october 1-3, 2019, the ankara hotel abstract book · dr. melda Çelİk hacettepe university faculty...

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1. INTERNATIONAL CONGRESS OF "BREASTFEEDING REALITY"

October 1-3, 2019, The Ankara Hotel

Ankara

ABSTRACT BOOK

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CONGRESS PRESIDENTS

Dr. S. Songül YALÇIN

Dr. Başak TEZEL

CONGRESS SECRETARY

Nrs. Melek KILIÇ

*The Congress has been credited with 30 STE.

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ORGANIZATION COMMITTEE

Name SURNAME Institution

Dr. Songül YALÇIN Hacettepe University Faculty Of Medicine Department of Pediatrics, Social Pediatrics Unit

Dr. Başak TEZEL General Directorate of Public Health Department of Child and Adolescent Health

Nrs. Melek KILIÇ General Directorate of Public Health Department of Child and Adolescent Health Services / TEMAS Association

Dr. Mehmet Ali TORUNOĞLU United Nations International Children's Emergency Fund (UNICEF), Turkey

Dr. Kadriye YURDAKÖK Hacettepe University Faculty Of Medicine Department of Pediatrics, Social Pediatrics Unit

Dr. Canan TÜRKYILMAZ Gazi University Faculty Of Medicine Department of Pediatrics, Neonatology Unit

Dr. Suna OĞUZ Ministiry of Health ,Ankara City Hospital

Dr. Suzan YALÇIN Selçuk University Faculty of Veterinary Medicine, Department of Food Hygiene and Technology

Dr. Kanuni KEKLİK Ministry of Health General Directorate of Public Health Services Department of Migration Health Services

Dr. Gonca YILMAZ Ankara Memorial Hospital

Dr. Deniz SAYINER Osman Gazi University Faculty of Health Sciences

Dr. Melda ÇELİK Hacettepe University Faculty Of Medicine Deopartment of Pediatrics, Social Pediatrics Unit

Dr. İlknur GÖNENÇ Ankara University Faculty of Health Sciences

Hasan DENİZ Mother Child Education Foundation

Dr. Burcu KAYHAN TETİK İnönü University Department of Family Medicine / TEMAS Association

Dr. Funda SALGÜR Başkent University Department of Family Medicine / TEMAS Association

Lecturer Sinem CEYLAN Ankara Medipol University Vocational School of Health Services / TEMAS Association

Nrs. İlkay ZENGİN Ministry of Health General Directorate of Public Hospitals / TEMAS Association

RD. Şule ELİTAŞ University of Health Sciences Obstetrics and Gynecology Department Etlik Zübeyde Hanım Gynecology Health Application and Research Center / TEMAS Association

RM. Sibel KARAGÖZ Ministry of Health General Directorate of Health Services / TEMAS Association

Nrs. Hamide TOPÇU Ankara Provincial Health Directorate / TEMAS Association

RM. Elif BİLGE Ankara City Hospital / TEMAS Association

RM. Dilek BURBUT İstanbul Provincial Health Directorate / TEMAS Association

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INTERNATIONAL SCIENTIFIC COMMITTEE MEMBERS


Dr. Amirhossein YARPARVAR UNICEF, Iran

Dr. Jeffrey GOLDHAGEN ISSOP, USA

Dr. Tony WATERSTON ISSOP, United Kingdom

Nrs. Geraldine CAHILL IBCLC, Ireland

Dr. Ghada SAYED Cairo University, Egypt

Dr. Tomris CESUROĞLU Athena İnstitute ,VU Amsterdam University, the Netherlands

Dr. Sevil HAKİMİ Tabriz University of Medical Sciences, Iran

Nrs. Maria MONBERG FEENSTRA Department of Gynaecology and Obstetrics - D, Odense University Hospital, Denmark

SCIENTIFIC COMMITTEE


Dr. S. Songül YALÇIN Hacettepe University Faculty Of Medicine Department of Pediatrics, Social Pediatrics Unit

Dr. Başak TEZEL General Directorate of Public Health Department of Child and Adolescent Health

Nrs. Melek KILIÇ General Directorate of Public Health Department of Child and Adolescent Health

Dr. Kadriye YURDAKÖK Hacettepe University Faculty of Medicine Department of Pediatrics, Social Pediatrics Unit

Dr. Canan TÜRKYILMAZ Gazi University Faculty of Medicine Deopartment of Pediatrics, Neonatology Unit

Dr. Betül ULUKOL Ankara University Faculty of Medicine Department of Pediatrics, Social Pediatrics Unit

Dr. Aydan BİRİ Natural Birth Association

Dr. Özlem MORALOĞLU TEKİN Ministiry of Health ,Ankara City Hospital

Dr. Yaprak ÜSTÜN Etlik Zubeyde Hanim Women's Health Care, Training and Research Hospital, University of Health Sciences

Dr. Bülent ŞEKEREL Hacettepe University Faculty Of Medicine Department of Pediatrics, Pediatric Allergy Unit

Dr. Eda KÖKSAL Gazi University Faculty of Health Sciences Department of Nutrition and Dietetics

Dr. Emel ÖRÜN Yuksek İhtisas University

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Dr. Fatma Figen ÖZGÜR BÜLBÜL Hacettepe University Faculty of Medicine, Department of Plastic, Reconstructive and Esthetic Surgery

Dr. Merih ÇETİNKAYA Kanuni Sultan Suleyman Training and Research Hospital

Dr. Meryem TEKÇİÇEK Hacettepe University, Faculty of Dentistry, Department of Pediatric Dentistry

Dr. Murat AKIN Gazi University Faculty of Medicine General Surgery Department

Dr. Murat YURDAKÖK Hacettepe University Faculty of Medicine Department of Pediatrics, Neonatology Unit

Dr. Nazmi BİLİR Hacettepe University Faculty of Medicine Department of Public Health, retired.

Dr. Perran BORAN Marmara University Faculty of Medicine Department of Pediatrics, Social Pediatrics Unit

Dr. Selda HIZEL BÜLBÜL Kırıkkale University Faculty of Medicine Department of Pediatrics

Dr. Sevtap VELİPAŞAOĞLU Akdeniz University Faculty of Medicine Department of Pediatrics, Social Pediatrics Unit

Dr. Suna OĞUZ Ministiry of Health ,Ankara City Hospital

Dr. Tolga İNCE Dokuz Eylul University Faculty of Medicine Department of Pediatrics, Social Pediatrics Unit

Nrs. Selma ZİRAMAN Neonatalogy Nurses Association

RM. Nesibe UZEL YAR Anatolia Midwives Association

Dr. Ali HABERAL Başkent University Faculty of Medicine

Nrs. İlknur OKAY El Bebek Gul Bebek Association

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SUPPORTING ORGANIZATIONS

UNICEF

ISSOP

AÇEV

BASKENT UNIVESITY

GAZI UNIVERSITY

ANKARA MEDİPOL UNIVERSITY

ANKARA UNIVERSITY FACULTY OF NURSING

ASSOCIATION OF BIRTH IN NATURE (DOĞASINDA DOĞUM DERNEĞİ)

ASSOCIATION OF NEWBORN NURSING

ANATOLIA MIDWIFES ASSOCIATION

ELBEBEKGULBEBEK ASSOCIATION

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SCIENTIFIC PROGRAMME

Precongress Courses (in Turkish)

September 30, 2019

Course Name Course director Participants Breastfeeding Support and Leading

Motherhood

Melek KILIÇ Mothers

Pregnancy, Childbirth and Breastfeeding: Yoga

Workshop

Emel GÖKÇEN

ÇELİK

Midwife, Nurse,

Doctors

Relactation

Canan

TÜRKYILMAZ

Midwife, Nurse,

Doctors

Kangaroo Care and Baby-Friendly NIC

Approaches

Suna OĞUZ Midwife, Nurse,

Doctors

Methods to Facilitate Birth and Birth Positions

Nesibe UZEL Midwife, Nurse

Basic Approaches of Newborn

Ebru TEMİZSOY Nurse

September 30, 2019

16:00-19:00 Registration

18:00-19:00 Opening Speeches

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October 1, 2019

07.30-08.45 Registration

08.45-09.30 Conference Chair: S. Songül YALÇIN

Breast-milk in The Nature and in The Human History

Murat YURDAKÖK

09.30-09.40 Discussion

09.40-10.20 BACK TO THE BREASTFEEDING IN THE WORLD AND IN TURKEY

Chairs: Geraldine CAHILL, Kadriye YURDAKÖK

Update on Infant Breastfeeding Status Around the World: Challenges, Possible Solutions

Jeffrey GOLDHAGEN

Breastfeeding Support Program in Turkey: From the Beginning to the Present

Başak TEZEL

10.20-10.40 Coffee Break

10.40-11.40 BREASTFEEDING CODE IMPLEMENTATIONS Chairs: Gonca YILMAZ, Bekir KESKİNKILIÇ

Why a Breastfeeding Code and What does It Say? Gonca KESKİNDEMİRCİ

Violation of BF Code by Pediatricians and Pediatric Societies; How to Prevent, UK Experience.

Tony WATERSTON

Breastfeeding and Child Rights Jeffrey GOLDHAGEN

11.40-13.00 THE IMPACT OF HEALTH PERSONNEL ON THE INITIATION OF EARLY BREASTFEEDING

Chairs: Ali HABERAL, Sinan BEKSAÇ

Obstetrician and The Support of Breastfeeding Yaprak ÜSTÜN

Midwifery and Breastfeeding Support Deniz SAYINER

Influence of Birth Type on Breastfeeding Practices: Obstacles and Benefits

Geraldine CAHILL

Maternal Antibiotic Use During Pregnancy, Childbirth and Postpartum Period: Is It Rational?

Özlem MORALOĞLU TEKİN

13.00-14.00 Lunch

14.00-15.00 BREAST-MILK SHARE: PROS AND CONS Chairs: Gülbin GÖKÇAY, Esin KOÇ

Breast-Milk Banking Sertaç ASLANOĞLU

Different Breast-Milk Banking Experiences Sevil HAKİMİ

Breast-Milk Share Canan TÜRKYILMAZ

15.00-16.00 BREASTFEEDING AND BIO-PSYCHO-SOCIAL HEALTH

Chairs: Jeffrey GOLDHAGEN, Mehmet Ali TORUNOĞLU

Breastfeeding and Early Childhood Development: What Can Be Done?

Amirhossein YARPARVAR

Effects of Breastfeeding and Human Milk on Brain Development

Nesrin ŞENBİL

Breastfeeding and Lifelong Psychological Health Dilşad FOTO ÖZDEMİR


16.20-18.00 KNOWN CONTENT OF HUMAN BREAST-MILK AND SPECIAL CONDITIONS

Chairs: Suna OĞUZ, Adem AYDIN

Olygosaccharides of Human Breast-Milk Sevtap VELİPAŞAOĞLU

Human Breast-Milk and Microbiota Meltem DİNLEYİCİ

Human Breast -Milk and Immunology Emel ÖRÜN

Metabolic Diseases and Breastfeeding Selda HIZEL BÜLBÜL

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October 2, 2019 08.30-09.00 Conference Chair: S. Songül YALÇIN

Clinical Trials in the Use of Sucrosomial Iron Germano TARANTINO

09.00-12.40 BREASTFEEDING COUNSELLING WORKSHOP (in Turkish)

09.00-10.20 TRANSITION TO EXCLUSIVE BREASTFEEDING Chairs: Emel GÜR, Canan TÜRKYILMAZ

The Effects of Artificial Feeding on Mother-Infant Dyads

Merih ÇETİNKAYA

Breastfeeding Transition Protocols For Artificially-Fed Infants

Suna OĞUZ

Relactation and Induced Lactation Ghada SAYED

Optimal Latching Technique For Effective Breastfeeding

Perran BORAN


10.40-11.40 BREASTFEEDING AND SPECIAL CIRCUMSTANCES

Chairs: Nilgün KÜLTÜRSAY, Aydan BİRİ

Support of Breastfeeding in Neonatal Intensive Care Units

Mehmet Yekta ÖNCEL

Food Allergies and Breastfeeding Bülent ŞEKEREL

Maternal Communicable Diseases (AIDS, HIV, Hepatitis B, Hepatitis C) and Breastfeeding

Melda ÇELİK

11.40-18.00 BREASTFEEDING ADVERTISEMENT WORKSHOP

11.40-13.00 Oral Presentations Chairs: Emel ÖRÜN, Tolga İNCE, Meda KONDOLOT, Perran BORAN

13.00-14.00 Lunch

14.00-14.20 Poster discussions Chair: İlker GÜNAY

14.00-14.20 Supporting New Parents Who are Ddischarged Early After Birth by Using App

Maria Monberg FEENSTRA

Selected Presentation: Factors Associated with Pre-lacteal Feeding Practices in Infants; Secondary Analysis of TNSA2013

Nilgün ÇAYLAN

14.20-15.20 BREASTFEEDING SUPPORT IN INFANTS LIVING UNDER DIFFICULT CIRCUMSTANCES

Chairs: Kanuni KEKLİK, M. Bahadır SUCAKLI

Breastfeeding in Emergencies Mehmet Ali TORUNOĞLU

Breastfeeding and Refugees

S. Songül YALÇIN

Refugee Health Programs in Turkey Kanuni KEKLİK


15.40-17.00 BREASTFEEDING AND NUTRITION Chairs: Türkan GÜNAY, Nevin ŞANLIER

Nutrition and Micronutrient Supplementation During Pregnancy and Lactation

Eda KÖKSAL

Micronutrient Supplementation in Breastfed Infants Tolga İNCE

Complementary Feeding Seda TOPÇU

Rational Use of Antibiotics Meda KONDOLOT

17.00-18.30 Oral Presentations Chairs: Meltem AKÇABOY, İlker GÜNAY, Suzan YALÇIN

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October 3, 2019 08.00-09.00 Oral Presentations Chairs: Türkan GÜNAY,

Suna OĞUZ, Ahmet ERGİN, Suzan YALÇIN

09.00-09.40 Conference Chair: Sevgi BAŞKAN

Breastfeeding and Environmental Pollution Kadriye YURDAKÖK

09.40-09.50 Discussion

09.50-10.50 DENTAL HEALTH OF PREGNANT, LACTATING MOTHER AND SUCKLING INFANT

Chairs: Betül ULUKOL, Hilal ÖZCEBE

Oral and Dental Health During Pregnancy Meryem TEKÇİÇEK

Oral and Dental Health and Breastfeeding Tülin İLERİ KEÇELİ

Oral and Dental Health During 0-2 Age Period Melek TURGUT

10.30-12.30 REALITIES AND MYTHS IN BREASTFEEDING (in Turkish)


11.10-12.30 DIFFERENT DISCIPLINES AND THEIR APPROACH TO BREASTFEEDİNG

Chairs: Altuğ TUĞ, Vedat KÖSEOĞLU

General Surgery and Breastfeeding Murat AKIN

Plastic Surgery and Breastfeeding Fatma Figen ÖZGÜR BÜLBÜL

Psychiatric Health and Breastfeeding Mevhibe İrem YILDIZ

Physioterapy, Pregnant and Lactating Mother Serap ÖZGÜL

12.30-13.30 Lunch

13.30-14.00 Conference Chair: İlker GÜNAY

The Role of the Father in the Initiation and Maintenance of Breastfeeding

Hasan DENİZ

14.00-15.40 BEİNG BABY-FRIENDLY Chair: Başak TEZEL, Sarp ÜNER

Legal Status in Breast-Milk and Breastfeeding Nazmi BİLİR

Primary Health Care Institution Baby-Friendly Practices

Funda SALGÜR

Baby-Friendly Practices in Maternity and Children Hospitals

Burcu KAYHAN TETİK

Engagement of Baby-Friendly Initiative Into Health Service Quality Programs

Sinem CEYLAN

Baby-Friendly and Civil Society, Mother to Mother Support Groups

Melek KILIÇ


16.00-16.30 Congress Notes Chairs: S. Songül YALÇIN, Başak TEZEL, Melek KILIÇ

Presentation on the Report of Breastfeeding Counselling Workshop

Workshop Secretary

Presentation of the Report of Breastfeeding Advertisement Workshop

Workshop Secretary

16.30-17.00 Congress Final Declaration, Award Ceremony and Closing

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October 2, 2019

BREASTFEEDING COUNSELLING WORKSHOP

09.00-12.00 Opening and aims of Workshop Chairs: Melek KILIÇ

09:00-09:20 Literature of breastfeeding counselling Sinem CEYLAN

09.20-11.00 Workshop groups

Group I Breastfeeding Counselling Practices in Health Care Organizations, Breastfeeding Counsellors Working Conditions, Payments and Into a private group

Chairs: Dilek BURBUT Reporters: Hamide TOPÇU, Rukiye DURSUN ALTIN, Burçin ARICAN UÇ

Group II

Who is Called Breastfeeding Consultant? What Skills and Training Should They Have?How the Training Model and Certification Should be?

Chairs: Meltem AKÇABOY Reporters: Sibel KARAGÖZ, Emel GÖKÇEN ÇELİK

Group III Breastfeeding Counseling Practices and Legislation Abroad, Comparison with the Situation in Turkey

Chairs: Nesibe UZEL YAR Reporters: Funda SALGÜR, Elif BİLGE, Şule ELİTAŞ

Group IV Breastfeeding Counselling in Turkey in which SWOT Analysis Intersectoral Cooperation Institutions Must Be, Roles

Chairs: Nilgün ALTUNTAŞ Reporters: İlkay ZENGİN, Huriye KAAN GÜVEN, Selma ZIRAMAN

11.00-12.00 Presentations of group studies Development of a joint action plan

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October 2, 2019

BREASTFEEDING ADVERTISEMENT WORKSHOP*

11.40-13.00 Opening and aims of workshop Chairs: S. Songül YALÇIN, Dilek HAZNEDAROĞLU

How to create media contribution for breastfeeding support

Nezih ORHON

A case for combating inappropriate marketing practices of infant formula over social media

Tomris CESUROĞLU

13.00-14.00 Lunch

14.00-17.00 Workshop groups

Group I How to gain media literacy on breastfeeding and infant nutrition to mothers [Annelere emzirme ve bebek beslenmesi konusunda medya okur yazarlığı nasıl kazandırılma yolları]

Chairs: Dilek ASLAN Reporters Özlem TEZOL, Bülent GÜNEŞ

Group II

Advertising breastfeeding and ways of promoting at the community level [Emzirmenin reklamı ve toplum düzeyinde teşvik yolları]

Chairs: Serpil Uğur BAYSAL, E. Nezih ORHON, Arzu DURSUN Reporters Beril AYDIN, İzzet ERDAL

Group III Advertising and promotion of breastfeeding at the level of health care institutions and employees [Emzirmenin sağlık kuruluşları ve çalışanları düzeyinde reklamı ve teşviki]

Chairs: Ahmet ERGİN, Defne ENGÖR, Burcu KAYHAN TETİK Reporters: Ayşe TOLUNAY OFLU, Ertan DEĞİRMENCİOĞLU

Group IV How to ensure the legal dimension and intersectoral cooperation in supporting breastfeeding [Emzirmenin desteklenmesinde hukuki boyut ve sektörlerarası işbirliği nasıl sağlanır]

Chairs: Nazmi BİLİR, Dilek HAZNEDAROĞLU, Aytül NOYAN Reporters Nilgün ÇAYLAN, Meryem Erat NERGİZ

Group V How can consensus be achieved in different disciplines? [Farklı Disiplinlerde Dil Birliği Nasıl Sağlanabilir?]

Chairs: Suzan YALÇIN, Vedat KÖSEOĞLU, Özlem BAĞ Reporters Atakan TANAÇAN, Tolga ÇELİK

17.00-18.00 Presentations of group studies Development of a joint action plan

*Workshop was supported by TUBITAK 2223-B Project; 1929B021900809.

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October 3, 2019 Realities and Myths of Lactation Symposium

Chairs: Melek KILIC

Conference

10.30 –10.55 Breast Problems S. Songül YALÇIN

10.55-11.15 Effects of Artificial Nutrition Canan TURKYILMAZ

11.15-11.40 Sustaining Lactation and Worries Pertaining to

Maternity

Tomris CESUROGLU

11.40-12.00 Expectations from Baby Friendly Hospitals Melek KILIC

12.00-12.20 Importance of Lactation Sule ELİTAS

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CONGRESS HONOR AWARD of THE 1. INTERNATIONAL CONGRESS OF

"BREASTFEEDING REALITY"

Prof. Dr. Ufuk BEYAZOVA

Dr. Dilek HAZNEDAROĞLU

HONOR AWARD of TEMAS ASSOCIATION

Prof. Dr. Ufuk BEYAZOVA

Prof. Dr. Gülbin GÖKÇAY

Prof. Dr. Betül ULUKOL

Dr. Dilek HAZNEDAROĞLU

RM. Ayşen OUZHAN ÇAKMAK

RM. Helen CAMUZ

Nrs. Nalan DEMİRCAN

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BEST PAPER AWARD

Sevda GÜRSEL, Güler KUŞÇU GÜNAY, Serap HİRA, Hatice KAVAS, Emine

ÇOLAK. The Effects of The Usage of Mobile Health Services for The Educational

Sessions on Pregnants and Puerperas About The Importance of Breast Milk

INCENTIVE AWARDS

Arzu AKPINAR, Hatice BALCI YANGIN, Havva ÇAKMAK, Fatma Ç. ÖZDÖL,

Mustafa AKÇAKUŞ. Breastfeeding success in preterm babies

Gül Demet KAYA ÖZÇORA, Gonca BEKTAŞ. The relationship between breast milk

intake and speech in children with cerebral palsy

Şeyma ÇİÇEK, S. Songül YALÇIN. Relationship between duration of breastfeeding

and emotional and behavioral problems of children

Asiye ARISOY. Monitoring Of Infant Feeding Processes

Elif ÖZYAZICI ÖZKAN, Canan TÜRKYILMAZ, Münci YAĞCI, Esin KOÇ, Ebru

ERGENEKON, Esra ÖNAL, Yıldız ATALAY. The relationship of subtypes of

leukocyte within the prenatal, natal and clinical risk factors assessed by flow

cytometric method at the colostrum

Birgül SAY. Kangaroo mother care: two years of experience in low birth weight and

preterm infants

Gökçen ÖRGÜL, Dilek ŞAHİN, Aykan YÜCEL. Impact of gestational diabetes

mellitus on breastfeeding attitude in a Turkish population

Ganime AYAR, S. Songül YALÇIN, Özge TANIDIR ARTAN. Effects of

breastfeeding on strengths and difficulties in children with specific learning

difficulties

Mehmet Sabri KIRIK, Suat TUNCAY, Engin YILMAZ, Başak CEVİZ. Evaluation of

video education for mothers in a baby-friendly state hospital

Nihan ÇAKIR BİÇER, Melike ERSOY. Breastfeeding practices in medical nutrition

treatment of phenylketonuria

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10.01.2019_ 18:15 HALL 1-- ORAL PRESENTATIONS

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Factors Associated with Pre-Lacteal Feeding Practices in Turkey

Nilgün ÇAYLAN1*, S. Songül YALÇIN2, Suzan YALÇIN3

1Ministry of Health, Child and Adolescent Health Department, Ankara; 2Hacettepe University Faculty of

Medicine, Department of Pediatrics, Social Pediatrics Unit, Ankara; 3Selçuk University Faculty of

Veterinary Medicine, Department of Food Hygiene and Technology, Konya, Turkey.

Objectives: Pre-lacteal feeding (PLF) can be defined as any solid or liquid food, other than breast milk

given to newborns before breastfeeding starts within the first three days after delivery.

The aim of this study is to analyze 2013 Turkey Demographic and Health Survey data which is a nationally

representative study to exploring factors associated with PLF.

Methods: Ever breastfed infants born in the past 24 months preceding the survey were included in the

study (n=1254). Data were analyzed using SPSS for Windows (version 22). Weighted case numbers and

percentages were calculated. Maternal and infant factors for giving PLF were analyzed by using complex

logistic multiple sample regression.

Results: Thirty two per cent of the mothers were within the ages of 25-29 years at the time of birth and

54.3% of mothers had secondary and above education. The prevalence of timely initiation of breastfeeding

(within one hour after delivery) was 65.9%. The overall prevalence of PLF was 34.4%. The most common

types of PLF were infant formula (77.5%) followed by sugar/glucose water (13.7%), other PLF (8.2%). In

the multivariable analysis, initiation of breastfeeding 24 hours after delivery had 16.05 times the odds of

giving PLF compared with initiation of breastfeeding within 1 hour (95% CI 9.47-27.22). Other factors that

were significantly associated with increased likelihood of PLF were caesarean section, delivery at home,

paternal age above 40 years, Arabic and other mother tongue, status of non-request for another child.

Belonging to the fourth wealth quintile was associated with lower likelihood of PLF compared with the

highest quintile (AOR: 0.59; 95% CI [0.35-0.99]).

Conclusions: Although the timely initiation of breastfeeding after delivery relatively high in under 2 years

old infants, one of every 3 children who were breastfed received foods other than breast milk during the

first 3 days of life. To eliminate suboptimal breast-feeding practices, interventions targeting to decrease

PLF rate is among vital importance issues. Counseling on breastfeeding during antenatal visits, postnatal

lactation management support and social support should be provided to all mothers.

Keywords: Breastfeeding, pre-lacteal feeding, formula

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10.02.2019_ 11:40-13:00 HALL 1- ORAL PRESENTATIONS

S03

Evaluation of the effect of pre-birth music/speech therapies on the mother-baby

relationship

Özer SÖNMEZ1* 1Özel ADN İnternational Hospital, Gaziantep,Turkey

Objective: The feeling that connects the person to important people in his / her life is called “attachment”

and the feeling of love and attachment between the baby and mother is called “secure attachment”. Secure

attachment enables the mother to feel confident and establish social relationships. The bond established

with the baby may begin during pregnancy for the mother or may develop in the weeks following birth. The

aim of this study was to evaluate the effects of prenatal music and speech therapies on mother and baby

relationship and mental health.

Methods: This study was carried out with pregnant and puerperal individuals who came to 3 gynecology

and obstetrics outpatient clinics in ADN International Hospital.

Results: In the study conducted with 75 pregnant women and 87 puerpera patients who were admitted to

the outpatient clinic, a questionnaire was applied to the individuals. As a result of the survey, 27 of 75

pregnant women talked with their baby in their pregnancy, 22 of them said that they both played music and

talked to their baby and 26 of them stated that they did not do any of these. On the other hand, in a

questionnaire study conducted with 87 puerpera, 37 of them stated that speech therapy with their baby in

their pregnancy, 24 of them stated that their baby was an active baby after birth and 16 of them did not

apply any therapy. and that it is having difficulty in bonding with her baby and this affects her mental

health in her relationship with her baby.

Conclusion: The baby starts to hear external sounds in the womb at about 18 weeks. In other words, when

the babies are born, they recognize the sounds they hear during pregnancy. A survey of 75 pregnant women

and 87 puerperians showed that music listening and speech therapies initiated the bond between mother and

baby when administered before birth and strengthened this bond after birth. In addition, music listening and

speech therapies reinforce the sense of motherhood, as well as positive effects on mother-baby mental

health and facilitate the connection between mother and baby.

Key words: Pregnancy, Therapy, Mother-Baby relationship

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S04

Nutritional Supplement Usage and Affecting Factors of Breastfeeding Mothers

Dilek ORBATU1*, Demet ALAYGUT 2, Oya BALTALI 3

SBÜ Tepecik Training and Research Hospital 1Department of Pediatrics; 2PediatricNephrology; 3Department of SocialPediatrics

Objective: The diet content of the mother during pregnancy and lactation are supports used for different

reasons for pregnant, breastfeeding mother and baby. The aim of this study was to evaluate the use of

nutritional supplements and non-vitamin products in breastfeeding mothers.

Methods: The study was carried out by applying a questionnaire to the mothers who came to the outpatient

clinic between April 2019 and July 2019 in the Healthy Child Monitoring Policlinic of of Tepecik Training

and Research Hospital. All mothers who had breastfeeding at least once were included in the study.

Results: A total of 312 mothers were included. The mean age was 27.15 ± 5.85 (17-45) years. When

education level was evaluated, 21.8% had no education. Income level was low (63.1%). 63 cases were

immigrants. While 259 cases were followed up during pregnancy, only 94 (30.1%) of all cases had

breastfeeding training. While 217 patients used nutritional supplements during pregnancy, 47 (15.1%)

patients used nutritional supplements during lactation. The use of iron and vitamin D during lactation was

markedly low (7.1% and 6.4%, respectively). The use of non-vitamin products was mostly in the form of

plant extracts during both pregnancy and lactation period (5.1% and 8.3%, respectively). Participants

reported the most common reason for use as health protection and the protection health of the baby.

Nutritional support use during pregnancy and middle income level increased significantly as the duration of

education increased (p <0.001). The highest level of vitamin mineral use was found in the middle income

level (p< 0.001). Iron (p = 0.002), vitamin D (p = 0.002) and B12 use (p = 0.003) were increased in the

education period of 12 years or more. Breastfeeding support product usage was significantly increased as

the education period increased (p = 0.05). However, there was no significant relationship between iron,

multivitamin, vitamin B12 and vitamin D intake and duration of education (p> 0.05). While there was a

significant relationship between income level and iron use during pregnancy, there was no correlation

between multivitamin, vitamin B12 and vitamin D use. In the breastfeeding period, the use of iron was

significantly higher in the moderate income group compared to the high and low income group (p = 0.03).

While being a immigrant decreased the use of iron and vitamin D in pregnancy, iron, vitamin D and

multivitamin use were significantly reduced in lactation period.

Conclusion: In our study, the use of vitamins and minerals was found to be low in nursing mothers. The

use of vitamin and mineral supplements during pregnancy and lactation, where nutrition is important,

should also be supported. In addition to breastfeeding training, it is important to provide training on

nutrition and vitamin-mineral use.

Keywords: breastfeeding mother, nutritional support, vitamin, mineral

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S05

Breast Milk and Breastfeeding Consultancy and Experiences in Primary Care

Fatima ÇELİK1*

1Batman Provincial Health Directorate Public Health Presidency Services, Batman, Turkey

Objective: Supporting breast milk and breastfeeding, reaching every mother in the field and ensuring that

babies get the right breast milk is essential for public health and is one of the investments made by health

workers for the future. In this study, it is aimed to assess the experiences and problems about breastfeeding

encountered by family physicians and family health workers in the field from their point of views.

Materials and Methods: Thirty two FHCs, including the central districts and villages of Batman, were

visited between the months of April and May, 2019. During these visits, face to face interviews were

conducted with family physicians and family health workers and their experiences about breastfeeding

were evaluated and problems in primary care were also discussed.

Results: Some issues emphasized by health care workers during these visits. Firstly, they told that parents

obtain their information about breast milk and breastfeeding mostly from social media and internet sites

and they get wrong information about food. It is stated that mothers' ‘milk is not enough’ concern is caused

by environmental pressure and the mother cannot resist and starts to feed with formula spontaneously.

After the caesarean section, pediatricians think as ’milk release will be late’, so they start to feed with

formula in hospital and the family continue feeding with bottle after discharge. Primary health care workers

think that early access to formula (between 1 week and 1 month) are discouraged with good counseling, but

breast rejection develops in infants who take longer (more than 1 month). Family physicians want to take a

common decision with pediatricians and they want to work together in this direction. The perception of

'overweight baby is a healthy baby' is the biggest problem of FHCs for families to begin feeding. It was

observed that because of the temperature was raised to 48 degrees in the summer months, water was given

to infants under six months, especially newborns. Parents say that pediatricians recommend it. In Batman,

families start supplement foods in the fourth month. Both working mothers and housewives start the

supplementary food early, families do not see water as an additional food. It was observed that it is a high

rate of pregnancy during breastfeeding and therefore mothers stop breastfeeding their babies. They think

that breast milk is not useful after the age of one and a half years. Mothers stop breastfeeding before their

children are two years old because they want pregnancy. Family physicians state that there is information

that pacifier has a preventive effect on sleep apnea. They are not sure about the use of pacifiers.

Conclusions: Breastfeeding problems are not just primary care issues. All health institutions, as well as

pediatricians need to take responsibility together and support breastfeeding. It is recommended that the

media should be used more actively to create awareness in families.

Key words: breast milk, breastfeeding, consultancy, primary care

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19

S06

Breastfeeding problems of new childbearing women in early postpartum

Dilek ÇAKMAK TOP1*, Tuba KUTLU1, Yasemin ALTUN1

1Beylikdüzü State Hospital, İstanbul, Turkey

Objective: Breastfeeding is very useful for mother and baby health. Postpartum period is an important

process in which the mother gets used to a new situation. During this period, one of the problems that the

mother has to deal with is breastfeeding. Timely diagnosis of this problem, which causes consequences

such as infection, engorgement, mastitis, and inability to feed the baby when it is not adequately guided, is

important for both mother and baby health. In our study, we examined breastfeeding problems based on 3

different factors: breast, mother and baby.

Method: The study was an observational study and prepared by lactation nurse (researcher) in gynecology

outpatient clinics and clinics of Beylikdüzü State Hospital between 01/06/2019 and 01/072019. The sample

was selected purposefully among all women who applied to lactation nurse. The questionnaire form

organized by researcher. Data collecting were one-on-one interviews by researcher. Institution permissions

of the study were obtained from the required units. Data analysis made with SPSS program.

Results: In our study, it was found that most mothers had breastfeeding problems in the postpartum period

and these problems were caused by factors related to mother, baby and breast.The mean age of the mothers

was 27 years. 55% of mothers had normal birth and 44% had caesarean section. Most mothers (35%) had

two pregnancies and had two children (38%). 12% of the mothers had a history of abortion and most of

them (39.5%) delivered at 39 weeks of gestation. The birth weight of most babies (67.5%) is between

3000-4000gr. The breastfeeding problems of the mother and the baby. According to this, the most common

problems related to the mother were redness in the breast (93.5%), inability to position the baby (91%),

mothers 'not enough milk' (63%), and restriction (17%). The most common problems associated with the

baby are; hyperbiluribinemia (11%), baby's health problems (8.5%), weight loss (8%).

Conclusion: Breastfeeding training given to mothers in postpartum period is thought to be important in

order to reduce breastfeeding problems. Starting from the prenatal period, all pregnant women were trained

in pregnant schools. Breastfeeding counseling, which is known as lactation nursing in health institutions,

helps mothers to switch to early breastfeeding and to extend the period of breastfeeding and to support

mothers' anxiety and adaptation to their new roles. If midwives and nurses support mothers in breastfeeding

and provide training and counseling services, we can ensure that newborns are fed more with colostrum

with the most appropriate content for healthy growth and development and that breastfeeding is extended.

It is thought that breastfeeding problems will decrease with individualized and continuous education and

support given to mothers, and that mothers can breastfeed their babies more effectively and babies can be

healthier.

Key words: Breastfeeding problems, postpartum, breastfeeding training

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20

S07

The Effects Of The Usage Of Mobile Health Services For The Educational Sessions On

Pregnants And Puerperas About The Importance Of Breast Milk

Sevda GÜRSEL1, Güler KUŞÇU GÜNAY2*, Serap HİRA2, Hatice KAVAS2, Emine ÇOLAK2 1Serdivan District Health Director, Sakarya, Turkey, 2Serdivan District Health Directorate Staff, Sakarya,

Turkey

Objective: In order to make the health services provided to mobile areas in the Serdivan district of Sakarya

rural, the importance of breast milk and trainings aimed at increasing breast milk intake (0-6 months) were

organized. In this context, the mobile health services and to gain a new awareness of the role model in

Turkey it is planned to contribute to the implementation of the general.

Method: This study was carried out on pregnant women and pregnant women determined in Selahiye,

Yukarıdere, Aşağıdere, Esentepe, Çubuklu, Kazımpaşa, Meseli, Kuruçeşme, Uzunköy, Reşadiye,

Hamitabat Dağyoncalı, Mahmudiye, Kızılcıklı, Beşevler mobile regions of the Sakarya Serdivan

countryside. 60 pregnant women and 20 puerperians between the ages of 18-44, who are not literate and

master and who have no verbal communication problems were given individual trainings. Our study lasted

approximately 6 months. Pre-test and post-test (10 days after the training) were applied to pregnant and

puerperians that we determined in mobile service area, which consisted of 20 questions about the

importance of breastmilk, the importance of colostrum, when to start breastfeeding, how long the

breastmilk should be given only and questioned how long it would be given. Knowledge level of the

respondents who answered at least 18 questions correctly was evaluated as “good”. The total number of

correct lines was 15-16 and the lar intermediate ”level was evaluated. Those with the correct number of

questions below 15 were considered to have “inadequate” knowledge.

Results: According to the pre-test results of the questionnaires conducted on pregnant women, 71.7% had

good knowledge, 18.3% had moderate knowledge and 10% had inadequate knowledge. In the last test

results, the knowledge level of 91.7% increased to “good” and 8.3% of the information level increased to

“medium”. In the pre-test results of the questionnaires applied on the puerpera, 90% had a “good” level of

knowledge and 10% had a “moderate” level. According to the latest test results, the knowledge level of

100% increased to “good” level. The knowledge of the pregnant women and their puerperians who had

moderate and inadequate level of knowledge increased the importance of breast milk, that only breast milk

should be given for the first 6 months and that breastfeeding periods should be continued for 24 months.

Conclusion: By introducing a different perspective to mobile health care, awareness has been created to

include breast milk trainings in the service. It is recommended that all mothers, regardless of their level of

education, receive active training by specially trained health personnel in the antenatal and early postnatal

periods.

Key words: breast milk, health service, mobile, puerperians

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S08

Kangaroo mother care: two years of experience in low birth weight and preterm infants

Birgül SAY1* 1Department of Neonatology, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey

Objective: Twenty million infants born with low birth weight due to preterm delivery or intrauterine

growth retardation. Kangaroo Care (KC) is a method providing attachment of the mother and infant,

facilitating the adaptation of the premature infant to an external environment. In this study, we aimed to

evaluate the clinical effects of kangaroo care in infants between 32 and 37 gestational weeks who were

followed-up and treated in the newborn intensive care unit (NICU).

Methods: A total of 208 late preterm infants born at 32 to 37 gestational weeks between September 2016

and September 2018 were retrospectively studied. Kangaroo care was given by the mothers to the infants

with stable vital findings (body temperature, heart rate, saturation values, and respiratory parameters) who

were receiving minimal or non-invasive respiratory support. Infants with major life-threatening

malformation and perinatal asphyxia were excluded from the study. Patients were divided into three groups

based on the number of kangaroo cares they received in a week. Premature infants receiving less than three

kangaroo care in a week were classified as intermittent kangaroo (Group 1), infants receiving more than

three kangaroo cares in a week were classified as continuous kangaroo (Group 2), and the infants receiving

no kangaroo care were put into control group (Group 3).

Results: The time to transition to full breastfeeding [median (min-max)=5(1–26)days)], and time to

discharge [median (min-max)=9 (3–32) days] in the Group 2 were significantly shorter compared with the

group 1 [median (min-max)=7 (0-20) ;13 (8–33) days] and group 3 [median (min-max)=8 (3-25 ; 21 (11–

53) days], respectively, (p<0.05).

Conclusion: Kangaroo care is a safe care model that provides contact between the mother and the infant in

the earliest period, and shortens the duration of hospitalization for the infants at risk. Therefore, kangroo

care should be involved in nursing standards.

Keywords: Kangaroo mother care, low birthweight, preterm birth, breastfeeding

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22

S09

Investigation of the Perceptions of Healthcare Personnel On The Effects of Social Media

on Breastfeeding Support

Melda ÇELİK1*, S. Songül YALÇIN1, Kadriye YURDAKÖK1

1Hacettepe University Faculty of Medicine, Department of Pediatrics, Social Pediatrics Unit, Ankara,

Turkey

Objective: Social media may effect attitudes, behaviors, and beliefs on breastfeeding. We aimed to

understand the perceptions of healthcare personnel on the effects of social media on breastfeeding support.

Method: Healthcare personnel participating in the Breastfeeding Counseling Courses organized by

Hacettepe University Social Pediatrics Department on October 2018 and July 2019 were included in the

study. They were asked to make a search of “breast-milk” and “breastfeeding” on their favourite social

media platforms between 18:00-20:00 in the evening of the first course day and select 2-4 news or sharings

about breastfeeding and breast milk that attract them and to write evaluations on whether these media

include positvity for breastfeeding support. Then they mailed them to the two course fascilitators who made

their evaluations separately.

Results: Sixty-seven healthcare personnel consisting of 27 nurses (19 from pediatric, 6 from obstetrics and

gynecology departments) and 40 doctors (22 pediatry assistants, 13 obstetrics and gynecology assistants, 5

public health and family medicine assistants) participated in the study. Fifty-seven (85%) were female. The

participants selected 242 media with a median of 3 (1-7) and a mean of 4 per capita. Sources were 83

(34.3%) instagram, 57 (23.6%) internet news, 37 (15.3%) official web sites, 27 (10.7%) personal blogs, 22

(9.1) Facebook and 4 (1.7%) Youtube. One hundred thirty-nine (57.7%) of the media included article with

image (photograph, picture, etc.), 64 (26.6 %) only article, and 38 (15.8 %) only image. The most common

topics were 32% (78) benefits of breast-milk, 16.5% (40) methods of giving breast-milk, 16.1% (39)

formula, 10.8 % (26) bottle, and 7.9% (19) duration of breastfeeding. Forty-seven (19.4 %) contained

commercials 66 % of which were obvious, 34 % were masked. While the participants evaluated nearly half

of the media as including positivity for breastfeeding, a quarter made no comment. One-hundred sixty-five

(68.2%) of the media evaluated by the fascilitators thereafter were determined to include positivity

although 75 (31%) included negativity. The inter-rater reliability between the participants and fascilitators

was found almost perfect (kappa coefficient:0.83).

Conclusion: There are news or sharings that effect breastfeeding negatively in social media platforms. It is

important to increase the sensitivity of the heathcare personnel, who frequently encounter with

breastfeeding mothers and give counselling, against this kind of media. In our study, it was observed that

training applied to the healthcare personnel constitutes high sensitivity.

Key words: breastfeeding, healthcare personnel, perception, social media.

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10.02.2019_ 17:00-18:30 HALL 1- ORAL PRESENTATIONS

S10

Evaluation of the Music’s and Oxytocin Massage Effects on the Breastmilk Production

of the Mothers of Premature Babies who are in the Neonatal Intensive Care Unit

Elif DAĞLI¹*, Neşe ÇELİK²

¹Çankırı Karatekin University, Eldivan Vocational School of Health Services, Çankırı, ²Eskişehir

Osmangazi University, Faculty of Health Sciences, Midwifery Department, Eskişehir

Objectives: This study aimed to evaluate the effect of music and oxytocin massage on breast milk secretion

in mothers of premature babies in the neonatal intensive care unit.

Methods: Designed in self-controlled experimental type, the study was conducted with 73 mothers who

hadpremature infants <34 weeks in the Neonatal Intensive Care Unit of the BalcalıHospital of Medical

Faculty at Çukurova University, March-August 2018. The study data were collected using Information

Form, Spielberger’s State-Trait Anxiety Inventory and Breastmilk Follow-up Form. All mothers were taken

to control, oxytocin massage and music sessions. In each session, both breasts were connected to the

milking pump at the same time and the amount of milk expressed was measured.Data were evaluated by

analysis of covariance,Sidak multiple comparison tests, and Pearson’s Correlation test. The statistical

significance level was accepted as 0.05.

Results: The mean age of the mothers was 31.22 ± 5.82 years. The birth week of the babies was 29.3 ± 2.1

weeks and chronological age was 20.7 ± 8.9 days. Breastmilk quantity measured were 34.0 +13.7 ml in

control session, 35.0 +14.6 ml in the oxytocin massage session, and 37.5 +15.3 ml in the music session. It

was found that mothers who were in the control session (38.3 ± 10.8) and oxytocin massage session (37.3 ±

11.0) were slightly anxious according to their State Anxiety mean scores and that those in the music session

were not anxious (33.0 ± 8.8). While the level of mothers’ State Anxiety decreased in the oxytocin massage

session and the music session, the amount of their breast milk secretion increased.

Conclusions: Music and oxytocin massage has a positive effect on increasing breast milk, which has a very

important place in the growth of babies and decreasing the anxiety of mothers relating to their premature

babies.

Keywords: Premature babies, breast milk, oxytocin massage, music, midwife.

https://r.search.yahoo.com/_ylt=AwrJRCBJRQBdXjUA5BsDjgx.;_ylu=X3oDMTByMnE1MzMwBGNvbG8DaXIyBHBvcwMzBHZ0aWQDBHNlYwNzcg--/RV=2/RE=1560327626/RO=10/RU=http%3a%2f%2fwww.discoveringstatistics.com%2fdocs%2fancova.pdf/RK=2/RS=XqLxIejw5zhQ2CPJ9zAFpfwAMdg-

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S11

Traditional breastfeeding practices; Systematic review

Öznur YAŞAR1* 1 Balıkesir University/ Faculty of Health Sciences / Obstetrics and Gynecology Nursing, Turkey,

Objectives: The importance of breastfeeding has been emphasized since the earliest sources. Tradition is a

cultural movement that has been carried from past to present, established a strong connection between the

individuals in a society, and been respected in a community as it carries the traces of the old times. The

study was conducted with the purpose of examining traditional breastfeeding practices from past to present.

Methods: The studies on traditional breastfeeding practices conducted between the years 2000 and 2019

were reviewed between the dates of 22-24 May 2019 on EBSCO-Host and CoHE (YÖK) by using the

keywords ‘breastfeeding, traditional practice, postpartum practices’. The universe of the study consisted of

367 studies. The obtained studies were evaluated in terms of their compliance with the inclusion (studies

with accessible research articles and full text) and exclusion (articles that were repeated twice, irrelevant

articles, systematic reviews) criteria. As a result of the evaluation, 15 studies constituted the study sample.

Results: According to the study findings conducted in Turkey, the most common method to increase breast

milk is drinking water- consuming liquid food (in five studies out of seven). Two studies conducted in

Turkey revealed that colostrum is not given to newborn traditionally and other types of nutrition apart from

breast milk are given in the first-feed period of the newborn. In a foreign study, women who were in the

postpartum period and provided care for a newborn highlighted different types of nutrition are given to a

newborn before breast milk. The review showed that three different studies conducted in Turkey indicated

that reciting azan is expected before breastfeeding of a newborn.

Conclusion: The findings of the reviewed studies revealed that traditional practices which might have

adverse impacts on the health of newborn such as not giving colostrum, and postponing breastfeeding, and

which do not have any positive impact on increasing breastmilk are still performed in Turkey. As a result of

the study, it is possible to argue that health professionals, particularly midwives and nurses working in the

field of women’s health, can make significant contributions to enhance newborn health and improve public

health by taking active roles in identifying inappropriate traditional practice and promoting good health

practices.

Keywords: breastfeeding, traditional practice, postpartum practices

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S12

Perinatal factors that influence early transition to oral feeding in preterm infants:

a retrospective study

İlkay ER1* 1Health Sciences University, Kocaeli Derince Traning and Research Hospital, Neonatology, Kocaeli,

Turkey

Objectives: Oral feeding is a major improvement during the care of preterm infants. These infants can only

be discharged from hospital when they are able to be safely and exclusively fed by oral route, which is an

important milestone in their development. We aimed to evaluate the perinatal factors that influence early

transition to oral feeding in preterm infants.

Methods: This retrospective study included Turkish preterm infants without any comorbidity and born at

˂37weeks of gestational age in our hospital between 2017-2018 years. Infants were categorized into two

groups regarding the timing of transition to oral feeding and the two groups were compared. Early oral

feeding group consisted of subjects that could be fed orally within the first three postnatal days and the rest

formed the late oral feeding group. Statistical findings were presented as median(IQR) and proportions, and

p<0.05 was considered statistically significant. Logistic regression analysis was used to determine the

independent perinatal factors affecting early transition to oral feeding.

Results: Of the 86 preterm infants, 48 were female and 38 were male. Maternal age was 30(26-34) years.

73.3% had cesarean section. Gestational age at birth and birth weight was 34(33-36)weeks and 2042(1853-

2475) grams, respectively. 25.6% were intubated, received surfactant and extubated. Duration of nasal

mechanical ventilation support was 1(0-3)days and duration of oxygen requirement was 3(1-5)days. All

started to receive breast milk within the first postnatal day. Duration to kangaroo care was 3(2-7)days.

Early transition to oral feeding was possible in %62.8(n=54). Duration to full enteral feeding was 6(4-10)

days and total duration of hospitalization was 10(7-18)days. When compared to the late oral feeding group,

more infants were at >33weeks of gestational age, >2000 g at birth, received no or minimal(≤1 day) nasal

ventilation support, required oxygen for ≤3 days, received kangaroo care within the first 3 postnatal days,

able to receive full enteral feeding within ≤7 days, and discharged within ≤10days in the early oral feeding

group (p<0.05). A birth weight >2000 g increased the chance of early transition to oral feeding 6 times,

while kangaroo care within the first 3 postnatal days increased 5 times. Whereas >1 day of nasal

mechanical ventilation support decreased the chance of early oral feeding 17 times.

Conclusions: Our findings suggest that increased birth weight and early kangaroo care positively effects

the ability for early oral feeding, whereas increased duration of nasal mechanical ventilation effects

negatively, in preterm infants without any comorbidity.

Key words: Early oral feeding, preterm infants, perinatal factors

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S13

The effect of cabbage leaves application on mothers having breast engorgement

Endam ÇETİNKAYA1*, Ümran SEVİL1, Demet TEREK2 1Ege University Faculty of Nursing, Women's Health and Diseases Nursing, Izmir,Turkey, 2Ege University

Faculty of Medicine, Department of Neonatology, Izmir, Turkey

Objective: In this study, our purpose is to define effects of cabbage application to mothers with

engorgement on pain, soothe the breast, amount of milk after milking with breast pump, anxiety level of

mother and satisfaction from cabbage application.

Methods: Universe of the study was included mothers of 315 hospitalized babies in second and third level

of a newborn intensive care unit between September 2018-January 2019. Power analysis was made to

define the sample number using with G*Power program. At least 11 mothers should be included to the

study according to the calculation. The study has been terminated after participation of 18 mothers. One

group experimental procedure was designed to evaluate effect of cabbage application on engorgement. One

of the mother’s breast was covered with cabbage leaf and applied for 2 hours. After the 2 hours of

application, milking of breasts was carried out with electric breast pump with the same speed and vacuum

settings. Mother Informing Form and State Trait Anxiety Inventory were used in the gathering of research

data.NCSS (Number Cruncher Statistical System) 2007 program was used for statistical analysis.

Results: When examined the relation of engorgement and breastfeeding/milking, five mothers were

affected less, five mothers were affected as medium level and eight mothers were affected more. Mean of

pain intensity 6.50±1.98 and 3.56±2.12, mean of soothe level 4.33±1.24 and 7.38±1.95, mean of

satisfaction level 4.72±1.71 and 7.94±2.10, mean amount of milking 30.06±29.24 mL and 46.44±34.99 mL

were found in mothers of cabbage applied group and cabbage not applied group, respectively. Pre-

application mean state anxiety inventory (SAI) score of mothers was 44.00±12.09 and mean trait anxiety

inventory (TAI) score was 40.94±6.93. Post-application mean SAI score of mothers was 34.33±8.76. It was

found that pain intensity of mothers with engorgement decreased in cabbage applied breast compared to

cabbage not applied breast significantly, soothe level, satisfaction level and milk amount were significantly

increased (p=0.001,p<0.01). It was determined that mothers with engorgement had significantly lower SAI

score in post-application compared to pre-application (p=0.001,p<0.01).

Conclusions: These results are pointing that cabbage leaf application may be effective on engorgement

treatment. However, further studies should be made because of the exact mechanism is unknown.

Researchers can study in with different study design on this issue. If cabbage’s effect can be defined

thoroughly on engorgement problem via examining physical and chemical structure of it, it can be

produced products and materials together.

Keywords: Cabbage; breast; lactation; pain

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S14

The effect of breast-feedıng positions on the breast-feeding success

Nazlı PEHLIVAN1*, Özlem DEMIREL BOZKURT2 1 Buca Obstetrics, Gynecology And Pediatrics Hospital/Breastfeeding And Lactation Consultancy, İzmir,

Turkey ;2 Ege Üniversitesi/Faculty Of Nursing/ Department Of Obstetrics And Gynecology Nursing, İzmir,

Turkey

Objectives: This study was implemented, quasi-experimentally, for the purpose of examining the effect of

breast-feeding positions used in the early postpartum period after a c-section on a mother’s breast-feeding

success and durations, satisfaction levels, nipple and incision pain.

Methods: The study was carried out in the intensive care and postpartum ward at Buca Obstetrics,

Gynecology And Pediatrics Hospital between 01/12/2017-30/03/2018. The study sample consisted of 67

Turkish-proficient primipara mothers who had to undergo a c-section with spinal anesthesia between the

aforementioned dates, and agreed to participate in the study. The mothers who participated were assisted in

breastfeeding by latchiıng the babies to both breasts within the first 30 minutes after coming to the

Intensive Care from the operation room. Then, they were examined for any nipple complications. The

mothers were received breastfeeding training regarding cradle-hold and football-hold positions in the

postpartum ward. The first breastfeeding positions were determined by lottery, and the second, the other

position. In the study, the gathered data used the Mother and Infant Introduction Form, LATCH

Assessment Tool, BreastFeeding Duration and Satisfaction Form and Verbal Rating Scales for Nipple and

Incision Pain that were prepared by the researchers. They were also conducted via face-to-face interviews

and observations.

Results: The mean age of the mothers was 25.68 ± 5.78; the mean of the final pregnancy week,

39,78±0,93; and the mean weight of the newborn was 3425.67 ± 565.78 gr, in which 49.3% of the babies

born were girls. Breastfeeding positions were not affected by the results on either sides of the breasts. The

breastfeeding success score according to LATCH was found to be 8.71±1.05 in the cradle-hold position and

8,00±1,11 in the football-hold position. There was a statistically significant difference between the

LATCH scores according to breastfeeding positions(p<0,05). Furthermore, the LATCH score was found to

be equal for 30 mothers in both positions. The mothers had not experienced any nipple pain before and

after breastfeeding. The cradle-hold position had increased the mothers’ incision pain, whereas there was

no change in the severity of incision pain before and after breastfeeding in the football-hold position. There

was no crucial difference between the mothers’ satisfaction levels and the mothers’ average breast-feeding

durations, according to breastfeeding positions(p>0,05).

Conclusions: Mothers had higher breastfeeding success score in the cradle-holding position and they had a

significant effect on LATCH breastfeeding success score, whereas they did not experience any major

nipple pain. However, there were no significant differences, statistically, between the breastfeeding

positions about breastfeeding times and satisfaction levels.

Keywords: Breastfeeding, Breastfeeding Positions, Breastfeeding Success, Incision Pain

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S15

The effect of the home visits and breastfeeding support for the families of moderate and

late premature infants on the breastfeeding and mother-infant bonding.

Elif Ünver KORĞALI1*, Filiz ŞİMŞEK ORHON2 1Cumhuriyet University Faculty of Medicine, Department of Pediatrics, Sivas, Turkey, 2Ankara University

Faculty of Medicine, Department of Pediatrics, Department of Social Pediatrics, Ankara, Turkey

Objective: Moderate and late premature infants (MLPI) (320/7 - 336/7 and 340/7- 366/7 gestational

weeks) constitute the highest rate of 84% of all premature births. MLPI are the most unlucky group in term

of breastfeeding. MLPI receive less breast milk and have a shorter breastfeeding period. Also, an increased

risk of developing an unsafe bonding model and insensitive parenting have been reported in the mothers of

MLPI. The aim of this study was to investigate the effect of education program and regular home visits on

breastfeeding and mother-infant bonding of MLPI in the period up to 1 year corrected age (CA).

Methods: This study was conducted in Sivas Cumhuriyet University Medical Faculty Hospital, Pediatric

Department between June 2015 and July 2017. The MLPI and their parents were randomly separated into 3

groups as the Standard Care Group (SCG) (n:22) of those who were regularly followed-up in the polyclinic,

the Mothers Education Group (MEG) (n:22) who had regular home visits and only the mothers

participated, and the Family Education Group (FEG) (n:22) with participation by both mother and father in

the education program. The education program was applied in a 2-hour home visit by the same pediatrician

and pediatric nurse at 1 week after discharge then at 1 month, 2 months and 3 months CA of the infant. In

the home visits information was given about breast milk, breastfeeding and mother-infant relationship.

Breastfeeding techniques have been shown by observing the feeding of the baby. All infants were followed

up in the pediatric policlinic until 1 year CA. The groups were compared in respect of the rate of

(exclusively) breastfeeding, the time of complementary feeding, mother-infant bonding and the mother’s

perception of the infant.

Results: The groups of SCG, MEG and FEG were homogenous groups with similar sociodemographic

characteristics of the mothers and infants (respectively birth weight 2050.2+466.6, 2086.8+485.9 vs

2086.1+398.5 gr, p= 0.95; gestational age 33.9+1.3, 34.1+1.1 vs 34.1+1.5 weeks, p= 0.87; mothers’ age

30.0+6.4, 29.1+5.3 vs. 28.0+4.9 years, p=0.48). No difference was determined between the groups in

respect of the decision to breastfeed and previous experience of breastfeeding. The ratio of mothers who

planned to breastfeed for at least 2 years was significantly higher in the MEG and FEG than the SCG

(respectively, 95.5%, 90.9% and 50.0%, p=0.01). The rates of exclusively breastfeeding in the SCG, MEG

and FEG were determined as 13.6%, 72.7% and 59.1% respectively, at 4 months CA (p<0.001), 27.3%,

68.2% and 54.5%, at 6 months CA (p=0.02). At 12 months CA, the rate of infants not receiving any

mother’s milk was higher in the SCG (respectively, 50.0%, 18.2% and 22.7%, p=0.04). The rates of

starting of complementary feeding in the SCG, MEG and FEG were detected as 40.9%, 4.5% and 4.5%

respectively, at 4 months CA (p<0.001), 77.3%, 13.6% and 13.6% at 5 months CA (p<0.001) and 86.4%,

100% and 100%, at 6 months CA (p=0.004). The scores of Maternal Attachment Inventory were

significantly higher in the MEG and FEG than the SCG at 1, 2, 3 and 4 months CA. It was detected that

mothers perceived their babies more positively in the MEG and FEG than the SCG at 1 week after

discharge, 3 and 12 months CA.

Conclusion: Home visits and breastfeeding support increase the rates of exclusively breastfeeding in the

MLPI and contribute to the initiation of complementary feeding at the right time. In addition, it contritubes

to the mother-infant bonding and positive baby perception of the mothers.

Keywords: Moderate and late preterm infants, home visits, breastfeeding, mother-infant bonding.

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S16

Tandem Breastfeeding

Pınar DOĞANCI1*, Sevgi ÖZSOY2

1Adnan Menderes Üniversitesi Doğum-Kadın Sağlığı ve Hastalıkları Hemşireliği Anabilim Dalı, Aydın,

Turkey, 2Adnan Menderes Üniversitesi Doğum-Kadın Sağlığı ve Hastalıkları Hemşireliği Anabilim Dalı,

Aydın, Turkey

Objective: Tandem breastfeeding is defined as breastfeeding of two babies at different ages at the same

time. Effects of postpartum breastfeeding of two siblings at different ages on maternal and child health is of

research interest. In the present study, results of studies on tandem breastfeeding were examined.

Methods: All articles including words tandem nursing, tandem breastfeeding, tandem breast feeding or

tandem breast-feeding were searched in databases of our university library and 228 articles were accessed.

Twelve articles downloaded fully were considered. They were about observational, qualitative or case

studies on tandem breastfeeding mothers, their opinions and breastfeeding behavior and effects of tandem

breastfeeding on mothers’ and babies’ health.

Results: In two cases, tandem breastfeeding was found not to have negative effects on mothers’ and

babies’ health. Two descriptive studies revealed that it protected babies against psychological traumas and

did not cause breastfeeding-related negative behavior. In another article, it was found to strengthen babies’

immunity and harmony between siblings. In two case-control studies, breast-related problems like mastitis

less frequently appeared in tandem breastfeeding mothers. In case reports, mothers preferred tandem

breastfeeding since it would honor their babies, made them feel better due to fulfillment of their babies’

needs and prevented jealousy between siblings. An observational study showed that it was too early to

wean the older child and that breastfeeding was a baby’s basic emotional need. In a case report, a mother

performing tandem breastfeeding in four of her five babies for 14 years said that her older child found her

breastmilk salty and that the child’s feces became soft and yellowish. Despite these, she continued to

breastfeed and did not have a health problem. In a study revealing a high prevalence of tandem

breastfeeding, mothers were found to wean their older babies only in case of illnesses like diarrhea and

vomiting.

Conclusion: In conclusion, there have been few studies on effects of tandem breastfeeding on mothers,

newborns and older siblings. Mothers think that tandem breastfeeding provides feeding of elder babies for

the recommended period of time, satisfy needs of babies, honors them and prevents jealousy between

siblings. None of the studies have shown negative effects of tandem breastfeeding on mothers’, newborns’

and elder babies’ health. If mothers want to perform tandem breastfeeding, they should be given counseling

about nutrition and be followed own and their babies’ health. In addition, further studies about tandem

breastfeeding should be conducted.

Key words: tandem nursing, tandem breastfeeding, tandem breast feeding or tandem breast-feeding.

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S17

Breastfeeding success in preterm babies

Arzu AKPINAR1*, Hatice BALCI YANGIN1*, Havva ÇAKMAK2, Fatma Ç. ÖZDÖL2, Mustafa

AKÇAKUŞ3 1 Akdeniz University Faculty of Nursing, Department of Obstetric and Gynecological Nursing, Antalya,

Turkey,2 Akdeniz University Hospital, Baby Friendly Hospital Program Coordination Unit, Antalya,

Turkey, 3 Lara Anatolia Hospital, Department of Pediatrics, Neonatal Intensive Care, Antalya, Turkey

Objectives: It is very important to support breastfeeding in preterm babies because these babies are more at

risk for feeding difficulties, low blood sugar, jaundice and dehydration compared to term babies. The aim

of this study was to determine the success of breastfeeding in preterm babies and the factors affecting it.

Methods: The study was conducted in a retrospective cohort design. The sample of the study consisted of

205 preterm babies born between June 1, 2016 and June 1, 2017 at Akdeniz University Hospital. In

addition to descriptive statistics, chi-square and t-test were used for data analysis.

Results :In the study, 67.8% of babies were late preterm (34w+0d - 36w+6d), 18.5% were early preterm

(24w+0d - 31w+6d) and half of them had low birth weight (1500-2499gr). 73.4% of the babies started

breastfeeding after more than 12 hours and 92.7% were given formula in the hospital. The mothers of

88.2% of the babies were taught cup-feeding and used cup-feeding in the hospital. At hospital discharge,

99% of babies began breastfeeding and 73.7% were discharged with exclusive breastfeeding. At the time of

the telephone interview, the mean age of the babies was 16.67±1.30 months and 49.8% of them continued

to breastfeed. The mean age of 103 babies who were discontinued breastfeeding was 7.49±4.79 months at

the time of stopping breastfeeding. Breastfeeding is planned to be stop at an average of 23.96 ± 3.19

months in 102 babies who continue to breastfeed. The rate of babies exclusively breastfed in the first six

months is 23.9%. Exclusive breastfeeding during the first six months is determined to be associated with

maternal age (χ²=11.038, p=0.026), mother's educational status (χ²=3.879, p=0.049), family type (χ²=4.621,

p=0.032). ), bottle use (χ²=32.885, p=0.000), mean age of starting bottle (t (149)=3.054, p=0.003),

frequency of bottle use (χ²=10.205, p=0.017), pacifier use (χ² =5.297, p=0.021) and the mean age of

starting the pacifier (t (90)=2.992, p=0.004).

Conclusions: The exclusive breastfeeding of preterm babies in the first six months is related to unalterable

sociodemographic variables such as maternal age and maternal education level, as well as the use of bottles

and pacifiers and related variables. Therefore, it would be beneficial to inform mothers about the negative

effects of bottle-pacifier use and to teach alternative methods such as cup-feeding to reduce bottle use.

After hospital discharge, breastfeeding success can be increased by supporting mothers in terms of

breastfeeding.

Keywords: Breastfeeding, Breastfeeding Support, Exclusive Breastfeeding, Preterm

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S18

Impact of gestational diabetes mellitus on breastfeeding attitude in a Turkish population

Gokcen ÖRGÜL1*, Dilek ŞAHİN1, Aykan YÜCEL1 1Department of Perinatology, Etlik Zubeyde Hanim Women's Health Care, Training and Research

Hospital, University of Health Sciences, Ankara, Turkey

Objective: Breastfeeding have positive effects on maternal glucose metabolism after birth in women with

gestational diabetes mellitus (GDM). Moreover, breastfeeding also protects neonates from metabolic

syndrome in their adulthood. Beside the advantages of breastfeeding on mother and child health, women

with GDM tend to breastfeed lesser. On the other hand, breastfeeding attitude in these women is not well

clarified yet. We aimed to understand the effect of GDM on breastfeeding attitudes during pregnancy.

Methods: This study was conducted at a tertiary hospital in the capital city of Turkey. We have a special

outpatient clinic for GDM where all prenatal follow-up is performed carefully. Age, parity and gestational

week matched 100 pregnant women (50 with GDM and 50 healthy) were enrolled. “Breastfeeding

Attitudes of The Evaluation Scale” was used to compare two groups. This questionnaire has a total of 46

parameters. Breastfeeding Evaluation Tool’s point (BETP) was calculated for each participation after

fulfilling the form. According to BETP, three subgroups (low: <90; moderate 91-124 and >125: high) were

also compared between groups.

Results: The mean BETP score was 115.98 ± 12.74, and median BETP score was 118 (78-140) among all

women. There was no statistically significant difference in terms of BETP between two groups (115.26 ±

12.64 vs 116.69 ± 12.92; p=0.977). Total BEP score was <90 in 5 (%5), 91-125 in 80 (80%) and >126 in

15 (15%) in all women. The rates of low, moderate and high scores were 6%, 66% and 28% in GDM group

and 4%, 66% and 30% in control group, respectively. There was no difference between the rate of low

score between groups (6% vs 4%, p=0.236 ).

Conclusion: We could not demonstrate any effect of GDM on breastfeeding attitude during pregnancy.

Lower breastfeeding rates in women with GDM are most probably due to obstetric and neonatal

complications which are more frequent compared to healthy pregnant women. All pregnant women with or

without GDM should be encouraged for effective breastfeeding.

Key words: breastfeeding, diabetes mellitus, gestational, impact

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S19

Awareness and Attitudes of Health Workers About Breastfeeding and Baby Friendly

Hospital Practices

Pınar YILMAZBAŞ1*, Gülbin GÖKÇAY2, Gonca KESKİNDEMİRCİ2, Perran BORAN3, Öykü

ÖZBÖRÜ3, Bahar KURAL4, İrem CANTÜRK2

1Health Science University, Okmeydanı Training and Research Hospital, Pediatrics Department, Istanbul, 2, İstanbul University, Institute of Child Health, Department of Social Pediatrics, Istanbul3 Marmara

University, School of Medicine, Department of Pediatrics, Division of Social Pediatrics, Istanbul, 4Health

Science University, Sadi Konuk Training and Research Hospital, Pediatrics Department, Istanbul, Turkey.

Objective: Breastfeeding is the first step in life which ensures that infants and young children get a healthy

start in life. The initiation and establishment of breastfeeding after birth is crucial to increase breastfeeding

practices. The aim of this study was to identify the awareness and attitudes about breastfeeding and Baby

Friendly Hospital Initiative (BFHI) among healthworkers (doctors and nurses) in 4 different health centers.

Methods: This descriptive cross-sectional study was carried out in June 2019 among 4 different hospitals;

İstanbul University Istanbul Medical Faculty, Marmara University Medical Faculty, Health Science

University Okmeydanı Training and Research Hospital and Health Science University Sadi Konuk

Training and Research Hospital. Ethical approval and permission from Medical Specialty Education Board

was taken. A structured questionnaire consisting of 21 items about sociodemographic features,

breastfeeding and baby friendly hospital practices declared by WHO and UNICEF was formed. The data

were collected via face to face interview method through this questionnaire, voluntarily.

Results: Of the 269 participants, 143 (53.1%) were asistant doctors, 72 (26.7%) were nurse and midwifes,

54 (20.0%) were specialists. 107 (39.33%) of the participants told that they attended proper training at

their institution about breastfeding and breastfeeding policies. We asked the participants what ‘’Baby

Friendly Hospital’’ means, 146 (54.27%) gave the right answer. 76 (28.25%) of the participants told they

knew ‘’The International Code of Marketing of Breastmilk Substitutes’’. Of this 76 participants, 58

(21.56%) knew the code right, 6 of them told ‘’it was to give free formulas to new borns at the hospitals’’.

247 (91.82%) of the participants said that mothers and infants should remain together 24 hours a day when

breastfeeding. 255 (94.79%) of the health workers believed that babies less than 6 months of age should not

be given water or other things than breastmilk. 139 (51.67%) of the participants felt themselves proficient

about breastfeeding, 91 (33.82%) did not feel proficient, 42 (15.44%) had no opinion. 201 (74.72%)

wanted to have proper education about breastfeeding and breastfeeding policies, 63 (23.42%) did not want,

8 of them had no opinion. Knowledge about baby friendly hospital was significantly lower among asistant

doctors than specialist and nurses. There was no difference between nurses and specialists. Knowledge

about international code of marketing of breastmilk substitutes was significantly lower among asistant

doctors than specialist and nurses. There was no difference between nurses and specialists. Feeling

proficient in terms of breastfeeding level was different in three professions (p<0,01). Asistant doctors did

not feel themselves proficient enough and asistant doctors requested training about breastfeeding more than

other two professions.

Conclusion: According to our results, health workers do not receive proper training about breastfeeding

and baby friendly hospital initiative at tertiary level hospitals. Our study demostrated lack of awareness

about baby friendly hospital definition, and the international Code for Marketing of Breastmilk Substitutes

definition among health workers.

Keywords: awareness, attitudes, baby-friendly, breastfeeding, health workers

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S20

The Effect of Rooming-in on Breastfeeding Self- Efficacy Levels

Şehribanu IŞIK1*, Fatma Nur SARI1, Cüneyt TAYMAN1

1Zekai Tahir Burak Kadın Sağlığı Eğitim Araştırma Hastanesi, Neonatoloji Kliniği, Ankara, Turkey

Objective: Breast feeding success is affected by a number of factors. Breast feeding self-efficacy was

thought to be among the important factors that might affect the breast feeding success. The aim of the study

was to evaluate the effect of rooming- in prior to being discharged from hospital on Breastfeeding Self-

Efficacy Scale

Methods: The study was carried out between December 2018 and February 2019 in Zekai Tahir Burak

Maternity and Teaching Hospital. The population of the study was consisted of mothers of the babies who

were treated in neonatal intensive care unit and were encouraged to rooming- in prior to being discharged

from hospital. Data were collected using the Mother-Baby Information Form and the Breastfeeding Self-

Efficacy Scale. Breastfeeding Self-Efficacy Scale form was administered to the mothers on the first day of

admission to mother baby care unit and before hospital discharge.

Results: A total of 190 mothers were included. The median age of the mothers was 28 and 39% of them

were secondary school graduates, 73% were housewives, 59% of them were indicated their financial

situation as moderate, 77% were planned pregnancy, 60% had cesarean section and 58% had previous

breastfeeding experience. The median gestational age and birth weight of the babies were; 36 weeks and

2580 g; respectively. The median weight of the babies at admission to mother baby care unit was 2670 g.

The diagnoses of the babies at NICU admission were prematurity (33%), respiratory distress (29%),

nutritional problems (9%), neonatal sepsis (7%), congenital anomalies (%7), perinatal asphyxia (5%),

hypoglycemia (5%), 3.7% other causes (5%). The mean ( SD) value of the breastfeeding self-efficacy

scale of the mothers at admission to mother baby care unit and before hospital discharge were 55.8 10.65

and 61.3 8.4; respectively (p< 0.001).

Conclusion: As a result, breastfeeding self-efficacy increased by rooming- in prior to being discharged

from hospital.

Key words: Self-efficacy, Breastfeeding, Mother, Rooming-in, Newborn

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10.02.2019_ 11:40-12:40 HALL 2 – ORAL PRESENTATIONS

S21

Do mothers feed their babies correctly?

Fatma İLKNUR VAROL1*

1İnönü University, Turgut Özal Faculty of Medicine, Department of Pediatrics, Pediatric Gastroenterology,

Hepatology and Nutrition Unit, Malatya, Turkey

Objectives: All over the world, breastfeeding is known to be the most ideal food for babies and contributes

to proper growth and development. In the 2008 TDHS data, the rate of breastfeeding exclusively for the

first 6 months was 41.6% in our country, while it decreased to 30% in the TDHS-2013 data. This situation

suggests that breastfeeding is not done properly in our country and that the families make wrong practices

while feeding their babies with breast milk. The aim of this study was to measure the mothers' knowledge

and misconceptions about their feeding habits.

Method: This cross-sectional descriptive study was applied to mothers of patients who applied to İnönü

University Faculty of Medicine Pediatric Gastroenterology, Hepatology and Nutrition outpatient clinic for

any reason between January and May 2019. A fifteen-question questionnaire, which was prepared by the

researcher, was applied on a voluntary basis and face-to-face interview technique. The survey consisted of

questions on demographical data, including age of the mother, age of the first delivery, education level,

profession of the mother, place of residence, and number of children, and questions on breastfeeding

knowledge, including when a baby should be fed first time after the delivery, what should be the first food

of a baby, how long should a baby be fed exclusively with breast milk, when additional food should be

started, what should be the first additional food, on how many meals should additional food be given,

whether they need their baby to watch phone, tablet and / or television while feeding your baby, whether

they sit with the baby during family meals, and whether they use salt and/or sugar in additional foods. Data

were evaluated with SPSS 17.0 and a value of p <0.05 was considered statistically significant.

Results: A total of 105 mothers participated in the study. The mean age of the mothers was 33 years and

47.6% were university graduates and 53.3% were working. 86.7% lived in the city center and 42.9% had

two children. The ratio of those who used salt in supplementary food was 9.5%, the ratio of those who used

sugar was 4.8% and the ratio of those who used salt and sugar was 40%. The ratio of mothers who received

help from the phone, tablet and / or television while feeding their baby was 46.7%.

Conclusion: In our study, it was found that mothers lack information about proper feeding and use of salt

and sugar. Many of the diseases of our age, including obesity, hypertension and multimedia addiction can

be prevented by raising the awareness of mothers and encouraging them to gain correct feeding habits.

Keywords: Breast milk, complementary nutrition, mother

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S22

The Effect Of Baby Friendly Neonatal Intensive Care Initiative On Exclusively

Breastfeeding Rates Following Discharge In Very Preterm Infants

Gülsüm KADIOĞLU ŞİMŞEK1*, Nazmiye Bengü KARAÇAĞLAR1, Fuat Emre CANPOLAT1, Hayriye

Gözde KANMAZ KUTMAN1 1Neonatal Intensive Care Unit, Zekai Tahir BurakWomen’s Health Education and Research Hospital,

University of Health Sciences in Ankara, Turkey

Objective: Zekai Tahir Burak Women’s Health Hospital, Neonatal Intensive Care Unit (NICU) which is a

120 bedded referral Level-3 NICU, certified as “Baby Friendly NICU” by Ministry of Health on 2016. We

aimed to investigate the effect of “Baby Friendly NICU” practice on exclusively breastfeeding rates

following discharge in very preterm infants

Methods: Very preterm infants (≤32 gestational weeks) who regularly followed up after discharge were

involved. Medical information recorded during follow-up visits were retrospectively collected. The feeding

technique, type of nutrition (breastfeeding, formula, mixed) and anthropometric measurements were

recorded for every month following discharge up to corrected 6 months of age. Exclusively breastfeeding

rates were compared between two periods before “Baby Friendly NICU” practice (epoch 1) and after

(epoch 2).

Results: Records from a total of 252 infants, 135 in epoch 1 and 117 in epoch 2 were analyzed. Neonatal

characteristics’ were similar in two epochs. Cumulative rate of exclusively breastfeeding was 35.7% on the

first follow-up visit and gradually decreased to 24.6% on 6 months corrected age. An insignificant increase

was observed in exclusively breastfeeding rates in epoch 2 (19 % vs. 31.3%). Anthropometric

measurements did not differed between exclusively breastfed infants and the others who fed with formula

or mixed nutrition.

Conclusion: Exclusively breastfeeding rates increased about 1.5 fold following baby friendly NICU

practices however that increase was statistically insignificant probably due to small sample size. Despite all

the efforts only 1/3 of preterm infants are exclusively breastfed on discharge. Additional policies and

supportive measures mainly following discharge are still required.

Keywords: Baby friendly neonatal intensive care, exclusively breastfeeding, formula, pr

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S23

Determination of The Results of The Evaluation Survey of Trainings of Pregnants

Participating The Pregnant School in A Training and Research Hospital

Çiğdem AVCI1*, Serpil KALI 1, Filiz ÖZKOÇAK TUNA1, Zeynep YILMAZ1, Fulya KAYIKÇIOĞLU1,

Özlem MORALOĞLU TEKİN1

1Etlik Zübeyde Hanım Gynecology Traininng and Research Hospital, Ankara, Turkey

Objective: This study was carried out in order to determine the opinions of pregnant women attending the

education in pregnant school in January-December 2018 in Ankara Etlik Zübeyde Hanım Women's

Diseases Training and Research Hospital and to develop practical suggestions in line with the obtained data

and results.

Method: Between January-December 2018,training session were held with a total of 29 different groups,

including 20 weekday groups and 9 weekend groups. 309 people have been graduated. 300 people were

included in the survey. The data were obtained by filling the questionnaire form prepared by the

researchersby the pregnant women who participated in the trainings. The results of SPSS 17 program are

given numbers and percentages.

Results: It was found that %51 of the pregnant women participating in the education were in the 26-32 age

range, %62 had University graduates or above, %62 were housewives, %78 were planning their first

pregnancy and %81 were planning their pregnancy. %83 of the pregnants had normal birth planning and

%59 of them were preferred because it is a natural method. %99 of the pregnant women are suitable for the

purpose of the education program, %96 of the education materials are sufficient enough, %88 of the

education contributes to it, %99 of the education they recommend to their environment, %99,7 of them

stated that they would prefer going hospital whwn needed. When the opinions of pregnant women

participating in the pregnant school trainings were evaluated, it was found that the satisfaction rates were

above the average values and met their expectations to a great extent.

Conclusion: Such evaluations will contribute to the existing system in terms of both the control of the

trainers themselves and the formation of training plans in line with the opinions and suggestions of the

trainers.

Keywords: Pregnant School, Pregnancy, Birth Preparation

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S24

Excessive breast engorgement in the early postnatal period: Is this a problem about

“feedback inhibition of lactation” (FIL)?

Asuman ÇOBAN1, Nevin YILDIZ1, Sema BAYRAKTAR2*, Erhan AYGÜN1, Gülbin GÖKÇAY3, Duygu

TUNÇEL1, Törehan ASLAN1, Zeynep İNCE1 1İstanbul University Faculty of Medicine, Department of Pediatrics, İstanbul, Turkey; 2Bezmialem

Foundation University, Faculty of Health Sciences, Istanbul, Turkey; 3İstanbul University, Institute of

Child Health, İstanbul, Turkey

Objective: FIL also a polypeptide, which is present in the breast milk is responsible for the control of milk

production. If the baby cannot fully empty the breast, this inhibitor prevents the secretion of milk from the

cells.

Case: 31-year-old gravida 3, para 3 mother had a baby who was born at 38 5/7 weeks of gestation by

elective caesarean section. Birth weight was 3050 g, height 49,5 cm and head the circumference was 34 cm.

The 1st minute Apgar was 7 and the 5th was 9. The postnatal adaptation was uneventful and physical

examination of the baby was normal. Breastfeeding counselling (BC) was given to the mother after birth.

The breast examination revealed collapsed nipples. Silicone nipple and nipple remover tool were

recommended. At 48th hour, there was a crack in the nipple. Breastfeeding was encouraged again. The

baby-mother couple was discharged for the next day. The baby was at 2880 g at the discharge. The mother

came into hospital the day after the discharge with complaints of pain and excessive tension in her breasts.

The mother's examination revealed excessive engorgement, mastitis, oedema, and redness and mother's

milk flow had been ceased. The baby was well active without any pathologic findings. Her weight was

2820 g. The baby was given a 20 cc formula milk by spoon. A hospital-type pump was used to milk the

breasts every 2 hours. This expressed milk was given to the baby by spoon. After milking, the cold dressing

was applied to the breasts. The formula milk, 8x30 cc was ordered to feed the baby and the baby was given

to the mother to breastfeed. Despite all these measures, the engorgement increased. The mother expressed

her unbearable discomfort as “Please, cut away my breasts now!” On the 5th day, the breasts of the mother

were very hard especially in the lateral part and the nipple were invisible due to oedema. International

Breastfeeding Society was contacted and recommendations were received. The condition of the mother was

tried to be explained by FIL. The ultrasonography of the breasts showed thickness of the skin and

subcutaneous tissue. Considering of the risk of mastitis treatment with ibuprofen, cold dressing and

prolactin inhibitor (cabergoline, low dose) were began. The cabergoline was given to reduce milk and to

relieve the breasts, not to cease the milk. The baby was fed with 8x40cc formula milk and breast milk. The

baby's weight was 2840g. At the 6th day the breasts softened, and the pain of the mother decreased slightly.

Cabergoline has been discontinued. The nipple crack receded as the baby sucked the breasts. The feeding

of the baby continued with 8x40 cc formula and mother milk, however she lost 40 g of her weight. At the

7th day the milk production was reduced. On the 10th postnatal day, the breasts were softened and the

breasts were milked again with the pump. 6x30 cc formula milk continued in baby's feeding. At the

following days the mother began milking her breasts. The situation of the breasts were improved

thoroughly. At the 14th day, She was discharged at 3000g by taking 4x30 cc formula milk and sucking the

mother. Two days later, the family came to control, the baby weighted 3170 g, and the mother had no pain.

Conclusion: Effective diagnosis and expert opinion are important for diagnosing FIL. The low-dose

treatment of cabergoline relieved the breasts without stopping the milk and provided continuity of

breastfeeding in our case. In addition, positive results were obtained with effective BC.

Keywords: FIL, breastfeeding counselling, engorgement, mastitis

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S25

Breastfeedig During Pregnancy

Sema BAYRAKTAR1*, Nevin YILDIZ 2, Zeynep İNCE2, Nuray ESKİ2, Asuman ÇOBAN2 1Bezmialem Vakif University/Faculty of Health Sciences, İstanbul, Turkey, 2Istanbul University/Istanbul

Faculty of Medicine, İstanbul, Turkey

Objectives: To determine women’s attitude towards breastfeeding during pregnancy and the reasons for

stopping breastfeeding when they became pregnant again.

Methods: The research was conducted as a descriptive study in Obstetrics and Gynecology Clinic between

1 January 2018 and 30 August 2019. The study population included mothers whose previous baby was

under 2 years old when they became pregnant again. Women at the postpartum period (n=84) were

interviewed at the clinic by the researcher. Data were collected by a questionnaire form which included

maternal, neonatal and obstetrical data, breastfeeding experience and problems during pregnancy.

Results: The mean age of the mothers was 29.1±5.6 years, gravidity was 3.1±1.6 and parity was 2.3±1.0.

76% of women (n=64) had not planned a second pregnancy while breastfeeding the previous child. At the

time when the mothers learned of their new pregnancy, the mean age of the breastfed infants was 12.6±5.4

months and 46% (n=39) of these infants were weaned from breastfeeding immediately. Only 6% (n=5) of

the mothers continued breastfeeding their previous child until birth. Mothers who continued breastfeeding

at the beginning but stopped breastfeeding before the 6th month of pregnancy at different weeks of

gestation were 48% (n=40) of the total participants. The mean duration of breastfeeding in this group of

mothers was 2.5±1.6 months. We found that 34% of women (n=27) stopped breastfeeding due to

professional advice, whereas 47% of women (n=37) stopped breastfeeding by themselves because of their

feelings that breastfeeding could have a negative effect on the unborn baby. Finally, other mothers (%19,

n=15) stopped breastfeeding because of social pressure.

Conclusions: Our findings indicate a need to provide counseling to women who became pregnant while

breastfeeding their previous child. It should be emphasized that the continuation of breastfeeding during

pregnancy does not have an adverse effect on the fetus.

Keywords: breastfeeding, pregnancy, infant

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S26

Determination of the Knowledge, Attitudes and Behaviors of Working Mothers With

Children Between 0-2 Years of Age About Breastfeeding and the Factors Affecting

Them Hülya ŞEKER YIKMAZ1* 1University of Health Sciences, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and

Research Hospital, Ankara, Turkey

Objectives: This study aimed to determine the knowledge, attitudes and behaviours of working mothers on

breastfeeding, to identify the factors affecting these conditions and to develop strategies to support

breastfeeding.

Methods: This descriptive study was conducted between8-31 July 2019 through a survey on mothers

reached by social media and on mothers visiting general paediatrics outpatient clinic of Dr.Sami Ulus

Maternity and Child Health and Diseases Training and Research Hospital. The population of the study

consisted of working mothers who had children between 0-2 years of age, were born between 37-42 weeks

and over 2500 grams and had no chronic disease and had breastfeeding experience. 312 mothers

participated in the study, 4 of them from the clinic and 308 of them through social media.

Results: 62% of the mothers surveyedprovided the information on the first child, 34% on the second child,

and the remaining 4% on the third or later child. The children included in the survey were within 0-2 age

range and the average age was 12.7 months.It was seen that 85.6% of the mothers had held their babies in

the first hour after birth, 79.5% had started breastfeeding within the first hour, but the milk had come after

birth in 67.9% of the mothers within the first day. It was found that 84.7% of the mothers surveyed were

still breastfeeding their babies while15.3% of them terminated breastfeeding their babies on average in 11.2

months. 58.9% of the mothers surveyed stated that they had problems with breastfeeding. It was

determined that the support of health professionals, social media and elderly family members, was mainly

obtained in the solution of the problems faced during breastfeeding. It was seen that on average mothers

returned to work when their babies were 8 months old. It was determined that 39.9% of the mothers were

able to pump their milk at theirworkplace and 68.2% of them had the opportunity store the milk there.

Conclusions: In this study, it was observed that most of the mothers started breastfeeding as their babies

were born, they used various methods to increase and maintain breast milk and the information obtained in

the prenatal and postnatal period was effective. For this reason, it is important that the mothers are

informed about the breastfeeding before and after the birth by the health personnel, and from social media

and internet.

Keywords: Working mother, breastfeeding, termination of breastfeeding

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S27

The effectiveness of structured education and monitoring in the management of

breastfeeding mothers’ perceived milk deficiency

Müge SAĞLIK1*, Zekiye KARAÇAM2

1Department of Midwifery, Adnan Menderes University, Health Sciences Institute, Aydın, Turkey, 2Division

of Midwifery, Adnan Menderes University School of Health Sciences, Aydın, Turkey,

Objective: The objective of the study was to examine the effectiveness of structured education and

monitoring in the management of breastfeeding mothers’ perceived milk deficiency.

Methods: The research was of randomized, controlled and experimental design and was conducted over

the period December 2018-June 2019 at Family Health Centers No.s 1, 2 and 3 in Armutlu, Yalova,

Turkey. A total of 64 women in their 32nd-42nd week of pregnancy were recruited into the study sample–

33 into the study group and 31 as a control group. Data were collected with a Descriptive Information

Form, a Breastfeeding Follow-up Sheet, and the “IMDAT Scoring System of the Amount of Breast Milk

Consumed by the Baby.” The data and descriptive statistics collected were analyzed with the chi-square

test, the t test and the Mann-Whitney U test.

Results: The mean age of the women in the study group was 27.52±5.136 years; that of the women in the

control group was 26.90±4.563 years. While 100.0% of the mothers in the study group breastfed their

infants after birth, this percentage was 96.8% in the control group; the difference however was found to be

statistically significant (χ²= 0.001; p= 0.975). It was observed that more mothers in the study group started

to breastfeed in the first half-hour after birth (66.7% versus 22.6%; χ²= 12.537; p= 0.000) and that more

mothers fed their babies exclusively breast milk on the 3rd-7th days (84.8% versus 32.3%; χ²= 18.328, p=

0.000), in the 1st month (87.9% versus 38.7%; χ²= 16.785, p=0.00), and in the 2nd month (78.8% versus

35.5%; χ²= 12,290, p= 0,000). It was found that a statistically lesser percentage of the mothers in the study

group perceived their milk to be deficient on the 3rd7th days (15.2% versus 61.3%; χ²= 14.518; p= 0.000),

in the 1st month (9.1% versus 61.3%; χ²= 19.307; p= 0.000) and in the 2nd month (21.2% versus 61.3%;

χ²= 10.644; p= 0.01). The IMDAT mean scores of the study group infants were statistically and

significantly higher than those in the control group on the 3rd-7th days (9.15±1.1761), in the 1st month

(8.82±1.489) and in the 2nd month (8.00±1.820) (as opposed to the control group mean xiii scores in the

order of 7.48±2.393; 7.03±1.87; 6.29±2.194) (p=0.001; p=0.000; p=0.001, respectively).

Conclusion: Structured education and monitoring increased the percentage of mothers initiating

breastfeeding in the first half-hour as well as the consumption of breast milk by 0-2-month-old babies, at

the same time reducing mother’s perceived breast milk deficiency and the percentage of mothers initiating

supplementary foods. Increasing the availability of such interventions can contribute to increasing the

percentages of infants that are exclusively breastfed.

Key words: breastfeeding, deficiency, education, monitoring

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S28

The relationship between breast milk intake and speech in children with cerebral palsy

Gül Demet KAYA ÖZÇORA1*, Gonca BEKTAŞ3 1 Pediatric Neurology, Şanlıurfa Research and Training Hospital, Şanlıurfa, Turkey, 2 Pediatric Neurology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey

Objectives: Children with cerebral palsy commonly have speech disorders. Speech motor development

requires oromotor coordination which could be impaired in children with cerebral palsy. In the early period

of life breastfeeding and breast milk intake may induce neuroplasticity which will improve physiologic

development of speech motor control. We aimed to determine whether there is an association between

breast milk intake and motor speech functions.

Methods: This was a retrospective study consisting of patients with cerebral palsy followed-up from

March 1, 2019, to July 31, 2019. Children older than 2 years old were included. The exclusion criteria were

as the followings; (1) children with hearing loss and (2) children with an orofacial cleft. Demographic

features, the duration of the only and total breast milk intake, the levels of Gross Motor Function

Classification System (GMFCS) and Viking Speech Scale (VSS) were abstracted from medical records.

GMFCS ranges from 1 to 5, and Viking Speech Scale ranges from 1 to 4 in which higher levels indicate

worse outcome in both scales. The relationship between the level of VSS and other variables were

evaluated in children with cerebral palsy.

Results: A total of 251 children with cerebral palsy were included in the study. The boy (n=153, 61%) to

girl (n=98, 39%) ratio was 1.6. The mean age of children was 5.9 3.6 years (2-17 years). 129 children

(59%) born preterm and 122 children (49%) born full-term. The mean length of stay in the neonatal

intensive care unit (NICU) was 31 39 days (0-270 days). The mean length of only breast milk intake was

57 65 days (0-180 days). The mean length of total breast milk intake was 7.4 8.2 months (range 0-36

months). The mean level of GMFCS was 3.7 1.4 (1-5). The mean level of VSS was 2.9 1.1 (1-4). There

was no statistically significant difference between genders in terms of the level of VSS (p=0.29). There was

no correlation observed between the age, the length of stay in the NICU with the level of VSS (p=0.79,

p=0.29, respectively). There was a negative correlation between the length of the only and total breast milk

intake with the level of VSS (p=0.049, r=-0.2, p=0.001, r=-0.36, respectively). We observed a positive

correlation between the level of GMFCS and the level of VSS (p<0,001, r=0,8).

Conclusions: We found that the children with longer duration of the breast milk intake were more likely to

present better motor speech functions.

Keywords: breast milk, cerebral palsy, speech

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S29

A Glance at Breastfeeding Reality in Turkey through Media News

İlknur Münevver GÖNENÇ1*, Neslihan Yılmaz SEZER 1 Faculty of Nursing, Ankara University, Ankara, Turkey

Objectives: This study was carried out to examine the news about breastfeeding.

Methods: The study used a qualitative research design and examined the news about breastfeeding with

qualitative and quantitative analysis methods. A Google search was carried out between 06 September 2018

and 06 September 2019 on the “news” tab using the “breastfeeding” keyword in the Turkish language. The

news published on the same subject and date was considered as the single news.

Results: A total of 152 news articles were included in the study from Turkey. The news articles included in

the study were analyzed in terms of content, and they were divided into three categories. These categories

were the practices for encouraging breastfeeding" (84 news articles), "increasing the success of

breastfeeding" (52 news articles) and "the benefits of breastfeeding" (16 news articles). The news articles

under first category consisted of topics such as financial support in breastfeeding, news about breastfeeding

celebrities, baby-friendly applications, breastfeeding training, breastfeeding booths and baby care model,

breastfeeding device for fathers, and breastfeeding leave. The news articles studied under the second

category included topics such as correct breastfeeding techniques, eating during breastfeeding, effective

breastfeeding examples, problems and mistakes in breastfeeding, and supports that can be utilized during

the breastfeeding process. On the other hand, the news topics examined under the third category were an

overview of breastfeeding and the benefits of breast milk and breastfeeding. Only 21 of these reports were

written by health personnel, and the source of the majority of the news was not clear. Some of the news

headlines attracted individuals' attention to breastfeeding, while others had a style that might create

negative thoughts about breastfeeding. For example, the titles of some of the positive news articles were

"the Miraculous Contact of Mother and Baby” and “Frequently Asked Questions about Breastfeeding”,

while the titles of some of the negative news articles were “Are the benefits of breastfeeding exaggerated?”

or “An infant died while it is being breastfed".

Conclusions: The number of news articles about breastfeeding is quite low, which indicates that media

coverage of breastfeeding is inadequate. Besides, the source of most news is unclear. To raise awareness

about breastfeeding, it is recommended that the title of breastfeeding should be discussed more in the news,

and a health professional should be consulted in creating these news articles.

Keywords: Breastfeeding, Breast milk, Media, Press news

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S30

The thoughts and attitudes of physician fathers about woman colleagues who use

breastfeeding leave

Ezgi AĞADAYI1*, DuyguAYHAN BAŞER2, Murat ÇEVİK3 1Akıncılar Public Hospital/Family Medicine Clinic, Sivas, Turkey, 2HacettepeUniversity School of

Medicine/Department of Family Medicine, Ankara, Turkey,3Güdül Public Hospital/Family Medicine Clinic

No. 3, Ankara, Turkey

Objectives: Our aim is to investigate the attitudes and thoughts of physicians fathers about their colleagues'

use of breastfeeding leave as a father and as a physician.

Methods: The data was collected through an online survey from a social media group named in Turkish as

“DoktorBabalar”,which had 20.300 members in the time of the study. We sent an informational message

and survey link to the group about the study. The survey, which was created by researchers, was including

24 questions. Collected data analyzed with a statistics software package. Descriptive statistics were

calculated. Chi-square test was used to analyze the categorical data.

Results: 198 physician fathers volunteered to participate in our study. The majority of the participants

(n=54, 27.3%) worked in the state hospital and were specialist doctor (n=106, 53.5%). Participants’

specialties were divided as surgical (n=60, 30.3%) and non-surgical department (n=125, 63.1%). 57.1%

(n=133) of physicians said they supported their colleagues in using breastfeeding leave. 36.9% (n=73) of

the participants stated that they had received education about breastfeeding and human milk. Most of them

(n=42, 60.0%) received this education at in-service training organized by the ministry.There was no

significant difference between being educated and supporting the colleagues in using leave (p=0.364).

Physicians, who supported their partners in child care at home, gave more support to their colleagues in

using leave (p<0.001).57.6% (n=114) of the participants stated that they did not have any difficultiesdue to

their colleagues using breastfeeding leave. Complaints of those who have difficulties in this regard are

increase in the number of patients examined at the outpatient clinic (n=60, 30.3%), increase in the number

of night shift (n=44, 22.2%), and having difficulties using the annual leave (n=23, 11.6%).

Conclusions: To our knowledge, this is the first study evaluating breastfeedingleave from the fathers'

perspective.The participants stated that they couldn’t support their colleagues sufficiently due to the

intensive workload. Using breastfeeding leave is the most natural right of a mother. However, by reducing

the burden on colleagues, professional peace could be achieved and the mothers could receive the

necessary support from male colleagues.

Key words: Women Physicians, Breastfeeding practices, Father Physicians, Interpersonal Relations

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S31

Breastfeeding Practices of Women in their Early Postpartum Period: Two Baby

Friendly Hospitals

Sevgi ÖZSOY1, Tuğba DÜNDAR1*

1Aydın Adnan Menderes University/Nursing Faculty/Obstetrics and Gyneocologic Nursing Department,

Aydın, Turkey

Objectives: The aim of this study was to determine breastfeeding practices of women giving birth in baby-

friendly hospitals in the early postpartum period.

Methods: The study was conducted in two baby-friendly hospitals in Aydın. The sample size was

calculated by using the prevalence reported in a similar study (63,8%). Based on stratified sampling, a total

of 335 women, of whom 282 (n= 4623) gave birth in a state hospital and 53 (n= 868) gave birth in a

university hospital, were contacted. Data were collected with questionnaire at face-to-face interviews.

Obtained data were analyzed with percentages, mean and Chi-square test.

Results: The mean age of the women was 28.11±5.74 years, the mean gestational week at delivery was

39.00±1.16 weeks,53,7% of the women were found to get education about breastfeeding/breastmilk during

their pregnancy. 57% of the women were interviewed on the second postpartum day.

50,1% of the women started to breastfeed in the first half an hour of delivery, 1,6% of the women hadn’t

breastfed yet and breastfeeding was delayed in the rest of the women. The first food given was breastmilk

in 88,1% of the babies. From the time of birth to the interviews, 28,7% of the babies were given food other

than breastmilk. The most frequent reason for this was insufficient/lack of breastmilk (23,9%). The food

most frequentlygiven was formula (64,6%) and it was most frequently recommended by family members

(42,7%). Of all the mothers, 45,7% reported health staff didn’t check their breastfeeding, 45,4% they

weren’t shown how to breastfeed, 44,8% weren’t informed about breastfeeding. When the two hospitals

were compared, significantly higher rate of the womenbreastfed their babies in the first half an hourand

first fed their babies with breastmilk, lower rate of the women gave food other than breastmilkin the state

hospital. In the university hospital, the rate of the women whose breastfeeding was checked and who were

shown how to breastfeed was significantly higher.

Conclusion: About half of the women couldn’t start breastfeeding in the first half an hour, three out of

every ten babies were given food other than breastmilkand about half of the women weren’t given

sufficient support for breastfeeding. The hospitals differed in terms of time of first breastfeeding, feeding

babies with food other than breastmilk, health staff’s checking breastfeeding, showing how to breastfeed

properly and informing the women about breastfeeding.

Key Words: Breastmilk, baby-friendly hospital, breastfeeding, nurse

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S32

Evaluation of breastfeeding attitudes of senior female university students

Müge YILMAZ1, Mualla AYKUT2, Neslihan ÖNER1, Eda BAŞMISIRLI2* 1Erciyes University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Kayseri, Turkey, 2Nuh Naci Yazgan University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Kayseri,

Turkey

Objective: It is important to know their attitudes towards breastfeeding in determining the content of

breastfeeding trainings to be given to young people. This research was done descriptively in order to

determine the breastfeeding attitudes of senior female university students.

Method: The study was conducted on the senior female students in the 2017-2018 academic years in all

the faculties (Economics-Administrative Sciences, Engineering, Health Sciences, Fine Arts-Design, Arts

and Science) of Nuh Naci Yazgan University in Kayseri province. From senior female university students

(489 individuals) who are the research population, the sample of the study consisted of 434 childless and

non-pregnant volunteers. The questionnaire including the questions about socio-demographic

characteristics and breast milk knowledge level of the individuals and the Iowa Infant Feeding Attitude

Scale (IIFAS) was filled in their classrooms by the students who received sampling under the supervision

of the researchers. IIFAS is designed to assess women's attitudes toward breastfeeding and to predict the

choice of infant feeding method as well as the duration of breastfeeding. The scale consists of 17 items with

a 5-point Likert-type, ranging from 1 (strongly disagree) to 5 (strongly agree). Nine items about breast milk

and 8 items about formula feeding in the scale contain positive expressions. Items favoring formula-feeding

are reverse-scored (1=5, 2=4, 4=2 and 5=1). The total attitude scores range from 17 (indicating positive

bottle-feeding attitudes) to 85 (reflecting positive breastfeeding attitudes). Turkish validity and reliability

has been made and the Cronbach’s alpha internal consistency coefficient of the scale was found to be 0.71.

In this study, the normal distribution of the data was analyzed by Kolmogorov-Smirnov test, comparison

between groups by independent sample t-test, ANOVA test, and by Bonferoni test from which group the

difference originated from. A p value <0.05 was considered significant.

Results: The mean age of the students was 22.62 ± 1.39 years (min-max: 20-30 years) and 40.1% of them

were attending the Faculty of Health Sciences. The majority (81.6%) lived in the Central Anatolian Region

with their families (65.9%) in the nuclear family (77%), the number of siblings was 2.2 ± 1.24 (min-max:

0-11), and 52.1% of them, in their own words, had good income for their families, 9.7% were engaged,

2.1% were married, 14.1% were employed, 12.2% were undecided about working in the future. Of the

students’ mothers, 65.0% were educated in high school (36.4%) and above. The proportion of those who

received training for breastfeeding was 47.7% and the mean score of IIFAS was 63.34±1.01 (min-max: 34-

85). IIFAS scores were found to be high among those who attending at Faculty of Health Sciences, those

who were 23 and under age, singles, those living in the nuclear family, those with a moderate family

income, those with a maternal education level below high school, those who did not work, those who

thought to work in the future, those who received information about breastfeeding (Table 1, p<0.05).

Conclusion: The mean IIFAS score of the senior female university students who were included in the

research was found to be close to the maximum score and it can be considered that they look positive for

breastfeeding. The attitudes of senior female university students toward breastfeeding should be improved

through educational programs, taking into account the influencing factors.

Key words: Breastfeeding attitude, Iowa Infant Feeding Attitude Scale, senior female university students.

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S33

Factors that impact breastfeeding among children who were brought to Akdeniz

University Hospital

Celal Mete KARAKURUM1*, Sevtap VELİPAŞAOĞLU2

1Akdeniz University Medical School Department of Pediatrics, Antalya, Turkey, 2Akdeniz University

Medical School Department of Pediatrics, Division of Social Pediatrics, Antalya, Turkey

Objective: Breastfeeding and especially exclusive breastfeeding for the first 6 months of life is the

optimum feeding method for reducing infant mortality and morbidity. It is estimated that increasing

breastfeeding rates to 95% in developing countries can avert 87% of preventable deaths in the first six

months of life. The aim of this study was to detect factors that affect exclusive or predominant

breastfeeding during the first six months of life.

Method: A questionnaire was applied to the mothers of 190 infants with no chronic systemic disease, who

were brought to the outpatient clinics of General Pediatrics, Well Child and Pediatric Surgery in Akdeniz

University Hospital. Infants who did not receive formula or complementary foods beyond 15 days of life

until 6 months of age were defined as the control group (n=95). Infants who were given formula beyond the

16th day and those who were given complementary foods in the first six months of life were included in the

case group (n=95). The study was approved by the Ethical Board of Akdeniz University.

Results: In univariate analysis infrequent breastfeeding (Odds ratio (OR): 2.61, 95% Confidence interval

(CI): 1.24-5.53, p=0.012), mother’s perception of her milk being nonnutritive (OR 5.25, 95% CI: 2.16-

12.76, p<0.001), recommendation of formula by someone (OR 0.35, 95% CI 0.19-0.63, p<0.001) were

found to impact exclusive breastfeeding. In multivariate logistic regression mother’s perception of her milk

being insufficient (OR 4.39, 95% CI: 2.21-8.75; p<0.001), or her feelings of hopelessness, being broken

down, anxious or unhappy (OR 3.26, 95% CI 1.45-7.32, p=0.004) were significantly associated with early

initiation of complementary foods.

Conclusion: Mothers should be properly supported, scanned for signs of depression and her perception of

insufficient milk supply should be taken seriously in order to increase exclusive or predominant

breastfeeding practices.

Key words: exclusive breastfeeding, predominant breastfeeding, complementary feeding, formula

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S34

Breastfeeding and supplementing with formula in malnourished infants below one year

of age

Arzu Meltem DEMİR1*

1University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and

Research Hospital, Department of Pediatric Gastroenterology, Ankara, Turkey

Objectives: Feeding problems occur in some chronic diseases such as gastroesophageal reflux,

prematurity, cerebral palsy, hypotonia, esophagus atresia. We aimed to investigate our breastfeeding rates

in infants with chronic diseases with malnutrition who was commenced on oral nutritional supplements

(ONS) / enteral nutrition or hypoallergenic formulas.

Methods: We retrospectively searched our electronic database for the patients below one year of age

recorded between January 2017 to January 2019. We determined the demographic data, underlying disease,

symptoms and feeding types. Weight, height, body mass index (BMI), weight standart derivation score

(SDS) were also calculated and results were recorded according to Centers for Disease Control and

Prevention (CDC) growth charts.

Results: We found 5957 patients below one year of age admitted to our pediatric gastroenterology clinic.

154 (2.5%) of them were commenced on ONS/enteral nutrition or hypoallergenic formulas for the

treatment of malnutrition, cow's milk allergy and other chronic diseases. 95 of these 154 patients (61.7%)

were female, their mean age was 207.1±97.6 days (median 209.5, min-max 7-365). Mean weight was

5.7±1.46 kg (median 5.9, min-max 2.2-10), mean height 64.5±5.65 cm (median 65.5, min-max 48-74),

BMI 14.07±1.59, weight SDS -2.5-+1.70 (median -2.3, min-max -8.84-+2.68). We detected most common

underlying diseases as gastroesophageal reflux (31.8%), prematurity (27.2%), cow's milk allergy (15.6%),

and others (25.4%) respectively. Most common symptoms were vomiting (35.1%), anorexia (14.3%)

chronic diarrhea (13.3%), and others (37.3%) respectively. Four infants were feeded via gastrostomy tube,

6 infants were feeded via nasogastric tube because of hypotonia or dysphagia. 72 of the infants (50%) were

feeded with breast milk. On admission, most common feeding styles were infant formula (26.2%), breast

milk and infant formula (20%), infant formula and supplementary food (20%) and only breast mik (11%),

and others (22.8%) respectively. 137 infants were shown to have cow's milk allergy. We encouraged

mothers to continue breast feeding with milk elimination diet. And, after one month, only 24 (17.5%) of

them were found to be feeded with hypoallergenic formula, others were still feeded only with breast milk.

Conclusion: Our findings shows that pediatric gastroenterologists are aware of benefits of breast milk and

we should continue breast milk even in chronic diseases or conditions such as gastroesophageal reflux,

prematurity, hypotonic infant, cow's milk allergy.

Keywords: Breastfeeding, chronic disease, supplementary formula

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S35

Breastfeeding In Baby-Friendly NICU and Our Experience

Elif KELEŞ1*, Canan TÜRKYILMAZ1, Nurten KÜREKÇİ1, Döne EROĞLU1, Emel AKTAŞ1, Başak

GÖKÇAY1, Aytaç KENAR1, Başak KAYA GÜRSOY1, İbrahim Murat HİRFANOĞLU1, Esra ÖNAL1,

Ebru ERGENEKON1, Esin KOÇ1 1Gazi University Faculty of Medicine, Department of Neonatology Ankara, Turkey

Objective: Breastfeeding in the preterm infants in neonatal intensive care units (NICU) decreases

morbidity and mortality. Our unit is a baby friendly NICU-certified unit that supports breastfeeding. Baby

friendly NICU has to ensure the milk pumping right after the birth, early skin contact, use of kangaroo and

good communication between mother and nurse team. In this study, we aim to compare infant

breastfeeding data before and after the baby friendly NICU certification.

Methods: 663 infants hospitalized in NICU between November 2017 and July 2019 were included in the

study. Breastfeeding, formula feeding, human milk fortifier and milk pumping data were recorded.

Results: The colostrum was obtained in 97.4% of the mothers in first few days of infants’ life. The rate of

receiving breastmilk on discharge was % 97,6 .75,5% rate of those were breastfed on the first day. While

93,1 % of the patients were brestfed on discharge. On discharge, 46.6% of infants receiving breastmilk had

only breastfeeding, whereas 41.8% and 11 % were both breastfeeding and pumping milk and only pumping

milk, respectively. The rate of breastfeeding in singleton pregnancy and multiple pregnancies were 75%

and 77,2% respectively. There is no significant difference between the rates of breastfeeding regarding the

mode of delivery. 92% of mothers received breastfeeding education.6,2% of mothers had breastfeeding

problem.60,5% of those mothers overcome these breastfeeding problems with the hand massage. Data

related to pumping method, breast problems and galaktagouge use were analyzed. 12,8% of infants were

discharged with milk fortifier. There was no significant difference the rate of breastfeeding between the

infants with or without milk fortifier.No significant difference was found between the pre- and post-baby

friendly NICU in breastfeeding data.

Conclusion: No significant difference was found between the pre and post baby friendly NICU in

breastfeeding data due to the fact that our unit supports breastfeeding intensively before having this

certification.The rate of breastfeeding for babies less than 28 weeks is lower than the other groups, because

the requirement of fortifiying breastmilk are higher than the other groups. Breastfeeding rates of high-risk

infants are thought to improve their outcome.

Key words: baby-friendly, breastfeeding, infants, NICU

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S36

The Relationship Of Subtypes Of Leukocyte Within The Prenatal, Natal And Clinical

Risk Factors Assessed By Flow Cytometric Method At The Colostrum

Elif ÖZYAZICI ÖZKAN1*, Canan TÜRKYILMAZ2, Münci YAĞCI3, Esin KOÇ2, Ebru ERGENEKON2,

Esra ÖNAL2, Yıldız ATALAY 1Antalya Research And Training Hospital Neonatology Department, Antalya, Turkey, 2Gazi University

School Of Medicine, Neonatology Department, Ankara,Turkey,3Gazi University School Of Medicine,

Hematology Department, Ankara, Turkey

Objectives: Breast milk is one of the preferred methods of all infants, including sick and premature

newborns. Breast milk provides anti-inflammatory and anti-infectious nutrients by the help of bioactive

factors. Nutritional content of breast milk is affected by several maternal factors such as gestation period,

delivery type and stress. However, there is limited information regarding the risk factors of affecting

leukocytes in breast milk. In this study, we aimed to investigate the leukocyte subsets of breast milk and

their relationship with perinatal, natal and clinical risk factors.

Material and method: Seventy-four mother who gave birth in Gazi University Medical Faculty Hospital

between 1.10.2009 and 31.3.2010 were conducted in the study. Ethics declaration was obtained from local

commitee. Milk samples of the mothers were collected by colostrum and analyzed by flow cytometry in the

first 5 days of neonatal life. Mothers participated in the study were, quiestioned of usage of smoking,

alcohol, and drug abuse for the pregnancy period. In addition, the vitals of neonates have been recorded.

Results: The mean age of the mothers were 29.3±4.5/year, wherease 31 of them were primative and 43 of

them were multiparative. Sixty-four of the mothers had cesarean section and the other ten of the remaning

gave spontaneous vaginal delivery. Fifteen of the mothers had multiple pregnancies, in which two has

experienced of preeclampsia. Seven of the patients has had gestational diabetes mellitus or diabetes

mellitus and in addition six has had history of thyroid diseases. Four mothers gave history of infection at

the last trimestery. In addition, twenty of them used drug during their pregnancies. The percentages of

colostrum leukocytes of surface markers detected by flow cytometry were CD14 23.7±22.5%; CD3

20.4±16.2%; CD19 2.4±2.0%; CD4 11.3 ±8.8%; CD8 10.6±8.8%; CD16-56 was 4.8±2.9. Conclusion:

There were no statistically significant difference detected between the groups based on the parameters of

maternal age, body mass index of the mothers, delivery method of the baby, multiple pregnancy, disease

history in pregnancy and drug use status. Breast milk can be considered as a safe, beneficial and supportive

source for the maturation and developing of neonates immunological system. However, all protective

structure, functions, relationship with each other and also clinical results of breast milk, including cells,

have not been fully figured out. Our study contributes to the literature, by showing the effect of the

prenatal, natal and infant's clinical characteristics on the number and content of breast milk cells.

Conclusion: there is a need of further studies at the immunological properties of breast milk including

subtypes of te leukocytes.

Keywords: Breast milk, Colostrum, leukocyte subgroups, Flow cytometry

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S37

The Effect of Breastfeeding on Length of Pediatric Intensive Care Unit Stay and Clinical

Outcome of Children Aged in Between 1 months to 2 years

Mutlu UYSAL YAZICI¹*, Ebru AZAPAGASI¹

¹ University of Health Sciences, Dr. Sami Ulus Maternity and Children Training and Research Hospital,

Pediatric Intensive Care, Ankara; Turkey

Objectives: The aim of the study was to evaluate the effects of breastfeeding duration and

frequency on the length of pediatric intensive care unit (PICU) stay and clinical outcomes of

diseases in pediatric patients aged in between 1 month to 2 years who were hospitalized in

PICU.

Methods: Patients' age, sex, nationality, diagnosis of hospitalization, median length of PICU

and mechanical ventilator and hospital stay were retrospectively recorded. It was questioned

that when the patients aged 1 month to 2 years old how many times in a day they were

breastfed, when they started supplementary food, how many months they were breastfed, and

whether the vaccines were administered according to the vaccination schedule of the Ministry

of Health.

Results: Six hundred and fifty two patients who were admitted to the PICU for a period of

one year were screened. Fifty eight (8.89%) of these patients were immigrant patients. The

age distribution of the patients was 1 month-2 years: 52% , 2-6 years: 28%, 6-12 years: 12%

2-18 years: 8%. The study included 45 patients regularly breastfed and 30 pediatric patients

who received irregular breastfeeding or were discontinued early and all of them were aged 1

month to 2 years and these patients were hospitalized for hypovolemic shock due to diarrhea

or lower respiratory tract infection. A total of 35 children were not fully immunized (25

foreign nationals, 10 Turks) and one 11-month-old child had no vaccination. This patient was

hospitalized in Syria due to severe pseudomonas sepsis and septic shock, connected to a

mechanical ventilator, plasma exchanged 5 times and discharged from the intensive care unit

without sequela. Of the 45 patients, 28 were female, 17 were male, and the median age was

13.8 months ± 1.2, while 18 of the 30 patients were male, 12 were female and the median age

was 16.8 ± 1.4 months. The most common reasons for PICU hospitalization were

bronchiolitis, pneumonia and hypovolemic shock. Eight (17.7%) of 45 patients required non-

invasive treatment, whereas 15 (50%) of 30 patients in the non-breastfed group were required

non-invasive treatment. In the regular breastfed group, the length of hospital stay was

significantly shorter than in the non-breastfed group, but this difference was not statistically

significant ( 4.3 day vs 7.1 day , p: 0,065)

Conclusion: Mortality is found to be 3.5-4.1 times higher in children younger than 6 months

old and received formula feeding compared with breastfed children. Breastfeeding reduces

length of hospitalization and PICU stay, but prospective studies involving a larger number of

children are needed.

Key Words: Breastfeeding, child, intensive care, breast milk

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S38

Association of Retinopathy of Prematurity with Nutrition

Mustafa Şenol AKIN1*, Şule YİĞİT2 1 Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey, 2 Hacettepe

University Faculty of Medicine, Department of Pediatrics, Neonatology, Ankara, Turkey

Objectives: Poor weight gain during the first weeks preterm infants associated with the risk of developing

the retinopathy of prematurity (ROP). Our study aimed to evaluate the effect of energy, macronutrient

intakes and weight gain the first 4 weeks of life on the risk for ROP.

Method: This study was designed as a single-center, retrospective, and case-control trial. Premature

infants, who were included in this study, were born before the 30th gestational age between the years 2000

and 2016 in Hacettepe University Hospital. The infants were divided into three groups as the control

(without ROP), mild ROP and severe ROP groups. Possible risk factors for ROP such as calorie intakes

within the first 28 days, drugs used, all medical administrations, daily weight gain, feeding characteristics

were compared between the groups.

Results: ROP was found in 32 (29.5%) of 108 infants included in this study. Twelve of them (11.1%) had

level 1-2 of ROP and 20 (18.5%) had advanced level of ROP (stage 3-4). The first enteral feeding day, full

enteral feeding day and total parenteral nutrition duration were significantly higher in infants with level 3-4

ROP than the others. In addition, oral protein, oral lipid uptake, total lipid, total calorie intakes were

significantly lower in level 3-4 ROP group compared to the other groups. We found that the risk of severe

ROP increased in infants who weigh gain less than 11 g/day and who received less than 91 kcal / kg of

calories. The 28th-day weight was lower in patients with advanced level of ROP, while the duration of

discharge was higher in patients with advanced level of ROP. Nutritional values of the patients in the first

28 days were calculated by collecting in milliliters. It was found that infants with severe ROP received

statistically (p <0.05) less breast milk, but there was no difference in formula intake.

Conclusions: We showed that low energy intake during the first 4 weeks of life was an independent risk

factor for severe ROP. This implies that the provision of adequate energy from parenteral and enteral

sources during the first 4 weeks of life may be an effective method for reducing the risk of severe ROP in

preterm infants.

Key words: Retinopathy of prematurity; total parenteral nutrition; weight gain

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10.02.2019_11:40-12:40 HALL 3 – ORAL PRESENTATIONS

S39

Determinants of in-hospital formula supplementation in a Baby-Friendly hospital

Selma AKTAŞ1*

1Acıbadem Mehmet Ali Aydınlar University, Faculty of Medicine, Department of Pediatrics, İstanbul,

Turkey

Objectives: Although exclusive breastfeeding is recommended for the first 6 months of life, in-hospital

formula supplementation is widespread all around the world and has been demonstrated to be a strong

determinant of shorter exclusive and any breastfeeding. The aim of the study is to assess the reasons in

which in-hospital formula supplementation occurs in a baby-friendly hospital.

Methods: This retrospective cohort study was conducted among 503 mother-infant pairs from January to

December 2018 at the Departments of Pediatrics, a foundation university hospital of Istanbul, Turkey. Data

collected from patient files were analysed to identfy factors associated with in-hospital supplementation

using Logistic regression.

Results: During the hospital stay 14.5 % (N:73) of the infants were received formula. The most common

reasons for supplementation were lack of human- milk (78 %) and hypoglycemia (15 %). The most

common way for supplemantation was cup-feeding ( 91.78 %). Lower gestational week (GW) (p:0.0001)

and birth weight (p:0.0001) of the infant, cesarean delivery (C/S) (p:0.0001), in vitro fertilisation (IVF)

pregnancy (p:0.0001), shorter breastfeeding duration of the siblings (p:0.033) were significantly higher in

formula-supplemented group. The factors associated with in-hospital formula supplementation in univariant

analysis were assessed with Logistic regression; lower birth weight, IVF pregnancy and C/S delivery were

still significant in formula-supplemented group.

Conclusion: Our results identified several factors that enhance supplementation in hospital. Healthcare

profesional recommandations and support before and after delivery may reduce the adverse effects of lower

GW and birth weight and IVF pregnancy. Special care is needed for mothers delivering by C/S to enable to

initiate and maintain breastfeeding and also mothers should be warned about the dangers of elective C/S for

breastfeedinf practices.

Key words: breastfeeding, in-hospital supplementation, infant formula

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S40

Assessment of nutritional practices and breastfeeding education protocols in preterm

infants

Hakan ONGUN1 *, Meltem DEMİR2 1İstinye University-Affiliated Antalya Medical Park Hospital, Department of Neonatology, Antalya, Turkey; 2 İstinye University-Affiliated Antalya Medical Park Hospital, Department of Medical Biochemistry,

Antalya, Turkey

Objective: To analyze the efficiency of family education program at neonatal intensive care unit (NICU) to

facilitate breastfeeding at post-discharge nutrition in preterm infants.

Methods: This prospective, observational, historically-controlled study was designed to identify preterm

infants (gestational age ≤34 weeks) among NICU admissions between 2016 and 2018, arrange face-to-face

family interviews and collect data on ‘one-year nutrition and breastfeeding experience after-discharge’

using a four-page questionnaire. Exclusion criteria were infants older than > 34 weeks, who died at follow-

up and parents reluctant to consent for the study. Infant and family demographics, NICU interventions

(obtained by retrospective search of electronic medical files) and post-discharge nutritional outcome were

analyzed between two groups (group categorization based on the education delivery). Multivariate logistic

regression by SPSS-23 was used to determine independent predictors of the breastfeeding outcomes.

Results: 358 families filled in the questionnaire out of 435 NICU admissions. Demographics included

gestational age 30.64±2.03 weeks, birth weight 1521.62±365.68 grams. Length of NICU stay was

39.31±24.13 days. Education-delivery group presented lower gestational age and weight (p=0.003,

p=0.019). Family demographics demonstrated 56.4% were working mothers with varying periods of

‘absence of birth leave’. Two groups demonstrated similar socio-demographic variables including parental

education levels, working status, family income. Post-discharge nutrition outcome revealed 51.1% of early

additional food supply despite significant BMF rate of 91.1%. Breastfeeding length was inversely

correlated with parental age and NICU stay (mother age: r=-0255, father age: r=-0.243, NICU stay: r=-

0.247). Education-delivery group (53.1%), exhibited significant desire for ‘breast milk only' (58.9% vs.

46.4%, p=0.007) and breastfeeding continuity (8.47±3.87 vs. 6.15±3.75 months, p<0.001). The most

significant benefit of the program appeared to be the ‘physical contribution of the father' on infant's

nutrition (%71.6, p<0.001). The overall success rate claimed by families was 91.6%. Program-delivery

increased the odds of extending ‘milk-only until six months' by 2.75 times (OR: 2.7562, 95%CI: 1.7936-

2.7562). In the multivariable logistic regression model, absence of birth leave and having a sibling were

determined as the independent risk factors for breastfeeding implementations over six months (OR:11.705,

95CI: 4.634-29.564, p<0.001 and OR: 1.771, 95CI: 1.217-2.579, p=0.003).

Conclusion: Breastfeeding education programs delivered prior to NICU-discharge increase BMF

implementations in preterm infants. Health-care facilities should improvise local protocol-based

breastfeeding programs to facilitate post-discharge infant nutrition.

Keywords: Human milk, breastfeeding protocol, baby-friendly initiative, nutrition

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S41

Determining The Breastfeeding Status of Hospitalized Children Aged 0-2 Years and

Influence of Mood Changes of Mothers’ On The Duration of Breastfeeding

Selda BÜLBÜL1, Ayşegül ALPCAN1*, Edanur ACAREL1

Kırıkkale University Medical School, Division of Pediatric Metabolic Diseases and Nutrition. Turkey

Objectives: The World Health Organisation recommends that babies receive only breastmilk for the first 6

months of life and continue for the first 2 years of life. However, in Turkey breastfeeding durations of

children are not at desirable levels in general. Specially mothers’ mood changes and their psychological

state can effect the duration on the negative way. The aim of this study was to determine the breast feeding

duration of children hospitalized in a university hostital pediatrics clinic aged 0-2 years and its relationship

with mothers' mood changes.

Method: A total of 179 children aged 0-2 years who were hospitalized in our clinic and their mothers were

participated in the study. Data were collected with a questionnaire prepared by the researchers. The

questionnaire were filled by one-to-one interviews with the mother next to the patient. The Beck

Depression Inventory was completed by the mothers after the information was given by the researcher.

Results: The mean age of mothers was 36.34±7.15 years and there were 2.78 ± 1.07 children at home. The

mean age of the inpatient children was 11.06 ± 7.7 months (min. 0 - max. 24 months) and mean hospital

stay was 2.77 ± 3.37 days (min. 1 - max. 37 days). 64.7% of the mothers were married and 17.2% gave

birth to the hospitalized child under the age of 20 years. 79.1% of the mothers received primary and lower

education and 88.6% did not have any income generating employment.

The average duration of breastfeeding in hospitalized children was 6,04 ± 5,6 months(min 0- max.18

months). 15.7% of the mothers stated that they gave breast milk for 0-1 months, 29.1% for 2-6 months,

28.4% for 7-12 months and 26.9% for 24 months. Among all, 19/22 (86.4%) mothers who gave breast milk

only for 0-1 months stated that they were discontinued as they had no milk anymore. Moreover, 29.3%

stated that they had problems in pregnancy. The mean Beck depression score (BDS) of the mothers was

8.93 ± 9.40, 9.7% had moderate mood disorder and 19.4% had different levels of clinical depression. There

was no significant relationship between the duration of breastfeeding and having problems during

pregnancy, BDS and behavior of the husband as he was angry.

Conclusion: According to the results of this study, the duration of breastfeeding in our province is not at

the desired level. No relationship was found between mothers' mood and duration of breastfeeding.

Key Words: Beck Depression Inventory, Breastfeeding, Breastfeeding Status

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S42

Research of breastfeeding and introduction to solids in children diagnosed with otitis

media

Ali GÜVEY1*

1Provincial Health Directorate, Sakarya, Turkey

Objectives: It is assumed that 80% of all children suffer from otitis media at least once until the age of two.

It is proposed that breastfeeding decreases the probability of the occurrence of otitis media through several

mechanisms. There is only a few evidence in literature about this issue. Our aim in this study is to

investigate the duration of breastfeeding in children who suffer from otitis media and the timeframe of the

introduction of solid foods.

Methods: Our descriptive study covered all children (12-36 months of age) during 2018 who had

diagnosed with otitis media at government-based health institutions (hospitals and primary care) in

Sakarya. The term “otitis media” regarding diagnostic ICD-10 codes were included in the study whereas

the codes containing the term “chronic” were excluded. The total number of cases were found as 1288 and

1116 phone interviews were made with parents (mothers) which gived us a rate of 86.6% of attainability

rate. Descriptive statistics were shown as average and percentage rating. The average results were shown as

mean±standard deviation and statistical significance value was accepted as p<0,05.

Results: 54.7% among cases were male and 45.3% were female. The average age for children was

29.28±3.48 in months. The average age of mothers in our study was 31.41±5.22 (years). The average

duration for breastfeeding for all cases was 14.11±8.32. The average period for introduction into solids for

all children was 5.40±2.13 months. The average period of breastfeeding for children whose mothers age

was 29 or younger are in shorter duration (12.84) in comparison to the children whose mothers age was 30

or older (14.88). 67.8% of children among all were breastfed only for the period of 0-6 months. There was

no influence of sexes or maternal age for breastfeeding in 6 months. Furthermore, there was no statistical

difference for introduction into solids among sexes or maternal age.

Conclusions: The duration of breastfeeding who suffered from otitis media was shorter (14.1) than

optimal. The shorter duration of breastfeeding in females was in accordance with literature data. We can

suggest further evidence-based studies on beneficial effects of breastfeeding in children with otitis media to

seek more evidence supporting the claim. Moreover, it would bring another positive aspect to support

literature data to make further cohort studies which embody the calculated risks of children who are not

breastfed and the children who had never diagnosed with otitis media.

Key words: breastfeeding, otitis media, eustachian tube, solid food, childhood infection

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S43

Monitoring Of Infant Feeding Processes

Asiye ARISOY1*

1Karaman Devlet Hastanesi, Karaman, Turkey

Objective: To monitor the feeding process of newborn babies and to establish data management systems

for nutrition monitoring.

Method: The study was carried out between 1st January - 30th June 2019. The babies who were born in

our hospital and transferred from other hospitals after delivery were included in the study. The babies were

divided into three groups. Different schedules were created. In acccordance with these schedules, it was

planned to monitor the nutritional status of the babies and to evaluate whether the targets in our hospital as

a baby-friendly hospital had been achieved or not. The first group included infants who were born in

hospital. The first chart included early skin-to-skin contact between mother and baby, breastfeeding status

of all healthy newborns in the first hour after delivery, and data showing the babies taken into special care.

It was aimed to keep the breastfeeding rate above 95% in healthy babies at discharge. The second group

included newborn babies followed up in the neonatal intensive care unit (NICU). The charts prepared for

this group included the nutritional status of the infant at admission to and discharge from the intensive care

unit. The third group included infants who were discharged. Questionnaires including breast feeding status

and feeding problems were administered to the mothers of the discharged infants by phone. It was aimed to

keep the breastfeeding rates of the babies who were discharged at home above 90%.

Results: Between 1 January and 30 June 2019, a total of 854 deliveries of which 436(%51) were normal

births were performed in our hospital. The skin-to-skin contact between the baby and the mother was

provided immediately after birth in 75.6% of the babies included in the first group. Fifty percent of babies

(429 baby) were breastfed at the delivery room (within the first half hour) and a total of 821 babies (95%)

were breastfed within the first hour. The remaining 5% of babies were not breastfed because of health

problems. The second group included 520 infants who were hospitalized in the NICU. During admission to

the intensive care unit, 78 infants (14.6%) had no oral intake, 409 infants (78%) were fed with breast milk,

33 infants were breastfed + formula (5.8%) and 1 baby was fed with formula. In the third group, infants

who were discharged were included. Of 298 babies who were monitrored after discharge, 292 babies

(97.7%) were only breastfed for the first six months. It was also seen that no mother chose to use the

formula of their own accord.

Conclusion: These charts that we have developed as a baby-friendly hospital for newborn babies allow the

monitoring of the feeding processes of healthy and inpatient babies and monitoring of feeding at home.

Key words: breastfeeding, baby nurse, nutrition

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S44

Breastfeeding status of 2-6 years old children in Sivas, mothers' practices weaning from

breastfeeding and evaluating their parental attitudes

Ayça KÖMÜRLÜOĞLU 1*, S. Songül YALÇIN2 1 Sivas Cumhuriyet University Faculty of Medicine, Department of Pediatrics, Sivas, Turkey, 2Hacettepe

Universty Faculty of Medicine, Department of Pediatrics, Social Pediatrics Unit, Ankara, Turkey

Objective: We aimed to examine breastfeeding status and affecting factors of 2-6 years old children in

Sivas, to investigate the mothers' practices weaning from breastfeeding and to evaluate and compare their

parental attitudes.

Methods: Data were collected from the mothers of 2-6 years old children admitted to university hospital

pediatric clinic. 160 mothers, who did not continue breasfeeding at that time, completed the two-part

questionnaire. First part included 38 questions about sociodemographic profiles, breastfeeding status,

supplementary food intake, when and how to stop breastfeeding. Second part was ‘Parental Acceptance-

Rejection/Control Questionnaire’ (PARQ/C), consists of 73 questions and 5 subscales, that was developed

to measure parents' perceptions of adoption and rejection to their children. Data were analyzed using SPSS

version 24.0 software program.

Results: The mean age of the mothers(n=160) were 32,9±5,1 years, children were 48,9±15,9 months.

50.6% of the mothers were housewifes, 64.4% had high school education and above. Within the first hour

of birth, 56,9% of the infants were breastfed. The mean duration of breastfeeding was 19,3±9,8 months.

82,5 % of the children were breastfed up to 1 years, 43,8% were breastfed up to 2 years. Only 23,8 % of the

infants were exclusively breastfed at the first 6 months. 123 mother had stopped breastfeeding by a planned

weaning process. 72,4% of them had used a traditional method. 58.2% had changed the taste of the breast

(applying tomato paste, pepper, etc.), 24,2% had changed the appearance of the breast (putting hair, dying

to black etc.) and 17,6% had separated child from the breast (sending baby out of the house, etc). 50,4% of

this mothers had stated no difficulty in weaning. PARQ/C total scores and hostility/ aggression,

indifference/neglect subscale scores were significantly higher in low educated mothers and housewifes than

other mothers (p<0,05). PARQ/C total score and subscale scores were similar between mothers who

used/did not use traditional methods for weaning, between traditional method groups and who had/did not

have difficulty in weaning from breastfeeding (p>0,05).

Conclusions: Supporting families with low education, low socioeconomic status and low income will be

important for children to grow up in a healthier family environment and to increase parental acceptance.

Mothers should be encouraged to continue breastfeeding up to 2 years and exclusive breastfeeding at the

first 6 months.

Key words: attitudes, breastfeeding, parental, weaning

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S 45

The effect of breastfeeding duration on parental attitudes in preschool children

Deniz YILDIZ YAHŞI1*, S. Songül YALÇIN2 1Dr. Sami Ulus Children’s Hospital,Ankara, Turkey, 2Hacettepe Universty Faculty of Medicine,

Department of Pediatrics, Social Pediatrics Unit, Ankara, Turkey

Objectives: Breastfeeding is known to be important for mother-infant bonding and the relationship with

the type of parent can be interesting. This study was aimed to investigate the effect of breastfeeding

duration on mothers' parental attitudes.

Methods: Mothers of children in a day care center and their neighborhoods having preschool children were

enrolled for the study between January-May, 2019. Children with chronic illnesses or with gestational

length under 37 weeks of age and with a birthweight of less than <2500 grams were not included.

Voluntary mothers filled a questionnaire including child age, gender, attendance to day-care center,

maternal age, education, occupation, birth order, family type and breastfeeding duration. Then, mothers

completed parental attitude scale. Breastfeeding duration was categorized as ≤6, 7-12, 13-24, >24 months.

Kolmogorov–Smirnov test revealed skewed distribution for scores of parental styles. “A two-step approach

for transforming data to normal” was applied, z scores were calculated and converted to original value with

specified mean and standart deviation. Scores of parenting styles in breastfeeding categories were

compared with ANOVA. After controlling questionnaire variables, univariate analysis of variance were

used to detect the effect of categorized breastfeeding duration on the scores. p<0.05 were considered

significant.

Results: 286 mothers with children aged between 2 and 6 years participated in the study. Of all children,

50.0% were male, 47.6% first child, 90.2% lived in a nuclear family, 66.1% attended day-care center. The

children’s mean (±SD) age was 4.5 (± 1.1) years. The mean (±SD) maternal age at delivery of index child

was 29.9 (± 4.3) years, 52.8 % of mothers were working and 60.5% educated more than 12 years. The

mean (± SD) duration of breastfeeding was 16.7 (± 8.3, median 18) months, 18.9 % of children breastfed

less than 7 months and 11.5% more than 24 months. The mean (± SD) scores of parental attitudes were

75.2 (±8.1) for democratic, 19.3 (±5.2) for authoritarian, 31.4 (±6.4) for overprotective and 19.3 (±5.4) for

permitting subscales. Mothers who breastfed more than 24 months had significantly lower authoritarian

subscale scores than those with less than 7 months, however, higher permitting subscale scores (p=0.044,

p=0.013; respectively). General linear models also revealed similar results when adjusting for confounding

factors. Breastfeeding duration did not change the mean scores of democratic and overprotective subscales.

Conclusion: Longer breastfeeding duration had an influence on authoritarian and permitting subscales of

parental attitude scale.

Keywords: breastfeeding duration, Parental Attitude Scale, preschool children

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S46

Relationship between duration of breastfeeding and emotional and behavioral problems

of children

Şeyma ÇİÇEK1*, S. Songül YALÇIN2 1 Etimesgut Şehit Sait Ertürk State Hospital, Clinic of Pediatrics, Ankara, Turkey, 2Hacettepe Universty

Faculty of Medicine, Department of Pediatrics, Social Pediatrics Unit, Ankara, Turkey

Objectives: Breastfeeding is known to ensure healthy growth and development as well as reduce various

behavioural problems of children. In this study, it was aimed to show the relationship between the duration

of breastfeeding and emotional-behavioural problems in preschool children.

Methods: Voluntary mothers of preschool children who admitted to the pediatric outpatient clinic were

included in the study. Children who were born under 37 weeks of gestation were not taken for the study.

Mothers filled a structured questionnaire including maternal age, education, occupation, child’s age,

gender, birth weight, breastfeeding duration and presence of sibling. Then, mothers completed Strength and

Difficulties Questionnaire (SDQ). Scores of emotional problems, conduct problems, hyperactivity, peer

problems and prosocial subscales were calculated. Being in the upper quintile of subscales were excepted

as high score, Q5. Breastfeeding duration was categorized as <6, 6-11, 12-17, 18 -23 and ≥24 months.

Logistic regression analysis was used to detect the effect of breastfeeding subgroups on subscales of SDQ.

After controlling child’s age, gender, maternal age, occupation, education, birth weight, and sibling

number, the effect of breastfeeding duration on subscales of SDQ (high or normal scores) was analysed

with multiple logistic regression analysis. Odds ratio and 95% confidence intervals were calculated. p

<0.05 significance level.

Results: A total of 325 children (53.5% under 4 years old and 49.8% male) are enrolled for the study. The

mean (±SD) ages of children and mothers were 3.9 ± 1.0 and 30.1±5.3 years, respectively. The mean

duration (±SD) of breastfeeding was 15.0 ± 7.9 months (median 14.0); 9.8% of the children were breastfed

under 6 months and 20.3% of them were breastfed over 24 months. Among behavioral problem scales,

breastfeeding duration affected only the rate of “Q5 prosocial problems” (p=0.007). When confounding

factors were adjusted, multiple logistic regression analysis revealed that mothers who breastfed their

children for ≥ 24 months had lower odds ratio for having “Q5 prosocial problem scores” compared to those

with breastfeeding duration less than 6 months (OR=0.29, 95% CI=0.10-0.87). Breastfeeding did not

change the ratio of Q5 levels in emotional problems, conduct problems, hyperactivity and peer problem

subscales.

Conclusion: The duration of breastfeeding had an influence on prosocial problems in children. To improve

behavioural problems in children, breastfeeding should be promoted.

Key words: behavioral, breastfeeding, children, duration, emotional, problems

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S47

Does gestational anemia have an impact on early breastfeeding success?

Merve KÜÇÜKOĞLU KESER¹*, Esin OKMAN¹, S. Songül YALÇIN², Evrim ALYAMAÇ DİZDAR¹,

Esra BEŞER ÖZMEN¹ 1University of Health Sciences, Zekai Tahir Burak Maternity Teaching Hospital, Neonatal Intensive Care

Unit, Ankara, Turkey.,2Hacettepe Universty Faculty of Medicine, Department of Pediatrics, Social

Pediatrics Unit, Ankara, Turkey

Objectives: Breastfeeding is important for the growth and development of the newborn. Anemia which is a

common health problem in the world that affects maternal health and therefore infant health. The aim of

this study was to investigate the effect of gestational anemia on early breastfeeding success in infants who

were born on time and early initiation of breastfeeding was started within the first hour.

Methods: The babies who were born in Zekai Tahir Burak Maternity Teaching Hospital between 1 April-

31 July 2019, who applied to the polyclinic for health control in the postpartum 5-10 days, whose

breastfeeding time was started within the first hour were included in the study. Infants whose gestational

length is less than 38 weeks and birth weight is below 2500 g were excluded from the study. In a structured

questionnaire, maternal age, educational status, gravida, mode of delivery, antibiotic usage, smoking

exposure, and some liquid or formula given outside breast milk in the first week after birth were

questioned. Hemoglobin values of mothers were recorded and values below 11 mg/dl were accepted as

anemic.

Results: Eighty-five of the 175 infants who met the inclusion criteria were included in the study. Mean age

of the mothers was 26.9 ± 5.8 years. The mean birth weight of the infants was 3280 ± 418 grams.

Gestational anemia was reported in 33 (38.8%) mothers. 29 (34.1%) infants were given formula in the first

7 days. In the first 7 days, it was observed that the use of the formula did not differ according to the materal

age, education level, whether the baby was the first child, the history of antibiotic use of the mother and the

history of any smoking exposure during pregnancy. While 48.5% of the mothers diagnosed with gestational

anemia had formula use in the first 7 days, this rate was found to be 25.0% in patients without gestational

anemia (p = 0.02) (OR = 2.8, 95% CI: 1.1 -7.1). When logistic regression analysis was performed in cases

with vaginal delivery, the risk of using formulas in the first week increased by 5.0 times in cases with

gestational anemia compared to cases without anemia (95% CI: 1,2-20,7).

Conclusions: Gestational anemia was found to be a risk factor affecting the success of breastfeeding.

Treatment with anemia may reduce the rate of use of formula in the first 7 days. Further studies are needed

on this subject.

Key words: anemia, breastfeeding, gestational, success

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S48

Is there any effect of hyperbilirubinemia on breastfeeding? If any, at which level?

Ayşe ÜNSAL1*, Nilgün ALTUNTAŞ1

1Ankara Yıldırım Beyazıt University Medical Faculty, Department of Pediatrics, and Division of

Neonatology, Ankara, Turkey.

Objectives: We wanted to investigate whether hyperbilirubinemia (significant or physiological) has an

effect on breastfeeding, milk intake, infant's wakefulness, and if any, which level of bilirubin affects

breastfeeding.

Methods: Healthy, term, and breastfed babies with significant hyperbilirubinemia required phototherapy

were included in the study (Group 1, n=71). In the neonatal outpatient clinic, a control group was formed

from babies with physiological jaundice (Group 2, n= 90). All infants were monitored during breastfeeding

and breastfeeding was evaluated with breastfeeding assessment tools (IBFAT and LATCH) and milk intake

was assessed by test scale. The same examinations were repeated after phototherapy when normal

bilirubine levels were reached.

Results: Milk intake, IBFAT (IBFATT, IBFAT1, IBFAT6) and LATCH scores were significantly lower

in-group 1 than control group (p <0.05). In-group 1, the amount of milk intake, IBFAT and LATCH scores

after phototherapy increased significantly compared to pre-phototherapy values (p <0.05). Looking at the

correlation matrix in the whole study group (groups 1 and 2) there were moderate but very significant

negative correlations between bilirubin and milk intake (r = 0.32, p = 0.001), IBFATt (r = 0.47, p = 0.001),

IBFAT1 (r = 0.57, p = 0.001), IBFAT6 (r = 0.65, p = 0.001) and LATCH scores (r = 0.49, p = 0.001). In the

ROC analysis, the cut-off bilirubin value was found to be 12 mg / dl.

Conclusion: Hyperbilirubinemia has a negative effect on breastfeeding and milk intake. Bilirubin levels

above 12, including in babies with physiological jaundice, adversely affect breastfeeding.

Key Words: hyperbilirubinemia, milk intake, LATCH, IBFAT, breastfeeding.

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S49

Comparison of duration of breast milk use and initiation time for complementary food

in obese and normal weight children

Emine ÇAMTOSUN1*, Ayşehan AKINCI1, Harika Gözde GÖZÜKARA BAĞ2

1Inonu University, School of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey, 2Inonu

University, School of Medicine, Department of Biostatistics and Medical Informatics, Malatya, Turkey

Objectives: Some studies investigating the effects of nutritional characteristics on infant body weight have

been found to have a protective effect against childhood obesity while some studies did not show this

effect. The aim of this study was to investigate whether there is a difference between obese and normal

weight children in terms of duration of breast milk usage and initiation time to complementary food.

Methods: Between 2-18 years old 100 obese children and 80 children who have normal (5-85 percentile)

body mass index were included. The anthropometric datas of the children, the duration of breast milk use

(DBU), initiation time to complementary food(ITC) and family history of obesity (FHO) were recorded

from the hospital records. Children who have history of prematurity, small or large for gestational age,

chronic illness, chronic drug usage were excluded. The groups were compared in terms of DBU and ITC.

Results: The mean ages (year) were 10.01 ± 3.85 in the obese group and 8.81 ± 3.73 in the control group

and they were not different statistically. The groups were similar in terms of gender distribution (51% of

the obese group and 55% of the control group were female). Mean DBU in the obese group was not

statistically different from the control group (15.77 ± 9.70 and 17.81 ± 7.78, respectively; p = 0.174).

Although the rate of breast milk use ≥ six months was higher in the control group than in the obese group,

no significant difference was found (94.9% and 85%, respectively; p = 0.058). The mean ITC in the obese

group was found to be later than in the control group (p = 0.027). The presence of a FHO was more

common in the obese group. When the obese (n = 40) and control (n = 50) groups without a FHO were

compared, the DBU and the rates of breast milk use for ≥ six months were still indifferent (p = 0.43). The

rates of breast milk use for ≥six months were similar also in obese and control subjects younger than 6

years old (p = 1.0). When the patients were divided into under 12 and ≥ 12 years of age, there was no

difference between the groups in both age groups in terms of median DBU and rates of breast milk use for

≥ 6 months.

Conclusions: In our study, rates of breast milk use for 6 months or more were 85% or high in both of the

healthy and obese groups. However, no significant difference was found between obese children and

healthy control group in terms of DBU. Due to the fact that the DBU in our country is higher than in

western societies, working with larger groups may show the difference significant. It was observed that

obese children started supplementary food later. The presence of a family history of obesity was found to

be a risk factor for childhood obesity.

Key words: breast milk, complementary food, childhood obesity

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0-2 Years Old Baby's Mother and Father's Breast Milk Perception

Nursan ÇINAR1, Öznur TİRYAKİ2*, Sultan PEKŞEN2*, Yusuf Onur PEKŞEN3

1 Sakarya University, Faculty of Health Sciences, Department of Pediatric Nursing, Sakarya; 2 Sakarya

University Training and Research Hospital, Sakarya; 3 Sakarya University Faculty of Medicine, Sakarya,

Turkey

Objective: Supporting the mother, role of fathers as well as mothers in nutrition of babies will increase the

success of breastfeeding. This study was carried out to determine the perceptions of parents of 0-2 year old

children about breast milk.

Method: This descriptive study has been conducted between 1 June and 15 July 2019. The universe of the

study consisted of the parents who applied to the pediatric outpatient clinics. Sampling of the study

consisted of mother and fathers who have 0-2 year-old children, who met the criteria for participation in the

study and who volunteered for the study. In order to collect data, ‘Parent Identification Information Form"

and "Perception Scale of Breastfeeding of Adults" prepared by the researchers were used. The scale

consists of 30 positive items and one sub-dimension. The minimum score that can be obtained from the

scale is 30 and the maximum score is 150. A high score indicates that adults have a good perception

regarding to breast milk. The data were analyzed in SPSS 21 program. Normality tests of the data were

evaluated by Kolmogorov-Simirnov test. After evaluation of the normal distribution of the data and due to

normal distribution of scores Mann-Whitney U test was used in two-group comparisons and Krsukall-

Wallis H test was used in comparisons with three or more groups.

Results: The mean age of the mothers among 230 participants (115 mothers, 115 fathers) was 28.63 ± 5.14

(min: 20, max: 44). It was determined that 47% of mothers were high school graduates and 19% worked.

The mean age of the fathers was 32.48 ± 5.19 (min: 21, max: 46). It was found that 47% of the fathers were

high school graduates and 91.3% were working. 63.5% of mothers stated that 67% of fathers received

breast milk and breastfeeding training, 74% of mothers and 60% of fathers stated that they received this

training from health personnel. For the question of "How often should the baby be breastfed / fed?" 57.4%

of the mothers and 54.8% of the fathers answered as "2 hours apart". For the question of "When should

complementary food started" 73% of the mothers and 54.8% of the fathers answered as "in 6th month". The

average of mothers “Breast Milk Perception Scale for Adults” was 130,32 ± 16,67 (min: 75 max: 150), and

the fathers were 129,91 ± 17,15 (min: 59 max: 150) and it was determined that there was no statistically

significant difference between the breast milk perception scores of mothers and fathers (z = 242, p = .804).

Conclusion: Parents' perception of breast milk was good and there was no difference in breast milk

perception when the mothers and fathers were compared.

Key Words: 0-2 year old child, Mother, Father, Breast milk, Perception

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S51

Breastfeeding rates and duration in children with cerebral palsy

Gülşah KARATAŞ1* 1Karabuk University Faculty of Medicine, Department of Physical Medicine and Rehabilitation Karabük,

Turkey

Objective: Cerebral palsy (CP) is the most common neurological disorder in childhood, which leads to

limitation of activity in children due to permanent damage in the developing brain. In children with CP, a

history of preterm delivery or any other reason for staying in intensive care unit is quite common. The

breastfeeding history and its duration were questioned in these children who were in close care with mother

after birth. The aim of this study was to determine whether there was a relation between neurological status

in children with CP and the rate or duration of breast milk intake.

Methods: A total of 84 children with CP who were followed up in Karabuk university faculty of medicine

were evaluated retrospectively by reaching their electronic files in hospital or contacting their families via

telephone. The demographic and clinical data of the children regarding whether or not they stayed in

intensive care unit or they had a history of breast milk intake were recorded after interviewing with

families. Children with CP who were able to maintain oral feeding and had stage 1 to 3 motor function

according to the gross motor function classification were included in the study.

Results: Fifty-two female and 32 male children were included, with a mean age of 9.94 ± 6.61 years. The

rate of breastfeeding was 72.6%, with a median time of breastfeeding being 7 (range; 1-48) months. The

breastfeeding period of the children who had history of intensive care unit stay was 5 (range, 1-24) months.

The duration of breastfeeding was significantly different in patients with and without history of intensive

care unit stay (p = 0.001). It was observed that 23 children did not receive breast milk and all had a history

of intensive care unit stay. Of the 45 children who had history of intensive care unit stay, 22 were breastfed.

In addition, among 61 children who received breast milk, 22 had a history of intensive care unit stay. There

was no significant relation of CP types with the rate and duration of breast milk intake (p = 0.14, p = 0.21).

Conclusion: According to the 2013 health and population survey conducted in our country, 96% of healthy

born children received breast milk, with an average duration of 16.7 months. In our study, both the ratio

and the duration of breastfeeding were in lower levels. This may have been related to initial oromotor

problems after the birth or a delay in receiving breast milk intake. Despite many adversities, breastfeeding

rates of children with CP are still promising and it will be even more beneficial to increase the rates of

breastfeeding.

Keyword: Cerebral palsy, breastfeeding, breast milk

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S52

Breastfeedingpractices in medical nutrition treatment of phenylketonuria

Nihan ÇAKIR BİÇER1*, Melike ERSOY2 1İstanbul Kültür UniversityFaculty of HealthSciences, Department of NutritionandDietetics, İstanbul,

Turkey, 2Pediatrics Clinic, Bakırköy Dr. Sadi Konuk Training andResearchHospital, Istanbul, Turkey

Objective: Phenylketonuria (PKU) is an inherited metabolic disease with the increase of phenylalanine

(phe) in the blood and body fluids in the absence of phenylalanine hydroxylase enzyme. PKU was the first

inborn error of metabolism treated with medical nutrition therapy (MNT). The aim of this study was to

evaluate the breastfeeding practices in the MNT of PKU patients followed up at Dr. SadiKonuk Training

and Research Hospital, metabolism reference clinic for three years.

Methods: Forty-two patients were reviewed for infants diagnosed with PKU between 2016 and 2019.

Eighteen PKU patients (8 mild-PKU, 10 classic-PKU) over two years old and diagnosed with National

Newborn Screening Program were included the study. MNT, blood phe, tyrosine (tyr) levels and

anthropometric measurements of patients were evaluated retrospectively.

Results: The mean age of patients is 2,5±0,4 years and 44% were male. The patients were diagnosed at a

mean age of 13,7±6,7 days with blood phe and tyr levels of the patients were 1756 µmol/dL and 65

µmol/dL. After the diagnosis, 24-hour-BH4-loading test was applied, breastfeeding was interrupted until

the blood phe level was <600 µmol/dL (mean 3,7±1,6 days) and breast milk was stored for reuse. In this

process, MNT was applied phe-free medical formula with an average of 2,1 g/kg/day essential amino acid

(eaa), 108 kcal/kg/day energy and 150 ml/kg/day fluid. After the blood phe level was <600 µmol/dL, free

breastfeeding was initiated. Mean breastfeeding duration of patients was 17,8±9,3 moths. In the first 6

moths 0.9 g/kg/day eaa, 43 kcal/kg/day and 57 ml/kg/day fluid were applied and average blood phe and tyr

levels were 240 µmol/dL and 70 µmol/dL. Complementary feeding education was given to all patients at 6

months. At the age of 6-12 months the patients received MNT containing average 0,9 g/kg/day eaa, 0,54

g/kg/day natural protein, 25 mg/kg/day phe, 74 kcal/kg/day energy and average blood phe and tyr levels

were 314 µmol/dL and 69 µmol/dL. At the age of 12-24 months, the MNT containing average of 1,1

g/kg/day eaa, 1 g/kg/day natural protein, 26 mg/kg/day phe, 109 kcal/kg/day was recommended to patients

and average blood phe and tyr levels were 312 µmol/dL and 82 µmol/dL and phe:tyr ratio was 3,8.

Anthropometric measurements of the patients were observed to be within normal range during the study.

Conclusion: Free breastfeeding is a successful and reliable practice that supports the healthy growth and

development of the child in the life-long MNT of PKU.

Keywords: Breastfeeding, phenylketonuria, medical nutrition treatment.

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S53

Analysis on how Sustainable Development Goals issue “breastfeeding”?

Dilek ASLAN1*, Neslihan YUKARIKIR2, Songül VAİZOĞLU3 1Hacettepe University, Faculty of Medicine, Department of Public Health, Ankara-Türkiye, 2Kırıkkale

Health Directorate, Kırıkkale, 3Near East University, Faculty of Medicine, Department of Public Health,

Lefkoşe-KKTC

Objective: Sustainable Development Goals (SDGs) of the United Nations (UN) are among the most

important guide for global health and in this regard, coverage of the most prior global health issues in

document is highly expected. There are currently 17 SDGs and they are known to be transformed from

Millennium Development Goals (MDGs) which were launched in 2000. All SDGs are closely connected

with each other, however, Goal 3 is has the major focus on Good Health and Wellbeing. Goal 1 is about

struggle with poverty and Goal 2 is on eliminating hunger. Our hypothesis is these three SDGs should have

details on initiation and sustaining exclusive breastfeeding which is preventive action to struggle with

hunger, disease, and mortality under the age of five.

Materials and Method: In this paper, 17 SDGs of UN were analysed and breastfeeding related content and

details of the content were recorded. The three Goals (Goal 1, 2, and 3) content were analysed to assess if

the breastfeeding related issues were covered within the details of the Goals. UN SDGs website and e-

handbook on SDGs were investigated concurrently in July 2019.

Results: None of the three Goals have detailed and direct purpose on promoting breastfeeding. Thus, there

are other linked campaigns which highlight the importance of SDGs and breastfeeding. One of them is

regularly campaigned via World Breastfeeding Week activities which is also supported by Post-Millennium

Development Goals-Global Targets 2025. Although it is a very important promotion campaign, more

focused aims should help the solution of the problem as the global breastfeeding rates are still very low

even in developing countries.

Conclusion: In conclusion, improving breastfeeding especially under 6 months of age is a “must” for the

global health agenda. The existence of many good initiatives is very promising, nevertheless, a more

emphasize on breastfeeding in the SDGs could be included and this might be helpful to follow up the

global situation in a more systematic manner.

Key words: Sustainable Development Goals, Breastfeeding, Global Health

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S54

Factors Influencing Formula Supplementation In Breastfed Infants In Turkey’s First

Relactation Unit Between Three Time Periods

Canan TÜRKYILMAZ1* 1Gazi University Faculty of Medicine, Department of Neonatology, Beşevler, Ankara, Turkey

Objective: The short and long term health benefits of breastfeeding for infant and mother are widely

acknowledged. Major risk factors of early breastfeeding cessation and formula supplementation are delayed

lactogenesis due to cesarean section delivery, excessive weight loss, poor weight gain, poor latch and/or

sore nipples. Aim of the present study was to determine the changing confounding factors for formula

supplementation in cases referred to our Turkey’s first“ Breastfeeding Support and Relactation Unit” in

Gazi University Hospital between three time periods.

Methods: Although Gazi University Hospital is certified as baby friendly since 2002, high cesarean

delivery rate and early discharge policy of maternity units lead to higher formula supplementation and

lower exclusively breastfeeding rates. To mitigate these breastfeeding problems, Turkey”s first

‘Breastfeeding Support and Relactation Unit’ was established at Gazi University Hospital in 2014. Cases

with lactation problems such as infants that have breast milk insufficiency, formula supplementation need

and NICU graduates are referred to this unit. Experienced lactation consultants help mothers to return to

exclusive breastfeeding.

Results: This study evaluates the factors influencing formula supplementation in three consecutive periods

which have different charecteristics. In first time period; cases were mostly from our nursery and NICU,

while during second period cases have been referred by specialized units of our hospital such as pediatric

gastroenterology, allergy, and follow up clinics. Surprisingly, the third period the most difficult cases such

as multiples, maternal depression, recurrent breast abscess/mastitis were admitted to the relactation unit,

most of them were referred from another hospitals or physicians. Primiparity, cesarean delivery and

prematurity rates remained same among three periods. In all three periods, formula supplementation is

mostly started during the first week of life. Only changed factors during these time periods were the causes

of formula supplementation. Delayed lactagenesis or breast milk insufficiency were the most common

cause of formula supplementation in first period. Meanwhile in the second period the most common causes

were cow milk/food allergies. Rare and difficult causes like multiplets, recurrent mastitis, breast abscess

and maternal depression were referred from another hospitals and physicians even another cities in the third

period.

Conclusion: The causes of formula supplementation differs from time to time and patient profile of local

unit. For that reason relactation units can be able to adapt to different scenarios so they should carefully

managed and planned for each locations in Turkey.

Key words: breastfeeding, formula supplementation, lactation support unit, relactation

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S55

Does adolescent motherhood effect macronutrient contents in breast milk?

Esin OKMAN1*, Esra BEŞER ÖZMEN1, Evrim ALYAMAÇ DİZDAR1, Merve KÜÇÜKOĞLU KESER1,

Fatma Nur SARI1, Cüneyt TAYMAN1, Şerife Suna OĞUZ1 1University of Health Sciences, Zekai Tahir Burak Maternity Teaching Hospital, Neonatal Intensive Care

Unit, Ankara, Turkey.

Objective: Breast milk is the best for newborns due to its rich dietary content, immunologic factors, ease of

accessibility and affordability. Given the fact that adolescent birth rate in Turkey is high, this study

examines the effects of adolescent motherhood with regard to macronutrient contents in breast milk.

Method: Colostrum samples were collected from mothers of neonates born in our hospital, whose

gestational ages were ≥37 weeks. Demographic characteristics of the patients were registered. To analyze

breast milk, MIRIS (Mid-Infrared Human Milk Analyzer) device was utilized, using spectroscopy method

for measurements. Protein, fat, carbohydrate and energy levels of the samples were measured and groups

were compared.

Results: The study includes 225 mothers of whom 76 were adolescents and 149 were adults. Maternal

weight, maternal body mass index, weight gain during pregnancy, mode of delivery and gestational age, as

well as birth weight and gender of the infants were similar. As breast milk contents were compared, there

were no statistically significant difference between the groups in terms of protein, fat, carbohydrate and

energy levels.

Conclusion: Macronutrient contents in colostrum of adolescent mothers constitute no differences to adult

mothers. Although adolescent motherhood may adversely affect the infant welfare, likeliness of breast milk

contents might be construed positively in terms of nutrition, growth and development.

Keywords: adolescent, breastmilk, nutrition, macronutrient, newborn

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S56

Relactation in mothers who have never breastfed or low milk supply; a prospective

cross-sectional study

Melahat Melek OĞUZ1*, Tülay ORTAKÇI1, Seval ÖZTÜRK1, Esma ALTINEL AÇOĞLU1, Fatma Zehra

ÖZTEK ÇELEBİ1, Hüsniye YÜCEL1, Şanliay ŞAHİN1, Emine POLAT1, Meltem AKÇABOY1, Saliha

ŞENEL1 1Dr.Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey

Objectives: Breast milk is the most excellent food that reduces mortality and morbidity in infants. In order

not to deprive children of this, re-lactation process should be handled carefully. Re-lactation is the process

of lactation of woman who newly gave birth to her baby however who did not initially breastfed or stopped

after breast feeding for few days to few weeks. Re-lactation may also have an increasing effect on milk

supply to some extent. We aimed to evaluate the causes of lactation failure and the effectiveness of the re-

lactation program in our breastfeeding counseling policlinic.

Methods: Mothers with their infants of less than 4 months of age, who were admitted with lactation failure

and had breastfeeding related problems between January 2018 and January 2019 were included in our

study. Adopted infants and infants with underlying chronic diseases were excluded.

Results: A total of 1455 mothers applied to our outpatient clinic for counseling during this period. A total

of 96 mothers who met the inclusion criteria and were prospectively followed for 6 months. The mean age

of the mothers was 27 (min-max: 18-37). The most common reasons for breastfeeding failure were the

mother's belief that milk was insufficient (60.4%) and bottle use (59.7%) respectively. Five patients had

breastfeeding failure due to tongue-tie. Partial re-lactation was achieved in all mothers. The number of

mothers who succeeded in complete re-lactation was 77 (80.2%). The only factor affecting the success of

the complete re-lactation was admission to breastfeeding counseling policlinic within six weeks after birth

(OR: 2.1 [1.7-3.1]). Maternal age, maternal education level and hospitalization did not have any effect on

the success of re-lactation. The mean time to complete re-lactation was 23 ± 9 days. The number of

mothers using lactogogue was 6 and 4 of them achived complete re-lactation.

Conclusion: The success of the re-lactation can be increased with the right support on time. Breastfeeding

counseling that begins prior to birth can prevent simple problems that may create obstacles to

breastfeeding.

Keywords: Re-lactation, lactation failure, breastfeeding

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Physicians’ knowledge and attitudes about breastfeeding

Şanliay ŞAHİN¹*, Ganime AYAR², Emine POLAT¹

¹University of Health Sciences, Dr. Sami Ulus Maternity and Childrens' Education and Research Hospital,

Turkey, ²University of Health Sciences, Ankara Childrens' Hematology Oncology Education and Research

Hospital, Turkey

Objectives: Breastfeeding is the best infant feeding method worldwide. It is important to understand the

factors that influence breastfeeding to reach high breastfeeding rates. Suggestions of a physician can

improve the rates, but physicians are sometimes not experienced in breastfeeding counselling. The aim of

this study was to investigate the knowledge, attitudes and practices of physicians regarding breastfeeding.

Methods: Volunteered physicians who agreed to participate constituted the sample of the study. The data

were collected by the researchers using an online questionnaire from February to May 2019. A

questionnaire was created according to determine demographics and attitudes of the physicians and

predefined correct responses.

Results: A total of 372 physicians were included in the study. 343 (92.2%) were female. Most of the

volunteers 65% were aged between 26 and 40 years. Of the participants, 31.2% were pediatricians, 10.7%

obstetrician, 27.4% family physician/general practitioner (GP) and 37.9% other medical fields. 48.7% of

the physicians stated that they had no education about breastfeeding. 73.4% of their children were

breastfed. Only 10.2% of the doctors stated that their own children received breastmilk for more than 24

months and 25% believed that breastfeeding should be maintained for longer than 24 months. Most of the

physicians believed that their guidance was more important before birth (84.7%). The baby-friendly

hospital feature was only known by 61.6% of the physicians and was better understood by pediatricians and

family physicians (65-69%). Features of the hospitals where doctors worked were recorded. There was no

difference between the physicians in terms of attitudes about the practice of breastfeeding, but the level of

knowledge was low in all physicians, more prominently in family physicians/GPs about the continuation of

breastmilk or situations that it should be discontinued. Very high percentage (93%) of the physicians

encounter mothers with breastfeeding problems (P>0.001) and 31.7% didn’t think that they have sufficient

knowledge (P<0.05). Only 69.9% of the physicians trusted themselves to lead a family with breastfeeding

problems and 69.1% would like to receive training about breastfeeding counselling (P>0.001).

Conclusions: Breastfeeding rates and continuation of breastfeeding are still not at the optimal level. The

fact is that education of physicians who have the most contact with infants will increase breastfeeding rates.

Physicians' level of knowledge and awareness must be increased through regular trainings, courses and

seminars. In addition, the knowledge about breastfeeding is basic and must be essential in medical school

programmes.

Key words: attitude, baby-friendly hospital, breastfeeding, knowledge, physicians

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Evaluation of video education for mothers in a baby-friendly state hospital

Mehmet Sabri KIRIK1*, Suat TUNCAY2, Engin YILMAZ1, Başak CEVİZ1 1Silvan Dr. Yusuf Azizoğlu State Hospital, Diyarbakır, Turkey, 2Bingöl University, Bingöl Health Science

Faculty, Nursing Department, Bingöl, Turkey

Objective: This study was planned to evaluate the level of knowledge, attitudes and behaviors of the

mother who given birth in a baby-friendly state hospital, about breastfeeding who received video

breastfeeding training.

Method: This research was designed in a quasi-experimental model with post-test control group between

March-May 2019. The sample of the study consisted of 60 mothers of 30 experimental and 30 control

groups who gave birth and accepted to participate to study After obtaining the necessary ethics committee

and institutional permissions, the research was started and data were collected by random sampling method.

As data collection tools; The demographic characteristics questionnaire which prepared by the researchers

in line of the literature and Breastfeeding Attitude Assessment Scale were used. Data were evaluated

electronically and frequency, average, chi-square test and t test in independent groups were used

Results: 58. 3% of the mothers who participated in the study were between 20 and 29 years of age. 88,3%

of the mothers were literate and and over and 95,5% were not employed in any job. When the

Breastfeeding Attitude Assessment Scale scores were evaluated, it was found that there was a statistically

significant difference between the breastfeeding success of the mothers who received video training and

who took verbal training (p <0.001). The average score of the mothers who received video training was

higher. After video training, score of breastfeeding attitude of the mothers were found as a 129,96± 23,78.

It was also determined that maternal age, educational status, occupation, where they live, family type,

number of children, monitoring pregnant, status of receiving information in the monitoring, the topics of

receiving informations, the way of receiving information, the information receiving from who,

effectedvideo breastfeeding status.

Conclusion: It was detected that postnatal video education effected significantly and positively on the

success of breastfeeding.

Key words: Breastfeeding, Baby-friendly hospital, Video education, Breast milk

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Breastfeeding implementations in female physicians

Özlem SARAÇ SANDAL1, Ebru Atike ONGUN2* 1Sivas Cumhuriyet University Faculty of Medicine, Department of Pediatrics, Sivas, Turkey, 2 University of

Health Sciences, Antalya Training and Research Hospital, Department of Pediatrics, Antalya,Turkey

Objectives: To observe breastfeeding implementations and analyze risk factors associated with early

termination (less than six monnths) in female health-care physicians.

Methods: This descriptive study involved 277 female physicians who had given birth within two years

period. The participants were asked to fill in the questionnaire (consisting topics of breastfeeding

implementations and nutritional support) via phone-call interview or e-mail contact. The perinatal

demographics, the breastfeeding experience at postnatal period, the duration of maternity leave and the

initiation of supplementary food were analyzed using SPSS-22. Multiple logistic regression was used to

determine the risk factors for early breastfeeding termination (less than six months).

Results: The demograhics revealed mean mother age of 31.51±3.86 years and 70% of caesarean delivery.

More than half of the participants (53.1%) did not receive any breastfeeding educational programme. The

first breastfeeding delivery within an hour occurred in 38.5% of the infants. Of them, 18.3% had received

formulary within the first twenty-four hours due to the mother’s concern for low blood-sugar related

problems (even if the birth weight was above 2500 grams). Moreover, the use of baby-bottle and pacifier

was observed at at a rate of 64.6% and 36% respectively. The rate of nutritional support in the form of

‘breastfeeding only for sixmonths’ was 38.7 %. The most frequent reasons of early supplementary food

delivery (less than 6 months) were reduced breast milk volumes and cosmetic reluctance (35%, 23.5%).

42.5% of the mothers were able to use their legal maternity-leave rights; while 28.2% had no access to

legal maternity-leave. The formulary nutrition and absence of maternity-leave were two significant factors

associated with early termination of breastfeeding (p<0.001, p=0.001). In the multivariate regression

model, in which the use of formulary, maternity-leave and caesarean delivery were included, only the

absence of maternity-leave increased the odds of early breastfeeding termination (less than six months) by

10.443 times (OR: 10.443, 95% CI: 4.672-23.343, p<0.001).

Conclusions: The present study had two major outcomes: despite, female medical associates’ self-

confidence on infant’s nutrition, they presented significant lack of nutritional guidance and breastfeeding

malpractices. They also demonstrated shorter period of ‘breastfeeding only’ nutrition, due to profession-

related obligations to early terminate maternity-leave or even abondance of their legal rights. To increase

breastfeeding practices in the mentioned health-care staff, special attention should be given to support

vaginal birth, acknowledge them about the avoidance of formulary nutrition (unless medically-indicated)

and encourage to use the legal maternity-leave rights.

Keywords: breastfeeding, milk, cesarean section, mother physicians

https://tureng.com/tr/turkce-ingilizce/supplementary%20food

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S60

Attitudes towards breastfeeding - The Iowa infant feeding attitude scale in midwifery

students

Ayla ERGİN1, Resmiye ÖZDİLEK1, Suzi ÖZDEMİR1* 1Kocaeli University/Faculty of Health Sciences/Department of Midwifery, Turkey

Objective: In this study, we aimed to evaluate the attitudes of 3rd and 4th year midwifery students towards

breastfeeding.

Methods: This was a descriptive research study that was carried out between April 30th–July 30th of 2019.

A total of 1008 midwifery students were selected from the top five ranking universities according to the

results of 2018 Higher Education Institutions Examination (YKS), and from the university where the

researchers work. Sample selection criterion was not used for the participants. The study was completed

with 929 participating students. The data were collected using a survey prepared by the researchers and

Iowa Infant Feeding Attitude Scale (IIFAS) which was prepared by De La Mora and Russell (1999) and

adapted to Turkish by Eksioğlu (2015). The analysis of the data was performed by SPSS 21.0 by

performing percentage, median, t-test and Kruskal Wallis tests. 95% confidence interval and p<0.05 value

was accepted to statistically meaningful.

Results: The mean age of the students was 22.64 ± 1.44 (min= 21 max= 29). 52.2% were third grade and

47.8% were fourth grade midwifery students. 69.5% of the students stated that they chose the midwifery

profession with their own wish. 56.5% of the students indicated that they had enough knowledge about

breastfeeding and 63% indicated that they encountered with women who breastfeed in public areas. The

mean score of IIFAS of midwifery students was 69±6.42 (min=19, max=80) and it was found moderate.

First item were excluded due to the low correlation with the scale integrity and the Cronbach’s alpha

internal consistency coefficient of the scale was found to be 0.72. The mean scores of the students were

found moderate. In addition, there was no statistically significant difference between the variables such as

grade, attitude and knowledge about breastfeeding (p<0.05).

Conclusions: IIFAS was found to be a valid and reliable assessment tool for the evaluation of midwifery

students' breastfeeding attitudes, and it could safely be used in research and clinical applications. However,

the mean scores of the scale are needed to be improved to a better level. Rearrangement of covering

breastfeeding education for midwifery students and health professionals should have positive effect on the

increase of breastfeeding rates.

Keywords: breastfeeding, breastfeeding attitude, Iowa Infant Feeding Attitude Scale, midwifery students

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S61

Breastfeeding motivation and social support levels of primiparous mothers in

postpartum period

Emine GÜLTEKİN1, Sümeyye BAKIR2*, Gül ERTEM2

1 Izmir University of Health Sciences Tepecik Training And Research Hospital; 2Ege University Faculty Of

Nursing, Department Of Women's Health And Diseases Nursing, Izmir

Objectives: Breastfeeding is not only physiological; has social and emotional factors. Motivation is one of

the strategies involved in women's decision to manage to breastfeed. Social support during the postpartum

period; support for baby care provided by the immediate family, household chores and emotional support.

In the literature, it is recommended that self-efficacy and motivation levels should be evaluated 4-8 weeks

after birth. In this study, it is planned to measure the breastfeeding motivation and social support levels of

primiparous mothers in the fourth week after birth.

Method: The study was conducted as a pilot study between July and August 2019 at Izmir University of

Health Sciences Tepecik Training and Research Hospital.. Between these dates, a total of 42 women were

reached. In this study, a questionnaire containing sociodemographic information and Breastfeeding

Motivation Scale (EMÖ) based on Self-Determination Theory and Multidimensional Perceived Social

Support Scale will be used. Socio-demographic data were evaluated by number and percentage

distributions. The results were evaluated at a 95% confidence interval and p <0.05 significance level.

Result: The mean age of the participants was 25.69±6.30, The rate of planning pregnancies was 71.4%.

Total score from Multidimensional Perceived Social Support Scale was 71.59±13.22. The average subscale

score obtained from family was found to be highest (24.52±5.43). The mean score of the integrated

regulation subscale was found to be highest among the women participating in the study (37.28±6.92). In

the study, a negative correlation was found between integrated regulation subscale, total social support

score, and planning of pregnancy. In the study, a positive and high correlation was found between the

integrated regulation subscale and total social support score.

Conclusion: As a result of the data collected in our study unplanned pregnancy negatively affects women's

breastfeeding motivation and perception of social support and breastfeeding motivation increases as the

social support of women increases.

Key Words: Breastfeeding; Breast milk; Motivation; Primiparous Mothers; Social Support

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Analysis of mothers' opinions about breastfeeding and breast milk

Ayşe BAŞAR AKDOĞAN1*, Seçil KOÇ1, Cennet YALÇIN TOPBAŞ1 1Alanya Alaaddin Keykubat University, Alanya Trainng and Research Hospital, Antalya

Objective:The aim of this study is to determine the opinions of mothers who applied to a public hospital in

Alanya about on the subjects of breastfeeding, breast milk, bottle and pacifier use.

Method: In this study, questionnaire was applied with face to face interviewing method to 100 women who

applied to the Obstetrics and Gynaecology Clinics of Alaaddin Keykubat University Alanya Training and

Research Hospital between 01.08.2019 and 27.08.2019. Before starting the study, legal permissions were

obtained from hospital management. A questionnaire, which is consisting of 24 questions, was applied to

the participants. The data obtained from the surveys were transferred to computer and analysed.

Findings: While 21% of the women (participants) are pregnant during the time of the survey, 79% of them

in the postnatal period. If demographics of the women are examined, the age of 25-34 years (52%),

housewives (80%), high school graduated women (33%) are identified in the highest rates. 42% of the

women state that their participation of regular training program during pregnancy. When the participants

were questioned where they obtained information about breast milk and breastfeeding, the highest response

options is obtained from the choice midwife-nurse. After delivery, the rate of mothers who breastfed their

baby within the first 30 minutes was 59%. When the positive effects of breast milk and breastfeeding on

mother and baby health and the negative consequences of bottle and pacifier use were questioned, women

picked the correct answers in high rates. However, 55% of women with 2 or more children, state that they

used bottles and pacifiers while raising their children.

Results: Midwives and nurses play an active role in providing women with information about breast milk

and breastfeeding. Although mothers were aware of the drawbacks of bottle feeding, it is found that they

used bottle and pacifier while raising children. It is stated thet the participation in a regular education

program during pregnancy is very important for mother and baby health. All women should be joined the

training program during their pregnancy.

Key words: breast milk, breastfeeding, baby bottle, pacifier.

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Investigation of breastfeeding and infant feeding practices between 0-24 months

Tuba TÜRKER1*, Devlet ALAKOÇ PİRPİR2, Didem ÖNAY DERİN3 1Ministry of Education, Child Development Teacher, Konya, 2Selçuk University Faculty of Health Sciences,

Department of Child Development, Konya, 3 Selçuk University Faculty of Health Sciences, Department of

Nutrition and Dietetics Department of Community Nutrition, Konya

Objectives: This research was conducted to determine the practices of on breastfeeding and infant feeding

of mothers with babies between 0-24 months.

Methods: The research was carried out within the scope of the case science pattern, one of the qualitative

research types. In the research, maximum diversity sampling of the sampling methods was used and the

study group consisted of 150 mothers with a baby between 0 and 24 months. In this study, a semi-

structured interview form consisting of open-ended questions was used in order to determine the

application of mothers on breastfeeding and infant feeding. The raw data obtained during the interviews

were analyzed with content analysis technique.

Results: According to the results of the study, it was determined that more than half of the mothers

(62.7%) gave breast milk as the first food to their babies after the birth. 28.0% of mothers breastfed their

babies in the first half hour after birth, close to half of mothers (47.3%) were breastfed their babies when

they want (cried). According to the findings, while most mothers (68.0%) perceive their milk as sufficient.

36.7% of the mothers consumed water to increase milk. It was found that the majority of the mothers

(97.3%) paid attention to the position of their baby during breastfeeding. In addition, more than half of

mothers (53.3%) stated that breastmilk can be given to the baby in case of mother and baby having health

problems. In addition it was determined 70.0% of the mothers were still breastfeeding. It was noted that

more than half of mothers (53.4%) fed their babies only with breast milk during the first 6 months. It was

determined that 66.7% of the mothers gave water only while giving breast milk. It was determined that the

majority of the mothers (72.0%) gave supplemental vitamin/ mineral while feeding their baby with breast

milk, while the majority of the mothers (93.5%) gave vitamin D and blood drugs in addition to their babies.

The findings obtained from the study, more than half of the mothers (66.0%) started to give any food to

their babies outside the mother's milk at 6th month. In addition, yogurt (530 point), soup (470 point), fruit

puree (394 point) were found to be the most preferred complementary foods by mothers.

Conclusions: As a result of the research, it was found that the rate of breastfeeding was high in the

majority of mothers.

Keywords: Breastfeeding, Complementary Feeding, Baby Nutrition

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Views of a group of female physicians on tandem nursing: a pilot study

Başak GÜVEN1*, Deniz ÇALIŞKAN1

1Ankara University, Faculty of Medicine, Department of Public Health, Ankara

Objectives: Tandem nursing (TN)’s breastfeeding more than one child, often an toddler and a newborn at

the same time. For healthy growth and development, infants need to be exclusively breastfed for six

months, with timely introduction of adequate, safe and properly fed complementary foods after 6 month

while continuing breastfeeding for up to two years of age or beyond. Breastfeeding creates a special bond

between the mother and child. It helps with the mental, physical and intellectual development of the child.

WHO recommends two years of birth spacing as a minimum for the sake of maternal and child health. The

risk of perinatal, newborn and neonatal mortalities, low birth weight and preterm labor is high when the

birth spacing is shorter. The primary approach of reproductive health services are to work on improving

healthy birth spacing. Should these effort fails and a woman gets pregnant, approaches and practices vary

concerning whether or not to continue breastfeeding the existing infant. Studies on TN are few in number

in the literature. However, findings suggest that TN in a healthy pregnancy doesn’t lead to complications

such as abortion, preterm labor or low birth weight. The aim of this pilot study was to find out the views of

female physicians on TN.

Methods: The data of this descriptive survey was collected from voluntary respondents (snow ball

sampling method) using an online survey including 7 multiple-choice and 11 open-ended questions.

Numerical values were defined as average and standard deviation. To responses to open-ended questions

were grouped by content and converted to numerical data by the researcher.

Results: 172 female physicians responded to the survey. The average age of the respondents is 40,36. The

average length of professional life is 16,34 years. 84,9% of the respondents are married and 9,9% are

single. 74,4% of the respondents have children. The average child number is 1.60. The average duration of

breastfeeding was 15,9 months excluding children who are still breastfed. 43,9% of the respondents thought

positively of TN. 33,1% said that they could recommend TN as a physician.

Conculusions: Even though it is not possible to generalize the data of this pilot study for all female

physicians, it is clear that physicians need to be better informed about the topic. More comprehensive and

representative studies on TN’re needed. It’s recommended to include TN in the regular breastfeeding

training topics for physicians.

Keywords: breastfeeding, TN, pregnancy, female physicians, online survey

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Closed Loop With Mother Milk Application; Relationship Between Number

of Phototherapy Sessions

Vakkas KARA1, Şenay TOSUN1*, Derya ERİKOĞLU1, Yeliz ACAR1, Yeliz PEKDOĞAN 1 1Ödemiş State Hospital, İzmir/Turkey

Objective: To reduce the number of sessions and reduce the number of days of hospitalization by ensuring

that the infants hospitalized for phototherapy treatment in the neonatal unit receive breast milk intake at the

right time and in the right amount.

Method: In January, February, March 2018, 153 newborns were admitted to the neonatal intensive care

unit. 112 babies (448 sessions) received phototherapy treatment. In January, February and March of 2019,

thanks to the decision supports written within the scope of Hims 7 activities by putting digital systems into

operation; By using physician decision support, nurse decision support, digital warning systems, laboratory

panic notifications, we have gained infant feeding habits. Thus, the number of infants performed in 2019

was 161 and 71 infants (284 sessions) received phototherapy treatment and were discharged with healing.

When we talked with mothers after 2 months, we were informed that their breastfeeding habits persisted.

Results: By using Closed Loop Breast Milk Application, the number of phototreative sessions and

hospitalization periods of the babies were significantly decreased and it was helped to gain the

breastfeeding habits.

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Breastfeeding Behaviors and Associated Factors Among Healthcare Professional

Mothers Having a 1- to 5-Year-Old Child

Sevil ŞAHİN1, Özlem Ülkü BULUT2*, Alaettin ÜNSAL3 1Ankara Yildirim Beyazit University, Faculty of Health Sciences, Ankara, 2KTO Karatay University,

Vocational School of Healthcare Services, Konya, 3Eskisehir Osmangazi University, Faculty of Medicine,

Eskisehir

Objective: To assess the breastfeeding behaviors of healthcare professional (HCP) mothers having a 1- to

5-year-old child and review associated factors.

Method: This is a cross-sectional study conducted on healthcare professional mothers having a 1- to 5-

year-old child and working at a state hospital in Ankara. The study was conducted from May 2019 to July

2019. The study group consisted of 118 HCP mothers who agreed to take part in the study. A questionnaire

which included questions on breastfeeding behaviors, socio-demographic characteristics of HCP mothers

and some variables that are believed to be associated with the level of breastfeeding behavior was used to

collect data. Questionnaires were completed by the mothers under supervision. Mann-Whitney U test,

Kruskal-Wallis test and Chi-Square test were used for data analyses. Statistical significance value was

accepted as p < 0.05.

Results: The age of women in the study group ranged from 24 to 40, with a mean age of 33.32 ± 4.22

years. The scores obtained from the questions on breastfeeding behaviors by the HCP mothers ranged from

7 to 13 with a mean score of 10.24 ± 1.32. There was no difference between the socio-demographic

characteristics and breastfeeding behaviors of the mothers. More positive breastfeeding behaviors were

determined in women who had cesarean section. In our study, breastfeeding knowledge of women was

found to be sufficient. It was determined that the level of breastfeeding knowledge was more insufficient in

mothers whose educational level is associate degree or lower.

Conclusion: It was concluded that breastfeeding behaviors of healthcare professional mothers were

positive in the study. No difference in breastfeeding behavior was determined in women who had sufficient

breastfeeding knowledge compared to those with insufficient knowledge. It would be advantageous to

improve working conditions and conduct informative activities to promote level of breastfeeding

knowledge and positive breastfeeding behaviors in HCP mothers.

Keywords: Healthcare professional mother, breastfeeding, behavior

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Effects of breastfeeding on strengths and difficulties in children with specific learning

difficulties

Ganime AYAR1*, S. Songül YALÇIN2, Özge TANIDIR ARTAN1 1Ankara City Hospital, Child Hospital Department of Pediatrics, Ankara; 2Hacettepe University Faculty of

Medicine Department of Pediatrics Unit of Social Pediatrics, Ankara.

Objectives: A specific learning disability (SLD) is a disorder that interferes with a student’s ability to

listen, think, speak, write, spell, or do mathematical calculations. An estimated 5 to 15 percent of school-

age children struggle with a learning disability. This study is aimed to investigate the social, emotional and

behavioral difficulties in children with SLD and examine the relationship between the breastmilk feeding.

Methods: This descriptive study was conducted between May and August in 2019. After approval from

the institute’s ethics committee, we included 6-13 years old children with SLD who were admitted to the

department of outpatient clinic. History of perinatal, natal and postnatal, measures of sociodemographic

background were asked to mother with a structured questionnaire. The duration of breast feeding has been

classified into four groups: six months or less; seven to twelve months; thirteen to twenty-four months;

more than twenty-four months. Social, emotional and behavioral functioning in children was evaluated by

Strengths and Difficulties Questionnaire (SDQ) applied to mothers. Each SDQ subscale and total scores

(emotional, conduct, hyperactivity, peer problems and prosocial and behavioral) were grouped according to

being upper quartiles (high scores) and lower ones. The relation between child characteristics and duration

of breast milk feeding was analysed with Chi-square test. After controlling confounding factors, the data

were analysed by multiple logistic regression analysis. Statistical significance level was p<0.05. IBM SPSS

21.0 programme was used for analyses.

Results: We examined 177 children with SLD (64 girls and 113 boys) with ages ranging from 6 to 13 years

(87 children aged 6-9 years and 90 children aged 10-13 years). Children having high scores for emotional

problems were 10-11 times more in children who were breastfed for less than 12 months in comparison to

that of over 24 months (for ≤6 months breastfeeding OR=11.5, 95% CI 1.3-102.0, p=0.028 and for 7-12

months breastfeeding OR=10.3, 95% CI 1.3-93.0, p=0.038). The total duration of breastfeeding does not

influence the frequency of high scores in conduct problems, prosocial behavior and hyperactivity-

inattention. The children who were breasfed for 6 months or less, faced 3.8 times more high scores for peer

problems OR=3.9, 95% CI 1.1-13.8, p=0.035.

Conclusion: Breastfeeding is positively associated with emotional functioning and peer relationships in

school‐aged children with SLD.

Keywords: Specific learning disability, children, breastfeeding, strengths and difficulties.

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Successful Breastfeeding In A Neonatal Cleft Lip-Cleft Palate Case

Nurten KÜREKÇİ1, Canan TÜRKYILMAZ1, Döne EROĞLU1*, Esin KOÇ1 1Gazi University Faculty of Medicine, Department Neonatology, Beşevler, Ankara, Turkey

Objective: Cleft lip-plate defects are one of the most seen congenital defects with prevelance of 1/1000

among caucasions and 0.95/1000 in Turkey. Surgical operations prefereably done at the 12-18th months

old in order not to distrupt face and chin development. Breastfeeding and risk of aspiration during feeding

are the biggest problem amongst these babies in newborn age. On the other hand, breastfeeding is a must

for these babies to have ideal growth, intellectual development, protection against infections and chronical

diseases. Breastfeeding in these newborns cannot be fully achieved due to complications from having a

cleft plate such as not being able to grip aerola properly and maintain a vacuum force for suction. Some

babies can be fed with breast milk through specialized bottles. nowadays prostetic feeding

plates(nasoalveolar molding) are commonly utilized to support feeding in these babies. Preperation time of

prostetic plate, rejection of the plate by the baby and the mother's concern of not being able to breastfeed

her baby are lowering the patient's coherence. In this cleft lip-plate case, patient's mother is encouraged to

breastfeed until recieving the prostetic plate and after the prostetic plate is placed, success of breast feeding

has been reported.

Case: Our patient was delivered vajinaly at the 39 weeks gestation from a 22 year old mother (G2P2) and

has 2685 g weight. Patient was admitted to NICU due to having a cleft lip-plate and had no anormal

physical exam finding. The patient was hospitilized "in a mother-baby adaptation room" in the Gazi

University NICU with the purpose of patient's adaptation and production of plate prostetic. Department of

Plastic Surgery took the mesurements for the prostetic plate. Patient was also evaluated for accompaning

genetic syndromes by the medical genetics department and the required tests were done. The breast milk

pumping and lactation education were given to the mother starting from the first day of hospitalization.

During the preparation of plates, hand milking procedure was introduced to the mother in order to maintain

breast milk continuity.The proper feeding position for cleft lip-plate patients was achieved. The mother was

informed that the proper latch can be achieved by holding the baby in a sitting-like vertical position and

against nipple meanwhile squeezing the upper lip with her thumb . Mother’s milk was given to the patient

by the Medela Haberman Bottle during this process. at the postnatal 10th day, the prostetic plate was placed

and immediately after this placement the feeding, directly from the breast, was achieved. Patient was

supported in order to maintain breastfeeding with the plate. Patient was discharged with exclusive

breastfeeding and clinical follow-up was planned. Mother and patient was directed to the "Breastfeeding

Support and Relactation Unit" in our hospital to maintain breastfeeding continuity.

Conclusion:For patients with cleft lip-plates, the required amount of effort needed from the baby during

the feeding increases, while the quality of feeding decreases. due to the previously mentioned problems,

patient's weight gain and development falls behind and surgical approach might be delayed. until the

surgical operation was done the best way to carry on breast feeding is by a prostetic plate. Preperation of

the prostetic plate might also be delayed so, supporting breastfeeding and milking the mother's milk is the

key to maintain milk production. babies with cleft lip-plate can be fed directly from breast with the proper

support and motivation.

Key words: Cleft lip-cleft palate, breastfeeding, nasoalveolar molding, lactation support

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Comparison of breastfeeding self-efficacy perceptions among high risk/non high risk

pregnancy mothers

Nihal ŞAHİN UYSAL1*, Dilek ŞAHİN2, Aykan YÜCEL2 1 Etlik Zubeyde Hanim Women's Health Care, Training and Research Hospital, Department of

Perinatology, 2 University of Health Sciences, Etlik Zubeyde Hanim Women's Health Care, Training and

Research Hospital, Department of Perinatology, Ankara, Turkey

Objective: We aimed to compare the breastfeeding self-efficacy perceptions among high risk/non high risk

pregnancy mothers in postnatal period.

Methods: In this study 51 high risk and 38 non-high risk pregnancy mothers hospitalized at the postnatal

service of Etlik Zubeyde Hanim Women's Health Care, Training and Research Hospital were included.

Personal information form, that questions demographic characteristics of mother and infant and the

shortened version of breastfeeding scale were used to collect the data. High risk pregnancy diagnoses for

the study group were hypertension, preeclampsia-eclampsia, diabetes mellitus, multiple pregnancy, preterm

labor and birth, premature rupture of membranes, intrahepatic cholestasis of pregnancy, fetal growth

restriction, placenta related conditions. Mothers with normal pregnancy follow-up and birth were formed

the control group. Mothers whose infants were not with them for any reason were excluded from the study.

Maternal age, gravidity, parity, education, occupation, marital and income status, maternal smoking,

gestational age at delivery, type of delivery, birth weight, gender of the baby and information about the

breastfeeding in the first day of the newborn were recorded. Breastfeeding scale scored the maternal

breastfeeding education, sources of the breastfeeding education, timing of the first breastfeeding, the

interval between the breastfeedings, duration of the breastfeedings and formula feeding. Statistical analyses

were performed using SPSS for Windows. A P value of < .05 was considered statistically significant.

Results: A total of 89 mothers were completed the survey questionnaire including personal information

form and breastfeeding scale. The median age of the mothers in the study group was 28.0±6.2 years, while

it was 29.6±5.0 years in the control group. The median maternal age and the education, occupation and

marital status and the numbers of the antenatal visits were not significantly different between the study and

control groups. There was statistically significant difference between the groups in terms of income status

and smoking behavior of the mothers (P < .05). The median of the gravidity, parity, type of delivery and

newborn gender were not significantly different between the study and control groups. The median

gestational age at delivery was 37.2±1.5 in the study group and it was 38.3±1.2 in the control group and

there was statistically significant difference between the groups (P < .05). The median birthweight was

3032.7±473 g and 3217.5±528.8 g in the study and control groups, respectively and there was not

statistically significant difference between the groups. There was not statistically significant difference

between the groups in terms of getting breastfeeding education. Source of the breastfeeding education was

73% vs 50% hospital, 10% vs 15.4% internet, 13.3% vs 23.1% pregnancy school and 3.3% vs 11.5 friends

and relatives in the study and control groups, respectively. Mean breastfeeding self-efficacy scale score was

45.3±6.32 in the study group while it was 48.03±10.8 in the control group and there was not statistically

significant difference between the groups.

Conclusion: There was no difference regarding the breastfeeding self-efficacy scale scores between high

risk and non-high risk pregnancies. Self-efficacy perceptions can be increased by breastfeeding support to

both groups. Implementation of breastfeeding self-efficacy scale can be useful to determine the mothers

who need breastfeeding support both in antenatally and postnatally.

Key words: breastfeeding, breastfeeding self-efficacy, high risk pregnancy

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Examination of the relationship between breast-feeding self-sufficiency and breast-

feeding sufficiency perception of mothers

Özlem AKALPLER1, Dilek SARPKAYA GÜDER1*, Serap TEKBAŞ1, Gülşen VURAL1 1 Near East University, Faculty of Nursing, Obstetric and Women's Health Nursing, Northern Cyprus

Objectives: The aim of this study was to investigate the relationship between breastfeeding self-sufficiency

and breast feeding sufficiency perception of mothers with 0-6 months healthy infants who applied to the

pediatric outpatient clinic of a state and an university hospital in the Northern Cyprus.

Methods: This research is a descriptive and relationship-seeker type. The universe of the study consisted of

mothers who had 0-6 months old infants and were applied to the pediatric outpatient clinic of a public

hospital and gynecology service of an university hospital. 95 women was taken from the State Hospital and

21 women was taken from the University Hospital. Data collection forms were implemented by researchers

using face-to-face interview with mothers'.The data of the study were collected by using the questionnaire

form containing mothers' descriptive information, postpartum breastfeeding self-sufficiency scale and the

insufficient milk perception scale. The data were analyzed using Pearson correlation, Mann Whitney U and

Kruskal Wallis variance analysis tests.

Results: When the mothers’ perception of breastfeeding self-sufficiency and insufficient milk scale score

averages are evaluated, it was found that the average score of breastfeeding self-sufficiency

(X:60.16±SS:9.00) and the average score of insufficient milk perception was (X:42.06±SS:8.26).A

statistically significant relationship between the two scales in a positive direction was determined(r=.-

0.66,p=0.00). Mothers' who were 25 years old and under and 36 years of age and older were found to have

higher perception of breastfeeding self-sufficiency than other groups (p<0.05). It is observed that

breastfeeding self-efficacy decreases as mothers' education level increases (p<0.05). It was found that as

the number of births of mothers had increased, breastfeeding self-sufficiency score increased (p<0.05).The

perception of breastfeeding self-sufficiency of mothers who breastfed their previous baby was lower with

an average score 61.46+8.67 and those who did not breastfeed 58.11+9.23(p<0.05). Mothers' who gave

their babies supplementary foods were found to have a lower mean score of breast-feeding self-sufficiency

than those who did not give food or additional foods(p<0.05).The average score of insufficient milk

perception of the mothers who gave supplementary food to their baby was 38.54+9.14, while those who did

not gave it was 46.09+4.57(p<0.05).

Conclusions: In the study, the perception of breastfeeding self-sufficiency was influenced by age,

education level, number of births, previous infant breastfeeding status and supplementary food supply

situation.The mothers' supplementary food supply situation affects the perception of milk insufficiency.

The study found that as breastfeeding self-sufficiency increases, so does the perception of milk adequacy.

Keywords: Breast milk, Breastfeeding, Self-sufficiency, Insufficient milk perception

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Evaluation of the news related to advices given in increasing excretion of the breast

milk published on daily newspapers

Eda ÜNAL1*,Aysel ÖZDEMİR2 1PhD Candidate, Uludağ University, Institute of Health Sciences, Public Health Nursing, Bursa, Turkey,

,2Assoc. Prof. Dr., Uludag University Faculty of Health Sciences Department of Public Health Nursing,

Bursa, Turkey

Objective: Breast milk is the most suitable nutrient for the growth and development of newborns and

infants. However, there may be deficiencies in the secretion of breast milk for various reasons. Being on

balanced nutrition during lactation is an imprtatant fact among all. Although access to information is very

simple nowadays, trusthworthy of the information being reached also questionable in sense of

scientificness. The aim of this study was to evaluate the scientific content of the advices given in

newspaper columns

Method: Using Google Search engine daily newspapers were sacnned for nenews related to breast milk.

Fifthy (n=50) news related to breast milk were reached and 15 of these news were directly related to

nutrients that help increase in excretion of the breast milk. Data were evaluated according to

current scientific evidence available on this topic.

Results: Seventy one (n=71) reccomendations were detected as nutrients in increasing excretion of

breast milk. Of these nutrients that increase excretion of breast milk; 4 of them were milk and dairy

products, 11 of them were meat-egg-legumes group; 43 of them were vegetable and fruit group; 2 of theem

were the bread and cereal group. Rest of the reccomendations were water, fruit juices and herbal teas. In

the related literatüre black seed, nettle, fennel, fenugreek, ginger, cumin, anoson, dill, palm, garlic wre

found to provide evidence that scientifically increased breast milk. The nutritional recommendations of the

breastfeeding period are; Vitamins A, D, K, B, vitamin C, folate, zinc, iodine, magnesium, calcium,

fluoride, phosphorus and micronutrients such as protein, carbohydrate, fat and macro nutrients.

Conclusion: It was determined that only a small portion of the information presented in the newspapers

about increaasing breast milk excretion was based on scientific information. The news presented to the

social media without being based on scientific evidence endangers both the health of mother and baby

especially the ones with inadequate health literacy. In this sense, estabilishing policies in this regard is

essential.

Keywords: Breast milk excretion, nutrients, news, newspaper

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S72

Timely initiation of breastfeeding and associated factors among Turkish mothers

Ayşe TOLUNAY OFLU1*, S. Songül YALÇIN2, Ayşegül BÜKÜLMEZ1, Pelin BALIKOĞLU1, Esra

ÇELİK1 1Afyonkarahisar Health Sciences University, Department of Pediatrics, Afyonkarahisar, Turkey, 2Hacettepe Universty Faculty of Medicine, Department of Pediatrics, Social Pediatrics Unit, Ankara

Hacettepe University, Institute of Child Health, Department of Social Pediatrics, Ankara, Turkey

Objectives: Timely initiation of breastfeeding is defined as placing the newborn in the breast within the

first hour after birth. The widespread application of this practice, which is one of the ten steps of successful

breastfeeding, is extremely important in terms of reducing neonatal mortality and morbidity. The aim of

this study was to determine the frequency and related factors of timely initiation of breastfeeding.

Methods: This study was conducted in Afyonkarahisar University of Health Sciences as a descriptive

study from July 01 to August 30, 2019. One hundred twenty mothers with healthy children aged up to 5

years admitted to our pediatric clinics were participated to our study. Face to face survey method was used

for obtaining the datas. A questionnaire was applied to the mothers to investigate the initiation time of

breastfeeding, socio-demographic and obstetric variables.

Results: The mean age of the mothers and children were 29.4 ± 4.7 years and 40.1 ± 11.7 months,

respectively. 44.2% of the children were female. The caesarean section ratio and preterm birth ratio were

found as 55.8% and 28.3%; respectively. The frequency of timely initiation of breastfeeding was 65.8%.

The odds ratio (OR) of initiation of breastfeeding within one hour was higher for mothers in the group of

spontaneous vaginal delivery (OR 6.7; 95% Confidence Interval [CI] 2.6, 17.1). When cases with caesarean

section was analyzed; the odds ratio was lower in general anesthesia group (OR 0.23; 95% CI 0.08, 0.66).

Counseling given during antenatal care and provided by a midwife had higher odds ratio than other cases

(OR 2.4; 95% CI 1.1, 5.2 and OR 8.4; 95% CI 1.7, 39.4; respectively).

Conclusions: In this study, we found that spontaneous vaginal delivery route increases the chance of

breastfeeding in the first hour. It was also found that spinal/epidural anesthesia is more appropriate to

increase the timely initiation of breastfeeding if caesarean section is needed. It is seen that there is a need

for public health projects that emphasize the importance of birth methods. Additionally, strengthening

counseling and active participation of obstetricians will be an important step in increasing breastfeeding

within the first hour.

Keywords: Breastfeeding, Timely initiation, First hour

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S73

Breastfeeding Success Needs Continuum of Support: Baby Friendly NICU-Follow -up

Clinic Outpatent Relactation Center

Münevver BAŞ*, Melda TAŞ1, Berkan ARISUT2, Canan TURKYILMAZ1, Elif KELEŞ1, Aytaç KENAR1,

İbrahim Murat HİRFANOĞLU1, Esra Eray ÖNAL1, Ebru ERGENEKON1, Esin KOÇ1 1Gazi University Faculty of Medicine Neonatal Intensive Care Unit Ankara; 2Gazi University Faculty of

Medicine Department of Pediatrics Ankara, Turkey

Objective: Breast milk is the optimal form of nutrition for all infants due to the short and long term

benefits, especially high risk infants in neonatal intensive care. However mothers of preterm and sick

infants hospitalized to the neonatal intensive care units ( NICU ) have some difficulties in breastfeeding. In

this study, we evaluated the feeding status of babies after discharge from a baby friendly NICU in terms of

a continuum of care and breastfeeding support in outpatient follow up and relactation clinics.

Methods: After discharge of Gazi University Hospital NICU (Baby friendly NICU) 216 patients followed

up at outpatient follow-up clinics and Relactation Center between 2017 and 2019 were included in the

study. The patients were examined in terms of demographic characteristics. Exclusive breastfeeding,

mostly breastfeeding, exclusive formula, mostly formula and fortified expressed breast milk were classified

in terms of nutrition. Exclusive breastfeeding success of patients was evaluated during outpatient follow-

up. The patients were examined for discharge, 1 month, 2-4 months, 4-6 months, 6-8 months, 8-12 months

in terms of nutrition at outpatient clinic controls.

Results: Of the 216 patients, (57%) were male and (43%) were female. Fifty (23%) of the patients were

SGA, (64%) were AGA and (13%) were LGA. Discharge rate of patients were exclusive breast milk

(63%), exclusive formula (%17,6) , mostly formula (%22) , mostly breast milk (10%), expressed breast

milk with fortification (19%). Among the mothers who feed their baby exclusive breast milk and breast

milk with fortification, breastfeeding rates were (74%), with pumping were (6%), breast and expressed

mother’s milk together were (52%).

In the first month of the outpatient clinic visit, exclusive breastfeeding rate was (53%), and exclusive

formula rate was (11%). Afterwards, breast milk ratio was found to be 50%, 40%, 39% and 13% until one-

year outpatient control, respectively. Only 2.3% of the patients received formula at the first outpatient

clinic follow-up, and then 5%, 7% and 8% until one-year outpatient control. Additional food and formula

were added to the nutrition of some of the patients who came for a follow-up of 6-8 months, but 93% of the

patients continued to receive breast milk.

Conclusion: After discharge even baby friendly NICU, it is very important to support the breastfeeding in

outpatient manner. Baby friendly NICU designation is associated with higher breastfeeding success rates

especially together with continuum of support at outpatient follow-up and relactation clinics.

Key words: breastfeeding, NICU, outpatient, relactation, support

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We can reduce the effect of LBW on infant and child mortality by exclusive

breastfeeding in the first six months

İzzet ERDAL1**, S. Songül YALÇIN1 1Hacettepe University Faculty of Medicine, Department of Pediatrics, Social Pediatrics Unit, Ankara,

Turkey

Objectives: Breastfeeding is unique for healthy growth of infant. Only breastfeeding is recommended by

the World Health Organization (WHO) for the first 6 months. Breastfeeding is known to reduce mortality

both by reducing infectious diseases such as diarrhea and pneumonia, and by accelerating recovery. Infants

born with low birth weight (LBW) are known to have higher infant and child mortality and morbidity rates

than infants born at normal weight. The aim of this study was to investigate the relationship between LBW

and infant and child mortality according to the countries' exclusive breastfeeding (EBF) rate in the first 6

months.

Methods: Countries with DHS data in the UNICEF report on the state of the world's children between

2010 and 2016 were included. EBF, LBW, infant mortality rate (IMR), under-five mortality rate (U5MR)

and stunted rates were analyzed. Countries were divided into 3 groups according to EBF rates; 0-24.99%

very low, 25-49.99% low, 50% and more evaluated as “global target”. The relationship between LBW,

IMR, U5MR and stunting rate according to EBF groups was examined by spearman correlation.

Results: 124 countries with full data included in the study. The median EBF rate of the countries was 41%,

the median LBW rate was 11%, the median IMR 22‰, the median U5MR 26‰, and the median stunting

rate was 23%. 34 of the countries were in the very low EBF group, 51 were in the low EBF group and 39

were in the target EBF group. There was a positive correlation between mortality rates and LBW in very

low and low group (rs = 0.76 and rs = 0.58 for IMR, rs = 0.77 and rs = 0.60 for U5MR, respectively); no

relationship was found in countries with a “target” ratio. The association between stunting rates and LBW

was rs=0.62, rs=0.65 and rs=0.48 for the lowest, lowest and target EBF group countries, respectively.

Conclusion: By achieving the global target of EBF in the first 6 months, both LBW can be disconnected

from infant and child mortality, and the stunted rate in LBW children can be reduced.

Keywords: Breastfeeding, low birth weight, mortality rate, stunted

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Validity and reliability of the Turkish version of the Infant Feeding Attitude

Questionnaire (IFAQ)

Leyla ERDİM1*, Neriman ZENGİN2 1Istanbul University Cerrahpasa, Faculty of Health Science, Department of Midwifery, İstanbul, Turkey 2,

Health Science University, Faculty of Health Science, Department of Midwifery, İstanbul, Turkey

Objectives: It is reported that attitudes that affect the decision to breastfeed begin to form in the early

stages of adolescence. Interventions are of the greatest importance in making a positive impact on the

decision-making process and on the attitudes of young people toward breastfeeding. This study was

conducted with the aims of creating the Turkish version of the Infant Feeding Attitude Questionnaire

(IFAQ), an instrument that assesses the attitudes of young people toward infant feeding, and analyzing its

psychometric characteristics and factor construct.

Methods: The study was of methodological design and was carried out with 889 male and female

university students (ages 20.42 ± 1.46) enrolled in different departments of a Faculty of Health Sciences.

An analysis was made of the content and construct validity of the instrument as well as of its reliability.

The Content Validity Index (CVI) was used to assess content validity and exploratory (EFA) and

confirmatory (CFA) factor analysis to evaluate construct validity. In the reliability analysis, the internal

consistency coefficient (Cronbach’s α) and the intraclass correlation coefficient (ICC) were calculated. The

factor construct was analyzed using item total correlations (CITCs).

Results: CVI was found to be 0.99. Whereas the original instrument had 15 items, it was observed that 13

items outside of two problematic items had CITCs >0.20. The 13-item IFAQ EFA displayed a three-factor

construct, which the CFA confirmed. Factor loadings were between 0.339-0.818. The internal consistency

coefficient (Cronbach’s α) for the entire sample was 0.74 and the test–retest ICC was calculated to be 0.96.

Conclusions: The study results showed that IFAQ is a valid and reliable tool to use in assessing the

attitudes of Turkish university students towards infant feeding.

Key words: attitude, reliability, questionnaire, validity

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Importance of pre-birth breastfeeding training

Funda SALGÜR1*, Gaye OLTULU 2, Latife ATASOY KARAKAŞ3 1 Baskent University Faculty of Medicine Department of Family Medicine, Ankara, Turkey, 2 Baskent

University Faculty of Medicine, Department of Nutrition and Dietetics, Ankara, Turkey, 3 Baskent

University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey

Objective: The World Health Organization recommends that babies receive only breast milk for the first

six months, and then continue breastfeeding until the age of two and beyond. In this context, many national

and international programs have been developed. According to the 2013 Turkey population and health

surveyand Health Survey, 30% of infants are exclusively breastfed. This study was performed in a

gynecology and obstetrics outpatient clinic in a university hospital. The aim of this study was to evaluate

the knowledge of pregnant women about breastfeeding and breast milk with the tests performed before and

after the training during the lactation weeks

Method: Thirty primiparous pregnant women who underwent breastfeeding training at the university

hospital between February and March 2019 were administered 9 questions before and after the training.

Pregnant and non-primiparous pregnant women were excluded from the study. Four of the questions posed

to pregnant women were multiple-choice and the others consisted of classical answered questions.

Results: The mean age of the 30 pregnant women included in the study was 28 years. 73.3% were

university graduates and 26.7% were high school graduates. A total of 84 correct answers were given at the

beginning of the training and 418 correct answers were given at the end of the training. At the beginning of

the training, the least correctly answered question was the storage of breast milk (10%), while 100% of the

participants answered this question correctly at the end of the training. The most correctly answered

question at the beginning of the training was about the situations that require the milking of breast milk

(73.3%). All participants answered this question correctly at the end of the training.

Conclusion: The importance of breastfeeding and support for problems encountered during breastfeeding

should begin during pregnancy. Pregnant will be better equipped for breastfeeding and will have less

confidence in breastfeeding. Pregnant women who have not received breastfeeding counseling training will

end very early when the breastfeeding is not adequately supported. Our study showed that many of the

misconceptions can be corrected by training on breastfeeding. Support for pregnant women should continue

after birth.

Key words: breastfeeding, breastfeeding training, pregnancy and breastfeeding

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Breastmilk and breastfeeding practices of mothers with 6-24 months old babies

Ayşe KABASAKAL1*, Özden DURMUŞ1, Ömür AKTAŞ1, Nihal ÖZKAN1, Canan TÜRKYILMAZ1 1Gazi Unıversıty Health Research and Applıcatıon, Ankara, Turkey

Objective: Our study was conducted to determine breastfeeding practices of mothers with 6-24-month-old

babies and factors affecting breastfeeding.

Method: The sample of this descriptive study was consisted of 390 mothers aged between 19 to 45 years,

who presented to the pediatric outpatient clinic of a university hospital and agreed to participate in the

study.

Results: Thirty percent of mothers breastfed their babies in half an hour after delivery. Half of the mothers

stated that they could not breastfeed their babies in the first half hour because babies failed to suck.

Majority (79.8%) of the mothers reported that the first nutriment of their babies after birth was breastmilk.

Twelve-point-three percent of the mothers stated the first nutriment of their babies was baby formula and

75% of those mothers were recommended to use baby formula by doctors. Majority (97%) of mothers

explained that they gave colostrum to their babies. Nearly half (43.8%) of mothers fed their babies only

with breastmilk in the first month of life. Additional food was generally started at the 5th month (60.8%)

and the first nutriment was water mostly (63.58%). Nursing strike of baby (35.17%) and insufficient

breastmilk (33.72%) were among the reasons of breastfeeding for less than 6 months. It was reported that

56.15% of mothers gave water during breastfeeding, 60.51% used feeding bottle and 61.02% used pacifier.

Conclusion: Our study revealed that only breastfeeding during the first six months recommendation is not

followed commonly. Although breastfeeding rate in the first hour is high, it is not at the desired level. Rate

of feeding babies with baby formula and other liquids shortly after delivery, and rate of using feeding

bottles and pacifiers are high. It is a remarkable finding that almost all of those who recommended to start

baby formulas are healthcare professionals. It is noteworthy that mothers delivering cesarean section had

high breastfeeding rates for less than 6 months. The reason for only breastfeeding less than six months is

nursing strike of baby and the belief of mother that her milk supply is low. Therefore, mothers and their

social supporters should be told about the importance of breastmilk-the miraculous nutrient. Also, they

should receive information about the importance of initiating breastfeeding during the first half hour after

delivery, giving colostrum absolutely to baby, and learn that the baby does not need any additional

nutrients including water for the first 6 months but breastmilk.

Key words: babies, breastfeeding, breastmilk, mothers, practice

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Breastfeeding motivation in mothers of infants with excessive crying: a correlation study

Muhammet BULUT1*

1Giresun Training and Research Hospital, Giresun, Turkey

Objective: This study was conducted to determine the correlation between mothers’ thoughts about crying

infants and the breastfeeding motivation.

Methods: Target population of the study which was carried out using cross-sectional, descriptive,

relational screening model consisted of mothers of infants aged 3 weeks to 6 months that were brought to

the Pediatrics Polyclinic of a Training & Research Hospital in northern Turkey because of excessive

crying. In the sample, 210 mothers who met the inclusion criteria between the dates specified and agreed to

participate were included. Data were collected using; “Introductory Information Form” concerning

mother’s and infant’s descriptive characteristics, “Crying Infant Form(CIF)” and “Breastfeeding

Motivation Scale(BMS)”. CIF consists of five lower dimensions (Bonding, Minimizing, Directive Control,

Brattiness and Crying as Communication) and totally 31 items. Items are designed to evaluate parents’

thoughts/feelings about crying infants (for example, I think my baby is trying to communicate with me) and

beliefs in achieving certain parenthood goals (for example, I will make my baby feel safe). Each item is

graded from 1(never) to 5(always). Based on Self-Determination Theory; BMS consists of 24 items

evaluating mothers’ breastfeeding motivation and 5 lower dimensions (internal motivation-integrated

regulation, identified regulation, introjected regulation, external regulation-infant health, external

regulation-instrumental needs). Data were analysed using SPSS 21.0 software package.

Results: Among the mothers who participated in the study; 63.8% were aged 25-29 years, 37.1%

university graduates, 73.8% unemployed, 80.0% had middle income and 12.9% no social security. The

infants in the study were 3.35±1.38 months old on average; 53.8% were girls and 65.2% were born via c-

section. 55.7% of the mothers stated that they could breastfeed right after labor, 71% had breastfeeding

training and 70.5% could breastfeed fully. Also they considered feeding their infants only breastmilk for

about 4.36±2.65 months. In our study, it was determined that there was a positively weak (r=0.26-0.49)

significant correlation between the mothers’ CIF lower dimensions; Bonding (39.51±1.68), Minimizing

(24.99±8.66), Directive Control (37.62±5.67), Brattiness (7.55±3.12) and BMS lower dimensions; Internal

motivation (33.77±3.66), Integrated regulation (18.45±2.31), Identified regulation (18.45±2.31), Introjected

regulation (10.14±2.35), external regulation-infant health (6.64±0.74).

Conclusion: It was determined that mothers with positive thoughts about crying infants had significantly

higher breastfeeding motivation. It is suggested that breastfeeding motivation of mothers of infants with

excessive crying be strengthened to encourage and sustain breastfeeding.

Keywords: Mother, Crying infant, Breastfeeding, Motivation

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The relationship between breastfeeding and childhood overweight: Secondary analysis

of “The State of the World’s Children 2016’’ report

Meryem ERAT NERGİZ1*, S. Songül YALÇIN2, Suzan YALÇIN3

1Yildirim Beyazit University, Yenimahalle Research and Training Hospital, Department of Pediatrics, 2Hacettepe University Faculty of Medicine, Department of Pediatrics, Social Pediatrics Unit, Ankara, 3Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Selçuk University, Konya,

Turkey.

Objectives: Exclusive breastfeeding (EBF) during the first six months of life is the most appropriate

feeding for children and has a great impact on reducing child mortality and morbidity. Therefore, the World

Health Organization (WHO) targets to increase the rate of EBF in the first 6 months up to at least 50%

globally by 2025. This study aims to investigate the effect of breastfeeding on overweight in children under

5 years of age.

Methods: Data from 202 countries between the years 2011-2016 were obtained from UNICEF's “The

State of the World’s Children 2016’’ report and analyzed. Countries with data for EBF<6 months (n=132),

continued breastfeeding at age 2 (CBF) (n=127) and childhood overweight (COw) (n=141) were included

in the study. EBF refers to percentage of children aged 0–5 months who are fed exclusively with breast

milk in the 24 hours prior to the survey, CBF refers to percentage of children aged 20–23 months who

received breast milk in the 24 hours prior to the survey, COw refers to percentage of children aged 0–59

months who are above two standard deviations from median weight-for-height of the WHO Child Growth

Standards (includes obesity), in this study. Correlation between breastfeeding and obesity was assessed

using Spearman's test. According to breastfeeding rates, countries were divided into three subgroups as the

low rate (< 25%), medium rate (25%-49%), and target rate (≥50%). When the low birth weight and total

adult literacy rate of the countries were adjusted, the mean rates of COw of countries in subgroups were

analysed with univariate analysis of variance. Data were analyzed using SPSS for Windows (version 23).

Results: In countries, the median (interquartile range) rates of EBF, CBF and COw were 38.6% (24.0-

53.1%), 38% (21.1-53.1%), 6.2% (3.5-9.3%), respectively. There were negative correlations between EBF

and COw (r=-0.36, p<0.001) and between BF2 and CHO (r =-0.53, p <0.001). When the confounding

factors were adjusted, compared to countries having low and medium EBF rates, it was observed that the

mean rate of COw was found to be lower statistically in the countries that achieved the target breastfeeding

rates (mean±SEM; 9.4±0.8%, 7.1±0.6%, 5.0±0.7%; respectively, p<0.001).

Conclusion: The COw rate was lower in the countries that achieved 2025 global target for EBF. Continued

breastfeeding for up to 2 years of age improved the rate of COw. By achieving global targets for

breastfeeding, it is possible to decrease childhood obesity.

Keywords: Breastfeeding, childhood overweight

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Evaluation of knowledge and skills of breastfeeding counseling of family health care

workers working in Denizli city center, Turkey

Ahmet ERGİN1*, Caner ÖZDEMİR2, Sertap ATÇI3 1Pamukkale University, Faculty of Medicine, Department of Public Health and Pediatrics and Child

Health, Social Pediatrics Unit; 2Pamukkale University, Faculty of Medicine, Department of Public Health,

Denizli; 3Çukurova University, Faculty of Medicine, Department of Public Health, Denizli, Turkey

Objective: The aim of this study was to evaluate the knowledge and skills on breastfeeding counseling of

family health care workers working in Denizli city center.

Methods: This cross-sectional study was conducted between 11-15 October 2015. Data collection was

completed with a questionnaire including 6 questions about participants' sociodemographic characteristics,

5 questions about their breastfeeding counseling training, 26 questions about breastfeeding counseling

knowledge, and 21 questions for the evaluation of breastfeeding counseling skills. Each correct answer to

the knowledge of breastfeeding counseling questions was scored as 1 point. The breastfeeding counseling

scores was between 0 and 50. Participant was given 0 point for "never", 1 point for "sometimes", and 2

points for "always", according to responses to the questions about the skills of breastfeeding counseling.

The breastfeeding counseling scores was between 0 to 42. Linear regression model was used to determine

the factors affecting the knowledge and skill scores.

Results: One hundred and twenty-eight participants (92.7%) completed the survey. The average age (SD)

was 38.4±4.1. Most (84.3%) of the participants were married and many (85.9%) had children. Half of the

participants (47.7%) had a two-year college degree and 71.1% worked more than 15 years, 89.8% of the

participants previously were received breastfeeding counseling training. Many (59.5%) had the time passed

from the last breastfeeding counseling training longer than 5 years. One third (31.3%) wanted to receive

another breastfeeding counseling training; 25.8% (n = 33) did not want to receive it; and 43% (n = 55) did

not answer this question. The mean (SD) counseling knowledge score was 38.68 (4.02). In bivariate

comparisons, the factors affecting participants breastfeeding counseling knowledge status were the

participants’ occupations (p<0.001), previous counselling training status (p<0.001), marital status (p=0.04),

and educational status (p<0.001). In multivariable analysis showed that participants’ marital status

(p=0.045) and educational status (p<0.001) were the significant factors affecting participants’ breastfeeding

counseling knowledge status. The mean (SD) counseling skill score was 39.32 (2.53). None of the factors

was associated with participants’ breastfeeding counseling skills in bivariate comparisons. In multivariable

analysis, participants with children had higher counseling skill scores, (p=0.033).

Conclusions: Midwives and nurses who are responsible for breastfeeding counselling in Denizli have the

middle-high level of the counseling knowledge and the high level of the counselling skills. Continuing

training in-service is needed to keep the midwives and nurses updated relevant to breast milk and

breastfeeding counselling.

Key words: Breastfeeding, counseling, midwives, nurses

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Obstacles to the maintenance of mother-infant association and breastfeeding from the

perspective of health personnel

Beril ÖZDEMİR1*, S. Songül YALÇIN2, Kadriye YURDAKÖK2 1Başkent University Faculty of Medicine, Department of Pediatrics; 2Hacettepe University Faculty of

Medicine, Department of Pediatrics, Unit of Social Pediatrics, Ankara, Turkey.

Objectives: Breastfeeding is an experience that only a mother and her infant can share. Infants who can

feed from the breast receive not only the best nutrition but also, due to the close physical contact between

mother and child, it is the optimal nurturance they can receive from their mother. It is necessary to maintain

breastfeeding for at least 2 years to ensure the best growth and development of the child. The aim of the

study was to identify the three obstacles that health personnel could see in supporting breastfeeding.

Methods: The population of the study consisted of health personnel who applied for ‘’Hacettepe

Breastfeeding Counseling and Baby Friendly Hospitals Training’’ in Hacettepe University Hospitals

between 2016-2017. Volunteer health personnel were asked to complete the questionnaire by recording

their title without any identification. Only physicians and nurses working in obstetrics and pediatrics

services / clinics were included in the study. The study group were asked to answer three obstacles that

prevent the maintenance of mother-infant association and breastfeeding in the postnatal period. Responses

were grouped and analyzed. Frequency and percentage distributions were calculated.

Results: 221 questionnaires were fully completed. 158 of the health personnel were working in the

pediatrics department and 35 in the obstetrics department. 94 physicians and 99 nurses participated in the

study. The most frequently reported problems were the lack of support or negativity in the family

environment (38.3%) (1), breast problems and milk insufficiency (35.2%) (2), lack of education in the

mother or health personnel (33.7%)(3), psychopathological problems of the mother (31.6%) (4) and skin-

to-skin contact (28.5%) (5). The distribution of the problem did not vary according to the title of the health

personnel and the unit where they worked. Breast related problems and milk insufficiency were seen in

28.7% of physicians and 41.4% of nurses (p = 0.065). Among the components of this main group, nipple

problem was reported by 6.4% of doctors and 18.2% of nurses (p = 0.013). The problem of milk

insufficiency and delayed lactation were also reported by 64.4% of the doctors and 16.2% of the nurses (p

= 0.033).

Conclusions: We expect that these findings will contribute to improve the knowledge of aspects still little

explored of the determinants of breastfeeding among health personnel. Besides medical problems, the

family structure and environment should be taken into consideration in the programming of breastfeeding

support.

Keywords: Breastfeeding, mothers, children, mother-infant association

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Breastfeeding status and breast problems of mothers who gave birth in Başkent

University Hospital

Cihan FİDAN1*, Arzu KARATAŞ2, Funda SALGÜR1, Altuğ KUT1 1 Başkent University Faculty of Medicine, Department of Family Medicine, Turkey, 2 Başkent University of

Medicine, Department of Dermatology, Turkey

Objective: In this study, we aimed to reach the women who gave birth in our hospital and to determine the

breastfeeding status of the mothers and the frequency of the nipple and breast problems such as nipple

wound or mastitis.

Method: This is a cross-sectional study. A total of 112 women who gave birth in Başkent University

Ankara Hospital in the last 3 years were included in the study. Individuals were reached by phone numbers

registered in hospital data. Participants were asked to answer the questionnaire which consisted of 39

questions that we prepared based on the literature. The data was analyzed with descriptive statistics and

chi-square test.

Results: The mean age of the women participating in the study was 37.9±4.5, 74.1% had university

education and 25.9% had primary-secondary-high school education. The majority of participants started

breastfeeding in the first 24 hours (81.3%). 68.8% of the participants received breastfeeding training and

68.8% of them received in prenatal period. 36.6% of the mothers had problems in the first breastfeeding

after birth. Almost half of the participants had nipple wound (47,3%). However, 24.1% of patients

developed mastitis. Nipple wound and mastitis were found to be more common in those who had problems

with first breastfeeding (p<0.01; p<0.01) and those who did not have breast milk on the first day (p<0.05;

p<0.05). In addition, it was observed that nipple sores occur more frequently in those who received

breastfeeding training in the postnatal period (p<0.05), and mastitis incidence is higher in those with nipple

wound (p<0.001). No statistically significant difference was found between nipple wound and mastitis with

maternal birth age, education level, smoking, type of birth, number of birth and nipple care in prenatal or

postnatal period (p<0.05).

Conclusion: This study showed that women still suffer from breastfeeding problems and that

prenatal/postnatal education should be increased in reducing the problems, and that mothers should be

supported for breastfeeding more especially in the first 24 hours.

Key words: Breastfeeding, Mastitis, Nipple wound

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We questioned the support given to mothers: A survey study

Nilgün ALTUNTAŞ1* 1Ankara Yıldırım Beyazıt University, Department of Pediatrics, Division of Neonatology, Ankara

Objective: Despite the high breastfeeding initiation rates, exclusively breastfeeding rates in the first 6

months in Turkey have not yet reached the desired level. We wanted to carry out a questionnaire

interrogating the reason for this failure in breastfeeding while baby-friendly hospital practices continued to

be carried out. For this reason, we aimed to see whether the mother’s received adequate support from the

hospital or not.

Method: Mothers who applied to our neonatal outpatient clinic for the postnatal control of their infants

between July and August 2019 were asked to participate in our survey. Our questionnaire consisted of

thirty questions about nursing and breastfeeding support given to mothers.

Results: 133 mothers participated in our study and answered all the questions in the questionnaire. Most of

the mothers with a mean age of 29.0 ± 4.45 were university graduates (54.0%). Of the mothers, 130 had

adequate follow-ups during pregnancy and 3 had no follow-ups anywhere. 86 of the mothers (64.66%)

stated that they did not receive any training about breastfeeding during pregnancy. 18 of the mothers had

given birth in a private hospital (13.53%) while 115 of them chose to give birth in a state hospital

(86.46%). 47 (35.33%) mothers stated that they did not receive any postnatal breastfeeding training and

25% of the mothers answered the questions about breastfeeding incorrectly. 20 mothers (15%) used

supplemented formula besides breast milk. Only 1 of the mothers was completely feeding her baby with

formula. Mostly doctors recommended formulas due to the mother’s milk insufficiency and baby's

excessive weight loss. Only 13 mothers received resuscitation training, and most mothers did not know the

normal values of body temperature, respiratory rate and heart rate of the newborn. 54 of the mothers

(40.60%) learned about infant care from a health care facility and 29 (21.80%) from neighbors and

relatives.

Conclusion: Our study showed that mothers were not sufficiently supported in terms of postnatal

breastfeeding training and infant care. They didn’t know what normal infant vital rates should be and they

didn’t receive resuscitation training. Hospitals need to put more effort into mother education and support.

Keywords: Breastfeeding, exclusively breastfeeding, baby care

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S84

In-hospital neonatal falls and near fall events in breastfeeding mothers

Sezin ÜNAL1*, Nihal DEMİREL 2, Betül TOKGÖZ ÇUNİ1, Fatma İYİGÜN1, Özlem MORALOĞLU

TEKİN3, Ahmet Yağmur BAŞ 1 Neonatology Dept., University of Health Sciences, Ankara Etlik Women's Health Teaching and Training

Hospital, Ankara, Turkey, 2 Division of Neonatology, Pediatric Dept., Ankara Yildirim Beyazit University,

Ankara, Turkey, 3 Gynecology and Obstetric Dept., University of Health Sciences, Ankara Etlik Women's

Health Teaching and Training Hospital, Ankara, Turkey.

Objectives: The incidence of neonatal fall in maternity ward is 1.6-5.9/10.000 live births. The most

common reason was fall of newborn from the arms of the sleeping mother durind breastfeeding. In this

study, we evaluated the clinical results of the newborns fell in maternity ward retrospectively and identified

the mother-infant pairs prospectively who were at risk of fall event during maternity ward stay.

Methods: Newborns who were admitted for follow-up after fall in maternity ward were included in the

study (Jan 2013-Jan 2019). The detail of the event, the time that the fall occurred, pathologic physical

examination, laboratory and imaging evaluation and the outcome were recorded. The data were given as

median (interquartile range) and n(%); SPSS V15. Same neonatologist performed daily visits maternity

ward and asked for near fall events (sleeping in the same bed, about to fall occasions) for two weeks.

Results: There existed 17 in-hospital neonatal falls during the six years of study period (1.8/10000 live

births). 14 events (82%) were occurred between 22.00-06.00. Median time of fall was 22 (5-62) postnatal

hours. All infants were exclusively breast fed. The causes were falling asleep during breastfeeding (n=9),

fall from bed while holding (n=6) and dizziness of mother (n=2). Bruising in skin and hematoma on scalp

were most common findings. Laboratory tests and imaging studies were normal in all patients. All cases

were discharged with health.32 mothers were found to experience near fall event (fall asleep during breast

feeding:30, about to fall event while picking their infant:2). In that two weeks of prospective arm of the

study a total of 740 days of 526 mothers were observed. Ratio of about to fall event was found to be 4.2 in

1000 days of hospital stay. All infants were exclusively breast fed, 15 events occurred in first 24 hours after

delivery (47%), 23 mothers delivered by caesarian section (72%) and 28 mothers had no companion (88%).

30 mothers attributed the event to their tiredness after delivery.

Conclusions: While promoting exclusively breast feeding in the maternity wards, specific approaches

should be taken to lessen the tiredness of the mothers to reduce the risk of fall events. Current ongoing

patient security policies should be improved to focus on the prevention of in-hospital neonatal falls.

Specific approaches should be taken to increase maternal well-being and sleep quality not only to reduce

fall events but also to comfort mothers while encouraging breast feeding.

Keywords: neonate, breast feeding, in-hospital falls, near-fall events

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Evaluation of short-term morbidities of preterm infants who are breastfed and not fed

Nilüfer MATUR OKUR1*

1 Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey

Objective: To compare the short and mid-term morbidity and weight gains of preterm infants under 32

weeks of gestational age and non-breastfed infants during admission

Methods: The data of preterm infants aged 32 weeks and under followed in the third level neonatal

intensive care unit between 1 October 2018 and 1 June 2019 were evaluated retrospectively. The patients

were divided into two groups as infants breastfed only during the hospital stay and as control group fed

with less than 50% breast milk. Short- and mid-term morbidity, weight gain and time to complete enteral

feeding were compared. Patients with severe asphyxia, major congenital anomalies and death were

excluded from the study period.

Results: The data of 54 patients in the breast milk group and 46 patients in the control group were

compared. Mean gestational age was 28.1 ± 2 weeks, birth weight was 1115 ± 242 grams and 27.4 ± 1.7

and 993 ± 200 in the control group, respectively, and there was no statistical difference between the groups

(p = 0.25 and p = 0.064, respectively). There was no difference between groups in terms of gender, delivery

type, multiple pregnancy, antenatal steroid use, 1st and 5th minute Apgar scores, respiratory distress

syndrome, patent ductus arteriosus (p> 0.05). Clinical and culture positive late neonatal sepsis rates were

similar. The rates of severe intracranial hemorrhage, retinopathy requiring treatment, bronchopulmonary

dysplasia and osteopenia were similar. When nutritional status is examined; time to full enteral feeding was

median 15 days in the breast milk group and 11 days in the control group (p = 0.21). When necrotizing

enterocolitis (NEC) rates of stage 2 and above were compared, no patients were detected in the breast-fed

group, whereas 4 patients in the non-breast-fed group (p = 0.04). The duration of hospitalization was

similar in both groups.

Conclusion: As expected, breastmilk is protective against NEC in preterm infants. In addition, there was

no increase in the rate of osteopenia in infants receiving breast milk. Other morbidities of preterm infants

may have prevented possible shortening of early breast feeding and discharge time of breast milk.

Keywords: Breast milk, preterm, nutrition

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S86

Importance of Breast-Feeding Assessment Form used in Obstetrics Clinics within the

scope of Assessing Breast-Feeding Success Rate

Ebru İNAN KIRMIZIGÜL1*, Gönül TOZLU1, Rukiye DURSUN ALTIN1, Elif BİLGE1, Fatma DEMİR1,

Feride ALAGÖZ1 1Ankara City Hospital – Maternity Hospital, Bilkent/Ankara/Turkey

Objective: The objective of this study is to identify the importance of “Breast-Feeding Inspection and

Assessment Form” (BFIAF) used for the assessment of breast-feeding in the clinic for its importance in

breast-feeding success rate.

Method: As cross-sectional and in descriptive type, this study was carried out on midwives and nurses

accepting to participate in the research, working in Obstetrics clinics in a training & research hospital in

Ankara between July 2019 – September 2019. The population of the study comprises of all the midwives

and nurses working in Obstetrics Clinics. Sampling of the research was completed with 22 participants (8

nurses, 14 midwives). After obtaining the verbal and written consent of all the midwives and nurses

participating in the study, they were kindly asked to fill the questionnaire form (socio-demographic

characteristics, BFIAF) and Latch Breast-Feeding Assessment and Diagnosis Scale (LATCH). For

statistical analyses, the frequency, along with the Spearman’s Rho Correlation analyses with percentages

were utilized. For statistical significant, p<0,05 was taken as basis.

Results: Among those who participated in the study, 63.6% are midwives, 36.4% are nurses, while 54.5

have bachelor’s degree. 90.9% of the participants were provided with human breast milk, breast-feeding

and lactation counseling trainings. According to BFIAF form used in the clinic, the most frequently

confronted problems were found to be the mother not knowing the breast-feeding duration & frequency

(86.4%) and holding the baby in the wrong position (22.7%). Latch mean score obtained in the study is 9

(min 2, max 10). 54.5% of the participants stated the use of BFIAF form to be easier. No statistically

significant correlation was found between the BFIAF form and LATCH scale average score in the study

(p>0.05).

Conclusion: It was found in the study that BFIAF form used in the clinic was not qualified to specify the

breast-feeding success rate, but rendered as a suitable form for the assessment of breast-feeding. Within this

scope, the tools that are validated and reliable are required to be used in the clinics.

Keywords: Midwifery, breast-feeding success rate, assessment of breast-feeding, nursing care

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S87

The effect of feeding shape on the frequency of illness in infants

Erdal ÜNLÜ1, Ramazan DULKADİR1 1Department of Pediatrics, Kırşehir Ahi Evran University Faculty of Medicine, Kırşehir, Turkey

Objectives: Infancy involves the process from birth to 2 years of age, and the mother and her milk are the

greatest helpers in the development of the baby. Mother milk is an excellent source of nutrition for the

growing baby, as well as antibodies, cytokines, growth factors, antimicrobial agents and specific immune

cells. In addition to providing primary protection against intestinal, respiratory and urinary tract infections.

In this study, it was aimed to investigate the frequency of infants' common diseases according to

breastfeeding.

Methods: In this study, we compared the incidence rates of 309 healthy born infants aged 0-24 months

who presented to Ahi Evran University Hospital Children's Polyclinic with different complaints according

to their feeding types (breast milk-formula) between February 2018 and March 2018. A questionnaire

consisting of 27 questions (age, sex, birth weight, gestational age, infant feeding style, when the first breast

milk was given, when additional foods were started, and the main diseases of the baby) were applied to the

mothers.

Results: Of the 309 patients included in the study, 54% (n = 167) were male and 46% (n = 142) of the

babies were female. 55.7% (n = 172) of the deliveries were caesarean section and 44.3% (n = 137) were

normal deliveries. 65.7% of the babies were fed with breast milk and 34.3% were fed with formula. The

most common diseases in infants participating in our study, 66.3% of upper respiratory tract infections,

diarrhea 31.7%, lower respiratuar tract infections 26.5%, 16.5% anemia, oral and dental health disorders

was 7.8%. Mother milk fed with those not seen any disease rate was 83.9% but the rate of those who were

fed with formula was 16.10% (P<0,05). 56.9% of the infants with anemia were fed with breast milk and

43.1% were fed with formula.

Conclusion: In this study, we observed that breastfed babies have less illness than others. Feeding of the

mother from prenatal nutrition to the age of two years affects the whole life and prospective health of the

baby. Inadequate nutrition in the mother's pregnancy provides the basis for chronic diseases that may occur

in the advanced life of the baby. Mother’s milk is an excellent source of nutrition for the growing baby and

contains unique immune cells. The results of this study support that breastmilk protects the baby from

infections until the baby's own immune system matures.

Key Words: Mother’s milk, formula, Kırşehir

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S88

Breastmilk zearalenone and deoxynivalenol levels during the first six months:

Cohort study

Bülent GÜNEŞ1*, S. Songül YALÇIN2, Suzan YALÇIN3

1Özel Şan Med Hospital, Child Health and Disease Service, Şanlıurfa; 2Department of Pediatrics, Facuty

of Medicine, Hacettepe University, Ankara; 3Department of Food Hygiene and Technology, Faculty of

Veterinary Medicine, Selçuk University, Konya, Turkey.

Objectives: Mycotoxins contaminating mothers may pass to their breast milk. This study was aimed to

determine the levels and changes of breastmilk Zearalenone (ZEA), Deoxynivalenol (DON) for the first six

months.

Methods: Voluntary breastfeeding mothers and their infants with birth weight>37 week and birth

weight>2500 g were enrolled between August 2017 and April 2018 in Özel Şan Med Hospital, Child

Health and Disease Service, Şanlıurfa. Mothers and infants with chronic health problem were not taken for

the study. Information’s form including mother-infant characteristics were filled by questioning the

mothers, and then breast milk samples were taken at three different time; on enrollment (Day 5-10),

between 4 and 6 weeks postpartum and between 4 and 6 months postpartum. Breast milk mycotoxin levels

were measured utilizing Helica brand commercial kit.

Results: Eighteen voluntary breastfeeding mothers and their infants with three breastmilk samples were

completed the study. The mean maternal and infant’s age (± SD) was 27.4 (± 5.5) years and 7.9 (± 2.0)

days on enrollment. Mean levels of breast milk ZEA and DON were 0.64 and 17.3 ng/ml, respectively.

During follow up period, ZEA levels were decreased significantly (median; 0.61 ng/ml, 0.44 ng/ml, 0.34

ng/ml; p<0.05). Compared to breastmilk sample taken at the last visit (median; 12.7 ng/ml), breastmilk

DON levels were found to be significantly higher in samples taken in visit 1 and visit 2 (median; 17.3

ng/ml and 22.8 ng/ml).

Conclusions: Contamination levels changed during lactational period. ZEA and DON could be present in

mother-infant environmental and little amount can pass to breast milk. Therefore, food for mothers and

children should be prepared carefully and breastfeeding should be encouraged.

Key words: breastmilk, mycotoxins, zearalenone, deoxynivalenol

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10.01.2019 POSTER PRESENTATIONS

PP1

Potential beneficial health effects of human milk oligosaccharides

Ipek ÇİÇEKLİ1* Raika DURUSOY1 1Ege University, Faculty of Medicine, Department of Public Health, Izmir, Turkey

Objective: Human milk is a special and functional food that contains bioactive components. These

components, play a pivotal role in infections, enhances the functions of the immunity and helps in the

maturation of gut in infants. The fact that breast milk has multiple functions that affect the health of infants

has inspired the investigation of its protective mechanism and many new findings have emerged about a

special structure among its components, human milk oligosaccharides (HMOs). This review aims to

describe the effects of HMOs on health with an emphasis on immunity and gut microbiota, relying on the

latest findings.

Methods: In this review, PubMed and EMBASE databases were scanned and the published articles were

reviewed non-systematically. The original surveys were screened for the last 5 years. The impacts of

HMOs on intestinal microbiota and their potential effects on immunity were investigated. A total of 157

articles were reached. Articles that didn't report original results were excluded. Studies on milk

oligosaccharides other than human milk were excluded. As a result of screening, the full texts of the studies

were retrieved. After exclusion, 17 articles were evaluated. Five of them were reviewed.

Results: One study found that higher concentrations of non-3-sialyl lactose HMOs in breast milk were

significantly associated with decreased infant mortality and protection against postnatal HIV transmission,

independent of other known risk factors. Another study found that lacto-N-fucopentaose I, remained

significantly lower in mothers with infants with cow’s milk allergy. One study conducted on adults found

that tolerance to HMOs was good and adverse events were mild and HMO supplementation specifically

modified the adult gut microbiota. Another study on infants found that breast-fed infants and infants fed

either with an experimental formula containing 2-fucosyllactose had 29–83% lower concentrations of

plasma cytokines compared to infants-fed with the control formula. An animal study found that a

significant reduction in the incidence of type1 diabetes mellitus detected within non-obese diabetic-mice

receiving HMOs early in life.

Conclusion: HMOs have some functions like providing modulation of microbial adhesion and intestinal

maturation in immunological pathways. Studies have partially elucidated the protective mechanism of

breast milk. So, these structures may become a new option in the treatment of diseases having

immunological pathogenesis in the future. Although promising findings are obtained with the models used

in animal studies, they should be further supported by human studies. Further comparative, prospective

randomized studies are needed to evaluate the clinical effects of HMOs.

Key words: beneficial, effects, health, human milk, oligosaccharides

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PP2

The right of the working women to breastfeed her baby

Selmin ŞENOL1*, Seda ARDAHAN SEVGİLİ1 1Ege University Faculty of Nursing, Child Health and Diseases Nursing Department, Izmir, Turkey

Objectives: Recent studies have highlighted the increase in female labour force employment due to the

impact of globalization.

Methods and Results: As of 2017, Women's labor force participation rate in European Union countries is

64.3% while in Turkey it is 29.3%. There are many individual, social, cultural and economic reasons why

women's labor force participation is still low in our country. These include attributing the responsibility of

caring for and raising the child to the mother entirely due to a traditionalist society structure, population

growth of children aged 0-6 years, and prejudices about the ability of working mothers to devote time to

their children. According to TurkStat 2018 fertility data, the fertility rate in our country is 1.99. In order for

these babies to grow healthy and to be able to establish healthy community foundations, they need to feed

only with breast milk, especially in the first six months after birth. In order for newborn babies to develop

healthily, the first age is very important and it is vital for the child and mother to spend time together, to

create a sense of trust in the child's life (to gain the basic sense of trust). The fact that working mothers give

up breastfeeding their babies early due to their work situation in the postpartum period, the inability to

spend adequate and quality time with their babies is a serious problem in terms of Child Health.

Conclusion: In order to strengthen the working mother and baby relationship, improving the legal

regulations that exist in our country is an important requirement. In addition, the baby's right to breastfeed,

the need for a mother in the process of gaining a basic sense of trust, the mother in the process of work,

leaving the dilemma, forcing the preference is a situation. The purpose of this review is to examine the

legal and social conditions of working mothers to deal with this dilemma and to give them the opportunity

to propose solutions.

Key words: working mother, breastfeeding, breast milk, legal regulations

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PP3

According to Turkey Demographic and Health Surveys breastfeeding status and practices by year in

Turkey

Ayşegül DOĞAN DEMİR1*

1Associated Professor, Bezmialem Vakıf University, Medical Faculty, Department of Social Pediatrics

Objective: International guidelines of WHO and UNICEF recommend exclusive breastfeeding start within

one hour after birth until a baby is 6 months old. Thereafter, infants should receive complementary foods

with continuous breastfeeding up to 2 years of age or beyond. According to WHO exclusive breastfeeding

means that the infant receives breast milk only. No other liquids or solids, not even water should be given

to the infant. Infant feeding includes breastfeeding practices, introduction of supplementary weaning foods,

and use of feeding bottles. TDHS reports are very important for monitoring the infant feeding practices of

20 years of change, especially breastfeeding practice based on the evidence. In this study, It was aimed to

see the changes in breastfeeding practices over time in Turkey based on TDHS data .

Method: From 1993 to 2013, the TDHS reports were examined and data on breastfeeding practices were

obtained. Median breastfeeding duration, percentage of breastfed for some period of time, children who

started breastfeeding within one hour of birth and within one day of birth, continued breastfeeding within

2ᵗʰ, 5ᵗʰ And 23ᵗʰ month of life. Percentages of exclusively breasted, fully breastfed (breastfeeding + water)

within 2ᵗʰ and 5ᵗʰ month of life were obtained, evaluated according to some significant characteristics such

as sex, geographic region, residence, maternal education status, status of assistance of delivery.

Breastfeeding status refers to preceding 24 hours, so, this exclusively breastfeeding definition does not

correspond exactly to WHO’s definition above.

Results: The vast majority of mothers breastfeed their babies at least for a while in Turkey. Over time this

situation and percentages did not change in 1993, 1998, 2003, 2008, 2013 (95, 95, 97, 97, 96 respectively).

Median breastfeeding duration tend to increase over the years (12, 12, 14, 16, 16,7 months respectively) but

it is still far from the desired target. Less educated mothers, East Anatolian region’s mothers had high

median duration in all reports, also median duration is longer in male infants (except for 2003 report) when

compared female infants although breastfeeding rate, initiation time, frequency of breastfeeding are similar.

Median duration of breastfeeding did not differ by gender in 2003 report. Although breastfeeding is a

common, initiation in the first hour of life increased in reports after 1993 but did not exceed about 50%.

Percentage of < 2 months and 4-5 months exclusive breastfeeding have increased over time but still not

reached the desired level. Moreover, these rates diminished in 2013 when compared with 2008. One of the

most striking results is the high rates of bottle feeding even at the <2 months .

Conclusion: Although breastfeeding is very common and the median breastfeeding duration increases from

year to year in Turkey, exclusive breastfeeding until 6 months and breastfeeding in first hour after birth are

well below the desired level. < 2 months and 4-5 months exclusively breastfed rate increased partially until

2008 but markedly decreased in 20013. < 2 months and 4-5 months bottle feeding rates have not decreased

in years but increased. There is a consistent increase in breastfeeding rates at age 2 only, but not enough. In

spite of the increasing number of baby-friendly hospitals that have been implemented since 1991, the

desired breastfeeding targets have not been achieved. Strict supervision of hospitals, education of health

personnel, mothers and the community can contribute to the increase of these rates as a sustainable health

service.

Key Words: TDHS, Turkey, Breastfeeding, TNSA

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PP4

Are herbal galactogogues safe during breastfeeding?

Aslı ER KORUCU1, İlknur Münevver GÖNENÇ*

1 Ankara University, Faculty of Nursing, Ankara, Turkey

Objective: Breastfeeding provides numerous benefits for newborn infants and mothers. The World Health

Organization recommends breastfeeding as the normal infant feeding method. But many mothers often face

challenges in their effort to breastfeed their infants. Breast milk insufficiency is one of mothers ’main

reasons to stop breastfeeding in the first six to eight weeks after birth. To augment breast milk production, a

substantial number of women turn to galactogogues, substances thought to increase the supply of milk. The

use of herbal galactagogues is increasingly common worldwide. The objectives of this review were to

evaluate the safety of herbal galactagogues in breastfeeding mothers and the effects on the infants.

Methods: This is an integrative review of the literature.

Results: Many mothers often face challenges such as breast milk insufficiency, family and relatives

recommendation, infant’s cry in their effort to breastfeed their infants. Among the challenges, insufficient

milk supply perception that may lead to early cessation of breastfeeding is the most encountered one.

Mothers who have an insufficient milk supply tend to the usage of galactagogues to benefit in increasing

the amount of milk production. Especially traditional cultures often lead mothers to opt for herbal

galactagogues which are believed to be safer and easily available in the market. The importance of using

herbal galactagogue has been emphasized in various studies. Among Western Australia women who were

breastfeeding, 24% reported the use of herbal galactagogues. In a study conducted in Switzerland and

Canada, midwives reported high use of galactagogues among their patients. Despite the lack of clinical trial

data on the actual increase in measured volume of breast milk production, indicators of breastfeeding

adequacy boosted participants’ confidence levels and resulted in psychological benefits. In many cultures,

the knowledge of herbal galactagogues is passed down from generation to generation. Examples of herbal

galactagogues include fenugreek, blessed thistle, milk thistle, fennel, anise, nettle, and others; however,

there are very few modern data on their safety and efficacy. Although certain herbs have a long history of

being used as galactagogues, scientific evaluation is lacking to verify the clinical efficacy of most of these

herbs. Herbal remedies are often viewed as harmless or safe, and herbal remedies can be sold without

evidence of their clinical usefulness or the absence of potentially harmful effects. Despite the dearth of

evidence supporting the safety and effectiveness of herbal galactagogues, most of lactation consultants

reported that they recommended one or more of these methods to mothers. Although there are some studies

indicating that some herbal galactogues are safe, a wide variety of adverse reaction on mothers and babies

have been reported with herbals, ranging in severity from mild to serious example of toxic epidermal

necrolysis, diarrhea, headache, skin reactions, allergic reactions, interaction with other medications etc.

Conclusion: There is limited evidence supporting safety of herbal galactagoguesuse, particularly among

lactating women. Therefore lactation consultants face the challenge of recommending galactagogues

without the benefit of strong evidence. Herbal galactatgog use during breastfeeding should be investigated

with high-quality clinical trial for reduce the risks associated with herbal use and increase successful

breastfeeding.

Key words: Herbal galacatagogues, breastfeeding, lactation

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PP5

Maternal Causes of Breasfeeding

Nesrin YÖRÜK1, Neriman SOĞUKPINAR1* 1 Ege University Institute of Health Sciences, İzmir, Turkey

Objective: Breast milk has remained an important nutrient from the past to the present. Breast milk is the

most important food that supports the development of the newborn. Breastfeeding is the easiest way to feed

the child. In this article, it is aimed to provide breastfeeding adequacy by recognizing the causes of

maternal breastfeeding barriers of health personnel who play an active role in breastfeedding counseling.

Method: We have reviewed the literatüre.

Results: In 1989, the United Nations General Assembly adopted the Convention on the Rights of the Child.

The aim of this Convention is to ensure that all segments of the society are informed, supported and

provided with educational opportunities in the field of breastfeeding. The World Health Organization

(WHO), American Pediatri Academy and the United Nations Children's Aid Fund (UNICEF) emphasized

the importance of breastmilk for the first six months and recommended nutritional supplements beside

breastfeeding until the age 2 years. Breastfeeding is the adaptation process for mother and her baby. During

the brestfeeding process, physical, biochemical, hormonal and psychological changes ocur to facilitate the

transfer of nutrients. There are some maternal causes that prevent breastfeeding with these changes. In this

article, the following maternal conditions will be discussed; postpartum study, smoking, alcohol and

substance use of the mother, pregnancy during breastfeeding, becoming pregnant with primiparous, mental

state of mother after birth, breast problems, medical problems. Prenatal period is important to increase

breastfeeding time and efficiency of breastfeeding. Maternal conditions that prevent breastfeeding by health

personnel should be known in the prenatal period.

Conclusion: Health personnel should be in contact with pregnant women. Medical staff should monitor

pregnant women well in the prenatal period. Thus, maternal causes that prevent breastfeeding can be

prevented.

Keywords: Breast-feeding, barriers, maternal causes

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PP6

The role of the father in breastfeeding

Raziye KAYA¹*, Şenay Ünsal ATAN²

¹ Dokuz Eylül Üniversitesi Hastanesi, Kadın Hastalıkları ve Doğum Servisi, İzmir, TURKEY

² Ege Üniversitesi Hemşirelik Fakültesi Kadın Sağlığı ve Hastalıkları Hemşireliği Anabilim Dalı, İzmir,

Turkey

Objective: This review aims to raise awareness about the benefits of breastfeeding and the role and

responsibilities of the father in breastfeeding in accordance with the literature.

Method: Literature have been reviewed.

Results: Breast milk is the most important food that has the characteristics to support the development of

the newborn. In addition to the positive effects of breastfeeding on the development of the newborn and

maternal health, it has also been recognized as a means of interaction for Mother-Baby-family. Babies who

are breastfed grow up better, feel less disease, and have better survival rates than babies who are not

properly breastfed or have never been breastfed. The American College of Obstetricians and Gynecologists

(ACOG) (2016) encourages women to breastfeed and supports every woman's right to breastfeed. ACOG

recommends that breastfeeding should be continued as a supplement to additional food during the first year

after breastfeeding only during the first 6 months. Breastfeeding is supported by both the World Health

Organization (WHO) and the United Nations Children's Fund (UNICEF). Both organizations recommend

breastfeeding with other foods for at least two years after birth, with only breast milk for up to 6 months.

Breastfeeding is clearly the mother's role, but there is evidence that the baby's father can have a significant

impact on the mother's breastfeeding decisions. It is possible that mothers who perceive the father with a

more positive attitude towards breastfeeding are more likely to breastfeed. In addition to mothers' own

attitudes, fathers' attitudes predict the mothers' intention to breastfeed. There is some evidence from

intervention studies in which fathers' knowledge of the benefits and management of breastfeeding may

affect the onset and duration. Some qualitative studies have revealed that fathers and mothers believe that

fathers can support breastfeeding. Providing breastfeeding support is important for men's role as father.

Therefore, men's perception that the support they provide to mothers results in a satisfactory breastfeeding

experience may be an important factor in promoting a positive transition to parenting for men. Health

professionals should also include the woman's spouse and other members of the family (such as

grandmother and mother-in-law) in the interviews and address questions and concerns about breastfeeding

and feeding the baby. This patient-centered approach enables healthcare workers, the patient and his / her

family to anticipate possible problems, develop appropriate methods to address these problems, and make

joint plans that take into account the special values of the family, individual characteristics and

expectations in the baby's nutrition, and help them to collaborate.

Conclusion: As a result, fathers can positively influence mothers' decision to breastfeed, increase their

motivation for the continuation of breastfeeding, develop solutions to breastfeeding problems, thus

increasing their breastfeeding rates. Considering the effective role of fathers who have such an effect on

breastfeeding process in the decisions given in the family; and the importance of inclusion in breastfeeding

training and counseling programs where they can provide the necessary support to their spouses and learn

the importance and benefits of breast milk.

Key words: breast milk, breastfeeding, father support

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PP7

What do fathers think about breastmilk bank?

Ayşe KABASAKAL1*, Ömür AKTAŞ1, Özden DURMUŞ1, Canan TÜRKYILMAZ1 1Gazi Unıversıty Health Research and Applıcatıon, Ankara

Objective: The main purpose of this study is to determine the knowledge and opinions of fathers related to

breastmilk banking.

Method: This descriptive research was conducted to determine the views of fathers related to breastmilk

bank whose babies were treated in the neonatal intensive care unit. The data of the research was collected

via a questionnaire prepared to define socio-demographic characteristics of fathers and to determine

information and opinions of fathers about breastmilk banking. The sample of our study consists of 112

fathers.

Results: The mean age of the fathers participating in the study was 27.4 years. Of the fathers, 40.2% were

high school graduates, all were working in a job and 82.1% were living in nuclear family. Thirty-three-

point-nine percent of the fathers were aware of the breastmilk bank and majority of them (89.5%) learned

this from the media. Sixty-five-point-two percent of the fathers stated that they wished breastmilk banking.

Rate of fathers wanting to donate their spouse's milk were 58.1% if a breastmilk bank exists. Forty-two-

point-nine percent of fathers stated that they would want to benefit from breastmilk bank in a situation

preventing their spouses from breastfeeding. Being religiously inappropriate (51.3%) and, risk of getting a

disease (20.7%) were among the reasons of fathers for refusing to benefit from breastmilk bank. Forty-

eight-point-two percent of fathers believed that breastmilk bank was a religious problem. There was no

significant relationship between the age, education level and working status of fathers and the desire to

benefit from breastmilk bank (p> 0.05). However, rate of desire to put breastmilk bank on the service was

lower in fathers believing breastmilk bank would be a religious problem (p <0.05).

Conclusion: More than half of fathers were not aware of breastmilk bank, but it is a favorable outcome that

most of them stated that they wanted breastmilk bank to be introduced in our country. However, religious

drawbacks related to breastmilk donation and concern of infection risk are important outcomes pointing out

factors that may hinder functioning of breastmilk banking system when it is established. Information should

be provided to community relating to the benefits of breastmilk bank and its impact on the health of

newborns. It is important for the development of newborn health to prevent prejudgments, fallacies and

wrong attitudes and, to open breastmilk banks.

Key words: bank, breast milk, fathers, opinion

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PP8

Traditional practices for breastfeeding

Derya YÜKSEL KOÇAK1, Merve AVCI1*, Cansu AYDEMİR1, Esra KILICIKESEN1, Dilek BİNGÖL1 1Hitit University Institute of Health Sciences /Turkey

Breastfeeding is an important and necessary element for the development and maintenance of the newborn.

Breast milk is the first step of feeding for the baby. Breastfeeding is a common and traditional event in our

country. Many factors such as insufficient breast milk, baby's crying reflexes and mother's breast

physiology are factors that affect breastfeeding. Breastfeeding, which the World Health Organization

considers appropriate, is the initiation of breastfeeding within the first hour after birth, and only

breastfeeding for the next six months. In breastfeeding, which is one of the postnatal care interventions of

the newborn, mothers receive support from their close circles to increase their milk or to separate the baby

from the breast and consider the traditions of their families. In the literature, it is seen that frequent

breastfeeding is necessary and herbal methods are used to increase milk. Although the importance of breast

milk is undeniable, breastfeeding after three prayer, small breasts of the mother's milk will be less, such as

beliefs and traditional practices can be harmful to the development of breast milk and baby. Some false

beliefs and practices lead mothers to start breastfeeding late. This situation neglects the baby's nutritional

health. Nurses and midwives; When planning trainings for breastfeeding and breast milk for mothers in the

postpartum period, their families should think as a whole with their culture. This review will be

enlightening in order to ensure that the trainings to be planned for nurses and midwives do not ignore

traditional practices and their negative effects on baby and mother health.

Keywords: Breastfeeding, Breast milk, Traditional practices

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PP9

Breastfeeding attitude in adolescent mothers

Figen KAZANKAYA1*, Ümran SEVİL1

1Ege University Nursing Faculty, Izmir,Turkey

Objectives: Adolescent pregnancies are an important health problem in both developed and developing

countries. Among the adolescent mothers who are in a risky period in many respects, the low rates of onset

and continuation of breastfeeding are among the important problems negatively affecting and neglecting

the health of the mother and the baby. This study was conducted to evaluate breastfeeding attitudes of

adolescent mothers.

Methods: It was planned as a review by reviewing the literature.

Results: One of the problems faced by adolescent mothers in the postpartum period is related to the

initiation and maintenance of lactation. Research has shown that there is a significant relationship between

maternal age and initiation and maintenance of breastfeeding, and there is a positive relationship between

maternal age and duration of breastfeeding. In a study, it was found that adolescent mothers' thoughts and

practices about breastfeeding were more negative than adult mothers. When the studies on adolescent

mothers are examined, it is seen that adolescent mothers are willing to breastfeed, but about half of the

breastfeeding mothers stop breastfeeding at the end of the first month postpartum. The initiation and

maintenance of breastfeeding is influenced by many factors. The factors affecting the breastfeeding attitude

of the adolescent mother are considered as maternal personal factors, social support and spousal support,

cultural factors and infant factors.

Conclusions: In postpartum care, early and frequent follow-up of adolescents and support for breastfeeding

can also contribute to breastfeeding rates. In this respect, it is important to organize breastfeeding trainings,

postpartum home visits and breastfeeding counseling within the scope of primary health care services.

Keywords: Adolescent, motherhood, breastfeeding

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PP10

The assessment of the problems and difficulties encountered by pediatricians and nurses

during their breastfeeding period

Burcu BERBEROĞLU ATEŞ1*

1Ankara City Hospital, Department of Pediatric Gastroenterology, Ankara, Turkey

Objectives: The importance of breastfeeding has been emphasized by national and international health

institutions and organizations, which have been trying to create effective breastfeeding policies. As health

agents in this field pediatricians and nurses play a critical role for making breastfeeding widespread. The

aim of our study is to assess the problems and difficulties encountered during their own breastfeeding

period by pediatricians and nurses whose working conditions are much harder than those of many other

occupational groups.

Methods: We prepared a questionnaire consisting of 18 questions seeking to measure problems and

difficulties encountered by 50 pediatricians and nurses employed at Ankara City Hospital Department of

Pediatrics.

Results: The questionnaire was applied to 27 pediatricians and 23 nurses. We found that the average for

exclusively breastfeeding period was 4.5 months. The results indicated that 65 % of the participants started

formula and that the reasons to start formula were mostly insufficient breast milk and having to start

working. 71.4 % of the participants pointed out that they could not enjoy legal breastfeeding leave. All

except 5 participants told they had felt unhappy during breastfeeding period. Of those 45 participants who

told to have felt unhappy, only one participant went to a mental health expert for psychological support.

The most common reason of their unhappiness was sparing time for themselves and their social life.

Conclusion: The importance of breastfeeding is obvious; it is the pediatricians and nurses who will raise

the public awareness about this importance. However it is underestimated that they are also breastfeeding

mothers. This study displays that those who know best and guide the mothers about breastfeeding

themselves encounter problems and difficulties in applying the knowledge and rules in their daily lives.

Keywords: Breastfeeding, pediatricians, nurses

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PP11

Relactation and Motivation in Providing Relactation

Ferhan ŞAHİN1, Hafize ÖZTÜRK CAN2

1 Kütahya Merkez TSM Sırören Sağlıkevi Kütahya, Turkey, 1Ege University Institute of Health Sciences,

Graduate Student,İzmir/Turkey, 2Ege University Institute of Health Sciences, Faculty Member,

Doç.Dr.,İzmir, Turkey

Objective: Breast milk is a valuable economic and natural food in terms of newborn growth and

development, which contains the necessary nutrients for the newborn. The World Health Organization

(WHO) and the United Nations Children's Aid Fund (UNICEF) emphasized the importance of breastmilk

only for the first six months, and recommended breastfeeding until the age of 2 with additional nutrients

after six months. Breastfeeding may be interrupted due to various reasons and breast milk may decrease.

This interruption of the breastfeeding process is undesirable for both maternal and infant health. In such

cases, relaxation applications are of great importance. Relactatıon, also called re-breastfeeding or induced

breastfeeding, is a physiological process in which lactation is restarted if milk release is interrupted or

decreased. In cases where there is difficulty in adapting to breastfeeding, inadequate milk production or

milk discontinuation, rejection of breastfeeding by the baby, breast problems, maternal and infant diseases,

untimely weaning, adoption, maternal death can be applied. In the relactation application, milk formation is

provided by breast situmulation. Breastfeeding supplements and instillation are two main methods used in

relactation. It is essential that the baby suckles the breast. Relactation can be applied to mothers who have

been milked and adoptive mothers who have never given birth. Relactation is a long and very motivating

process, both the mother's desire for breastfeeding and her self-confidence in achieving it, and the support

of healthcare professionals are crucial for the success of relactation. For this reason, the aim of this article

is to re-start, sustain and evaluate breastfeeding, methods used to re-start breastfeeding, situations in which

relactation is applied, motivation of mother and health work in relactation and to be informed about these

issues.

Conclusion: Mother and child health has a very important place in the development of society.

Breastfeeding is also one of the cornerstones of mother and child health. Therefore, the continuation of the

interrupted breastfeeding process should be implemented by health professionals who are knowledgeable

about the correct methods. Thus, breastfeeding parameters will increase and thus maternal infant mortality

and morbidity rates will decrease significantly.

Key Words: Breast-feeding; relactation, infant; breast milk

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Index

Ahmet ERGİN, 93 Ahmet Yağmur BAŞ, 97 Alaettin ÜNSAL, 79 Ali GÜVEY, 55 Altuğ KUT, 95 Arzu AKPINAR, 30 Arzu KARATAŞ, 95 Arzu Meltem DEMİR, 47 Asiye ARISOY, 56 Aslı ER KORUCU, 105 Asuman ÇOBAN, 37 Asuman ÇOBAN, 38 Ayça KÖMÜRLÜOĞLU, 57 Aykan YÜCEL, 82 Aykan YÜCEL, 31 Ayla ERGİN, 73 Aysel ÖZDEMİR, 84 Ayşe BAŞAR AKDOĞAN, 75 Ayşe KABASAKAL, 90, 108 Ayşe TOLUNAY OFLU, 85 Ayşe ÜNSAL, 61 Ayşegül ALPCAN, 54 Ayşegül BÜKÜLMEZ, 85 Ayşegül DOĞAN DEMİR, 104 Ayşehan AKINCI, 62 Aytaç KENAR, 48 Aytaç KENAR, 86 Bahar KURAL, 32 Başak CEVİZ, 71 Başak GÖKÇAY, 48 Başak GÜVEN, 77 Başak KAYA GÜRSOY, 48 Beril ÖZDEMİR, 94 Berkan ARISUT, 86 Betül TOKGÖZ ÇUNİ, 97 Birgül SAY, 21 Burcu BERBEROĞLU ATEŞ, 111 Bülent GÜNEŞ, 101 Canan TURKYILMAZ, 86 Canan TÜRKYILMAZ, 48, 81 Canan TÜRKYILMAZ, 14, 49, 67, 90, 108 Caner ÖZDEMİR, 93 Cansu AYDEMİR, 109 Celal Mete KARAKURUM, 46 Cennet YALÇIN TOPBAŞ, 75 Cihan FİDAN, 95 Cüneyt TAYMAN, 68 Cüneyt TAYMAN, 33 Çiğdem AVCI, 36

Demet ALAYGUT, 17 Demet TEREK, 26 Deniz ÇALIŞKAN, 77 Deniz YILDIZ YAHŞI, 58 Derya ERİKOĞLU, 78 Derya YÜKSEL KOÇAK, 109 Devlet ALAKOÇ PİRPİR, 76 Didem ÖNAY DERİN, 76 Dilek ASLAN, 66 Dilek BİNGÖL, 109 Dilek ÇAKMAK TOP, 19 Dilek ORBATU, 17 Dilek SARPKAYA GÜDER, 83 Dilek ŞAHİN, 82 Dilek ŞAHİN, 31 Döne EROĞLU, 48, 81 Duygu TUNÇEL, 37 DuyguAYHAN BAŞER, 43 Ebru Atike ONGUN, 72 Ebru AZAPAGASI, 50 Ebru ERGENEKON, 48 Ebru ERGENEKON, 49, 86 Ebru İNAN KIRMIZIGÜL, 99 Eda BAŞMISIRLI, 45 Eda ÜNAL, 84 Edanur ACAREL, 54 Elif BİLGE, 99 Elif DAĞLI, 23 Elif KELEŞ, 48 Elif KELEŞ, 86 Elif ÖZYAZICI ÖZKAN, 49 Elif Ünver KORĞALI, 28 Emel AKTAŞ, 48 Emine ÇAMTOSUN, 62 Emine ÇOLAK, 20 Emine GÜLTEKİN, 74 Emine POLAT, 69, 70 Endam ÇETİNKAYA, 26 Engin YILMAZ, 71 Erdal ÜNLÜ, 100 Erhan AYGÜN, 37 Esin KOÇ, 48, 81 Esin KOÇ, 49, 86 Esin OKMAN, 68 Esin OKMAN, 60 Esma ALTINEL AÇOĞLU, 69 Esra BEŞER ÖZMEN, 68 Esra BEŞER ÖZMEN, 60 Esra ÇELİK, 85

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114

Esra Eray ÖNAL, 86 Esra KILICIKESEN, 109 Esra ÖNAL, 48 Esra ÖNAL, 49 Evrim ALYAMAÇ DİZDAR, 68 Evrim ALYAMAÇ DİZDAR, 60 Ezgi AĞADAYI, 43 Fatima ÇELİK, 18 Fatma Ç. ÖZDÖL, 30 Fatma DEMİR, 99 Fatma İLKNUR VAROL, 34 Fatma İYİGÜN, 97 Fatma Nur SARI, 68 Fatma Nur SARI, 33 Fatma Zehra ÖZTEK ÇELEBİ, 69 Ferhan ŞAHİN, 112 Feride ALAGÖZ, 99 Figen KAZANKAYA, 110 Filiz ÖZKOÇAK TUNA, 36 Filiz ŞİMŞEK ORHON, 28 Fuat Emre CANPOLAT, 35 Fulya KAYIKÇIOĞLU, 36 Funda SALGÜR, 89 Funda SALGÜR, 95 Ganime AYAR, 70 Ganime AYAR, 80 Gaye OLTULU, 89 Gokcen ÖRGÜL, 31 Gonca BEKTAŞ, 41 Gonca KESKİNDEMİRCİ, 32 Gönül TOZLU, 99 Gül Demet KAYA ÖZÇORA, 41 Gül ERTEM, 74 Gülbin GÖKÇAY, 32, 37 Güler KUŞÇU GÜNAY, 20 Gülsüm KADIOĞLU ŞİMŞEK, 35 Gülşah KARATAŞ, 64 Gülşen VURAL, 83 Hafize ÖZTÜRK CAN, 112 Hakan ONGUN, 53 Harika Gözde GÖZÜKARA BAĞ, 62 Hatice BALCI YANGIN, 30 Hatice KAVAS, 20 Havva ÇAKMAK, 30 Hayriye Gözde KANMAZ KUTMAN, 35 Hülya ŞEKER YIKMAZ, 39 Hüsniye YÜCEL, 69 Ipek ÇİÇEKLİ, 102 İbrahim Murat HİRFANOĞLU, 48 İbrahim Murat HİRFANOĞLU, 86 İlkay ER, 25 İlknur Münevver GÖNENÇ, 42, 105

İrem CANTÜRK, 32 İzzet ERDAL, 87 Kadriye YURDAKÖK, 22, 94 Latife ATASOY KARAKAŞ, 89 Leyla ERDİM, 88 Mehmet Sabri KIRIK, 71 Melahat Melek OĞUZ, 69 Melda ÇELİK, 22 Melda TAŞ, 86 Melike ERSOY, 65 Meltem AKÇABOY, 69 Meltem DEMİR, 53 Merve AVCI, 109 Merve KÜÇÜKOĞLU KESER, 68 Merve KÜÇÜKOĞLU KESER, 60 Meryem ERAT NERGİZ, 92 Mualla AYKUT, 45 Muhammet BULUT, 91 Murat ÇEVİK, 43 Mustafa AKÇAKUŞ, 30 Mustafa Şenol AKIN, 51 Mutlu UYSAL YAZICI, 50 Müge SAĞLIK, 40 Müge YILMAZ, 45 Münci YAĞCI, 49 Münevver BAŞ, 86 Nazlı PEHLIVAN, 27 Nazmiye Bengü KARAÇAĞLAR, 35 Neriman SOĞUKPINAR, 106 Neriman ZENGİN, 88 Neslihan ÖNER, 45 Neslihan Yılmaz SEZER, 42 Neslihan YUKARIKIR, 66 Nesrin YÖRÜK, 106 Neşe ÇELİK, 23 Nevin YILDIZ, 37 Nevin YILDIZ, 38 Nihal DEMİREL, 97 Nihal ÖZKAN, 90 Nihal ŞAHİN UYSAL, 82 Nihan ÇAKIR BİÇER, 65 Nilgün ALTUNTAŞ, 96 Nilgün ALTUNTAŞ, 61 Nilgün ÇAYLAN, 15 Nilüfer MATUR OKUR, 98 Nuray ESKİ, 38 Nursan ÇINAR, 63 Nurten KÜREKÇİ, 48, 81 Oya BALTALI, 17 Ömür AKTAŞ, 90, 108 Öykü ÖZBÖRÜ, 32 Özden DURMUŞ, 90, 108

115

115

Özer SÖNMEZ, 16 Özge TANIDIR ARTAN, 80 Özlem AKALPLER, 83 Özlem DEMIREL BOZKURT, 27 Özlem MORALOĞLU TEKİN, 36 Özlem MORALOĞLU TEKİN, 97 Özlem SARAÇ SANDAL, 72 Özlem Ülkü BULUT, 79 Öznur TİRYAKİ, 63 Öznur YAŞAR, 24 Pelin BALIKOĞLU, 85 Perran BORAN, 32 Pınar DOĞANCI, 29 Pınar YILMAZBAŞ, 32 Raika DURUSOY, 102 Ramazan DULKADİR, 100 Raziye KAYA, 107 Resmiye ÖZDİLEK, 73 Rukiye DURSUN ALTIN, 99 S. Songül YALÇIN, 85 S. Songül YALÇIN, 15, 22, 57, 58, 59, 60, 80,

87, 92, 94, 101 Saliha ŞENEL, 69 Seçil KOÇ, 75 Seda ARDAHAN SEVGİLİ, 103 Selda BÜLBÜL, 54 Selma AKTAŞ, 52 Selmin ŞENOL, 103 Sema BAYRAKTAR, 37 Sema BAYRAKTAR, 38 Serap HİRA, 20 Serap TEKBAŞ, 83 Serpil KALI, 36 Sertap ATÇI, 93 Seval ÖZTÜRK, 69

Sevda GÜRSEL, 20 Sevgi ÖZSOY, 29, 44 Sevil ŞAHİN, 79 Sevtap VELİPAŞAOĞLU, 46 Sezin ÜNAL, 97 Songül VAİZOĞLU, 66 Suat TUNCAY, 71 Sultan PEKŞEN, 63 Suzan YALÇIN, 15, 92, 101 Suzi ÖZDEMİR, 73 Sümeyye BAKIR, 74 Şanliay ŞAHİN, 69, 70 Şehribanu IŞIK, 33 Şenay TOSUN, 78 Şenay Ünsal ATAN, 107 Şerife Suna OĞUZ, 68 Şeyma ÇİÇEK, 59 Şule YİĞİT, 51 Törehan ASLAN, 37 Tuba KUTLU, 19 Tuba TÜRKER, 76 Tuğba DÜNDAR, 44 Tülay ORTAKÇI, 69 Ümran SEVİL, 110 Ümran SEVİL, 26 Vakkas KARA, 78 Yasemin ALTUN, 19 Yeliz ACAR, 78 Yeliz PEKDOĞAN, 78 Yıldız ATALAY, 49 Yusuf Onur PEKŞEN, 63 Zeynep İNCE, 37 Zeynep İNCE, 38 Zeynep YILMAZ, 36

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Organizasyon İletişim

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