Volume 20, Issue 5 (12-2021)
TB 2021, 20(5): 54-64 |
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Research code: 6162
Ethics code: IR.SSU.REC.1398.053
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Marzban A, Afkhami Aghda M, Servat F L, Dolat Abadi M, Emami P. Evaluation of Knowledge, Attitude and Performance of Breastfeeding Women in Abarkooh City towards Heavy Metals Transferred from Breast Milk. TB 2021; 20 (5) :54-64
URL: http://tbj.ssu.ac.ir/article-1-3226-en.html
URL: http://tbj.ssu.ac.ir/article-1-3226-en.html
Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. , dolatabadimaryam222@gmail.com
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Evaluation of Knowledge, Attitude and Performance of Breastfeeding Women in Abarkooh City towards Heavy Metals Transferred from Breast Milk
Ameneh Marzban (Ph.D.) 1, Mohammad Afkhami Aghda (Ph.D.) 2 , Farokh-legha Servat (M.Sc.) 3, Maryam Dolatabadi (Ph.D.) 4, Payam Emami (M.Sc.) 5
1. Ph.D. Student of Health in Disasters and Emergencies, Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
2. Assistant Professor, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
3. M.Sc of Health Education, Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
4. Corresponding Author: Ph.D. Candidate of Environmental Health Engineering, Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Email: dolatabadimaryam222@gmail.com Tel:09172458896
5. MSc. of Emergency Nursing, Department of Emergency Medical Sciences, School of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Abstract
Introduction: Breast milk is the best, most useful and most effective food for the baby. On the other hand, contamination of milk with various toxic elements can have adverse effects on children's health. The aim of this study was to investigate the knowledge, attitude and performance of breastfeeding women referring to Abarkooh health centers regarding heavy metals transferred from breast milk.
Methods: This was a descriptive cross-sectional study conducted in October ,2019, in which 250 breastfeeding women referred to health centers in Abarkooh were selected by cluster sampling. Data were collected through a 4-part questionnaire(demographic, knowledge, attitude, performance) used in a similar study. Finally, data were coded using SPSS 24 software and descriptive statistics, t-test, analysis of variance, and Pearson correlation coefficient.
Results: The mean scores of knowledge, attitude and performance of the women were 5.24 ± 3.18, 16.25 ± 5.28 and 15.17 ± 5.39, respectively. There was a significant difference between the mean and standard deviation of the variables of knowledge, attitude and performance in the women under the study regarding demographic variables. There was only a significant difference between knowledge and education level of women (P = 0.01). There was also a significant positive correlation between women's knowledge, attitude and performance.
Conclusion: Low awareness of heavy metals transferred from breast milk, can increase the risks associated with various types of breast milk poisoning in infants; therefore, educational programs ,such as programs and workshops related to proper nutrition, lifestyle and health behaviors for breastfeeding mothers can be effective in increasing the level of awareness in women. It should be noted that training programs should be designed to lead to appropriate attitudes and performances.
Keywords: Knowledge, Attitude, Performance, Breast Feeding women, Heavy Metals
Conflict of interest: The authors declared that there is no conflict of interest.
1-Vahidinia A, Samiee F, Faradmal J, Rahmani A, Javad MT, Leili M. Mercury, lead, cadmium, and barium levels in human breast milk and factors affecting their concentrations in Hamadan, Iran. Biological trace element research. 2019;187(1):32-40.
2-Marzban A, Rezaei Z, Karkhane M, Marzban H, Eslami H. Surveying the knowledge, attitude and performance of lactating women of Yazd city about heavy metals transmitted from breast milk. Hozan; a scientific journal of environmental sciences. 2017;2(2):1-10.
3-Gurung R, Silwal M, Gurung A, Sah I, Koirala D, Paudel S, et al. Knowledge, Attitude and Practice towards Exclusive Breastfeeding among Mothers in Pokhara-Lekhnath. Journal of Gandaki Medical College-Nepal. 2018;11(1):40-5.
4-Nazarpour S, Teimoori L, Teimoori S. Cadmium and Chrome Concentrations in Human Milk. Journal of Knowledge & Health. 2014;9(1):21-9.
5-Kunter I, Hurer N, Gulcan HO, Ozturk B, Dogan I, Sahin G. Assessment of aflatoxin M1 and heavy metal levels in mothers breast milk in Famagusta, Cyprus. Biological trace element research.2017;175(1):42-9.
6-Rehman K, Fatima F, Waheed I, Akash MSH. Prevalence of exposure of heavy metals and their impact on health consequences. Journal of cellular biochemistry.2018;119(1):157-84.
7-Malakootian M, Golpayegani A. Determination of Pb, Cd, Al, Zn and Ca in infant formula and baby foods in Iran and estimation of daily infant intake of these metals. Iranian Journal of Nutrition Sciences & Food Technology. 2013;8(3):251-9.
8-Qin H, Hu T, Zhai Y, Lu N, Aliyeva J. The improved methods of heavy metals removal by biosorbents: A review. Environmental Pollution. 2020;258:113777.
9-Bahmani P, Maleki A. Investigation Of Mercury, Cadmium And Arsenic Levels In Breast Milk Andtheir Relationship With The Studied Parameters In Sanandaj, Iran. Zanko J Med Sci. 2018;62(19):84-97.
10-Krishnendu M, Devaki G. Knowledge, attitude and practice towards breasfeeding among lactating mothers in rural areas of Thrissur District of Kerala, India: a cross-sectional study. Biomedical and Pharmacology Journal. 2017;10(2):683-90.
11-Hegazi MA, Allebdi M, Almohammadi M, Alnafie A, Al-Hazmi L, Alyoubi S. Factors associated with exclusive breastfeeding in relation to knowledge, attitude and practice of breastfeeding mothers in Rabigh community, Western Saudi Arabia. World Journal of Pediatrics. 2019;15(6):601-9.
12-Palmieri JR, Meacham S, Brunette J, Miluski T, Dhanju S, Stein S. Effects Heavy Metal and Organic Contaminants During Pregnancy and Lactation on Child Health. J Clin Case Rep Trials. 2019;2:26-34.
13-Sinkiewicz-Darol E, Bernatowicz-Lojko U, Lubiech K, Adamczyk I, Twaruzek M, Baranowska B, et al. Tandem Breastfeeding: A Descriptive Analysis of the Nutritional Value of Milk When Feeding a Younger and Older Child. Nutrients.2021;13(1):277.
14-Samiee F, Vahidinia A, Javad MT, Leili M. Exposure to heavy metals released to the environment through breastfeeding: A probabilistic risk estimation. Science of The Total Environment. 2019;650:3075-83.
15-Marzo RR, Rou KZ, Yin OY, Gill AS, Salam A. Knowledge, Attitude and Practice on Exclusive Breastfeeding among Mothers in Malaysia. International Medical Journal. 2019;26(2):77-80.
16-Dukuzumuremyi JPC, Acheampong K, Abesig J, Luo J. Knowledge, attitude, and practice of exclusive breastfeeding among mothers in East Africa: a systematic review. International Breastfeeding Journal. 2020;15(1):1-17.
17-Singh J, Bhardwar V, Kumra A. Knowledge, attitude and practice towards exclusive breastfeeding among lactating mothers: descriptive cross sectional study. International Journal of Medical and Dental Sciences. 2018;7(1):1586-93.
18-Zakria M, Afzal M, Hussain M, Gillani S. Assess knowledge, attitude, and practices of mothers regarding infant and child breastfeeding in the community. Globus An International Journal of Medical Science, Engineering and Technology. 2020;9(2):15-23.
19-Al-Saleh I, Shinwari N, Mashhour A. Heavy metal concentrations in the breast milk of Saudi women. Biological trace element research. 2003;96(1):21-37.
Ameneh Marzban (Ph.D.) 1, Mohammad Afkhami Aghda (Ph.D.) 2 , Farokh-legha Servat (M.Sc.) 3, Maryam Dolatabadi (Ph.D.) 4, Payam Emami (M.Sc.) 5
1. Ph.D. Student of Health in Disasters and Emergencies, Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
2. Assistant Professor, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
3. M.Sc of Health Education, Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
4. Corresponding Author: Ph.D. Candidate of Environmental Health Engineering, Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Email: dolatabadimaryam222@gmail.com Tel:09172458896
5. MSc. of Emergency Nursing, Department of Emergency Medical Sciences, School of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Abstract
Introduction: Breast milk is the best, most useful and most effective food for the baby. On the other hand, contamination of milk with various toxic elements can have adverse effects on children's health. The aim of this study was to investigate the knowledge, attitude and performance of breastfeeding women referring to Abarkooh health centers regarding heavy metals transferred from breast milk.
Methods: This was a descriptive cross-sectional study conducted in October ,2019, in which 250 breastfeeding women referred to health centers in Abarkooh were selected by cluster sampling. Data were collected through a 4-part questionnaire(demographic, knowledge, attitude, performance) used in a similar study. Finally, data were coded using SPSS 24 software and descriptive statistics, t-test, analysis of variance, and Pearson correlation coefficient.
Results: The mean scores of knowledge, attitude and performance of the women were 5.24 ± 3.18, 16.25 ± 5.28 and 15.17 ± 5.39, respectively. There was a significant difference between the mean and standard deviation of the variables of knowledge, attitude and performance in the women under the study regarding demographic variables. There was only a significant difference between knowledge and education level of women (P = 0.01). There was also a significant positive correlation between women's knowledge, attitude and performance.
Conclusion: Low awareness of heavy metals transferred from breast milk, can increase the risks associated with various types of breast milk poisoning in infants; therefore, educational programs ,such as programs and workshops related to proper nutrition, lifestyle and health behaviors for breastfeeding mothers can be effective in increasing the level of awareness in women. It should be noted that training programs should be designed to lead to appropriate attitudes and performances.
Keywords: Knowledge, Attitude, Performance, Breast Feeding women, Heavy Metals
Conflict of interest: The authors declared that there is no conflict of interest.
1-Vahidinia A, Samiee F, Faradmal J, Rahmani A, Javad MT, Leili M. Mercury, lead, cadmium, and barium levels in human breast milk and factors affecting their concentrations in Hamadan, Iran. Biological trace element research. 2019;187(1):32-40.
2-Marzban A, Rezaei Z, Karkhane M, Marzban H, Eslami H. Surveying the knowledge, attitude and performance of lactating women of Yazd city about heavy metals transmitted from breast milk. Hozan; a scientific journal of environmental sciences. 2017;2(2):1-10.
3-Gurung R, Silwal M, Gurung A, Sah I, Koirala D, Paudel S, et al. Knowledge, Attitude and Practice towards Exclusive Breastfeeding among Mothers in Pokhara-Lekhnath. Journal of Gandaki Medical College-Nepal. 2018;11(1):40-5.
4-Nazarpour S, Teimoori L, Teimoori S. Cadmium and Chrome Concentrations in Human Milk. Journal of Knowledge & Health. 2014;9(1):21-9.
5-Kunter I, Hurer N, Gulcan HO, Ozturk B, Dogan I, Sahin G. Assessment of aflatoxin M1 and heavy metal levels in mothers breast milk in Famagusta, Cyprus. Biological trace element research.2017;175(1):42-9.
6-Rehman K, Fatima F, Waheed I, Akash MSH. Prevalence of exposure of heavy metals and their impact on health consequences. Journal of cellular biochemistry.2018;119(1):157-84.
7-Malakootian M, Golpayegani A. Determination of Pb, Cd, Al, Zn and Ca in infant formula and baby foods in Iran and estimation of daily infant intake of these metals. Iranian Journal of Nutrition Sciences & Food Technology. 2013;8(3):251-9.
8-Qin H, Hu T, Zhai Y, Lu N, Aliyeva J. The improved methods of heavy metals removal by biosorbents: A review. Environmental Pollution. 2020;258:113777.
9-Bahmani P, Maleki A. Investigation Of Mercury, Cadmium And Arsenic Levels In Breast Milk Andtheir Relationship With The Studied Parameters In Sanandaj, Iran. Zanko J Med Sci. 2018;62(19):84-97.
10-Krishnendu M, Devaki G. Knowledge, attitude and practice towards breasfeeding among lactating mothers in rural areas of Thrissur District of Kerala, India: a cross-sectional study. Biomedical and Pharmacology Journal. 2017;10(2):683-90.
11-Hegazi MA, Allebdi M, Almohammadi M, Alnafie A, Al-Hazmi L, Alyoubi S. Factors associated with exclusive breastfeeding in relation to knowledge, attitude and practice of breastfeeding mothers in Rabigh community, Western Saudi Arabia. World Journal of Pediatrics. 2019;15(6):601-9.
12-Palmieri JR, Meacham S, Brunette J, Miluski T, Dhanju S, Stein S. Effects Heavy Metal and Organic Contaminants During Pregnancy and Lactation on Child Health. J Clin Case Rep Trials. 2019;2:26-34.
13-Sinkiewicz-Darol E, Bernatowicz-Lojko U, Lubiech K, Adamczyk I, Twaruzek M, Baranowska B, et al. Tandem Breastfeeding: A Descriptive Analysis of the Nutritional Value of Milk When Feeding a Younger and Older Child. Nutrients.2021;13(1):277.
14-Samiee F, Vahidinia A, Javad MT, Leili M. Exposure to heavy metals released to the environment through breastfeeding: A probabilistic risk estimation. Science of The Total Environment. 2019;650:3075-83.
15-Marzo RR, Rou KZ, Yin OY, Gill AS, Salam A. Knowledge, Attitude and Practice on Exclusive Breastfeeding among Mothers in Malaysia. International Medical Journal. 2019;26(2):77-80.
16-Dukuzumuremyi JPC, Acheampong K, Abesig J, Luo J. Knowledge, attitude, and practice of exclusive breastfeeding among mothers in East Africa: a systematic review. International Breastfeeding Journal. 2020;15(1):1-17.
17-Singh J, Bhardwar V, Kumra A. Knowledge, attitude and practice towards exclusive breastfeeding among lactating mothers: descriptive cross sectional study. International Journal of Medical and Dental Sciences. 2018;7(1):1586-93.
18-Zakria M, Afzal M, Hussain M, Gillani S. Assess knowledge, attitude, and practices of mothers regarding infant and child breastfeeding in the community. Globus An International Journal of Medical Science, Engineering and Technology. 2020;9(2):15-23.
19-Al-Saleh I, Shinwari N, Mashhour A. Heavy metal concentrations in the breast milk of Saudi women. Biological trace element research. 2003;96(1):21-37.
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Received: 2021/06/29 | Accepted: 2021/11/24 | Published: 2021/12/31
Received: 2021/06/29 | Accepted: 2021/11/24 | Published: 2021/12/31
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