Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Multipar Gebelerin Gebelikte Emzirme ve Tandem Emzirme Konusundaki Düşünceleri ve Etkileyen Faktörler: Tanımlayıcı Kesitsel Araştırma
Thoughts of Multiparal Pregnancy on Breastfeeding and Tandem Breastfeeding and Affecting Factors: Descriptive and Cross-Sectional Research
Ebru SADIÇa , Zümrüt YILAR ERKEKb
aTokat Gaziosmanpaşa Üniversitesi Erbaa Sağlık Hizmetleri Meslek Yüksekokulu, Sağlık Bakım Hizmetleri Bölümü, Tokat, Türkiye
bTokat Gaziosmanpaşa Üniversitesi Sağlık Bilimleri Fakültesi, Ebelik Bölümü, Tokat, Türkiye
Turkiye Klinikleri J Health Sci.
doi: 10.5336/healthsci.2025-109145
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışma, multipar gebelerin gebelikte emzirme ve tandem emzirmeye yönelik görüşlerini ve etkileyen faktörleri belirlemek amacıyla gerçekleştirilmiştir. Gereç ve Yöntemler: Tanımlayıcı ve kesitsel türdeki araştırma, Mart-Mayıs 2022 tarihleri arasında bir ilçe devlet hastanesi non stres test polikliniğine başvuran 271 gebe üzerinde yürütülmüştür. Veriler, araştırmacı tarafından oluşturulan anket formu aracılığıyla yüz yüze toplanmıştır. İstatistiksel analizlerde tanımlayıcı istatistikler, ki-kare, Fisher's Exact Pearson testi, Kolmogorov-Smirnov testi, t-testi ve Mann-Whitney U testi kullanılmıştır. Anlamlılık düzeyi p<0,05 olarak kabul edilmiştir. Bulgular: Çalışmaya katılan gebelerin %92,3'ü bebeğin ilk 6 ay yalnızca anne sütü alması gerektiğini, %56,8'i ise emzirme süresinin 24 ay ve üzeri olması gerektiğini belirtmiştir. Gebelikte emzirmeye devam edilmesi gerektiğini düşünenlerin oranı düşük olup, bu grubun %47,3'ü sağlık personelinin önerisine göre hareket edeceklerini ifade etmiştir. Gebelikte emzirmenin zarar verebileceğini düşünenlerin %33,6'sı erken doğum veya düşük riskine, %23,5'i ise fetüsün yetersiz beslenmesine neden olabileceğini belirtmiştir. Gebelerin %28,4'ü emzirme döneminde gebe kaldığını fark etmiş ve tamamının ilk trimesterde olduğu saptanmıştır. Emzirirken gebe kalanların %59,7'si emzirmeye 1-13. haftaya kadar devam etmiş, %14,3'ü anne sütünde tat veya renk değişikliği gözlemlemiştir. Gebelik süresince emzirmeyi sonlandırma konusunda %40,3'ü sağlık personeline danışmış, %48,0'i ise yakın çevrelerinden olumsuz geri bildirim almıştır. Gebelerin %28,8'i tandem emzirme hakkında bilgi sahibi olup, yalnızca %10'u gebelikte tandem emzirmeyi düşündüğünü belirtmiştir. Sonuç: Bulgular, gebelerin gebelikte emzirme ve tandem emzirme konusunda bilgi eksikliği yaşadığını ve olumsuz düşüncelere sahip olduğunu göstermektedir. Emzirmenin fetüs üzerindeki olası etkilerine dair kaygılar yaygın olup, gebeler arasında kararsızlık gözlenmektedir. Kanıta dayalı uygulamalar, tıbbi gereklilikler dışında gebelikte emzirmenin kesilmesini desteklememekte, bireyselleştirilmiş yaklaşımları önermektedir. Ancak, gebelerin gebelikte emzirme/tandem emzirme konusunda sağlık profesyonellerinden danışmanlık alma oranı düşüktür. Bu doğrultuda, sağlık profesyonelleri tarafından interkonsepsiyonel bakım kapsamında kanıta dayalı rehberlere uygun eğitim ve danışmanlık hizmetleri sunulmalı, gebelikte emzirme ve tandem emzirme konusunda bilimsel verilere dayalı rehberlik sağlanmalıdır.

Anahtar Kelimeler: Ebelik; gebelikte emzirme; multipar gebe; tandem emzirme
ABSTRACT
 Objective: This study was conducted to determine the views of multiparous pregnant women on breastfeeding and tandem breastfeeding during pregnancy and the factors affecting them. Material and Methods: The descriptive and cross-sectional study was conducted on 271 pregnant women who applied to the Non Stress Test outpatient clinic of a district state hospital between March and May 2022. The data were collected face-to-face through a questionnaire form created by the researcher. Descriptive statistics, chi-square, Fisher's Exact Pearson test, Kolmogorov-Smirnov test, t-test and Mann-Whitney U test were used in statistical analysis. Significance level was accepted as p<0.05. Results: Among the pregnant women who participated in the study, 92.3% stated that the baby should be exclusively breastfed for the first 6 months and 56.8% stated that the duration of breastfeeding should be 24 months or more. The rate of those who thought that breastfeeding should continue during pregnancy was low and 47.3% of this group stated that they would act according to the recommendation of the health personnel. Among those who thought that breastfeeding during pregnancy could cause harm, 33.6% stated that it could cause the risk of preterm birth or miscarriage, and 23.5% stated that it could cause malnutrition of the fetus. It was found that 28.4% of the pregnant women realized that they became pregnant during breastfeeding and all of them were in the 1st trimester. Among those who became pregnant while breastfeeding, 59.7% continued breastfeeding until weeks 1-13, and 14.3% observed a change in the taste or color of breast milk. Regarding the discontinuation of breastfeeding during pregnancy, 40.3% consulted with health personnel and 48.0% received negative feedback from their immediate environment. 28.8% of pregnant women were informed about tandem breastfeeding and only 10% stated that they were considering tandem breastfeeding during pregnancy. Conclusion: The findings show that pregnant women lack knowledge and have negative thoughts about breastfeeding during pregnancy and tandem breastfeeding. Concerns about the possible effects of breastfeeding on the fetus are widespread and there is ambivalence among pregnant women. Evidence-based practice does not support the discontinuation of breastfeeding in pregnancy except for medical necessity, and recommends individualized approaches. However, the rate of pregnant women receiving counseling from health professionals is low. In this direction, health professionals should provide education and counseling services in accordance with evidence-based guidelines within the scope of interconceptional care, and guidance based on scientific data on breastfeeding during pregnancy and tandem breastfeeding should be provided.

Keywords: Midwifery; Breastfeeding during pregnancy; multiparity pregnancy; tandem breastfeeding

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30.03.2014

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