Literature review and Hypothesa A. Hyper uricemia

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 Table 1. Socio-demographic profile of the subjects. Socio-demographic profile Control Group f N = 30 Experimental Group f N = 30 Age - - - - 20 years 21 – 25 years 26 – 30 years 31 years 02 06.7 15 50.0 10 33.3 03 10.0 01 03.3 14 46.7 10 33.3 05 16.7 Educational self - - - - Till 6 th SD 7 th – 9 th SMP 10 th – 12 th SMA 13 th 03 10.0 05 17.0 15 50.0 07 13.0 04 13.0 04 13.0 17 57.0 05 17.0 Occupation self - - House-wife Employed 16 53.0 14 47.0 17 57.0 13 43.0 Place habitat - - Rural Urban 17 47.0 13 53.0 16 53.0 14 47.0 Per Capita Income - - - - IDR.600.000 IDR. 600.000 – IDR. 1.200.000 IDR. 1.200.000 – IDR. 1.800.000 IDR. 1.800.000 13 43.3 10 33.3 06 20.0 01 03.4 10 33.3 12 40.0 06 20.0 02 06.7 Type of Family - - Joint Nuclear 16 53.0 14 47.0 18 60.0 12 40.0 Majority of the subjects were in the age group of 21-25 years. Age of the study subjects mothers in the control group ranged between 19 to 38 years. Per capita income of subjects ranged between IDR 450.000- IDR 2.100.000- per month. 13 43.3 subjects from group had per capita income of IDR 600.000 – whereas 12 40.0, subjects from experimental groups had per capita income IDR 600.000- IDR 1.200.000- per month. Educational of subjects ranged between till 6 th SD - 16 th post graduated, 15 50.0 subjects from control group had educational 10 th – 12 th 1275 SMA – whereas 17 57.0, subjects from experimental groups had educational 10 th – 12 th SMA. In the control group, educational ranged between till 6 th SD - 16 th post graduated. More than half of the subjects i.e. 57.0 from experimental group and 53.0 from control group were house wives. More than half 47.0 of subjects from control group and 53.0 from experiment group were from rural background. More than half type of family 53.0 of subjects from control group and 60.0 from experiment group were joint family. Table 2. Gravida status, gestation period and sex of baby of the subjects Variables Control Group f N = 30 Experimental Group f N = 30 Gravida - - Primi Gravida Multi Gravida 17 57.0 13 43.0 15 50.0 15 50.0 Period of Gestation in weeks - - - 36 – 37 37 – 40 40 – 42 05 17.0 23 77.0 02 07.0 04 13.0 24 80.0 02 07.0 Sex of baby - - Boy Girl 11 37.0 19 63.0 20 67.0 10 33.0 More than half of the study subjects were primigravida i.e. 50.0 from control group and a half i.e 57.0 from experimental group. Majority of the control group of study subjects i.e 77 delivered between 37 to 40 weeks groups and control group 80. In the control group, 11 37.0 subjects, had baby boy 19 63.0 had baby girl while in experimental group, 20 67.0 subjects, had baby boy and 10 33.0 had baby girl. period of gestation and experimental Table 3. Maternal – infant bonding score at 24 and 48 hours Maternal – Infant bonding score Control Group Experimental Group Value of TIME N = 30 N = 30 t Mean + S.D Range Mean + S.D Range After 24 73.4 + 9.0 44.3 – 87.2 80.1 + 5.3 62.2 – 90.1 -7.401 hours of delivery p=0.002 After 48 74.2 + 8.7 44.3 – 91.2 82.3 + 5.3 61.7 – 91.2 -8.891 hours of delivery The comparison of maternal-infant bonding was done at 24 and 48 hours of the delivery and the scores were compared. In control group, mean bonding score on maternal-infant attachement scale at 24 hours of delivery ranged from 44.3 - 87.2 with mean score 73.3 + 9 and at 48 hours the score ranged from 44.3-91.2 with mean + S.D score 74.2 + 8.7. In the experimental group. Mean bonding score and range in maternal-infant attachment scale at 24 hours of the delivery between 62.2 - 1276 p=0.001 90.1 with mean score 80.1 + 5.3 and while at 48 hours it ranged from 61.7 - 91.2 with mean score 82.3 + 5.3. The t test for equality of means was applied to asses maternal-infant bonding at both 24 and 48 hours was -7.401 and -8.891, respectively p = 0.002 at both 24 hours and p = 0, 001 for 48 hours, this shows that there was significant difference in bonding score in the control and experimental group both at 24 hours and 48 hours of the delivery.