Effectiveness of Hoffman's Exercise on Successful Breast Feeding among Primipara Mothers with Flat and Retracted Nipples

 

Prof. P. Padmavathi

Principal, Dhanvantri College of Nursing, Pallakkapalyam, Namakkal District -637 303

Corresponding Author Email: Padmasekar2009@gmail.com

 

ABSTRACT:

Inverted and flat nipples are commonly present in primipara mothers.  Nipple abnormalities are commonly encountered in clinical practice especially in relation to lactation problems in postnatal. Statement of the problem: Effectiveness of Hoffman's exercise on successful breast feeding among primipara mothers with flat and retracted nipples. The research design adopted was quasi experimental design. The study conducted at in Government Head Quarters Hospital, Erode and Nirmala Hospital, Erode. The study was conducted on 30 primipara mothers (15 in control group and 15 in experimental group) immediately after delivery. Experimental group received Hoffman’s exercise. The levels of successful breast feeding were assessed in both groups. The study concluded that in control group majority (80%) of primipara mothers were medium risk and 20% of them were low risk whereas in experimental group 73 of them were low risk and 27% of them had medium risk. The overall mean percentage was 56% in control group whereas in experimental group 78% with ‘t’ value 6.82, significant at P < 0.05).

 

KEY WORDS: Effectiveness, Hoffman’s exercises, primipara mothers, flat and inverted nipple.

 

 

INTRODUCTION:

A mother who is breast feeding for the first time is in a vulnerable position and requires support, encouragement and knowledgeable assistance. She has to make the transition from being insecure, anxious and self-doubt to being self-assured and confident in herself and her abilities. The mother should be prepared for each breast feeding and helped with the supportive measures.

 

Inverted and flat nipples are commonly present in primipara mothers.  It is better to treat antenatally itself helps the newborn baby to suck easily. Infant sucking is also good for mothers, immediately after birth stimulating the nipples triggers the release of oxytocin, which makes the uterus contract. This helps control postpartum bleeding and hastens the return of the uterus to its pre-pregnant size. (Annamma Jacob, 2005)

         

Nipple abnormalities are commonly encountered in clinical practice especially in relation to lactation problems in postnatal. These abnormalities include flat or inverted nipples, fissured nipples. These are common with an incidence of 16.3% among nulliparous women attending ANCs. Large majority (90.2%) of them exclusively breast fed with satisfactory weight gain with adequate support. Incidence of flat / non protractile inverted nipple is 9.6%. Large majority of flat / non protractile can be corrected antenatal (75%) with Hoffman exercises and they could successfully breast feed the offspring. (Sanjeevana Amarsena, 2006)

This is being a major problem among primi mother against breast feeding, hence forth the investigator felt that evaluate the effectiveness of Hoffman's exercise on breast feeding among antenatal mothers with flat and retracted nipples.

 

STATEMENT OF THE PROBLEM:

Effectiveness of Hoffman's exercise on successful breast feeding among primipara mothers with flat and retracted nipples

 

OBJECTIVES:

1.       To assess the level of successful breast feeding among control and experimental group primipara mothers after Hoffman's exercise

2.       To compare the effectiveness of Hoffman's exercise on successful breast feeding among experimental group primipara mothers in both the groups.

3.       To find out the association between post test scores of successful breast feeding among experimental group and control group of primipara mothers with their selected demographic variables.

 

RESEARCH HYPOTHESIS:

H1:  There will be a significant improvement in successful breast feeding among control than experimental group of primipara mothers after Hoffman's exercise

H2:  There will be a significant effectiveness of Hoffman's exercise on successful breast feeding among experimental group primipara mothers in both the groups.

H3:  There will be a significant association between post test scores of successful breast feeding among experimental group and control group of primipara mothers with their selected demographic variables.

 

METHODOLOGY:

Quantitative research design – Quasi Experimental design – Non equivalent post test only. The study was conducted with permission of Medical Superintendent from Government Head Quarters Hospital, Erode and Managing Director from Nirmala Hospital, Erode. The sample consisted of 30 primipara mothers who fulfil the inclusion criteria were chosen for the study by using purposive sampling technique. The tools used to collect the data were demographic variables and modified Via Christi breast feeding assessment tool. The experimental group received Hoffman’s exercise (Placing the thumb, or the forefingers, close to the inverted nipple, then pressing into the breast tissue quite firmly and gradually pushing the fingers away from the areola) five times a day for 3 days. Both the groups’ data were collected after 4th day of delivery. Descriptive and inferential statistical methods were used to analyse the data.

 

RESULTS AND DISCUSSIONS:

The study findings showed that majority of the sample (73% and 80%) were in the age group of 21 – 25 years, 80 and 67% were educated, 87 and 73% were normal vaginal delivery. In experimental group 73% were inverted nipple whereas in control group 67% of them were inverted nipple.

 

1-Level of successful breast feeding among control and experimental group primipara mothers after Hoffman's exercise reveals that, in control group majority (80%) of primipara mothers were medium risk and 20% of them were low risk whereas in experimental group 73 0f them were low risk and 27% of them had medium risk.

 

2-Compare the effectiveness of Hoffman's exercise on successful breast feeding among experimental group primipara mothers in both the groups

 
The overall control groups mean score was (5.62±0.64) which was 56% whereas in experimental group the mean score was (7.77±1) which was 78%. It reveals the difference of 22%. It shows that hoffman’s exercises is found to be effective in successful breast feeding among primipara mothers. The paired ‘t’ test value was 6.82 which was statistically highly significant at p< 0.05 level. Brigham M. (2009), reported that, 86% of the respondents reported that the hofffman’s exercise helped them continue to breastfeed. The study concluded that exercise can be a useful lactation tool in maintaining the breastfeeding relationship until problems are resolved. These women were able to successfully breastfeed within one week.

 

 

Table. 1: Comparison of mean, SD and mean percentage of successful breast feeding scores of primipara mothers in control and experimental group

Primipara mothers

Max. Scores

Level of successful breast feeding

Difference in mean %

Control group

Experimental group

Mean

SD

Mean %

Mean

SD

Mean %

Latch-on

2

0.66

0.23

33

1.66

0.49

83

50

Length of time before latch-on and suckle

2

0.91

0.28

45

1.73

0.26

87

42

Suckling

2

0.92

0.16

46

1.52

0.67

76

30

Audible Swallowing

2

0. 96

0.25

48

1.63

0

82

34

Mom's evaluation

2

0.83

0.41

42

1.34

0.91

67

25

Total

10

5.62

0.64

56

7.77

1

78

22

 

 

 

 

3-There is no statistical significant association was found in post test scores of level of successful breast feeding among primipara mothers in control group and experimental group with demographic variables such as age, education, type of delivery and type of nipple at P<0.05 level of significance.

 

CONCLUSION:

The present study assessed the effectiveness of Hoffman’s exercises on successful breast feeding among primipara mothers. The study findings revealed that Hoffman’ exercises was effective in improvement of breast feeding among primipara mothers. It is simple, effective and safe method. This method practiced during antenatal it is more helpful for the mothers to enhance the breast feeding in post partum period. The study suggests that long term Hoffman’s exercise use will not cause any problems in the breast feeding.

 

REFERENCES:

1.        Annamma Jacob. A comprehensive text book of midwifery. 2nded. Bangalore: Jaypee Brothers medical publishers Pvt Ltd; 2005. p.243.

2.        Sanjeevana Amarsena. Incidence of breast and nipple abnormalities among primigravid women in Srilanka. Srilanka journal of child health. Srilanka: 2006; 51-4.

3.        Alexander J, Grant A, Campbell M. Randomised control trial of breast shells and Hoffman exercises for inverted and non protractile nipples. BMJ 1992: 304: 1030.

4.        Australian breastfeeding association. Breastfeeding with nipple problems. State of Victoria, Australia: 2010; 16(3):1-3.

5.        Brigham M. Mothers' reports of the outcome of exercises use. Human lactation Journal. India: 2009 Jun;13(2):100

 

 

 

Received on 11.02.2015          Modified on 17.03.2015

Accepted on 21.03.2015          © A&V Publication all right reserved

Int. J. Nur. Edu. and Research 3(2): April-June, 2015; Page 124-126