A Comparative Study to assess the effectiveness of application of cold cabbage leaves verses hot application on breast engorgement among postnatal mothers in selected hospitals
Ms. Sunanda S. Nagre1, Mrs. Ujwala Parker2
1M.Sc (N) Final Year Student, College of Nursing, Wanless Hospital Miraj, Dist - Sangli, India.
2M.Sc (N), Associate Professor, Department of Obstetrics and Gynaecological Nursing,
College of Nursing, Wanless Hospital Miraj, Dist- Sangli, India.
*Corresponding Author E-mail: tusharskedar1212@gmail.com
ABSTRACT:
Background: Breast engorgement is the overfilling of breast milk that causes discomfort and pain to the mother whilst non-infectious mastitis is inflammation of the breast due to milk duct blockage. Breast engorgement is associated with hard, painful, throbbing, aching and tender breasts which may result in women needing analgesia, developing mastitis or temporarily or permanently stopping breastfeeding. Objectives: 1. To assess the level of breast engorgement among postnatal mothers. 2. To determine the effectiveness of application of cold cabbage leaves and hot application on breast engorgement in experimental groups. 3. To compare the effectiveness of application of cold cabbage leaves and hot application on breast engorgement in experimental groups. Method: A Study was conducted in selected hospitals to compare the effectiveness of application of cold cabbage leaves verses hot application on breast engorgement among postnatal mothers in selected Hospitals. A 30 samples was selected using purposive sampling technique. The socio demographic variable of the subjects was consist of seven items, which included age, Parity, Education, type of delivery, time of breastfed after delivery and frequency of breastfeeding. The pretest and posttest was done by using Self Rated 6-Point Breast Engorgement Scale and observational Checklist and two group posttest design was used. It was done for 2 times a day for 3 days for the 15 min duration. Results: Group A mean posttest scores was 2.40 with standard deviation ±1.18 and Group B mean posttest was 3.80 with standard deviation ±1.32. The test statistical value of unpaired t test was 3.06 with p value 0.005 which is >0.05, hence H0 is rejected and H1 is accepted. Conclusion: : It concludes that, application of cold cabbage leaves on breast engorgement among postnatal mothers was more effective than hot application.
KEYWORDS: Assess Effectiveness, Comparison, Cold Cabbage leaves, Hot application.
1. INTRODUCTION:
The birth of a baby is an important event in any family. It is therefore important that for a mother to have a healthy baby, she gives her baby the best nutrition. Breast milk is the best food for babies as breastfed babies are generally healthier than formula fed babies. The theme of world breastfeeding week 2020 is “support breastfeeding for a healthier planet’’. WHO and UNICEF are calling on governments to protect and promote women’s access to skilled breastfeeding counseling, a critical component of breastfeeding support.1
WHO recommends that, in all parts of the world, babies should be exclusively breastfed for the first six months “to achieve optimal growth, development and health”.
Breast engorgement occurs if the baby removes less milk from the breast when feeding than the amount that the mother produces. Breast engorgement is the overfilling of breast milk that causes discomfort and pain to the mother whilst non-infectious mastitis is inflammation of the breast due to milk duct blockage.2
Breast engorgement usually occurs within a week of the birth, but can occur later. Primary engorgement occurs in the first few days after the baby is born, and it occurs when the mother’s body is still trying to adjust to the amount of milk that the baby demands. Secondary engorgement occurs later when the mother is not feeding as frequently as she used to, or the baby removes less milk from the breast.4
Breast engorgement is associated with hard, painful, throbbing, aching and tender breasts which may result in women needing analgesia, developing mastitis or temporarily or permanently stopping breastfeeding. The distress associated with breast engorgement may mean that women initiating breastfeeding may not persevere beyond the first few days after the birth.1
2. Problem Statement:
“A Comparative Study To Assess The Effectiveness Of Application Of Cold Cabbage Leaves Versus Hot Application On Breast Engorgment Among Postnatal Mothers In Selected Hospitals.”
3. OBJECTIVES OF THE STUDY:
1. To assess the level of breast engorgement among postnatal mothers
2. To determine the effectiveness of application of cold cabbage leaves and hot application on breast engorgement in experimental groups.
3. To compare the effectiveness of application of cold cabbage leaves and hot application on breast engorgement in experimental groups.
4. HYPOTHESIS:
H0 – There will be no significant difference between effect of application of cold cabbage leaves and hot application on breast engorgement among post-natal mothers in experimental groups.
H1 – There will be significant difference between effect of application of cold cabbage leaves and hot application on breast engorgement among postnatal mothers in experimental groups.
5. METHODOLOGY:
Research approach:
Quantitative-Comparative study approach
Research design:
Two group post-test design
Setting of the study:
Wanless Hospital Miraj and Somshekhar Hospital Miraj.
Research Variables:
1. Independent variables:
Cold cabbage leaves and Hot application
2. Dependent variables:
Breast Engorgement
Target Population:
Postnatal mothers diagnosed and admitted with breast engorgement.
Accessible Population:
Postnatal mothers diagnosed and admitted with breast engorgement in postnatal wards.
Sample Size: The sample size of the present study was 30 postnatal mothers with breast engorgement, 15 in each group
Sampling Technique:
Purposive sampling technique
Criteria For Selection of The Sample:
Inclusion Criteria:
· Postnatal mothers with mild to severe breast engorgement from second day of postnatal period.
· Who are willing to participate in the study
Exclusion Criteria:
· Postnatal mothers with other breast disorders like breast abscess and mastitis.
· Mothers who are receiving lactation suppressants.
Plan For Data Analysis:
The data obtained was analyzed using both descriptive and inferential statistics based on objectives and hypothesis of the study.
6. RESULT:
Section- I
Analysis related to demographic data, of the postnatal mothers with breast engorgement in selected hospitals in terms of frequency and percentage.
Table No. 1: Frequency and percentage distribution of Postnatal Mothers according to demographic variable n=30
|
Sr. No. |
Variables |
Groups |
Group A |
Group B |
||
|
Frequency (f) |
Percentage (%) |
Frequency (f) |
Percentage (%) |
|||
|
1 |
Age in years |
18-20 |
1 |
6.66 |
4 |
26.66 |
|
21-25 |
4 |
26.66 |
2 |
13.33 |
||
|
25-30 |
7 |
46.66 |
4 |
26.66 |
||
|
30 year and above |
3 |
20 |
5 |
33.33 |
||
|
2 |
Parity |
Primipara |
9 |
60 |
7 |
46.66 |
|
Multipara |
6 |
40 |
8 |
53.33 |
||
|
3 |
Education |
Illiterate |
7 |
46.66 |
10 |
66.66 |
|
Primary |
4 |
26.66 |
1 |
6.66 |
||
|
Secondary |
3 |
20 |
2 |
13.33 |
||
|
Graduate |
1 |
6.66 |
2 |
13.33 |
||
|
4 |
Type of Delivery |
Normal Vaginal |
4 |
26.66 |
7 |
46.66 |
|
LSCS |
10 |
66.66 |
8 |
53.33 |
||
|
Forceps |
1 |
6.66 |
0 |
0.00 |
||
|
Vacuum |
0 |
0.00 |
0 |
0.00 |
||
|
5 |
Initiation of Breastfeed after delivery |
Within 1 hour |
3 |
20 |
3 |
20 |
|
1-2 hour |
2 |
13.33 |
2 |
13.33 |
||
|
After 3 hour and more |
10 |
66.66 |
10 |
66.66 |
||
|
6 |
Frequency of Breastfeeding |
2 hourly |
5 |
33.33 |
5 |
33.33 |
|
>2 hourly |
10 |
66.66 |
10 |
66.66 |
||
SECTION II
Analysis of data related to assessment of pretest and posttest score of Group A and Group B by using Self-Rated 6 Point Breast Engorgement Scale.
Table No-2: Assessment of pretest and posttest score of breast engorgement- cold cabbage leaves (Group-A) n=15
|
Group A |
Size |
Mean |
S.D. |
t value |
P value |
|
Pre Test |
15 |
4.73 |
±0.88 |
18.52 |
0.00 |
|
Post Test |
15 |
2.40 |
±1.24 |
The above table depicts that, mean pretest score was 4.73 with standard deviation ±0.88 and mean posttest score was 2.40 with standard deviation ±1.24. The test statistical value of the paired t test was 18.52 with p value 0.00 which is < 0.05. It concludes that, application of cold cabbage leaves on breast engorgement among postnatal mothers was effective.
Table No- 3: Assessment of mean pretest and posttest score of breast engorgement among postnatal mothers in Group B (Hot application) n=15
|
Group B |
Size |
Mean |
S.D. |
t value |
p value |
|
Pre Test |
15 |
4.60 |
±1.18 |
10.25 |
0.00 |
|
Post Test |
15 |
3.60 |
±1.05 |
The above table depicts that, mean pretest score was 4.60 with standard deviation ±1.18 and mean posttest score was 3.60 with standard deviation ±3.60. The test statistical value of the paired t test was 10.25 with p value 0.00 which is < 0.05. It concludes that, hot application on breast engorgement among the postnatal mothers was effective.
Table 4: Assessment of mean pretest and posttest score of breast engorgement among postnatal mothers –Group- A (Cold cabbage leaves) n=15
|
Group A |
Size |
Mean |
S.D. |
t value |
P value |
|
Pre Test |
15 |
4.46 |
±1.18 |
17.49 |
0.00 |
|
Post Test |
15 |
2.40 |
±1.18 |
The above table depicts that, mean pretest score was 4.46 with standard deviation ±1.18 and mean post test score was 2.40 with standard deviation ±1.18. The test statistical value of the paired t test was 17.49 with p value 0.00 which is <0.05. It concludes that, application of cold cabbage leaves on breast engorgement among postnatal mothers was effective.
Section III:
Analysis of data related to comparison of the effectiveness of cold cabbage leaves verses hot application on breast engorgement among postnatal mothers by using Self-Rated 6 Point Engorgement Scale and observational checklist.
Table 5: Comparison of mean posttest score of breast engorgement using Self-Rated 6 Point Engorgement Scale n=30
|
Post Test |
Size |
Mean |
S.D. |
t value |
P value |
|
Group A |
15 |
2.40 |
±1.24 |
2.85 |
0.008 |
|
Group B |
15 |
3.60 |
±1.06 |
Above table depicts that, Group A mean posttest score was 2.40 with standard deviation ±1.24 and Group B mean posttest score was 3.60 with standard deviation ±1.06. The test statistical value of unpaired t test was 2.85 with p value 0.008 which is <0.05, hence H0 rejected and H1 is accepted. It concludes that, application of cold cabbage leaves was more effective than hot application on breast engorgement among postnatal mothers.
Table 6: Comparison of breast engorgement among postnatal mothers – cold cabbage leaves (Group A) versus hot application (Group B) by using observational checklist n=30
|
Post Test |
Size |
Mean |
S.D. |
t value |
p value |
|
Group A |
15 |
2.40 |
±1.18 |
3.06 |
0.005 |
|
Group B |
15 |
3.80 |
±1.32 |
Above table depicts that, Group A mean posttest scores was 2.40 with standard deviation ±1.18 and Group B mean posttest was 3.80 with standard deviation ±1.32. The test statistical value of unpaired t test was 3.06 with p value 0.005 which is >0.05, hence H0 is rejected and H1 is accepted. It concludes that, application of cold cabbage leaves on breast engorgement among postnatal mothers was more effective than hot application.
LIMITATIONS:
1. The findings of the study cannot be validated and generalized as the sample size was small.
2. The study was time bound.
RECOMMENDATIONS:
On the basis of findings and the experiences while conducting the study, following recommendations are offered for further research:
1. A similar study can be replicated in different settings to strengthen the findings.
2. A similar study can be done on large sample size to generalize the findings.
3. A comparative study can be done on cabbage leaves and cold application.
CONCLUSION:
1. Review of literature has helped the investigator to gain in-depth knowledge of content, to develop conceptual framework for the study, tool for data collection and analysis of data.
2. The purpose of the study, A comparative study to assess application of cold cabbage leaves verses hot application on breast engorgement among postnatal mothers have been statistically proved that cold cabbage leaves were more effective than hot application.
REFERENCES:
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3. Jacob Annamma. A Comprehensive Textbook of Midwifery. Jaypee Publication. 2001. Pg. 508- 511
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Received on 06.06.2023 Modified on 19.06.2023
Accepted on 28.06.2023 ©A&V Publications All right reserved
A and V Pub Int. J. of Nursing and Medical Res. 2023; 2(2):45-48.
DOI: 10.52711/ijnmr.2023.12