Knowledge Attitudes And Practices Of Breast Milk Expression And Storage Among Working Mothers With Infants Under 6 Months Of Age In Public Well Baby Clinics

Abstract

Background: A negative relationship has been noted between exclusive breastfeeding and postpartum return to work. Many studies show that working mothers are not able to successfully exclusively breastfeed. Expression and storage of breastmilk has been seen as a strategy to ensure continued breastmilk consumption in the event of temporary separation of an infant from the mother. The 2018 Kenyan guidelines on Securing a Baby Friendly Work Environment outline the roles of the employer in terms of provision of lactation rooms and lactation breaks as per the 2017 Breastfeeding Mothers Act. However, very few studies have been done in Kenya to explore the knowledge, attitude and practice of breastmilk expression and storage among working mothers. Objective: The main objective of the study was to assess the Knowledge Attitude and Practice of breastmilk expression and storage among working women with infants below six months of age in Public Well Baby Clinics. Methodology: A hospital based cross sectional study was conducted at the well-baby clinics of Kenyatta National Hospital and Mbagathi District Hospital. A total of 395 working mothers were interviewed using a structured questionnaire. Open and closed ended questions were used to establish the knowledge and practice around breastmilk expression and storage. A scoring system was used to analyze responses to closed ended questions on knowledge. A five point Likert scale was used to explore the attitudes of the mothers towards the expression and storage of breast milk. Inferential statistics calculated using Odds ratios and Adjusted Odds ratios for univariate and multivariable analysis respectively. Results: The median age of the mothers was 29 years(IQR=25-34), >85% had attained secondary education or higher, 76%(302) were in the private sector, and the median age of infant at resumption of work was 3 months(IQR=2-4). The prevalence of breastmilk expression was 41% (161 mothers). Poor knowledge of breast milk expression and storage was in 66% of mothers interviewed. Those who had attained tertiary education and those working in the public sector had some significantly higher odds of having satisfactory knowledge OR4.47(95% CI 2.01-11.07) and OR2.26(95%CI 1.33-3.85) respectively. Attaining tertiary education was significantly associated with a higher odds of expressing milk OR3.6(95% CI 1.81-7.95). xii The main challenges during breast milk expression were pain and the process of expression being cumbersome. Most mothers used hand expression (50%) followed by manual pumps at 30%. Conclusion: Knowledge gaps exist in the expression and storage of breastmilk. Generally working mothers were confident that expression of milk could help them achieve six months of exclusive breastfeeding. More effort needs to be made by the health care workers in teaching lactating mothers on how to express and store breast milk which would help them overcome the challenges of pain while expressing milk.