DOI: 10.21045/2071-5021-2018-62-4-7

Contacts: Pastbina Irina, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Pastbina I.M., https://orcid.org/0000-0003-1475-1529
Menshikova L.I., http://orcid.org/0000-0002-1525-2003
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

Abstract

Organization of early initiation and continuation of exclusive breastfeeding during the first six months of life are crucial for both optimal development of the child and maternal health. Introduction of modern technologies to improve and support breastfeeding into practice of obstetrical facilities has a positive effect on initiation and duration of exclusive breastfeeding.

Purpose: to evaluate the existing practice of the interregional obstetric center for women with low and medium perinatal risks to support exclusive breastfeeding to further improve perinatal care delivery in the region.

Methods. A survey covered 226 women in the obstetric center for women with low and moderate perinatal risk and 6 months later the discharge. Several variables were assessed: participation in prenatal training, attitude to partner delivery, rooming in, initiation, support and duration of exclusive breastfeeding.

Statistical analysis. Statistical analysis was performed using program SPSS version 21.0. The Pearson chi-square test was used to compare two qualitative variables; Mann-Whitney criteria – to compare a quantitative data with non-normal distribution; McNemar’s test - to find out relationship between two dichotomous variables in «before-after» cases.

Results. The study showed a low coverage of pregnant women with prenatal training (less than 30%), denial of partner delivery (75%), late initiation of breastfeeding (30%), widespread use of formulas and giving water to healthy newborns (over 50%); influence of several factors on early discontinuation of breastfeeding.

Conclusions. Prenatal education, early attachment of full-term baby to breast, length of "skin to skin" contact and partner births are insufficiently provided to women with low and medium perinatal risk.

The study has identified social determinants and factors of the perinatal period that discourage and encourage mothers to prolong breastfeeding. Along with the increasing partner births this information can be used to further improve perinatal care in the region.

Scope of application: antenatal clinic, obstetric hospitals, pediatric clinic.

Keywords: healthy newborns; partner birth; rooming-in; exclusive breastfeeding.

References

1. Abol'yan L.V. Rol' sovremennykh mediko-organizatsionnykh tekhnologiy v povyshenii dlitel'nosti grudnogo vskarmlivaniya [The role of modern health and organizational technologies in increasing the duration of breastfeeding]. Yakutskiy meditsinskiy zhurnal 2015; (3): 18-21. (In Russian).
2. Baybarina E.N. Ekspertnyy analiz kachestva pomoshchi novorozhdennym, kak metodika perinatal'nogo audita [Expert analysis of the quality of care for newborns, as a method of perinatal audit]. Problemy upravleniya zdravookhraneniem 2011; (1): 34-40. (In Russian).
3. Belyaeva N. A. Otsenka znaniy kormyashchikh materey v voprosakh grudnogo vskarmlivaniya do i posle zanyatiy v shkole materinstva [Assessment of the nursing mothers’ knowledge in breastfeeding before and after studying at the maternity school]. Saratovskiy nauchno-meditsinskiy zhurnal 2014; 10 (1): 108-110. (In Russian).
4. Bukina T.A. Razvitie Initsiativy VOZ/YuNISEF «Bol'nitsa dobrozhelatel'naya k rebenku» na territorii Sverdlovskoy oblasti [Development of the WHO/ UNICEF "Child Friendly Hospital" initiative in Sverdlovsk Region]. In: Abol’yan LV, Polesskiy VA, editors. Grudnoe vskarmlivanie v sovremennom mire: rol' sektora zdravookhraneniya v okhrane i podderzhke grudnogo vskarmlivaniya [Breastfeeding in the modern world: the role of the health sector in protecting and supporting breastfeeding]. Tezisy dokladov Vserossiyskoy nauchno-prakticheskoy konferentsii s mezhdunarodnym uchastiem (Moscow, 14–16 May 2014). Moscow: Pervyy Moskovskiy gosudarstvennyy meditsinskiy universitet im. I.M. Sechenova; 2014. P. 31-32. (In Russian).
5. Gurkina E.Yu., Belyaeva E.N., Gavrishchuk Yu.G., Pivsaeva E.V. Vliyanie zanyatiy v shkole budushchikh materey pri perinatal'nom tsentre FGBU FMITs im. V.A. Almazova na psikhoemotsional'noe sostoyanie beremennykh i techenie rodov. [The influence of studying in the maternity school at FGBU V.A. Almazov perinatal center on the psycho-emotional state of pregnant women and the course of childbirth]. In: Aktualnye voprosy pediatrii i perinatologii [Actual issues of pediatrics and perinatology]. Sbornik rabot posvyashchennykh 35-letiyu FGBU FMITs im. V.A. Almazova. St-Petersburg. 2015. p. 259. (In Russian).
6. Ivanov D.O. Sovremennye vozmozhnosti podderzhki grudnogo vskarmlivaniya [Current opportunities to support breastfeeding]. Detskaya meditsina Severo-Zapada 2012; 3 (4): 36–42. (In Russian).
7. Kompleksnyy plan osushchestvleniya deystviy v oblasti pitaniya materey, a takzhe detey grudnogo i rannego vozrasta [Comprehensive plan for the implementation of nutrition interventions for mothers and infants and young children]. Geneva: World Health Organization. 2014. 22 p. (In Russian).
8. Kondrat'yeva E.I., Stankevich S.S., Barabash N.A., Linok E.A. Otsenka effektivnosti raboty regional'nogo tsentra podderzhki grudnogo i ratsional'nogo vskarmlivaniya [Assessment of the effectiveness of the regional center for breastfeeding and rational feeding]. In: Abol'yan L.V., Polesskiy V.A., editors. Grudnoe vskarmlivanie v sovremennom mire: rol' sektora zdravookhraneniya v okhrane i podderzhke grudnogo vskarmlivaniya [Breastfeeding in the modern world: the role of the health sector in protecting and supporting breastfeeding]. Tezisy dokladov Vserossiyskoy nauchno-prakticheskoy konferentsii s mezhdunarodnym uchastiem (Moscow, 14–16 May 2014). Moscow: Pervyy Moskovskiy gosudarstvennyy meditsinskiy universitet im. I.M. Sechenova; 2014. P. 60-64. (In Russian).
9. Kontseptsiya demograficheskoy politiki Rossiyskoy Federatsii na period do 2025 goda [The concept of the demographic policy of the Russian Federation for the period until 2025]. Utverzhdena Ukazom Prezidenta Rossiyskoy Federatsii ot 9 oktyabrya 2007 g. ¹ 1351. [Online] [cited 2018 May 17]. Available from: http://www.zakonprost. ru/content/base/part/538230 (In Russian).
10. Lukoyanova O.L., Borovik T.E., Belyaeva I.A., Yatsyk G.V. Otsenka klinicheskoy effektivnosti novykh tekhnologicheskikh podkhodov k podderzhke grudnogo vskarmlivaniya [Assessment of the clinical effectiveness of new technological approaches to support breastfeeding]. Voprosy sovremennoy pediatrii 2012; 11 (4): 182–186. (In Russian).
11. Natsional'naya programma optimizatsii vskarmlivaniya detey pervogo goda zhizni v Rossiyskoy Federatsii [The National Program for the optimization of feeding of children of the first year of life in the Russian Federation]. Moscow: Soyuz pediatrov Rossii. 2011. 68 p. (In Russian).
12. Ob utverzhdenii gosudarstvennoy programmy Rossiyskoy Federatsii «Razvitie zdravookhraneniya» [On approving the state program of the Russian Federation “Development of health care”]. Postanovlenie pravitel’stva Rossiyskoy Federatsii ot 15.04.2014; ¹ 294 (red. ot 31.03.2017). [Online] [cited 2018 Apr 30]. Available from: http://base.garant.ru/70643470. (In Russian).
13. Ob utverzhdenii Poryadka okazaniya meditsinskoy pomoshchi po profilyu «akusherstvo i ginekologiya» (za isklyucheniem ispol'zovaniya vspomogatel'nykh reproduktivnykh tekhnologiy) [On the approval of the procedure for the provision of medical care in the obstetrics and gynecology (with the exception of the use of assistive reproductive technologies)]. Prikaz Ministerstva zdravookhraneniya Rossiyskoy Federatsii ot 01 noyabrya 2012 goda ¹572n (red. ot 12.01.2016)]. [Online] [cited 2018 Apr 30]. Available from: http://base.garant.ru/70352632/ (In Russian).
14. O natsional'nykh tselyakh i strategicheskikh zadachakh razvitiya Rossiyskoy Federatsii na period do 2024 goda [On the national goals and strategic tasks for the development of the Russian Federation during the period up to 2024]. Ukaz Prezidenta Rossii V.V. Putina ot 7 maya 2018 goda. [Online] [cited 2018 May 17]; Available from: http://tass.ru/politika/5182019/ . (In Russian).
15. Povyshenie kachestva uslug po okhrane reproduktivnogo, materinskogo, neonatal'nogo, detskogo i podrostkovogo zdorov'ya v evropeyskom regione [Improving the quality of services for the protection of reproductive, maternal, neonatal, child and adolescent health in the European region]. Regional'naya programma podderzhki vnedreniya politiki «Zdorov'e-2020». [Online] [cited 2018 Apr 30]. Available from: http://apps.who.int/iris/bitstream/10665/249155/1/9789241511216-eng.pdf (In Russian).
16. Romanenko L.V., Murav'eva T.N. Organizatsiya monitoringa Initsiativy VOZ/YUNISEF «Bol'nitsa dobrozhelatel'naya k rebenku» na Ukraine [Organization of monitoring of the WHO / UNICEF "Child Friendly Hospital" in Ukraine]. In: Abol'yan L.V., Polesskiy V.A., editors. Grudnoe vskarmlivanie v sovremennom mire: rol' sektora zdravookhraneniya v okhrane i podderzhke grudnogo vskarmlivaniya [Breastfeeding in the contemporary world: the role of the health sector in protecting and supporting breastfeeding]. Tezisy dokladov Vserossiyskoy nauchno-prakticheskoy konferentsii s mezhdunarodnym uchastiem (Moscow, 14–16 May 2014). Moscow: Pervyy Moskovskiy gosudarstvennyy meditsinskiy universitet im. I.M. Sechenova; 2014. p. 107-110. (In Russian).
17. Rukovodstvo po analizu deyatel'nosti sluzhby okhrany materinstva i detstva Rossiyskoy Federatsii [Guidance on the analysis of the activities of the maternity and child welfare service in the Russian Federation]. Moscow: TsNIIOIZ, 2009. 173 p. (In Russian).
18. Starodubov V.I., Stupak V.S, Fil'kina O.M, Sen'kevich O.A, Vorob'eva E.A. Sotsiologicheskie issledovaniya kak indikator kachestva meditsinskoy pomoshchi v sisteme nepreryvnoy profilaktiki perinatal'noy patologii [Sociological researches as healthcare quality indicator in the system of continuous preventive surveillance of perinatal pathology]. Sotsial'nye aspekty zdorov'ya naseleniya [serial online] 2012 [cited 2018 Apr 30]; 4(26). Available from: http://vestnik.mednet.ru/content/category /5/61/30/lang,ru/ (In Russian).
19. Filippov O.S., Bashmakova N.V, Mal'gina G.B., Davydenko N.B. Litvinova A.M. Perinatal'nyy audit. Sovremennaya metodologiya: metodicheskie rekomendatsii [Perinatal audit. Modern methodology: methodological recommendations]. Moscow. 2014. 60 p. (In Russian).
20. Furtsev V.I., Budnikova E.V. Grudnoe vskarmlivanie (statisticheskaya otchetnost'): metodicheskie rekomendatsii dlya uchastkovykh pediatrov, zav. pediatricheskimi otdeleniyami, gl. vrachey detskikh poliklinik i detskikh bol'nits [Breastfeeding (statistical reporting): Methodical recommendations for district pediatricians, heads of pediatric departments, chief doctors of children's polyclinics and children's hospitals]. Krasnoyarsk. 2013. 12 p. (In Russian).
21. Furtsev V. I. Rossiyskaya shkola po podderzhke grudnogo vskarmlivaniya: realizatsiya paradigmy na praktike. [Russian school to support breastfeeding: implementation of the paradigm in practice]. Voprosy sovremennoy pediatrii 2014; 13 (5): 92–94. (In Russian).
22. Sharapova O.V., Baklaenko N.G., Kuznetsov P.P., Baybikov D.R. Razrabotka monitoringa sluzhby rodovspomozheniya – aktual'naya sovremennaya problema [Developing monitoring of the obstetrics service - an actual contemporary problem]. GlavVrach 2010; (3): 14–23. (In Russian).
23. Shuvalova M.P., Pis'menskaya T.V., Grebennik T.K. Rezul'tativnost' tret'ego urovnya sistemy regionalizatsii perinatal'noy pomoshchi v Rossiyskoy Federatsii [Performance of the third level of regionalization of the system of perinatal care in the Russian Federation] Sotsial'nye aspekty zdorov'ya naseleniya [serial online] 2017 [cited 2018 May 01]; 53 (1). Available from: http://vestnik.mednet.ru/content/view/814/30/lang,ru/ (In Russian).
24. Heiberg E., Kondakova N.I., Dinekina T.Y., Kabakov V.L., Skurtveit S. Voices of women in the barents region. report from the project family friendly maternity care in the barents region in the barents health programme 1999-2003. Oslo, 2004. P. 134.
25. Horta L.B., Bahl R., Martines C.J., Victora C.G. Evidence on the long effects breastfeeding: systematic reviews and meta-analysis. Geneva: World Health Organization. 2007. 52 p.
26. Victora C.G., Bahl R., Barros A.J.D., França G.V.A, Horton S., Krasevec J., et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016; 387: 475–490.

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