PENDAHULUAN Conclusions and Recommendations

Introduction infancy and continues over the next few years. The bonding process has Breast feeding is the process whereby the infant receives breast milk. 1 Breast feeding is a multidimensional health behavior influenced by some factors such as social, demography, biology, prepost natal and psychology. Its universally acknowledged to be the best and complete food for infant as it fulfills specipic nutritional needs. 2 Extensive research in the recent years, documents diverse and compelling advantages og breast feeding to infants, mothers, families and society. These also included nutritional, immunological, developmental, psycological, social, economic and enviromental benefits. 3,4,5 Professional support also influences breast feeding initiation and duration. 6 One study evaluated the results of a breast feeding programe in neonated care unit that offered that service of a lactation nurse and a developmental specialist.as a result of program, the number of infant receiving expressed milk while in the hospital nearly doubled. At discharge 83 of the infant were fully of receiving breast milk 7 Hospital team can be have a significant impact on the initiation and maintenence breast feeding, if they have sufficience knowledge of its benefits and the necessary clinical management skills or habbits. 8 In order to ensure success in breast feeding, it is important that it be initiated as early as possible during the neonatal period. 7 Right after birth the sucking releks is most active and babies are more alert during the firts 30-60 minutes are put to mother‟s breast within this period, chances of exclusive breast feeding increase. 9 Early initiation of breast feeding enchaces maternal infant bounding. 10 tremendous implications for both mother and child and is affected by many factors. 11 Many studies have addressed the question of whether there is what has been called a „sensitive period‟ for parent-child contact in the first minutes, hours and days of life that may alter the parent‟s behaviors with their infant later in the life. 11 In each study, increasing suckling improves caretaking by the mother. 11 Salariya et all also found that babies who were first fed within 30 minutes of birth were likely to remain breast feeding for longer. 12 The relationship between early first contact of mother and infant and outcome of breastfeeding may be closely related to wthat Klaus and Kennell 1976 describe as an early sensitive period in the mother. This immediate postpartum period seems to be the time for optimum attachment or bonding of the mother to the infant. 12 A study at Brazil 1974 compared the breastfeeding of two groups of 100 women. The mothers of one group nursed their infants immediately after birth and maintained permanent contact throughout the hospital stay with with their infants in cribs by their beds. The control group mothers had a glimpse of their infants shortly after birth and then visits for approximately 30 minutes, every 3 hours, 7 times a day, beginning 12-14 hours after birth. At 2 months, 77 of the experimental group mothers were breastfeeding without supplemental formula. In contrast, only 27 of the control group mothers were breastfeeding without formula suplements at 2 months. Knowledge and support must also be considered causal factors in the study as a special nurse Maternal infant bonding means the worked with the mothers of the development of the core relationship experimental group to stimulate and between mother and child. 11 The encourage breastfeeding. 13 bonding process is accurs in both infant and mother and has tremendeus implications of the child‟s future development. 11 Maternal infant bonding is a vital process which begins in early 1273 The factors that affect the intention, initiation and duration of breast feeding are complex and therefore to address these factors, specialized approach is required. 14 Hospital policies and routines greatly influence breastfeeding success. The peri-partum hospital experience should include adequate support, instruction and care to ensure the successful early initiation of breastfeeding. Such management is part of continuum of care and education begin during the pre-natal period that promotes breastfeeding as the optimal method of infant feeding and includes information about maternal and infant benefits. 15 Though, it is important to initiate breast feeding to new born baby within 1 Method The quasi- experimental study was hour of delivery, yet no studies have been done so far in the Institute to see the effect of initiation of breast feeding within 1 hour of delivery on maternal- infant bonding. WHO recommends that breast feeding should be initiated within 1 hour of delivery. So, the need aroused to conduct the study and assess the effect of initiation of breast feeding within 1 hour of delivery on maternal- infant bonding and produce research based evidence. All the mothers with normal vaginal delivery period of gestation 36 weeks conducted with the mothers and their and above who were willing to new born babies in the obstetric unit Mohamad Djamil Hospital Padang Indonesia in September – Oktober 2014. participate in the study were considered eligible and included in the study except the mothers and new born babies in the Purposive sampling technique was exclusion criteria. And the mothers employed to select sample from the having the problem i.e medical surgical population. During first phase the disease which intervered with the mothers were conductes after one hours of the delivery and asked weather they have initiated breast feeding to their baby. If the breast feeding was not initiated within one hour of the delivery, mother-infant dyads was considered in the experimental group. During the second phase, the mother were conducted within one hour of the delivery and breast feeding was initiated within one hour of delivery using developed protocol i.e mother infant dyad were considered in the experimental group. Protocol of the initiation of breast feeding was developed by consulting the experts and review the literatur. Result and Analysis Thirty mother – infant dyads were enrolled for the study and considered for analysis. Each group control and initiation of breast feeding, post partum haemorrage and post partum psychosis, twin pregnancy, eclampsia. The newborn babies with the problem a.e. pre term less than 36 weeks of gestation, birth weight less than 1800 gr, APGAR score less than 7 at 1 and 5 minutes, congenital malformations which interfered with the breast feeding, babies shifted with the breast feeding, babies shifted to neonatal intensive care units NICU, babies with medical surgical problems where direct breast feeding is contraindicated were excluded from this study. mother – infant dyads. Analysis of gathered data was done using differential and inferential statistics. experimental comprised of thirty 1274