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UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 1

CHAPTER I
INTRODUCTION
BACKGROUND OF THE STUDY
Breast mi!
Breast milk is the natural food for full-term infants and is the appropriate milk for
the 1st year of life. It is always available at the proper temperature and requires no
preparation time.
Human milk contains bacterial and viral antibodies, including relatively high
concentrations of secretory immunoglobulin , that prevent microorganisms from
adhering to the intestinal mucosa. It also contains substances that inhibit the growth of
many common viruses as well as specific antibodies that are thought to provide local
gastrointestinal immunity against organisms entering the body via this route.
Breast milk contains all the nutrients that an infant needs in the first ! months of
life, including fat, carbohydrates, proteins, vitamins, minerals and water. It is easily
digested and efficiently used. Breast milk also contains bioactive factors that augment the
infant"s immature immune system, providing protection against infection, and other
factors that help digestion and absorption of nutrients.
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY #
$acrophages in human milk may synthesi%e complement, lyso%yme, and
lactoferrin. In addition, breast milk contains lactoferrin, an iron-binding whey protein that
is normally appro&imately ' saturated with iron and has an inhibitory effect on the
growth of Escherichia coli in the intestine. Human milk also contains bile salt-stimulated
lipase, which kills Giardia lamblia and Entamoeba histolytica.
Breast"ee#i$%
Breastfeeding plays a particularly important role in child survival in developing
countries( it contributes to the child)s immunologic defense system, and increases its
resistance to disease. dequate nutrition during infancy and early childhood is essential
to ensure the growth, health, and development of children to their full potential.
ccording to *H+, in #,,! an estimated -.. million children died before their
fifth birthday, and two thirds of these deaths occurred in the first year of life. /nder-
nutrition is associated with at least 0.1 of child deaths. It is also a ma2or disabler
preventing children who survive from reaching their full developmental potential. round
0#1 of children less than . years of age in developing countries are stunted and 1,1 are
wasted. It is estimated that sub-optimal breastfeeding, especially non-e&clusive
breastfeeding in the first ! months of life, results in 1.3 million deaths and 1,1 of the
disease burden in children younger than . years.
4he first two years of life provide a critical window of opportunity for ensuring
children"s appropriate growth and development through optimal feeding. Based on
evidence of the effectiveness of interventions, achievement of universal coverage of
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 0
optimal breastfeeding could prevent 101 of deaths occurring in children less than . years
of age globally, while appropriate complementary feeding practices would result in an
additional !1 reduction in less than five mortality.
In #,,#, the *orld Health +rgani%ation and /5I678 adopted the Global
Strategy for infant and young child feeding. 4he strategy was developed to revitali%e
world attention to the impact that feeding practices have on the nutritional status, growth
and development, health, and survival of infants and young children.
*H+ and /5I678"s a global recommendation for optimal infant feeding
includes e&clusive breastfeeding for ! months 91:, days; and nutritionally adequate and
safe complementary feeding starting from the age of ! months with continued
breastfeeding up to # years of age or beyond.
<oor breastfeeding and complementary feeding practices are widespread.
*orldwide, it is estimated that only 03.:1 of infants are e&clusively breastfed for the
first ! months of life, the ma2ority receiving some other food or fluid in the early months.
6omplementary foods are often introduced too early or too late and are often nutritionally
inadequate and unsafe.
Breastfeeding confers short-term and long-term benefits on both child and mother,
including helping to protect children against a variety of acute and chronic disorders. 4he
long-term disadvantages of not breastfeeding are increasingly recogni%ed as important.
=iarrhea and pneumonia are more common and more severe in children who are
artificially fed, and are responsible for many of these deaths. rtificially-fed children
have an increased risk of long term diseases with an immunological basis, including
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 3
asthma and other atopic conditions, type 1 diabetes, celiac disease, ulcerative colitis and
6rohn"s disease. rtificial feeding is also associated with a greater risk of childhood
leukemia.
>everal studies suggest that obesity in later childhood and adolescence is less
common among breastfed children, and that there is a dose response effect, with a longer
duration of breastfeeding associated with a lower risk. 4he effect may be less clear in
populations where some children are undernourished. ?egarding intelligence, a meta-
analysis of #, studies showed scores of cognitive function on average 0.# points higher
among children who were breastfed compared with those who were formula fed. 4he
difference was greater 9by ..1: points; among those children who were born with low
birth weight. Increased duration of breastfeeding has been associated with greater
intelligence in late childhood and adulthood, which may affect the individual"s ability to
contribute to society.
8or the mother, breastfeeding also has both short- and long-term benefits. 4he risk
of postpartum hemorrhage may be reduced by breastfeeding immediately after delivery,
and there is increasing evidence that the risk of breast and ovarian cancer is less among
women who breastfed. 7&clusive breastfeeding can also delay the return of fertility, and
accelerate recovery of pre-pregnancy weight. $others who breastfeed e&clusively and
frequently have less than a #1 risk of becoming pregnant in the first ! months
postpartum, provided that they still have amenorrhea.
Health workers do not always have the opportunity to ensure that mothers
successfully establish breastfeeding. $others may give birth at home, or they may be
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY .
discharged from a maternity facility within a day or so after delivery. =ifficulties may
arise in the first few weeks with breastfeeding, and later on when complementary foods
are needed. 8amilies and friends are usually a mother"s main source of advice about
feeding her children, but this advice is sometimes fraught by misconceptions.
4he propensity to breastfeed is not only of importance with regard to the
beneficial effects on the individual, but is also of concern as an indicator of health
behaviour related to social conditions.
Internationally, studies on weaning of term infants suggest that mothers who have
lower education wean earlier than those with higher education.
@arious studies have found that socially disadvantaged mothers start breastfeeding
less often and also breastfeed for a shorter period. t the start of their lives, children from
socially disadvantaged families may already run a higher risk of several diseases.
Breastfeeding behavior can be predicted by attitudes, perceived control, and social
support, including social norms, peer influence, and intergenerational factors 9elements of
the theory of planned behavior;.
8actors associated with breastfeeding include hospital practices and maternal
sociodemographic characteristics, as well as biomedical, environmental-support, and
psychosocial factors.
4he decline in the initiation and duration of breastfeeding is an inevitable
consequence of the moderni%ation process. In a broad sense, moderni%ation entails a
rapid abandonment of traditional approaches to childrearing, and the adoption of modern
practices, including the use of modern health services and the use of supplementary foods
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY !
for infants, in favor of breastfeeding or prolonged lactation. /rbani%ation is usually
associated with lower incidence and a shorter duration of breastfeeding. 4he adoption of
bottle-feeding in the urban areas is widespread both because it is considered to be more
modern, sophisticated and convenient 9especially if the mother works outside the home;,
and because there are fewer breastfeeding role models for urban women to emulate. In
the rural environment, however, breastfeeding calls for little change in lifestyle. 4he
presence of additional family members in the household, in particular mothers-in-law,
provides positive support for breastfeeding practices, encouraging mothers to breastfeed
for a longer period of time. In line with this, mothers and families need support to initiate
and sustain appropriate infant and young child feeding practices.
Health care professionals can play a critical role in providing that support,
through influencing decisions about feeding practices among mothers and families.
4herefore, it is critical for health professionals to have basic knowledge and skills to give
appropriate advice, counsel and help solve feeding difficulties, and know when and
where to refer a mother who e&periences more comple& feeding problems.
STATEMENT OF THE PROBLEM
4his study on the Determination of the Different Demographic Profile that can
contribute to the cessation of breastfeeding mothers among their infants before 1 year of
age in the University of Santo Tomas Hospital!ut Patient Department for the month of
"anuary to #ebruary $%11 seeks to answer the following questions(
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY A
1. *hy do women stop breastfeeding their infants before 1 year of age B
#. *hat are the different demographic factors that can lead to the cessation of
breastfeeding of mothers to their infants before 1 year of age in the /niversity of
>anto 4omas Hospital-+ut <atient =epartment for the month of Canuary to
8ebruary #,11B
SIGNIFICANCE OF THE STUDY
Breastfeeding has distinct advantages which benefit the infant and the
mother, including the hospital and the country that adopt its practice. It is the first
preventive health measure that can be given to the child at birth. It also enhances mother-
infant relationship. 8urthermore, the practice of breastfeeding could save the country
valuable foreign e&change that may otherwise be used for milk importation. However
there are factors that affect the practice of breastfeeding and the use of breast milk
especially in developing countries where influences due to urbani%ation are significant. It
is therefore important to determine the causes of cessation breastfeeding &Determination
of the Different Demographic Profile that can contribute to the cessation of breastfeeding
mothers among their infants before 1 year of age in the University of Santo Tomas
Hospital!ut Patient Department for the month of "anuary to #ebruary $%11' in which it
can be useful for designing breastfeeding interventions that address issues most likely to
affect mothers of infants at various ages. It can be used by doctors and lactation
consultants to help mothers overcome breastfeeding barriers. It can also be useful to
health officials when attempting to design targeted interventions to prolong breastfeeding
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY :
by focusing on the issues that constitute the most important barriers to breastfeeding
among mothers of infants of various ages.
SCOPE AND LIMITATION
4his study will only cover the determination of the different demographic factors
that can lead to the cessation of breastfeeding of mothers to their infants before 1 year of
age in the /niversity of >anto 4omas Hospital-+ut <atient =epartment for the month of
Canuary to 8ebruary #,11.
OB&ECTIVES OF THE STUDY
4he study aims to determine the different demographic factors that can lead to the
cessation of breastfeeding of mothers to their infants before 1 year of age in the
/niversity of >anto 4omas Hospital-+ut <atient =epartment for the month of Canuary to
8ebruary #,11.
CHAPTER II
REVIE' OF RELATED LITERATURE
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY -
Breast milk and breastfeeding nowadays are among the most advocated natural
products and practice worldwide since both of them have beneficial effects to the infant
and to the mother. However, there are a lot of factors that contribute to poor consumption
and poor practice of breast milk and breastfeeding respectively.
ccording to /5I678 the importance of Breastfeeding includes( a. Breastfeeding
saves lives. 4he risk of death for infants who are not breastfed is 1,-times greater in the
first 0-3 months of life than those babies who are e&clusively breastfed. +ver ! million
infant lives are saved each year by breastfeeding, b. Breastfeeding is ideal and perfect
food for infants. It fulfills the infant"s total nutritional requirement through 3-! months of
age, c. Breastfeeding prevents diarrhea, d. Breastfeeding confers immunity. 6olostrums is
the child"s first immuni%ation. It protects the infants from bacterial and viral pathogens, e.
Breastfeeding is an effective family planning. 7&clusive breastfeeding will provide
almost total protection from pregnancy during the first ! months when amenorrhea is
present, f. Breastfeeding protects mother"s health. side from child spacing, it
significantly lowers the mother"s risk of breast and ovarian cancer and reduces the
chances of fatal post partum hemorrhage, g. Breastfeeding saves money, h. Breastfeeding
promotes bonding. It is during this hour that he feels, smells and has visual image of each
member becomes mutually imprinted and bonding occurs 9=+H, $anila 1--3;.
In the study by Dianto, they determined the e&tent of current knowledgeE
information of mothers about breastfeeding, defined the varied roles of health personnel
in the art of promoting the art of successful initiatives and maintenance of breastfeeding.
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 1,
4o improve the breastfeeding practice among mothers and thereby enhancing child
survival, information is needed to determine the adequacy of maternal knowledge and
practice regarding lactation. ?esults of the study showed that the women chose breastfed
babies because breast milk is economical and protects their babies from infections.
8riends and relative have greater impact than health workers do in influencing mothers to
breastfeed. $aternal knowledge and information regarding advantages of breastfeeding,
establishment and maintenance of lactation, care of nipples and breasts, and proper diet
are inadequate. >everal misconception and beliefs regarding breastfeeding have been
recogni%ed 9Dianto, 1--.;.
+n the other hand, 4antuco conducted a survey over a four-month period at
6ardinal >antos $edical 6enter 96>$6; in an attempt to look at the present picture of
breastfeeding and weaning practices among urban mothers with children ! months t 0
years of age. Incidence of breastfeeding among these women was -11. $aternal
employment appeared to be a ma2or obstacle to successful breastfeeding. Bottle-feeding
seems to be the most common if not the only option to most working mothers 94antuco,
1---;.
4he study of 8lorentino was conducted for si& weeks. $ost of the sub2ects were
housewives who had either 1-# children and had college degrees and these respondents
caged me from economically advantaged group. 6ases showed significant post test in
many aspects of their knowledge and attitudes regarding breastfeeding although their
practices were unchanged. 4his showed that participation of health personnel proving
adequate information helps improve general knowledge and attitudes with regards to
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 11
breastfeeding since efforts have to be doubled in promoting and supporting the practices
and maintenance of breastfeeding through informational campaign, health education and
provisions of adequate local and national dissemination 98lorentino, 1--.;.
ccording to *orld Health +rgani%ation 9*H+; statistics, everyday, between
0,,,, to 3,,,, die from diarrhea and acute respiratory infections because the ability to
feed them adequately has been taken away from their mothers. 4housands more succumb
to their illness and malnutrition. 7very week, a quarter of million children die in the
developing world. In the <hilippines, about 1,,,,,, infants die each year. $any more
live on with ill health and poor growth.
4o encourage breastfeeding from the time of childbirth, to prevent difficulties
from arising and to overcome difficulties should they occur, mothers need appropriate
management and skilled help. >upport and counseling should be available routinely
during antenatal care, to prepare mothersF at the time of birth to help them initiate
breastfeedingF and in the postnatal period to ensure that breastfeeding is fully established.
$others and other caregivers who are not able to breastfeed need counselling and support
for alternative methods of infant feeding.
4he Baby-friendly Hospital Initiative 9B8HI; was launched in 1--# with the aim
of transforming maternity facilities to provide this standard of care. *ithout the B8HI,
practices often undermine breastfeeding, with damaging consequences for infant health.
S())*rt *" Breast"ee#i$%
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 1#
$others need continuing support to maintain e&clusive and continued
breastfeeding, to implement other methods of infant feeding when breastfeeding is not
possible, and to establish adequate complementary feeding when the child is ! months of
age and older. If a child becomes ill, the mother may require skilled support from a health
worker to continue feeding her child. 4his support can be provided by trained personnel
in the community, and in various other settings, such as a primary care facility or a
paediatric department in a hospital.
4here should be no missed opportunities for supporting feeding in any contact
that a mother and child have with the health system, whether it involves doctors,
midwives, nurses or community health workers. Day or peer counselors who have the
skills and knowledge to support optimal infant and young child feeding can also
contribute to improved feeding practices. 6ollectively, all these providers should ensure a
continuum of care from pregnancy through the postnatal period into early childhood.
*hen they help a mother, they should also talk to other family members, showing respect
for their ideas, and helping them to understand advice on optimal feeding. In addition,
they can share information and create awareness about the importance of appropriate
infant and young child feeding through other channels, for e&ample, by involving school
children or e&tension workers from other sectors. 4his multi-pronged approach to
promoting and supporting infant and young child feeding has been shown to be effective
in many settings.
Infant and young child feeding counseling is the process by which a health worker
can support mothers and babies to implement good feeding practices and help them
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 10
overcome difficulties. =etails of infant and young child feeding counseling depend on the
child"s age and the mother"s circumstances. Generally, a health worker should use good
communication and support skills, assess the situation, manage problems and reinforce
good practices and follow-up.
ccording to ?epublic ct 5o. 1,,#:, HE(panded )reastfeeding Promotion *ct
of $%%+, , an act e&panding the promotion of brestfeeding, amending for the purpose of
?epublic ct 5o. A!,,, otherwise known as Hn act providing incentives to all
government and private health institutions with rooming-in and breastfeeding practices
and for other purposes. 4he >tate adopts rooming-in as a national policy to encourage,
protect and support the practice of breastfeeding. It shall create an environment where
basic physical, emotional, and psychological needs of mothers and infants are fulfilled
through the practice of rooming-in and breastfeeding. 4he >tate shall likewise protect
working women by providing safe and healthful working conditions, taking into account
their maternal functions, and such facilities and opportunities that will enhance their
welfare and enable them to reali%e their full potential in the service of the nation. 4his is
consistent with international treaties and conventions to which the <hilippines is a
signatory such as the 6onvention on the 7limination of =iscrimination gainst *omen
967=*;, which emphasi%es provision of necessary supporting social services to enable
parents to combine family obligations with work responsibilities. 4he >tate shall promote
and encourage breastfeeding and provide the specific measures that would present
opportunities for mothers to continue e&pressing their milk andEor breastfeeding their
infant or young child.
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 13
+n 6hapter I@, >ection 10 of the ?epublic ct 5o. 1,,#:, -ontinuing Education.
/eeducation and Training of Health 0or1ers and Health 2nstitutions. It stated that the
=epartment of Health with the assistance of other government agencies, professional and
nongovernmental organi%ations shall conduct continuing information, education, re-
education, and training programs for physicians, nurses, midwives, nutritionist-dietitians,
community health workers and traditional birth attendants 94Bs; and other health
worker on current and updated lactation management.
=uring the prenatal, perinatal and postnatal consultations andEor confinements of
the mothers or pregnant women in a health institution and the health worker to
immediately and continuously teach, train and support the women on current and updated
lactation management and infant care, through participatory strategies such as
organi%ation of mothers) clubs and breastfeeding support groups and to distribute written
information materials on such matters free of charge.
4he =epartment of Health is mandated to develop and provide breastfeeding
programs for working mothers whose employees are encouraged to avail of it as part of
their human resource development programs.
4o equip women of reproductive age with accurate information on maternal
nutrition and proper nourishment in preparation for successful and sustainable
breastfeeding, the =epartment of Health is likewise mandated to produce and make
available relevant information and programs which should be disseminated to all city,
municipal and barangay health centers.
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 1.
7mployers are also highly encouraged to develop breastfeeding or lactation
support programs which main functions are to assess the needs of lactating employees
with adequate information regarding lactation management in the form of brochures,
pamphlets and other educational materials.
E+,(si-e Breast"ee#i$%
7&clusive breastfeeding until the age of 3 months followed by partial
breastfeeding was associated with a significant reduction of respiratory and
gastrointestinal infectious diseases in infants. 7&clusive breastfeeding until the age of !
months tended to be more protective than e&clusive breastfeeding until the age of 3
months and partially thereafter 9=ui2ts, Diesbeth et.al., #,1,;.
Fa,t*rs t.at ,a(ses ,essati*$ *" /reast"ee#i$%
In a study by 8laking, et. al., which provides the first population based data on the
association between socio-economic status 9>7>; 9which includes, level of education and
employment; and breastfeeding duration up to 1 year in mothers of preterm and term
infants, it showed that all >7> factors showed a strong association with breastfeeding up
to ! months of infant"s postnatal age. +n the other hand, preterm infants are breastfed for
a shorter time compared with term infants, despite the known health benefits of
breastfeeding in the preterm infants. 4his study also suggested that strategies like
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 1!
increased opportunities for being together in privacy, individuali%ed care routines,
psychological support and empowering attitudes, may entail feelings of trust and pride
and less symptomatic response to the e&perienced situation of having a preterm infant as
well as being beneficial for longer breastfeeding duration. 4he findings in the study also
call for substantial improvements in the pre- and post-natal care of mothers e&posed to
low >7> and of mothers of preterm infants. >uch improvements include better allocations
and prioriti%ations of resources to meet the needs in these more vulnerable mothers and
infants 98laking, ?ene et.al.;.
In a study by van ?ossem, Dennie et.al., it was found out that socially
disadvantaged mothers are less likely to start breastfeeding and to continue it for #
months. In addition to this, lifestyle-related and birth characteristics are important
modifying factors in the association between educational level and breastfeeding. It was
suggested that interventions on promoting breastfeeding should start early in pregnancy
and should increase their focus on low-educated women. lso in this study, maternal
education was used as an indicator of socioeconomic status, because it reflects not only
material resources but also noneconomic characteristics such as general and health-
related knowledge, which in turn influence health behavior, and problem-solving skills
9@an ?ossem, et.al., #,,-;.
+ne of the key determinants of the decline in breastfeeding in the <hilippines is
the increasing level of education among women, a factor which plays a role in the
adoption of modern ideas, and which usually leads to the abandonment of traditional
practices regarding child care. 4his shift in the balance of family relations can manifest
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 1A
itself in the abandonment of traditional sources of influence, namely e&tended family
members, which can often result in breastfeeding of a shorter duration. 4he transition
from traditional to modern societies has prompted a move away from breastfeeding of
long duration, particularly among younger generations of women. +n the other hand,
increasing maternal age and high parity can also lead to breastfeeding of a shorter
duration. Higher parity leads to shorter birth intervals and hence shorter times available
for breastfeeding 9bada, 4eresa et.al., #,,#;.
CHAPTER 0
RESEARCH METHODOLOGY
MATERIALS AND METHODS1
Concept Map
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 1:
Materials
A set of questionnaires that was translated in Filipino by a professional
translator were given to women who had previously stopped breastfeeding .
The sample questionnaire can be found in the Appendix.
Procedure
Women that were present in the Univeristy of Santo Tomas !ut "atient
#ivision who had a history of breastfeeding and stopped breastfeeding were
as$ed to participate in this study. %erbal consent were as$ed before
proceeding to answer the questionnaire .
CHAPTER 2
Target
"opulation&wom
en who stopped
breastfeeding
before infant's (
year of age)
Free and informed
consent*
questionnare
demographic
pro+le
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 1-
RESULTS AND DISCUSSION
PRESENTATION OF DATA
4able 1.4his table shows the percentage of educational attainement women who stopped breastfeeding.
Educational Attainment

Frequency "ercent
,lementary
- (-..
/igh School
(0 1.
2ollege
(( 3-..
%ocational
1 (4
Total
14 (44
4able #. 4his table shows the number of children of women who stopped breastfeeding.
No. of Children

Frequency "ercent
(
(1 5..64
3
34 .(.30
1
. (3.03
Total
56 (44.44
4able0. 4his table shows the number of months of breastfeeding their infants.
No. of Months of Breast Feeding
7onths
Frequency "ercent
(
(( 3-..
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY #,
3
(4 3.
5
6 33..
1
( 3..
.
( 3..
8
5 -..
-
( 3..
0
3 .
(3
3 .
Total
14 (44
4able3. 4his table shows the lactational factors of women who stopped breastfeeding
Lactation Factors
Factors
Frequency "ercent
9one of the above
31 84
7y baby had trouble suc$ing or latching on
1 (4
7y breasts were overfull or engorged
( 3..
:reast feeding was too painful
0 34
2ombination
5 -..
Total
14 (44
4able.. 4his table shows the psychosocial factors of women who stopped breastfeeding
Psychosocial Factors
Factors
Frequency "ercent
None of the above
7 17.5
Breastfeeding was too tiring
1 2.5
I have too many household chores
13 32.5
I wanted/needed someone to feed my baby
22.5
!omeone else wanted to feed the baby
1 2.5
"ombination
22.5
#otal
$% 1%%
4able!. 4his table shows the nutritional factors of women who stopped breastfeeding.
Nutritional Factors
Factors
Frequency "ercent
None of the above
23 57.5
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY #1
Breastfeed alone did not satisfy my baby
12 3%
I had trouble getting the mil& flow to start
1 2.5
I did not have enough mil&
1 2.5
"ombination
3 7.5
#otal
$% 1%%
4ableA. 4his table shows the lifestyle factors of women who stopped breastfeeding.
Lifestyle Factors
Factors
Frequency "ercent
None of the above
3 7.5
I wanted my body bac& to myself
1 2.5
#otal
$% 1%%
4able:. 4his table shows the lifestyle factors of women who stopped breastfeeding.
Lifestyle Factors
Factors
Frequency "ercent
None of the above
3$ '5
(y baby became sic& and could not breastfeed
3 7.5
I was sic& or need to ta&e medicines
1 2.5
I became )regnant or wanted to become )regnant again
2 5
#otal
$% 1%%
4able-. 4his table shows the milk pumping factors of women who stopped breastfeeding.
Milk Pumping Factors
Factors
Frequency "ercent
None of the above
2' 7%
I could not or did not want to )um) or breast feed at wor&
12 3%
#otal
$% 1%%
4able1,. 4his table shows the infants factors of women who stopped breastfeeding.
Infants Factors
Factors
Frequency "ercent
None of the above
3* %
(y baby lost interest or began to wean him/herself
$ 1%
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY ##
#otal
$% 1%%
4able11. 4his table shows the civil status factors of women who stopped breastfeeding.
Ciil !tatus Factors
Factors
Frequency "ercent
(arried
27 *7.5
!ingle
13 32.5
#otal
$% 1%%
4able1#. 4his table shows the age of women who stopped breastfeeding.
"espondents# Age
9 7inimum 7aximum 7ean
14 34 .6 36.8
A$a3sis *" Varia$,e
H*1 4he mean ?f values of the solvent systems are not significantly different from each other.
94he type of solvent system 9=6$ fraction; does not affect the mean ?f value;
Ha1 t least one pair of the mean ?f values of the different solvent systems is significantly
different from each other. 94he type of solvent system significantly affects the mean ?f value;
lpha I ,.,.
=ecision rule( ?e2ect Ho if # JI # crit I 0.1,! or if Pvalue KI ,.,.
# 3 ::.A#:#,.10 4 5.1%6
Pvalue I 3.A#:#:7-,- 4 %.%7
t .,. level of significance, we re2ect the null hypothesis of equal mean ?f values across the
solvent systems. 4hus, we conclude that there is sufficient evidence to prove that at least one pair
of the mean ?f values of the different solvent systems is significantly different from each other.
5ote that this test only tells us that some solvent systems are different from each other but does
not tell us which is the closest to 6H6l0(6H0+H(H#+ 91:(:(1;. /sually there are some who
wants to know which pair of treatment 9solvent; means caused the difference. In our case, we
want to know the pair of treatments that did not cause the difference, preferably, the solvent
system whose treatment mean does not significantly differ from the control
96H6l0(6H0+H(H#+ 91:(:(1;;.
4o know what =6$ fraction has the closest ?f value results to 6H6l0(6H0+H(H#+ 91:(:(1;, we
performed the 8isher"s D>= $ethod to know which pairs of solvents differ significantly from
each other.
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY #0
Fis.er4s LSD Met.*#
/sing =esign 7&pert 9a program;, the output of the test is(
Treatme$t Mea$s
Estimate#
Mea$
1-chcl0(ch0oh(h#o ,.!.
#-1:(:(1 ,.A,
0-1A(-(1 ,.!0
3-1A..(:..(1 ,.!,
.-1:..(A..(1 ,.A!
!-1-(A(1 ,.-,
Mea$ Sta$#ar# t "*r H
5
Treatme$t Di""ere$,e DF Err*r C*e""65 Pr*/ 7 8t8
1 vs # -,.,., 1 ,.,1A -#.-3 ,.,1#0
9 -s 0 5:5;5 9 5:59< 9:9= 5:;>;9?
1 vs 3 ,.,., 1 ,.,1A #.-3 ,.,1#0
1 vs . -,.1# 1 ,.,1A -!.:! K ,.,,,1
1 vs ! -,.#! 1 ,.,1A -1..1, K ,.,,,1
# vs 0 ,.,A, 1 ,.,1A 3.1# ,.,,13
# vs 3 ,.1,, 1 ,.,1A ..:: K ,.,,,1
# vs . -,.,!A 1 ,.,1A -0.-# ,.,,#,
# vs ! -,.#1 1 ,.,1A -1#.1! K ,.,,,1
0 vs 3 ,.,0, 1 ,.,1A 1.AA ,.1,0,
0 vs . -,.13 1 ,.,1A -:.,3 K ,.,,,1
0 vs ! -,.#: 1 ,.,1A -1!.#: K ,.,,,1
3 vs . -,.1A 1 ,.,1A --.:1 K ,.,,,1
3 vs ! -,.01 1 ,.,1A -1:.,3 K ,.,,,1
. vs ! -,.13 1 ,.,1A -:.#3 K ,.,,,1
@alues of L<rob J MtML less than ,.,.,, indicate the difference in the two treatment means
is significant.
@alues of L<rob J MtML greater than ,.1,,, indicate the difference in the two treatment
means is not significant.
4he starred value indicates a pair of means that are not significantly different. 4he only pair of
means that do not differ significantly is 1 and 0. 4his tells us that the =6$ fraction that has the
closest ?f value results to 6H6l0(6H0+H(H#+ 91:(:(1; is 6H0+H(H#+ 91A(-(1;. 4he following
graph shows the result(
Ge$era #is,(ssi*$
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY #3
Based on the data obtained on <otassium 8erricyanide- 8erric 6hloride, the three
batches of 2pomoea muricata e&tracts contain <henols, 4annins and 8lavonoids due to the
positive result which is the formation of blue spots.
Based on =ragendorff"s spray test, all three batches of 2pomoea muricata e&tracts
contain alkaloids due to the formation of orange spots immediately after spraying.
Based on the @anillin->ulfuric acid test, all three batches of 2pomoea muricata
conatin triterpenes and sterols due to the formation of blue-violet spots.
4he negative result on /@ 0!! means that 2. muricata does not e&hibit the
property of fluorescence 9*agner and Bladt, 1--!;
BIBLIOGRAPHY
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY #.
bada, 4eresa >.C. et.al., Determinants of breastfeeding in the Philippines8 a survival
*nalysis. >ocial >cience and $edicine. 6anada. #,,1
=ui2ts, Diesbeth et.al., Prolonged and E(clusive )reastfeeding /educes the /is1 of
2nfectious Diseases in 2nfancy. Cournal of the merican Pediatrics #,1,F1#!. #,1,
8lacking, ?eneN e et.al.. Effects of socioeconomic status on breastfeeding duration in
mothers of preterm and term infants. 7uropean Cournal of <ublic Health, @ol. 1A, 5o. !,
.A-O.:3. #,,A
Florentino; A2., Improving Breastfeeding Practices Through Active Interaction
by a Physician.; 7a$ati 7edical 2enter; 92<; (66.
8ourteenth 6ongress 4hird ?egular >ession. ?7</BDI6 64 5o. 1,,#:. #,,-
Di, ?uowei et.al., 0hy 9others Stop )reastfeeding8 9others: Selfreported /easons for
Stopping During the #irst ;ear. merican cademy of <ediatrics. #,,:
Dianto, 7mma $., * survey on )reastfeeding Practice Through *ctive 2ntervention by a
Physician. 9a1ati $edical 6enter, 1--.
Tantuco; "anasagen S.=.; Breastfeeding and Weaning pRactices Among the
Urban Mothers in the !"s; 92< 7anila; (666
The "revalence and #uration of :reastfeeding> A 2ritical <eview of Available
?nformation; =eneva> World /ealth !rgani@ation; #iscussion of Family /ealth
van ?ossem, Denie. *re Starting and -ontinuing )reastfeeding /elated to Educational
)ac1ground< The Generation / Study. merican cademy of <ediatrics. #,,-
*H+. 2nfant and young child feeding 9odel -hapter for te(tboo1s for medical students
and allied health professionals. 8rance. #,,-
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY #!
APPENDICES
APPENDI@ A
SAMPLE SURVEY AUESTIONNAIRE
7agandang umaga;
Aami po ay mga magaaral ng 7edisina na $asalu$uyang nasa i$aapat na
taon sa Unibersidad ng Santo Tomas. Aami po ay nananali$si$ tung$ol sa estatisti$a
ng mga babaeng tumigil sa pagpapasuso ng $anilang mga sanggol gamit ang gatas
ng ina. Ang questionnaire po na ito ay ma$a$atulong ng mala$i sa aming
isinasagawang pagaaral. "a$isagutan lang po ng tama ang mga tanong na
na$asulat sa baba. 7a$a$aasa po $ayong magiging $onpidensyal ang mga
impormasyon na inyong binahagi. 7araming salamat po.
7ga Tanong U$ol sa "agsisiyasat
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I. Pangunahing $aalaman
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,dad>BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
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"etsa ng
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Aabansaan>BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
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"ina$amataas na 9a$amit sa "agaaral> & ) 7ababang "aaralan & ) 7ataas na "aaralan
& ) "amantasan & ) Aursong :o$asyonal
:ilang ng Ana$> & ) Unang "angangana$ & ) "angalawang :eses nang 9agbuntis
&BB:ilang ng ana$BB) & ) Cimang beses o higit pang 9agbuntis &BB:ilang ng ana$BB)
II. Pananaliksik %kol sa Pagpapasuso ng !anggol &amit ang &atas ng Ina
a. 9agawa mo na bang magpasuso ng iyong sanggol gamit ang sarili mong gatas
&bilang isang ina)D
& ) !o & ) /indi
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY #A
Aung !o; ilang buwan &o taon) na ang iyong ana$ nang huminto $a nang pasusohin
siya ng sarili mong gatasD BBBBBB buwanE taong gulang
&maaaring magpatuloy sa i$atlong $atanungan)
Aung /indi; maaaring magpatuloy sa i$atlong $atanungan.
III. Bakit hindi mo pinasuso ang iyong anak ng sarili mong gatas o 'akit mo
na naihinto ang pagpapasuso mo sa iyong anak gamit ang sarili mong
gatas(
Sali$ sa "agpapagatas>
& ) 7ay problema ang a$ing ana$ sa pagsipsip
& ) 9agsusugat o pumuputo$ ang a$ing utong
& ) /indi litaw o natabunan ang a$ing utong
& ) 9alalinan o may impe$siyon ang a$ing utong
& ) Sobrang maggatas ang a$ing suso
& ) 7asyadong masa$it ang magpasuso
Sali$ sa Aaisipang"anlipunan>
& ) 9a$a$apagod ang magpagatas gamit ang sariling suso
& ) /indi maginhawa ang magpagatas gamit ang sariling suso
& ) 7asyado a$ong maraming gawaingpambahay
& ) =usto o $ailangan $ong may ibang magalagaE magpasuso &gamit ang bote) sa
a$ing ana$
& ) 7ay ibang gustong magalagaE magpasuso &gamit ang bote) sa a$ing ana$
& ) Ayaw $ong magpasuso &gamit ang sarili $ong suso) sa harap ng madla
Sali$ sa "ag$ain &9utrisyon)>
& ) /indi sumasapat ang pagpapasuso $o lamang para sa a$ing ana$
& ) Sa tingin $o hindi nagtatamo ng tamang timbang ang a$ing ana$
& ) 7ay isang $awani ng $alusugan ang na$apagsabing hindi nagtatamo ng tamang
timbang ang a$ing ana$
& ) 9ahihirapan a$ong simulang palabasin ang gatas mula sa a$ing dibdib
& ) Wala a$ong sapat na gatas sa $atawan para sa a$ing sanggol
Sali$ sa "araan ng "amumuhay
& ) Ayaw $ong magpasuso gamit ang sarili $ong gatas
& ) =usto $ong $umuha ng diyetang pampapayat
& ) =usto $ong bumali$ sa dati $ong diyeta
& ) =usto $ong manigarilyo ulit
& ) =usto $ong ibali$ ang a$ing $atawan sa a$ing sarili &gawin ang gustong gawin
nang hindi inaalala ang $alusugan ng a$ing ana$).
Sali$ sa Aalusugan>
& ) 9ag$asa$it ang a$ing sanggol at hindi siya ma$asuso mula sa sarili $ong gatas
& ) 9ag$asa$it a$o at $inailangan $ong uminom ng mga gamot
& ) Wala a$o sa piling ng a$ing ana$ sa ilang personal na $adahilanan maliban sa
hanapbuhay.
& ) 9abuntis a$o agad o ginusto $ong mabuntis muli
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY #:
Sali$ sa "agbomba ng =atas>
& ) /indi $o $aya o ayaw $ong magbomba ng suso o magpasuso gamit ang sarili $ong
gatas sa oras ng trabaho
& ) Ang pagbubomba ng suso ay hindi ganoon $ala$i ang pa$inabang para
pagsumi$apan ito
Sali$ sa "agawat sa "agsuso sa ?na>
& ) 9agumpisa nang mangagat ang a$ing ana$
& ) 9awalan ng gana ang a$ing ana$ at nagumpisa nang iwalay ang sarili sa pagsuso
mula sa a$ing dibdib
& ) 7ala$i at may gulang na ang a$ing ana$
?ba pang dahilan>
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
BBBBBBBBBBBBBBBBBBBBBBBBB
Salamat sa iyong partisipasyon sa aming pananali$si$F
APPENDI@ B
CURRICULUM VITAE
6ontact Information
5ame( Prista nne B. 7smael
ddress( Ilagan >treet, <oblacion *est, >anta Ignacia, 4arlac
4elephone( 9,#; A3#-:!1
6ellphone( ,-##0!.-,00
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UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY #-
Personal 2nformation
=ate of Birth( =ecember #,,1-:!
<lace of Birth( 6amiling, 4arlac
6iti%enship( 8ilipino
@isa >tatus( <ermanent ?esident
Gender( 8emale
Education
High >chool 4arlac 6ollege of griculture-Daboratory High >chool 91----
#,,0;
/niversity /niversity of >anto 4omas 9#,,0-#,,A; O B> <harmacy
8ebruary- $ay #,,! Intern, /<- <GH
Graduate >chool /niversity of >anto 4omas 9#,,A-#,11; O =octor of $edicine
Publication
4hesis <aper( Thin =ayer -hromatography8 Solvent System Development of the -rude
E(tract from the Dried Seeds of 2pomoea muricata &=inn.' "ac>. &-onvolvulaceae'
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>ports, movies, music
AGliations>
USTF7S Table Tennis Team
2hristian Houth in Action; Tarlac 2hapter
6ontact Information
5ame( Prista nne B. 7smael
ddress( Ilagan >treet, <oblacion *est, >anta Ignacia, 4arlac
4elephone( 9,#; A3#-:!1
6ellphone( ,-##0!.-,00
7mail( kristanelleQyahoo.com
Personal 2nformation
=ate of Birth( =ecember #,,1-:!
<lace of Birth( 6amiling, 4arlac
6iti%enship( 8ilipino
@isa >tatus( <ermanent ?esident
Gender( 8emale
UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 0,
Education
High >chool 4arlac 6ollege of griculture-Daboratory High >chool 91----
#,,0;
/niversity /niversity of >anto 4omas 9#,,0-#,,A; O B> <harmacy
8ebruary- $ay #,,! Intern, /<- <GH
Graduate >chool /niversity of >anto 4omas 9#,,A-#,11; O =octor of $edicine
Publication
4hesis <aper( Thin =ayer -hromatography8 Solvent System Development of the -rude
E(tract from the Dried Seeds of 2pomoea muricata &=inn.' "ac>. &-onvolvulaceae'
2nterests
>ports, movies, music
AGliations>
USTF7S Table Tennis Team
2hristian Houth in Action; Tarlac 2hapter
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ddress( Rone #, Brgy. yudante, 6andon 6ity, Ilocos >ur
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UNIVERSITY OF SANTO TOMAS - FACULTY OF MEDICINE & SURGERY 01
Education
High >chool >aint Coseph Institute 91----#,,0;
/niversity /niversity of >anto 4omas 9#,,0-#,,A; O B> Biology
Graduate >chool /niversity of >anto 4omas 9#,,A-#,11; O =octor of $edicine
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4hesis <aper( H7ffect of Gonadotropin on...T I forgot the titleU PalokaU O to follow
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