Human milk is recognized for its numerous benefits including inducing tolerance to allergens, providing passive immunization, improving liquid profile and controlling blood pressure. It is a natural food for babies; it provides the nutrients and energy required by every infant for a healthy life. Many studies conducted in neonatal units proved that infants who were fed with human breast milk had fewer severe infections, less necrotizing enterocolitis and less colonization by pathogenic organisms [1-4].

The need of human milk also increases due decreased production of mother’s milk associated with factors like stress and poor health of mother and inability to use mother’s milk due to use of certain drugs like chemotherapy. Additionally some of mothers are not willing to feed their baby. Pasteurized donor milk from a healthy mother should be the first consideration for supplementation for such babies. In such cases the role of human milk banks becomes vital where the donated breast milk is stored and is made available, for use in vulnerable population [5].

Human milk bank is “An organization that collects, stores, processes (to exclude the risk of viral and bacterial transmission) and dispenses donated human milk. This donor milk is excess human milk provided by a mother for use by a recipient that is not the mother’s own baby. This recipient is a hospitalized preterm or ill infant [6].

As per WHO, 2015, India is the major contributor to preterm births that is 33.4 lakhs (22%). Henceforth there is a strong need to strengthen Human Milk Banking in public as well as private sectors in India [7-10].

Objectives of the Study

• To assess the knowledge related to Human Milk Banking among staff nurses working in selected hospitals of District Shimla, Himachal Pradesh

• To assess the attitude related to Human Milk Banking among staff nurses working in selected hospitals of District Shimla, Himachal Pradesh

• To find out the correlation between knowledge and attitude related to Human Milk Banking among Staff Nurses working in selected hospitals of District Shimla, Himachal Pradesh

• To find out the association of knowledge score related to Human Milk Banking with selected demographic variables

• To find out the association of attitude score related to Human Milk Banking with selected demographical variables

• Research Approach: Quantitative approach 

• Research Design: Descriptive

• Setting of the Study: Selected hospitals of District Shimla

• Study Population: Staff nurses working in selected hospitals of District Shimla

• Sample Size: About 100 staff nurses

• Sampling Technique: Convenient sampling technique

• Informed Consent: Was taken from the staff nurses and confidentiality was maintained

Inclusion Criteria

Staff nurses who were willing to participate. Staff nurses who were available at time of data collection. Staff nurses working in selected hospitals of Shimla, H.P.

Exclusion Criteria

Staff nurses who were not willing to participate. Staff nurses who were not present at the time of data collection. Matrons, Nursing Superintendents and Ward Sister were excluded in this study.

Development of Tool

A self-structured knowledge and attitude questionnaire was constructed to assess the knowledge and attitude related to human milk banking among staff nurses. The tool was developed after extensive review of literature, expert’s opinion and researchers own experience to increase the knowledge and attitude of staff nurses related to human milk banking. The structured tool is divided into three parts:

• Section-1: This part consists of personal information such as age, professional qualification, year of experience, working area, aware of human milk banking; attend any training programme/workshop on human milk banking

• Section-2: This part consists of self-structured questionnaire related to human milk banking which consists of 29 items. This tool consists of multiple choice questions related to human milk banking. Each question has various options out of which one is correct

• Section-3: A Likert scale was developed to assess the attitude related to human milk banking among staff nurses. This tool consists of 16 items. 5 point Likert scale was developed to assess the attitude related to human milk banking among staff nurses

Validity of Tool

By the experts in this field

Permission

Obtained from the concerned head of the selected hospitals of District, Shimla.

The collected data is tabulated, analyzed, organized and presented under the following headings:

• Section-1: Frequency and percentage distribution of staff nurses according to their sample characteristics.

• Section-2: Frequency and percentage distribution of knowledge and attitude related to human milk banking among staff nurses

• Section-3: Part-1: Correlation between knowledge and attitude related to human milk banking among staff nurses. Part-2: Association of knowledge score related to human milk banking with selected demographic variables. Part-3: Association of attitude score related to human milk banking with selected demographic variables

Section-1

Frequency and percentage distribution of staff nurses according to their sample characteristics.

Table 1 majority of the staff nurses 38 (38%) were in the age group of 25-30 years followed by 36 (36%) under the age of more than 30 years and few 26 (26%) were under the age group less than 25 years. It was seen that majority of staff nurses 41 (41%) were GNM whereas 34 (34%) were Post Basic B.Sc. nursing and few 23 (23%) were Bachelor. Majority of the staff nurses 28 (28%) were working in other department whereas 25 (25%) were working in NICU, 14 (14%) were working in SNICU, 12 (12%) were working in PICU and Postnatal ward and very few 9 (9%) were working in labour ward. Majority of staff nurses 36 (36%) were having experience in between 5-10 years whereas 33 (33%) were having less than five year and few 31 (31%) were having experience more than 10 years. According to data analysis majority of staff nurses 83 (83%) were aware of this concept whereas few 17 (17%) were unaware about this concept. Majority of staff nurse 98 (98%) had not attended any training/workshop program and very few 2 (2%) had attended the training/workshop program.

Table 1:  Frequency and Percentage Distribution of Staff Nurses according to Their Sample Characteristics

Section-2

Frequency and percentage distribution of knowledge and attitude related to human milk banking among staff nurses.

Table 2 represent that majority 81 (81%) staff nurses had average knowledge whereas 11(11%) had poor knowledge and very few 8(8%) had good knowledge.

Table 2: Frequency and Percentage Distribution of Knowledge Related to Human Milk Banking

Table 3 shows that majority of staff nurses possess Favorable attitude had 68 (68%) and few 32 (32%) of them possess neutral attitude.

Table 3: Frequency and percentage distribution of attitude score related to human milk banking

Section-3

Part-1: Correlation between knowledge and attitude related to human milk banking among staff nurses.

Table 4: Part-1: Correlation between Knowledge and Attitude Related to Human Milk Banking among Staff Nurses

*Significant positive correlation

Table 4 showed that there was a significant positive correlation (r = 0.064) at 0.05 level of significance between knowledge and attitude related to human milk banking among staff nurses. Hence, hypothesis H₁ was accepted as there will be a significant relationship between between knowledge and attitude related to human milk banking among staff nurses.

Part-2

Association of knowledge score related to human milk banking with selected demographic variables.

Findings

Revealed that association of knowledge with their selected demographic variables among staff nurses were not significantly associated with age, professional qualification, working area and year of experience, awareness related to human milk banking and attended any Training/workshop programme related to human milk. Hence, Hypothesis H2: There will be significant association of knowledge score of staff nurses related to human milk banking with their selected demographic variables was rejected.

Part-3

Association of attitude score related to human milk banking with selected demographic variables.

Findings

Revealed that association of attitude with their selected demographic variables among staff nurses was not significantly associated with age, professional qualification, working area, year of experience; awareness related to human milk banking and attended any training/workshop programme related to human milk. Hence, Hypothesis H3: There will be significant association of attitude score of staff nurses related to human milk banking with their selected demographic variables was rejected. The calculated chi-square values were less than the table value at the 0.05 level of significance.

Results of present study showed that majority of staff nurses in our hospital were aware about human milk banking but only few of them had attended workshops/seminars related to human milk banking which indicates that there is need to address this issue and take initiative to equip staff nurses with adequate knowledge and information. Here by it is concluded that implementation of human milk bank is a complex power game involving health professionals, institution itself as well as public.

Recommendation

A similar study can be carried out to assess the knowledge and attitude related to human milk banking among health care providers and parents of preterm. An experimental design could be adopted to evaluate the effectiveness of planned teaching programme. A similar study can also be replicated on larger sample which can increase generalization of the study. Comparative study can also done between hospitals which have breast milk bank and which does not have breast milk bank.

Ethical Approval

Approval from the ethical and research committee of Sister Nivedita Govt. Nursing College Shimla and ethical committee of IGMC was taken to conduct the research study. Permission for data collection was obtained from the Principal of college of nursing, Principal of IGMC and hospital Shimla, Medical Superintendent of IGMC and nursing superintendent of IGMC, Medical Superintendent of KNH, Nursing Superintendent of KNH. 

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