Indmedica Home | About Indmedica | Medical Jobs | Advertise On Indmedica
Search Indmedica Web
Indmedica - India's premier medical portal

Indian Journal of Community Medicine

Knowledge, Attitude and Practices of Mothers about Breast-Feeding in Bihar

Author(s): R.J. Yadav, P. Singh

Vol. 29, No. 3 (2004-07 - 2004-09)

Abstract

Objective: The present paper aims at providing knowledge, attitude and practices of mothers about breast feeding in Bihar.

Design: Two stage design was adopted with Probability Proportional to Size (PPS) sampling.

Setting: Study covered 28,630 households from 1,418 villages from all 50 districts of Bihar.

Subjects: About 8,000 mothers (6,676 from rural and 1,279 from urban) were studied.

Methods: The method of 24 hours recall was used to assess the nutritional intake as well as the knowledge, attitude and practices about breast feeding in Bihar.

Results: About 29 percent of the mothers started breast feeding within 24 hours. About two third mothers discarded the colostrum. About one third mothers discarded the colostrum on the advice of their elders. Most of the mothers breastfed their child upto more than one year. About 55 percent of the mothers introduced supplement to their infants between 6-12 months. Rice was the main supplement given to children. The main reasons for starting supplements were mother's insufficient milk, child's demand and supplements are required for proper growth. The special foods preferred by the mothers during pregnancy and lactation period were mainly ghee and milk products irrespective of their socio-economic conditions.

Key words: Probability Proportional to Size (PPS) Sampling, Breast Feeding

Introduction

The Institute for Research in Medical Statistics, (IRMS) Delhi undertook a study to assess nutritional intake as well as the knowledge attitude and practices about breast feeding in Bihar. There may be some studies on the subjects of knowledge, attitude and practices of mothers but these are on the basis of micro level data, the results of which can not be generalized. Thus, there is a need to undertake large scale studies on this subject, finding of which could be used for framing appropriate policies for this group of population. Bihar is the state with high poverty and backwardness. About 40 percent of the population in the state was below poverty line. The institute covered all the blocks of each district of Bihar state. The present paper aims at studying the knowledge attitude and practices of mothers relating to breast feeding practices and introduction of supplements and substitutes in Bihar.

Subject and Methods

This is a part of the study undertaken by Institute for Research in Medical Statistics, Delhi in all the districts of Bihar. Two villages were selected from each block by using Probability Proportion to Size (PPS) sampling. In each village / ward, 20 households were selected. The survey covered about 28,000 households from all 591 blocks of the districts. About 8,000 mothers (whose children were upto 2 years of age) were interviewed. Information was collected on households characteristics, demographic profile, anthropometry. Information was also collected on breast feeding practices, special food intake during pregnancy, lactation, awareness and cause of night blindness etc.

Results

Information on knowledge attitude and practices about breast feeding and reason for discard of colostrum and their reasons are being presented in table I.

Table I: Breast Feeding Practices in Bihar (%)

  Urban Rural Combined
Started of Breast feeding at
First day 29.7 28.3 28.5
Second day 34.9 36.2 36.0
Third day 35.5 35.5 35.5
Discard of Colostrum (Yes) 62.5 66.3 65.7
Reason for discarding colostrum
Not good for Health 22.3 24.1 23.8
Elders advice 34.2 37.2 36.6
Child can not suck 6.0 5.1 5.3
Not applicable 37.5 33.6 34.3
Age up to breast fed
<6 Months 4.2 4.2 4.2
6-12 Months 26.1 25.7 25.7
> 12 Months 69.7 70.1 70.1

Table II: Information on Supplementary Feeding Practices (%).

Supplements Urban Rural Combined
Time of start
<6 Months 17.7 13.1 13.8
6-12 Months 53.7 54.2 54.1
13-18 Months 9.8 12.0 11.7
19-24 Months 0.2 0.2 0.2
Not applicable 18.6 20.5 20.2
Type of supplement
Milk 20.9 17.0 17.7
Rice 33.4 39.9 38.9
Roti 6.5 10.3 9.7
Adults foods 8.1 5.6 6.0
Commercial Baby Food 11.4 5.9 6.7
Others/ Not available 19.7 21.3 21.0
Reason for giving supplements
Mothers Milk not sufficient 30.0 28.9 29.0
Mothers ill Health 3.2 3.2 3.2
Child asked for 21.1 22.4 22.2
Required for proper growth 16.5 14.0 14.4
Cultivate habit 8.5 8.1 8.2
Don't Know/Not available 20.7 23.4 23.0

It has been observed that in most of the districts, higher proportion of mothers started breast feeding at the second day. It has been observed that more than 70 percent of the mothers opined that a child should be breast fed for more than a year except in the districts of Bokaro, Chatra, Garwah, Gopalganj, Khagaria, Kishanganj, Nalanda, Singhbhum (E) and Siwan where mothers were of the opinion that child should be brestfed up to one year of age. It has also been observed that majority of mothers from rural and urban areas were in favour of breast feding for more than one year in all the districts.

Discussion This study reveals that about 29 percent of the mothers started breast feeding within 24 hours. The proportion was almost same in urban and rural area. About two third mothers discarded the colostrum. About one third mothers discarded the colostrum on the advice of their elders. The main reasons for this were the advice of elders and belief that colostrum was not good for the health of the newborn. More than two third mothers breastfed their child upto more than one year. The trend in breast feeding between rural and urban areas was almost same. Cereal preparations and milk formed the major food item as supplement/substitute for children for breast milk. The main reasons for starting supplements were insufficient milk production by mother, child's demand and supplements are required for proper growth. The special foods preferred by the mothers during pregnancy and lactation period were mainly ghee and milk products irrespective of their socio-economic conditions. The reasons were better health of mother and infant. The special foods avoided during lactation were not specific.

Majority of the mothers were aware of night blindness and anemia. Only few knew about protein energy malnutrition. The reasons for having such deficiencies were not known to majority of the mothers.

Efforts should be made to have IEC activities targeted to educate the mothers specially in rural areas.

Acknowledgement

The authors are grateful to Food and Nutrition Board, Department of WCD, Ministry of HRD for financial support and Government of Bihar for their cooperation in conducting the survey.

References

  1. Yadav RJ, Singh, Nutritional assessment amongst adults of Bihar. Indian Journal of Preventive & Social Medicine, 1999; 30:10-13.
  2. Gopalan C, Ramashastry BV, Balasubramaniam SC. Table of food composition, Nutritive value of Indian foods. National Institute of Nutrition, ICMR, Hyderabad, 1993.
  3. State Nutritional Profile of Bihar. Institute for Research in Medical Statistics, ICMR, New Delhi, 1997.

Institute for Research in Medical Statistics,
Indian Council of Medical Research,
Medical Enclave, New Delhi - 110 029, INDIA

Access free medical resources from Wiley-Blackwell now!

About Indmedica - Conditions of Usage - Advertise On Indmedica - Contact Us

Copyright © 2005 Indmedica