Effectiveness of Breast Crawling Technique in the Duration of Placental Expulsion among Parturient mothers in a Tertiary Care Centre, Thiruvananthapuram
Elby T Andrews1, Lekshmi A S2
1Lecturer, KIMS College of Nursing, Thiruvananthapuram.
2Assistant Professor, Govt College of Nursing, Thiruvananthapuram.
*Corresponding Author E-mail: elbyandrews@gmail.com
ABSTRACT:
The present study was intended to assess the “Effectiveness of breast crawling technique in the duration of placental expulsion among parturient mothers in a tertiary care centre, Thiruvananthapuram”. The objective of the study was to evaluate the effectiveness of breast crawling technique in the duration of placental expulsion. Theoretical frame work adopted for the study was Modified Kristen M. Swanson Theory of Caring (2011). The research approach adopted for the study was quantitative and the data was collected from 70 parturient women. The study design was quasi experimental research design and consecutive sampling technique was used to select the study participants. For collecting data, observation and review of record method was used. Data analysis was carried out using both descriptive and inferential statistics. In the experimental group the mean value of duration of placental expulsion was 5.27 and standard deviation was 0.88 since ‘t’ value is 14.30 and the calculated ‘p’ value was <0.05. Hence it is statistically significant and it can be concluded that initiation of breast feeding through breast crawling technique was effective in reducing the duration of placental expulsion.
KEYWORDS: Breast crawling technique; Placental expulsion; Parturient mother.
INTRODUCTION:
Breast crawl describes what occurs when a new born baby is placed on their birth parent's chest or belly immediately after birth and given time to find the parent's nipple and begin to feed on their own. This phenomenon was first described in 1987 in Sweden at the Karolinska Institute.
Early suckling gives tremendous release of hormone, oxytocin which facilities in contraction of smooth muscles of uterus and breast, producing milk ejection and separation of placenta and minimizing the blood loss during postpartum period.1 According to the United Nations Children Emergency Fund, Breast crawl is novel, easy, readily available, evidence based and cost-effective miraculous method to initiate breast feeding. It does not require elaborate preparations or instructions and can be performed in all birth settings and units.2 World Health Organization, states that about 75% of mothers initiating breast feeding after the birth of their baby. Often expulsive contractions can be encouraged by putting the infant to the breast following the delivery. The placenta remains undelivered, then greater is the risk for bleeding as placenta is still in it. These physiological changes can be enhanced by encouraging baby to suckle mothers. This results in release of oxytocin from the posterior lobe of the pituitary gland, which helps good uterine contractions.4 Studies on breast crawl have shown that 70-100% of babies successfully complete the breast crawl to take their first feed immediately after birth. The few who do not complete, achieve it with some assistance. There is scientific evidence to believe that breast crawl is associated with a variety of sensory, central, motor and endocrine components. These directly or indirectly help the baby to move towards the breast and nipple and to successfully breastfeed when placed on the mother chest and abdomen in between the breasts.4 After reading multiple articles regarding breast crawling technique, I realized that this technique is not being practiced in the labour room of SAT Hospital, Thiruvananthapuram. so I decided to conduct a study regarding breast crawl technique in a tertiary care centre to evaluate the effectiveness of this technique. It significantly helps to reduce the placental expulsion duration and hence reduces the blood loss.
OBJECTIVE:
To evaluate the effectiveness of breast crawling technique in the duration of placental expulsion.
MATERIALS AND METHODS:
The research approach adopted for the study was quantitative and sample for the present study consists of parturient mother admitted to labour room of Sree Avittom Thirunal Hospital, Thiruvananthapuram, during the study period. who satisfied inclusion criteria and exclusion criteria. The data was collected from 70 parturient women after obtaining permission from Institutional Research Committee and Institutional Ethics Committee of Government College of Nursing, Principal of Government Medical College, Obstetrics and Gynaecology Department of SAT Hospital. The study design was quasi experimental research design and consecutive sampling technique was used to select the study participants. An Informed consent obtained from the mothers those who were willing to participate in the study. For collecting data, observation and review of record method was used. The collected data were coded and analysed by using Statistical Package for Social Sciences (SPSS). Basic demographic details and clinical data of the mother and newborn were described in terms of frequency and percentage. Mean, standard deviation, two sample ‘t’ test was carried out to evaluate the effectiveness of breast crawling on duration of placental expulsion.
RESULTS:
Time taken for placental expulsion between experimental and control group (n=70)
Figer 1 shows that time taken for placental expulsion in experimental group is 4-8 min (100%) and time taken for placental expulsion in control group is 9-12 min (60%).
Table 1: Effectiveness of breast crawling technique in the duration of placental expulsion among parturient mothers (n=35)
|
Duration of Placental Expulsion (min) |
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||||
|
Group |
f |
Mean duration |
Standard Deviation |
t |
P Value |
|
Experimental (n=35) |
35 |
5.27 |
0.88 |
14.3 |
0.001** |
|
Control (n=35) |
35 |
11.23 |
2.30 |
|
|
**significance p<0.05
The above table shows that in the experimental group the mean value of duration of placental expulsion was 5.27 and standard deviation was 0.88 since t value is 14.30 and the calculated p value was <0.05. Hence it is statistically significant so null hypothesis is rejected and research hypothesis is accepted. It can be concluded that initiation of breast feeding through breast crawling technique was effective in reducing the duration of placental expulsion.
DISCUSSION:
The present study revealed that time taken for placental expulsion in experimental group after initiation of breastfeeding through breast crawling technique is 4-8 min (100%), and time taken for placental expulsion in control group is 9-12min (60%). This study was congruent with an experimental study conducted in the labour ward of Govt. Headquarters hospital Kanchipuram to assess the effectiveness of breast crawling on early expulsion of placenta which shows there is significance of breast crawling in the early expulsion of placenta and blood loss in the experimental group. This study was congruent with a prospective cohort observation study done on 200 research cases & similarly control cases were selected from full term newborn babies delivered vaginally, in Dr. B. R. Ambedkar Memorial. Hospital. And Pt JNM Medical College, Raipur (C.G.). Out of 200 full term babies, 166 babies were able to successfully crawl within in 50 min. Out of 166 breast crawl mothers–(1) 95% mothers had early expulsion of placenta. (2) 96% mothers had decrease in uterine size. (3) 100% breast crawl mothers were satisfied. (4) 93% mother had no anaemia in postpartum period of same pregnancy.3
CONCLUSION:
In the light of the above findings, the following conclusions were drawn: The time taken to initiate breast crawling in the experimental group was within 1 to 2 min and time taken for placental expulsion in experimental group after initiation of breastfeeding through breast crawling technique is 4-8min (100%) and time taken for placental expulsion in control group is 9-12min (60%). Results show that in the experimental group the mean value of duration of placental expulsion was 5.27 and standard deviation was 0.88 since t value is 14.30 and the calculated p value was < 0.05. Hence it is statistically significant and therefore null hypothesis is rejected and research hypothesis is accepted. It can be concluded that initiation of breast feeding through breast crawling technique was effective in reducing the duration of placental expulsion.
REFERENCE:
1. Gomathi M N. Effectiveness of breast crawling technique in the early expulsion of placenta and blood loss among women in third stage of labour.
2. Infant and Young Child Feeding [internet]. [cited 2023 nov 5]. Available from: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding
3. 3003288sadhanad.pdf [internet]. [cited2023nov5]. Available from: http://repository-tnmgrmu.ac.in/780/1/3003288sadhanad.pdf
4. Rana P, Swain Md. Understanding the effective breast crawl on maternal and newborn benefits and its feasibility: a Literature Review. 2022
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Received on 22.11.2024 Revised on 19.02.2025 Accepted on 03.04.2025 Published on 23.05.2025 Available online from May 26, 2025 A and V Pub Int. J. of Nursing and Med. Res. 2025; 4(2):69-71. DOI: 10.52711/ijnmr.2025.14 ©A and V Publications All right reserved
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