Assessment of Knowledge and Practices of Mothers about Infant Feeding: A Hospital Based Study

Introduction: Exclusive Breast Feeding (EBF) is one of the most efficacious and cost effective intervention for reduction of child morbidity and mortality. Institutional delivery with maternal counselling and training is accepted as an effective modality to implement EBF. However, EBF rates have remained unacceptable despite high proportion of institutional deliveries in India. Aim: To estimate EBF rate amongst institutional deliveries, and the factors affecting breastfeeding practices among these mothers. Materials and Methods: This was a cross-sectional hospital based study. Institutionally, delivered infants attending Paediatrics Out-Patient Department (OPD) and immunisation clinic, who had received complete vaccination till 14 weeks, were included. All mother-baby pairs satisfying inclusion criteria were recruited after written informed consent. Institutional ethics committee approved the study. Infant and Young Child Feeding (IYCF) guidelines and Integrated Management of Neonate and Child Illness (IMNCI) Feeding Assessment Questionnaire based proforma was used to access breastfeeding knowledge and practices amongst recruited subjects. Chi-square test was used to assess the relationship between background characteristics of subjects and feeding practices. Further these associations were tested using multiple logistic regression models with each associated factor. Results: A total of 500 mother and baby dyad were recruited. Only 64 (12.8%) mothers initiated breastfeeding within 1 hour of birth; 12.6% babies never received breastfeeding. A 17.6% discarded colostrum considering it bad or indigestible for their babies. Prelacteal feeding in first six months of birth was practiced by 47.6% mothers. Scheduled and on-demand breastfeeding was higher amongst mothers living in nuclear families as compared to those in joint families (90.4% vs. 80.7%; p=0.003). Conclusion: Inspite of institutional delivery and multiple contacts with health personnel, EBF rate is still low. Many faulty practices, like withholding colostrum and prelacteal feeding are still prevailing in the society. Effective and repeated counselling is required in each contact with care givers for successful EBF.