| Summary: | Cesarean section team is one of the microsystem that support the improvement of healthcare
service in the hospital. In Baby Friendly Hospital Initiatives (BFHI), this microsystem supposes to
perform early breastfeeding for the baby born by cesarean section. In fact, incidence of early
breastfeeding in cesarean section in Indonesia is low, only 4.2% in Semarang. Studies show that
cesarean section is negatively correlated with early breastfeeding but cesarean section is not
contraindication for early breastfeeding. Support from the cesarean section team is needed in
order to perform early breastfeeding in the operation theater.
Objectives: (1) To measure the incidence of early breastfeeding in cesarean section. (2) To
identify the perception of cesarean section team about the benefit of early breastfeeding in
cesarean section. (3). To identify the perception of cesarean section team about the protocol of
early breastfeeding in cesarean section. (4) To identify the attitude of health care professionals
toward hospital practices regarding early breastfeeding in cesarean section. (5) To identify the
barriers of early breastfeeding in cesarean section.
Methods: Mixed-method with embedded design. Cross sectional design to identify incidence of
early breastfeeding in cesarean section, the perception of cesarean section team about the
benefit and protocol of early breastfeeding in cesarean section and their attitude toward hospital
practices regarding early breastfeeding in cesarean section. Qualitative design for obtaining
barriers of early breastfeeding in cesarean section. Sample is all cesarean section team involved
in early breastfeeding in cesarean section in 2 private maternity hospitals in Jakarta and Bekasi,
and minimum 62 babies born within 2 month research period is being observed.
Result: Research was conducted from March to May, 2011 in two private maternity hospital in
Jakarta and Bekasi. Skin to skin contact were observed in 99% babies (N=68) with average
duration of 9 + 4 minutes. All babies were positioned in their mother nipples. From 81 returned
likert scale questioners, 55 are valid to be analyzed. Average perception of cesarean section
team about the benefit of early breastfeeding in cesarean section is 4.22 + 0.49. Average
perception of cesarean section team about the protocol of early breastfeeding in cesarean section
is 3.98 + 0.56. Average attitude of cesarean section team toward hospital practices regarding
early breastfeeding in cesarean section 2.58 + 0.69. Barriers to early breastfeeding in cesarean
section is contraindication from mother and or baby, mother refusal, lack of team commitment,
lack of socialisation and magement support, lack of human resources and time to observe the
early breastfeeding for an hour or more.
Conclusion: Incidence of early breastfeeding in cesarean section is zero, due to inadequate
protocol of early breastfeeding in cesarean section. The perception of benefit and protocol of
early breastfeeding in cesarean section is good in all team. Most of the cesarean section team
disagree with the hospital practices regarding early breastfeeding in secarean section, but in
some items nurses tend to agree with the hospital practices regardless the perception of the right
protocol.
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