Biology and Medicine

Study the Breastfeeding Awareness among the Females of Indore

Kajal Gupta^1*, Priyachitle² and Vibhuti Trivedi^{3 1}Researcher, (Nutrition & Dietetics) DDUKK, DAVV, Indore, India
²Dietician, Rajshree Apollo, Indore, India
³Dietician, Choithram Hospital, Indore, India
^*Correspondence: Kajal Gupta, Researcher, (Nutrition & Dietetics) DDUKK, DAVV, Indore, India, Email:

Received: 06-Jul-2021 Published: 30-Sep-2021, DOI: 10.35248/0974-8369.21.13.445

Introduction

The word ‘NUTRITION’ is derived from ‘Nutricus’ which means to suckle at the breast. Breast milk is natural milk for the Infant and it is a best way of giving a great start to a child. Breastfeeding is the normal way of providing young infants with nutrients they need for healthy growth and development.

First 1000 days of life are to create human resource intelligent, healthy and productive. The nutrition problem such as malnutrition early age [1-2] diseases has taken up world’s attention. In 1000 days, 270 days for Pregnancy & 730 days from birth to age of 2 years of child.

The word ‘NUTRITION’ is derived from ‘Nutricus’ which means to suckle at the breast. Breast milk is natural milk for the Infant and it is a best way of giving a great start to a child. Breastfeeding is the normal way of providing young infants with nutrients they need for healthy growth and development. First 1000 days of life are to create human resource intelligent, healthy and productive. The nutrition problem such as malnutrition early age [1-2] diseases has taken up world’s attention. In 1000 days, 270 days for Pregnancy & 730 days from birth to age of 2 years of child.

Practice of giving pre- lacteal feed.

Supplementary feed that is being started after 6 months must be of proper quantity and quality. Position of baby during breastfeed must be properly aligned and mother must support them with hands. Frequency of breastfeeding must be according to child’s demand and breastfeed from both the breast, but one at a time must be taken into practice. Practice of using pacifiers, pumps and bottles and other stationary products. Pre and Post-natal care must be taken and Diet of the mother should meet all the recommended nutrients. Pre and Post-natal check-ups must be done. And in case of any disease or complication special care must be taken.

Rational

Virtually all mothers can breastfeed properly when they have accurate information and the support of their family, the health care system, society at a large. Breastfeeding has number of benefits for baby as well as mother (Table 1).

Table 1: Benefits for Baby and Benefits for Mother.

According to WHO (2018), Globally, approximately 149 million children under 5 suffer from stunting over 49 million children under 5 were wasted and nearly 17 million were severely wasted. It is estimated that sub-optimal breastfeeding, especially nonexclusive breastfeeding in the first 6 months of life results in 1.4 million deaths and 10% of the disease burden in children younger than 5 years

According to data from the National Health Survey in (2010), is known to as many as 33.6% of infants in Indonesia are getting exclusive breastfeeding means there are still about 2/3 of a baby in Indonesia are still not getting exclusive breastfeeding.

Herta & Zein stated that Effect of Nutrition Counseling knowledge & attitude towards Mother Breastfeeding and Baby growth [3] in sub Lubuk Pakam, Indonesia. Researchers found that the treatment group was given nutritional counseling intervention for 3 months. Conducted test indicated that there is influence nutritional counseling on knowledge and attitudes in the intervention group.

Census of India (2001) stated that there is nearly 46% of young female population in India. So that knowledge among the young females about the breastfeeding keeps an importance [4]. Therefore if there is any lack in their knowledge so it needs to be improved [5]. Various programs and awareness counseling of the young females and pregnant women must be done. Arranging Counseling sessions, Workshops in both rural and urban areas using various techniques like Video, Presentation, lectures, pamphlets etc. will make easier to convey the message.

It is cycle where a healthy Young female will become a healthy Mother and give birth to a healthy Infant and awareness about common aspects of Sanitation, hygiene, diet and overall health aids to problem. Young female and Women should be kept at priority to provide basic knowledge of breastfeeding, supplementation, weaning, mother’s diet, rooming in, mother’s health etc. So to bring this knowledge in to practice and to keep baby and mother healthy and safe from diseases to reduce mortality and morbidity rate. And to burst myth and false perception and bring breastfeeding (exclusively with supplementary feed and breastfeed up to 2 years) into practice.

Awareness among the family members, surrounding people, nursing staff etc. is also important as they work as support system during the period of pregnancy and lactation (breastfeeding). Breastfeeding mother needs a happy, peaceful environment with supportive people so it becomes easier for her to feed baby comfortably. And there are numerous benefits to mother if she is in peaceful, happy environment as this is helpful in milk secretion, make her feel relax etc.

Operational Definitions

Breastfeeding: Breastfeeding is to provide mother’s milk to infant to fulfill their nutrient requirement for growth and development.

Awareness: Awareness is to have knowledge or being conscious about particular

Objectives

To study the awareness about breastfeeding in term of

➣ Awareness on basic knowledge of Breastfeeding.

➣ Awareness on pre-lacteal feed and weaning.

➣ Knowledge and practice related to rooming in

➣ Awareness towards stationary equipment for baby

➣ Awareness towards mother’s and baby’s health.

Delimitations

The study was delimited to the females of Science (Biology) stream studying in college.

The study was delimited to the females pursuing Bachelor’s and Master’s degree

Sample

The sampling method used in research was “Purposive sampling’’ method.

And sample was of Science (Biology stream) background. The sample size was of 100 students, each of them was given Breastfeeding Awareness Scale tool to complete. The sample includes female from different colleges of Indore. Sample was from science (Biology) stream of full- term courses of B.Sc., Nursing, Physiotherapy, M.Sc., M. HSc. Age group of samples lie between 18-30 years. Samples include both unmarried and married females. Sample studying in college was from both rural and urban areas (Table 2).

Table 2: Distribution of sample based on medium.

Tool

Tool used for data collection by Researcher for breastfeeding awareness was ‘BREASTFEEDING AWARENESS SCALE’.

Tool used in the research is Questionnaire. Tool consists of 35 items which covers the objectives of research. Tool was designed by professional while keeping the Age group and Education of the sample in mind. Tool was designed in both Hindi and English language. Tool was designed in such a way, which can be completed in given time limit.

Data Collection

Sample was from various colleges of Indore. Researcher has visited to the respective Colleges and after taking permission from respective Principals, Survey was conducted on Breastfeeding Week, 2019. Test was conducted at DDUKK, DAVV with the sample from the different colleges of Indore. After establishing reputation with the sample, test was conducted after distribution of Breastfeeding Awareness Scale to the sample by the students of B.Voc (Nutrition and dietetics).

There was a set time limit of 20 min. in the test. Use of internet, books and other references, cheating was strictly prohibited. Identity such as Name of students was kept confidential.

In the end test was completed successfully

Data Analysis

Researcher has used PERCENTAGE ANALYSIS method for data analysis of the survey

To study the awareness on basic knowledge of Breastfeeding (Table 3)

Table 3: Items based on basic knowledge of Breastfeeding.

Result

The result shows 59% students think baby should be breastfeed up to 6 months, these students may be relating it with exclusive breastfeed. While only 30% students think that baby should be breastfeed up to 2 years of age, these students are aware with the basic knowledge about breastfeed. While 6% students think that baby should be breastfeed up to 1 year these students are fully aware. And remaining 5% think that baby should be breastfeed up to 3-5 years of age, these students may believe that that breast milk is beneficial and should be given up to preschool age.

The result shows 70% female student think breastfeeding should be started as soon as mother gains consciousness, these female students are aware about importance of Breastfeed as soon as child’s birth. While 15% female students think that breastfeeding should be started after 2- 3 days of baby’s birth, as they may believe that mother is weak and if she has not consumed any food, if there is no milk secretion etc. but these female students are not aware about the concepts such as baby’s suckling can start milk secretion etc. 10% female students think that breastfeed should be started as soon as baby is born. These female students are aware but not completely as it are important to breastfeed as soon as possible but conditions are not favorable sometimes. 5% female students didn’t answer the question as they may don’t have any knowledge about this.

The result shows that 19% students think breastfeeding should be started immediately after birth, so these students must have knowledge about that breastfeeding baby immediately is important. While 73% students think that breastfeed should be started after an hour of birth, so they have knowledge but that may be influenced by the other facts or myths and the remaining 8% think that breastfeed should be started after 4 hours of birth, these students may believe that if mother is weak and unable to breastfeed to early after birth or unconscious such as in cesarean delivery.

The result shows 2% female’s students think that breast milk can be increased by medication, these females do not have awareness about the breast milk, its quantity and quality, maybe they believe on medicines rather than natural process like suckling of baby. While 41% students think breast milk can be increased by making mother happy, females’ students may believe that change in emotional behavior can change the quantity of breast milk secreted. While 57% students think that frequent breastfeeding is helpful as they are aware.

The result shows 17% female students believe that artificial formula milk available in market should be given to the baby, as this shows their unawareness and they may believe that formula milk is easily available and can be easily given to baby without knowing its disadvantages. While 80% female students believe that artificial formula milk available in market should not be given to babies as Mother’s milk is best food for the baby. 3% female students didn’t give the answer as they are either confused or not aware.

The result shows 2% females students think that exclusive breastfeeding should be continued up to 4 months of age. These female students are not aware and may have confusion between 4 months and 6 months or maybe they think that it is sufficient to feed baby. While 31% students think that exclusive breastfeeding should be continued up to12 months of age, these female students are not fully aware. 67% female students think that it should be continued up to 6 months of age means they are aware of basic knowledge of breastfeed.

To study the awareness on pre-lacteal feed and weaning (Table 4).

Table 4: Items based on pre- lacteal and weaning.

Table 4: Items based on pre- lacteal and weaning.

Result

The result shows that 1% female students think that Boiled water should be given to baby after birth as they may believe that baby is thirsty and boiled water will not cause any harm to baby. While 7% female students think that Ghutti should be given because they may believe that it increases heat in body and can protect baby from cold. 12% female students think that Honey should be given to baby as they may believe that it can make gums stronger. 4% female students think that all of the above options are correct and hence these students do not have awareness on breastfeeding. While 71% female students think none of the above options should be given to baby as they are aware that these items may cause harm to baby’s health. Remaining 5% didn’t give the answer as these students may got confuse between the given options.

The result shows that 0% or no female students have answered for glucose water. While 63%

Female students believe that Mother’s milk and formula feed should be given to baby in such.

Situation as they are slightly unaware and may have conception that if there is less secretion of breast milk or it may not fulfill the baby’s requirement. While 4% female students think that Formula feed should be given to baby as they unaware and may believe that formula feed can fulfill baby’s requirement of milk. 33% female students think that drop by drop mother’s milk should be given to baby as they are aware and know that frequently giving mother’s milk , even less in quantity can be a better option than formula feed etc.

The result shows that 50% female students believe that Ghutti and Gripe water should be given to baby as they are not aware and even confused between the other items asked in previous question where most of the female students have answered that none of the above item should be given to baby. While 40% female students think that these items are not beneficial for baby as they are aware that these items may cause infection and other problem to baby. 10% female student didn’t give the answer.

The result shows that 75% female students think that weaning should be started from age of 6 months hence these females are aware about weaning and may believe that it is important for growth and development of baby. 6% female students think that weaning should be started from age of 2 years as they do not have knowledge and they may believe that if breast milk is continued up to 2 years then it is sufficient for baby. 16% female students think that weaning should be started from age of 12 months as they are unaware and may believe that at 12 months of age child starts standing and walking hence more energy is required so weaning can be started. While 3% females students didn’t give the answer.

The result shows that 11% female students think that water should be given to baby at night so baby may not feel thirsty at night as these female students are not aware about addition and restriction of food for infant. While 89% female students think that water should not be given to baby at night as they are aware and have knowledge that breast milk should be the last food of the day.

To study the knowledge and practice related to rooming in Table 5

Table 5: Items based on rooming in.

Result

The result show that 11% female students think that by measuring baby’s weight before and after breastfeeding one can know that baby is receiving sufficient amount of milk. These students are not aware about hunger and health of baby during breastfeed. 59% students think that it can be known if baby is passing urine 5-6 times/day hence these students are aware and have accurate knowledge. 25% female students think that it can be known if baby is not crying as they may believe that if baby is full he/she will not cry, hence they do not have knowledge about hunger and health of baby during breastfeed. 5% female students didn’t answer the question.

The result shows that 25% it is necessary to keep the baby separate to provide rest to the mother as they may believe that baby may disturb the mother’s sleep, hence they are not aware. 70% female students think it is not necessary to keep the baby separate to provide rest to the mother as these students may believe that baby is dependent on mother and it is safe for baby to stay close to mother and sleeping next to baby will not disturb mother’s sleep too. Hence these females are aware of practice related to rooming in. While 5% female students didn’t answer the question.

The result shows 70% female students think that if there is any crack in the nipple breastfeeding should be stopped as this shows their unawareness and they believe that crack nipple may get more severe or mother may feel pain etc. While 27% female students say that breastfeeding should not be stopped, this shows their awareness and that they have knowledge that breastfeed during this condition will not cause any harm. 3% female students didn’t answer the question.

The result shows 23% female students think that bath should be given to baby immediately after birth as they may believe that giving bath to new born may reduce the chances of infection and maintain the hygiene. While 61% female students think that bath should not be given to baby immediately after birth as they are aware that it may change the body temperature of baby increase chances of infection etc. 16% female students didn’t give the answer.

The result shows 87% female students think that breast should be cleaned before feeding as they believe that cleaning breast may reduce chance of infection but are not aware.

While 13% female students think that breast should not be cleaned before feeding as they are aware.

The result shows 84% female students think that baby should be feed on demand and allowed to breastfeed till he wants as they are aware and know that baby shows signs of demand and child must be allowed to breastfeed till he wants as this will make him full for longer time. 16% female students think that baby should not be feed on demand and allowed to breastfeed till he wants as they are not aware about baby’s demand and may believe the mother can feed in fixed time or whenever she wants, hence they are not aware.

The result shows 56% female students think that if baby is asking feed frequently or is crying, it means mother’s milk is insufficient for the baby and he should be given formula milk. This shows their unawareness as they may believe that baby is mother is unable to feed or secrete sufficient milk 44% female students believe that formula milk should not be given to baby even he/she is crying or asking for feed instead mother should frequently feed the baby.

To study awareness towards stationary equipment for baby (Table 6).

Table 6: Items based on stationary equipment for baby.

Result

The result shows 39% female students think that Pacifier can be used for the baby as these students are not aware about its use and disadvantage. While 61% students believe that pacifiers should not be used for the baby, as they are aware and know that it may get infected from microbes and should be washed regularly, it’s material can be toxic for baby etc.

The result shows 60% female students think that Baby carriers available in the market can be used, as they do not have knowledge and may believe that baby carriers are helpful and make it easy to carry babies. While 40% female students thinks that Baby carriers available in the market should not be used as they have knowledge that baby can be carried by mother herself and also that baby carriers may have improper weight distribution or is non-adjustable or other disadvantage.

The result shows 66% female students believe that feeding bra and feeding gown are convenient for breastfeeding they are not aware of their disadvantage. While 34% these items are not convenient for breastfeeding, as these students are aware and know that mother may feel more comfortable without use of feeding bra and gown.

To study awareness towards mothers and baby’s health (Table 7).

Table 7: Items based on mother’s and baby’s health.

Result

The result shows that 38% female students think Post-delivery 10-20% of mothers feel depressed as they are aware. 38% female student’s think that 40% mothers feel depresses post- delivery hence they are not aware. While 24% female students think that only 5% mothers feel depressed post-delivery as they may believe that less mothers feel depressed post-delivery, hence they are also not aware.

The result shows that 60% female students think burping the baby is every time necessary after every breastfeed as these students are aware and know the importance of burping i.e. burping helps to release air which baby may have swallowed during breastfeed. While 30% female students think that it is necessary sometime to burp baby hence these students are not fully aware. 10% females students think that it not necessary to burp baby, as these students are not aware of the importance of burping.

The result shows 23% female students believe that breastfeeding be stopped If baby is having loose motions as they are not aware about benefits of breastfeeding and may think that breast milk can be cause more indigestibility to baby. While 72% female students believe that Breastfeeding not be stopped as they are aware and know the importance of breast milk. While 5% female students didn’t give the answer because they were may be perplexed or not aware.

The result shows 68% female students believe that Preterm low birth weight and NICU babies should be feed with formula feed as they not aware and may believe preterm baby require more nutrition than normal hence formula feed may fulfill the required need. While 32% female students believe Preterm low birth weight and NICU babies should not be feed with formula feed as they are aware and know the benefits of breast milk i.e. it can fulfill nutrient requirement.

The result shows 75% female students believe that in case of twins, feeding both at the same time is beneficial as it they may believe that both babies can get same quality and quantity milk. While 25% female students believe that this may cause inconvenience to mother.

The result shows 52% female students believe that if mother is not able to breastfeed first baby, breastfeeding second baby will be difficult as they are not aware with general knowledge of breastfeed and they may think mother is not producing sufficient milk if she was unable to feed first baby. While 48% female students believe that this is not true and they may have knowledge that mother can breastfeed second baby as milk production depends on hormones, baby’s suckling etc.

The result shows 49% female students believe that if the baby is not asking for milk or leaving the breast soon it means mother is producing less or no milk hence this shows their unawareness as they may believe that baby’s reaction towards feeding shows that there is problem in feeding either with the quality or quantity. While 51% female students believe that if the baby is not asking for milk or leaving the breast soon it doesn’t means mother is producing less or no milk as they are aware that baby do not show a constant behavior or reaction towards breastfeed hence mother’s milk production should not be judged on this basis.

The result shows 16% female students believe that Mother should drink less water while breastfeeding as females are not aware and may believe that more water intake can lead to secretion of watery milk. While 84% female students believe that Mother should not drink less water as they aware and may know that milk formation require water.

The results shows 41% female students believe that Diet restriction should be there while breastfeeding because they may believe that some food substance may alter the breast milk quality or quantity etc. While 59% female students believe that Diet restriction should not be there as they are aware about the importance of diet and nutrition for lactating mother.

The result shows 86% female students think that during pregnancy, it is important to get the breast checked once as they are aware that it is important to know if mother is healthy specially to prevent Breast cancer. While 14% female students think that during pregnancy it is not important to get the breast checked once, this shows their unawareness towards health and disease like breast cancer.

The result shows 72% female students think that during breastfeeding all medication should be stopped as it can harm the baby this shows their unawareness and they may believe that medicines can be transferred from milk to baby and may harm baby. While 28% female students think that medication should not be stopped as they are aware that general medicines do not cause harm, unless doctor says to stop any specific medicine.

Conclusion

This research shows that a large number of females even though they are the part of relatable subjects and degrees are not even aware about basic knowledge and principles of breastfeeding. Research shows that most of the female’s population believes on the conventional thinking that is being followed in their region or religions.

The overall awareness about Breastfeeding which includes the pre and post-natal care, response of the baby, use of stationary products etc. is important aspect as the entire knowledge can improve the breastfeeding behavior’s and will raise a healthy society. The health benefits of breastfeeding and recommended breastfeeding duration should be emphasized in education programs when encouraging females and mothers to comply with the WHO and other recommended breastfeeding guidelines.

Positively interaction with young females and mothers will inevitably bring many health benefits. Improving young female’s awareness about the recommendation and strengthening their intention to breastfeed could lead to increased attention towards Exclusive breastfeeding, weaning, mother’s and baby’s and help in bursting myths.

REFERENCES

1. B.Srilakshmi, Chennai: New Age International (P) Limited. J Nutr. Sci.2018
2. Hayashi Levels and trends in child malnutrition. Washington DC: WHO Geneva and the Development Data Group of the World Bank. 2019
3. Herta, M., & Zein, A. Effect of Nutrition Counseling Knowledge and Attitude toward Mother Breast Feeding and Baby Growth in Sub Lubuk Pakam. J Nutr. Sci 2017(1-2)
4. Ministry of Home Affairs Age Structure and Marital Status India: Registrar General & Census Commissioner. 2001.
5. World Health Organization Infant and young child feeding, WHO Press, Switzerland, Publisher. 2013.