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Indian Journal of Community Medicine

Bottlenecks to Breast Feeding in Rural Rajasthan

Author(s): Deeksha Sharma* and Sheel Sharma

Vol. 30, No. 4 (2005-10 - 2005-12)

In Tonk district of Rajasthan, 699 mother's of 0-3 year old children were surveyed for KAP about breast feeding on a pre-tested questionnaire.

The mothers often believed that their milk was not sufficient for their infants and made addition of top milk in their diet, which disminished the intensity of breast feeding, there by directly predisposing mothers to the risk of pregnancy as the period of lactational amenorrhea got shortened due to reduction of breastfeeding and its replacement by bottle feeding.

In rural areas, feeding was started only after a ritual performed on the third day after childbirth. A common belief was that only after second-third day, mother was capable of secreting sufficient quantity of milk to feed the baby. Such practice made the mother more vulnerable to postpartum haemorrhage. An account of this practice in the study area can be estimated as 60% of the population started breast feeding their children from 2nd to 3rd day. However initiation of breast feeding after 3rd day was particularly high in low socio-economic class and the same within 0-12 hours was maximum among upper socio-economic class.

Mothers of this rural area had to go to fields to work as agricultural labourers and thus their children had to be supplemented by top milk early in life. Due to poverty, in many cases, top milk was not available at home and mothers usually fed the children breast mlk supplemented with inadequate quantity of complementary foods for economic reasons. 60% of the population has been found following partial breastfeeding for more than 24 months, and a significant proportion of male children in comparison to their female counterparts got breastfeeding for this duration.

There was a common belief in this rural area that the first milk (colostrum) has some unusual ocnstituents in it, which could be hazardous for the newborn infant and the breast needs to be squeezed free of this. Thus the baby was put to the breast only after 3 days and most of the times, first feed to the infant had been other than breast milk.

To mitigate the hunger of newborn child for 3-5 days, prelecteal feed was a very common practice in this area. However, giving this to the child was the responsibility and prerogative of mothers-in-law. Infant's mother didn't even know the reason for feeding this or even if she knew she bothered the least about child feeding during the first crucial days of child's existence.

"Jaggery water" was given in majority (65%) of the cases with practice of giving "tea" as prelacteal feed (30%) was also becoming order of the day, because of its easy availability at home and at the hospital. The use of tea as prelacteal feed was most common (39%) in middle social-economic class. However, other sweetened liquids were maximally practiced (72%) in low socio-economic class.

In rural areas, mothers still didn't have even an idea about appropriate age of initiation of complementary feeding. So, instead of giving their child transitional foods in the order of liquids, semisolids and solids, they fed their children with solid foods straihtway, much like other family members, while partaking meals. Initiation of semisolid vary widely in duration ranging from 6-10 months (54%) to more than 10 months (42%) and the delay in initiation (> 10 months) is particularly clear (53%) in low socio-economic class.

Acccknowlegements:

The authors acknowledge the Breast Feeding Promotion Network of India (BPNI), New Delhi, for providing help in the form of financial assistance for this study.

Deeksha Sharma* and Sheel Sharma
Department of Foods & Nutritiion,
Banasthali Viyapith-304022
* presently working in Human Nutrition Unit,
AIIMS, New Delhi;
Email: [email protected]

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