Maternal Satisfaction Through Breastfeeding: An empirical study

A growing body of research indicates that both mothers and children benefit from breastfeeding. Reflecting such research, public health officials and organizations promote the practice of breastfeeding. Despite such research, advocacy, and gradually increasing breastfeeding rates over the past decade, a large fraction of mothers do not breastfeed for a shorter period than the recommended six months. We have identified maternal satisfaction (MS) as a predictor variable and six criterion variables namely maternal knowledge (MK), a socio-cultural attitude of mothers (SCI), mother-baby bonding (MBB), family tradition (FT), concerns for health and figure (CHF), and government initiatives (GI). Primary data were collected from hospitals, tabulated and processed to draw the inferences and relationships among the variables. Results show that there is weak maternal knowledge among the mothers, especially for the first baby delivery. Moreover, there are many concerns like family traditions, social and cultural attitudes, mothers concerns on health and physical figure, government initiatives with maternal satisfaction in our study.


Introduction
Breastfeeding is the act of providing milk to a newborn or infant from the mother's breasts. Breast milk is sterile, easily digested, non-allergenic, and transmits maternal antibodies that protect against many infections and illnesses (Thomas, 1997). World Health Organization (2008) explained as breastfeeding is a way of providing ideal food for the healthy growth and development of infants. Leung and Sauve (2005) stated that breastfeeding is the optimal method of infant feeding. Breast milk provides almost all the necessary nutrients, growth factors and immunological components a healthy term infant needs. Breastfeeding is the most widely accepted preferred method of nutrition of the newborn thus providing numerous health benefits to both the mother and her infants (Sinusas & Gagliardi, 2001). Thus, Breastfeeding is a way of providing ideal food the growth and development of infants and protecting against several infectious diseases and thereby experiencing maternal satisfaction by mothers.
Breast milk has been a traditional food for newborn babies. It fulfils not only the physical need for optimum growth but enhances emotional and intellectual development. Breast milk contains an ideal balance of nutrients for the complete growth of the body and brain; more than a food it is a multipurpose medicine, rich in antiinfective factors which protect the baby. Breast milk contains a number of protective substances including antibodies, disease-resistant factors and antimicrobials. World Health Organization (WHO) recommends that children should be exclusively breastfed during the first 6 months and should continue, with supplementation, up to the age of two years.
breastfeeding than full-time housewives. Mortin et al, (2016) said that breast care is directed at maintaining cleanliness and adequate breast support is necessary for the normal function of the breast and the comfort of the mother. All these studies shown that though most working women want to do the best for their children, they lack information on the benefit of breast milk, and the method of expression and storage of breast milk. Hoyer et al, (1998) conducted a study on successful breastfeeding as a result of a health education programme for mothers and results found out that the written instructions, as well as personal encouragement by the field nurse, exerted a favourable influence on breastfeeding practices which was taken as a guideline for our further professional work and change of standards in the field of breastfeeding promotion.
Jennifer Callen, et.al., (2017) conducted a study on breastfeeding is beneficial for preterm infants. The result showed that by proper breastfeeding the infant was protected from nutritional, gastrointestinal, immunological, developmental, and psychological disorders. Dykes F et.al.,(2006) described the lived experience of breastfeeding, in primiparous women. The main focus was upon women's perceptions related to the adequacy of their breast milk, for the purpose of exclusively nourishing their babies. Perceived breast-milk inadequacy is underpinned by a complex and synergistic interaction between socio-cultural influences, feeding management, the baby's behaviour, lactation physiology and the woman's psychological state.

Research Gap
We find a dearth of study on breastfeeding practices and its various communities' health-related dimensions in Indian provinces. India being an old cultural country, mothers were fully aware of breastfeeding benefits and we think therefore we find least research studies on Indian mothers. The literature is lacking in what breastfeeding mothers perceive in terms of maternal satisfaction as supportive in the postpartum period to assist them in achieving their breastfeeding goals. The policy statements, guidelines, and recommendations for breastfeeding success set forth by professional groups are published like health department and community health and publically communicated.

Rationale of the Study
Since breast milk is essential for the infant's health, the mother has to continue exclusive breastfeeding. But in the case of working women, they can feed their children only when they are getting leisure time. One of the other methods through which working women can manage their baby's health is through expressed breast milk. The expression of breast milk is beneficial to both the baby as well as the mother; it provides nutrition to the child and prevents breast complications also. In India, there are a lot of mothers who are working, so there is a need to develop a module on the expression and storage of breast milk, with a view that the health professionals for the employed mothers could utilize this module as a health education material. This study would establish the strength of relationships between the identified variables that would express the importance of criterion variables and the maternal satisfaction amongst the mothers.

Proposed Perceptual Model of Maternal Satisfaction
Journal of Health, Medicine and Nursing www.iiste.org ISSN 2422-8419 An International Peer-reviewed Journal Vol.95, 2021 Objectives of the Research 1. To explore mothers' experiences about breast feeding to babies 2. To identify the factors influencing mothers' breast feeding 3. To find out the level of satisfaction of mothers in breast feeding 4. To find out variables stimulating agents of breast feeding among the mothers

Research Hypothesis
Ho1: There is no significant relation of maternal satisfaction and maternal knowledge Ho 2: There is no significant relation of maternal satisfaction and socio-cultural attitude Ho 3: There is no significant relation of maternal satisfaction and mother baby bonding Ho 4: There is no significant relation of maternal satisfaction and family traditions Ho 5: There is no significant relation of maternal satisfaction and concerns for health and figure Ho 6: There is no significant relation of maternal satisfaction and the role of Government initiatives

Research Methodology Sampling Method
We have used simple random and targeted sampling of the mothers who come to Sitapur district hospital for medical services either pre-delivery or post delivery care and OPD services. We have prepared questionnaire and administered to most of mother who visited the hospital in three month duration. We explained the questions to the respondent mothers and they filled it serious and carefully.

Sample Size
In three months duration we find 126 mothers and they were included in our sample of the study. Hence our sample size is 126 mothers who delivered babies either in the hospital or in home.

Design and Development of Questionnaire
We have conceptualized and developed seven constructs/variables and designed a questionnaire suitable for the subject of study i.e. breastfeeding practices amongst the mothers in the sampled area and drawing thereby maternal satisfaction of the mothers. The scale in the form of a questionnaire has been tested for its consistency and reliability. We have also examined and ensured the validity of the questionnaire. There are many research studies and authenticated reports about the acceptable values of alpha, ranging from 0.60 to 0.95. The Cronbach's alpha value for our entire seven identified constructs for the purpose of the study has arrived at .692 which shows that the designed questionnaire is reliable as its value must be above .60. Thus our estimates value shows the reliability and it is free of errors.
The Kaiser-Meyer-Olkin is the measure of sampling adequacy, which varies between 0 and 1. The values closer to 1 are better and the value of 0.60 is the suggested minimum. Bartlett's Test of Sphericity is the test for the null hypothesis that the correlation matrix has an identity matrix. Table-3 depicts that our instrument of research study has been valid scientifically as it has better factor loading above 0.40 in all the cases considering the minimum threshold for judging face validity, construct validity and criterion validity. The correlation matrix as shown in table -4 depicts that maternal knowledge (0.109) has the weakest strength of relationship with the maternal satisfaction (MS) followed by maternal knowledge (MK) and family traditions (FT) i.e 0.124 then with concerns for the physical figure (CPF) i.e 0.131 and 0.174 strength of relationship with social and cultural attitude (SCA). It needs to be strengthened in the communities so that breastfeeding practices can be promoted adequately.

Regression Model
In the regression model, the independent variable is labelled the X variable, and the dependent variable is the Y variable. The relationship between X and Y can be shown on a graph, with the independent variable X along the horizontal axis, and the dependent variable Y along the vertical axis. The aim of the regression model is to determine the straight-line relationship that connects X and Y. The straight line connecting any two variables X and Y can be stated algebraically as Y = a + bX where is called the Y-intercept, or simply the intercept, and b is the slope of the line. If the intercept and slope for the line can be determined, then this entirely determines the straight line.

Hypothesis Testing
Pearson Correlation Coefficient is used to test the relationship between the role of green marketing and its seven identified independent variables. ANOVA is used to test the variance from its mean values in the research question and research objectives. For deciding whether the hypothesis is rejected or accepted, the researcher has to examine the significance (p) value. The rule is the null hypothesis is rejected if the p-value (significance value) is less than Alpha. Since the analysis was measured with 95% of the level of confidence, so the alpha would be 5 % i.e. 0.05. Therefore, if the significance value is less than 0.05, the alternative hypothesis (Ha) is accepted. If the significance value is greater than 0.05, the null hypothesis (Ho) is accepted. The results of the hypotheses testing are shown below in the compiled tables:

Findings and Conclusion
We have found that the demographic profile of the respondents has no significant difference in the perception of the role of maternal satisfaction and demographic profile of the respondents in our sample of study like education, employment, breastfeeding counselling, the role of government initiatives etc. There is a significant impact of maternal satisfaction on mother-baby bonding, on the family tradition, on concerns on the physical figure, on Socio-Cultural attitude, on Maternal Knowledge, on the Role of Government initiatives. The mothers in the sampled area do not have maternal knowledge and hence the government must take proper steps to enhance the knowledge so that they could understand its importance.

Suggestions
There is the need to extensively train all health care providers in the state. Health care providers must organize educational programmes for all persons on appropriate delivery care practices such as delay bathing of newborn babies immediately after birth, proper cord care practices, exclusive breastfeeding, breastfeeding on-demand, hygienic breastfeeding practices, as well as recognition and management of more severe danger signs in the neonate. Women should be educated more on neonatal and early neonatal care, From the findings, factors that influenced exclusive breast feeding in the study community included; Infant age; Infant health; maternal morbidity; maternal experience of breastfeeding complications; maternal correct knowledge on duration of exclusive breastfeeding; maternal knowledge that breastfeeding delays pregnancy; maternal knowledge that semi-solid and solid foods should be introduced at six months and attitudes and beliefs regarding exclusive breastfeeding practice.
The strongest predictor of exclusive breastfeeding in the study community was infant morbidity. Those children who were ill were less likely to receive exclusive breastfeeding. Maternal experience of breastfeeding complications was also a predictor of exclusive breastfeeding in the study community. Mothers who experienced breastfeeding complications were less likely to exclusively breastfeed their infants. Maternal correct knowledge on duration of exclusive breastfeeding was also a predictor of exclusive breastfeeding in the study community. Mothers who had correct knowledge on duration of exclusive breastfeeding were more likely to breastfeed their infants exclusively.