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Assessing Mandated Breastfeeding Education in Istanbul

Dolgun, Gülümser PhD, RN; Yüksel, Aysşe PhD, RN

MCN: The American Journal of Maternal/Child Nursing: September-October 2010 - Volume 35 - Issue 5 - p 293–296
doi: 10.1097/NMC.0b013e3181e62802
Feature Article

Purpose: To assess the implementation of a breastfeeding education program for women in Istanbul against the backdrop of the relevant policies adopted by the country of Turkey.

Methods: Descriptive and cross-sectional survey of mothers of 801 infants, ages 0 to 12 months, who presented at the vaccination and neonatal follow-up unit of the Yenibosna Mother and Child Health and Family Planning Center in Istanbul. Mothers were interviewed using a questionnaire developed by the investigators. Frequency distributions and chi-square analyses were used for the data.

Results: Forty-six percent of the women in the sample had received breastfeeding education either when they gave birth or right afterward; 63.8% had initiated breastfeeding in the first hour after birth. The rate of exclusive breastfeeding was 81.1% in the first month, 51.5% in the fourth month, 19.8% in the sixth month, and 1% in the twelfth month. The average duration of exclusive breastfeeding was 3.45 months (±2.1). Introduction to a supplementary food started at an average of 4.4 months (±2.1), usually with tea, water, fruit juice, or yogurt.

Clinical Implications: Despite a government mandate to educate every new mother about the advantages of breastfeeding, less than one-half of the women in this study actually reported receiving the education. Nurses who work with pregnant and postpartum women can use this study to help guide implementation of interventions to increase breastfeeding programs. It is clear that more effort needs to go into teaching women not only about initiating breastfeeding, but also about exclusive breastfeeding until at least 6 months of age.

In the United States, breastfeeding is encouraged, but in Turkey breastfeeding education is mandated for all women. Does this approach work?

Gülümser Dolgun, PhD, RN, is an Assistant Professor, Department of Nursing and Midwifery, Bakirkoy School for Health Sciences, Istanbul University, Turkey. The author can be contacted via

Ayşe Yüksel, PhD, RN, is a Professor and Head of Department, Yuzuncu Yil University Medical Faculty, Department of Public Health, Turkey

The authors have disclosed that there are no financial relationships related to this article

© 2010 Lippincott Williams & Wilkins, Inc.