses knowledge regarding human milk banking working in Kashiben Gordhandas Patel Children Hospital, Baroda, Gujarat

 

OBJECTIVES:

1    To assess the knowledge of paediatric Staff Nurses regarding human milk banking.

2    To find out the association between the knowledge of paediatric Staff Nurses regarding human milk banking with their selected demographic variables

 

HYPOTHESIS:

H1: There will be an significant association between the demographic variables with the knowledge score of human milk banking.

 

MATERIALS AND METHODS:

Research approach and design:

Descriptive research design was used to collect the data from paediatric staff nurses those who are working in KGC hospital

 

Setting of the Study:

The study was conducted at KGC children Hospital, Baroda.

 

Population:

Paediatric Staff nurses working in KGC children Hospital, Baroda

 

Sample and Sample technique:

30 staff nurses working in KGC children Hospital, were selected by convenient sampling technique

 

DESCRIPTION OF THE TOOL:

The tool has two section A & B

Section A: Consist of demographic variables of paediatric Staff Nurses, those who are working in KGC children Hospital.

 

Section B: Consists of dichotomous structured questionnaire related to paediatric Staff Nurses, those who are working in KGC children Hospital Dichotomous structured questionnaire was formulated in the form of check list on human milk banking on 3 point scale. (yes, no, don’t know). It consists of 20 items. In that 14 items are positive structured questionnaire and 6 items are negative structured questionnaire.

 

MAJOR FINDINGS:

Table 1: Knowledge score of paediatric staff nurses working in KGC children hospital (N=30)

Area of Knowledge	Inadequate		Moderate		Adequate
	Frequency	%	Frequency	%	Frequency	%
Human milk banking among paediatric Staff Nurses	4	9%	9	39%	17	52%

 

 

Table 2: Association between knowledge score with their selected demographic variables

Demographic Variable	DF	CV	Table Value	Level of Significant
Age	6	2.45	2.52	Non Significant
Years of experience	4	4.83	2.78	Significant
Education	4	21.73	2.78	Significant
Marital Status	2	4.30	0.82	Non Significant
Birth order	4	16.93	2.78	Significant
Previous knowledge of human milk banking	2	9.2	4.30	Significant

 

Data in this table shows that there was significant association between the knowledge score of staff nurses with Year of experience, Education, birth order and previous knowledge of human milk banking. There was no Significant association between the knowledge score of age and Marital Status.

 

CONCLUSION:

The study was conducted to assess the paediatric staff nurses knowledge regarding Human milk banking at Kashiben Gordhandas Patel Children Hospital, Baroda, Gujarat.  In the present study 30 staff nurses were selected by convenient sampling techniques. The major conclusion drawn from this study was the highest percentage (52%) of the paediatric staff nurses working in Kashiben Gordhandas Patel Children Hospital having adequate knowledge regarding Human milk banking.

 

REFERENCES:

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16.   UNICEF. Six million babies now saved every year through exclusive breastfeeding. [cited 2015 April 16].

17.   Sharma R. We need to promote the culture of donating breast milk. [cited 2015 April 16].

18.   URL: http://www.downtoearth.org.in/content/we-need-promote-culture-donating-breast-milk

19.   URL: www.unicef.org/nutrition

20.   20.http://www.thehindu.com/news/national/other-states/first-public-sector-breast-milk-bank-inaugurated-in Kolkata/article4999460URL:

21.   http://worldbreastfeedingconference.org/

 

 

 

 

Received on 13.03.2019         Modified on 20.04.2019

Accepted on 30.05.2019      ©A&V Publications All right reserved