A Descriptive Study to Assess the Knowledge and Practice related to

Breast feeding among mothers in General Hospital, Jayanagar,

Bangalore

by

CICY JOSPEH

Dissertation submitted to the

Rajiv Gandhi University of Health Sciences,
Karnataka, Bangalore

In partial fulfillment
of the requirements for the degree of

Master of Science in Nursing

in

Pediatric Nursing

Under the guidance of

Mrs. P. Chitra

Department of Pediatric Nursing

Sarvodaya College of Nursing,

Vijayanagar, Bangalore – 560 040

May 2005
 ii

Rajiv Gandhi University of Health Sciences, Karnataka

DECLARATION BY THE CANDIDATE

I hereby declare that this dissertation / thesis entitled “A Descriptive Study to

Assess the Knowledge and Practice related to Breast Feeding among mothers in

General Hospital, Jayanagar, Bangalore” is a bonafide and genuine research

work carried by me under the guidance of Mrs. P.Chitra, Asso. Professor,

Department of Pediatric Nursing, Sarvodaya College of Nursing.

Date : Signature of the Candidate

Place : Bangalore - 40.
CICY JOSPEH
 iii

CERTIFICATE BY THE GUIDE

This is to certify that the dissertation entitled “A Descriptive Study to assess

the knowledge and Practice related to Breast Feeding among mothers

in General Hospital Jayanagar, Bangalore” is a bonafide research work

done by Cicy Joseph in partial fulfillment of the requirement for the degree of

Master of Science in Nursing.

Date : Signature of the Guide

Mrs. P Chitra
Place : Associate Professor,
Department of Pediatric Nursing,
Sarvodaya College of Nursing
 iv

ENDORSEMENT BY THE HOD, PRINCIPAL / HEAD OF THE

INSTITUTION

This is to certify that the dissertation entitled “A Descriptive Study to Assess

the Knowledge and Practice related to Breast Feeding among mothers in

General Hospital, Jayanagar, Bangalore” is a bonafide research work done by

Cicy Joseph, under the guidance of Mrs. P. Chitra, Asso. Professor, Department of

Pediatric Nursing, Sarvodaya College of Nursing.

Seal & Signature of the HOD Seal & Signature of the Principal
Prof. G.R. Chanmalkar, M.Sc. (N) Prof. G.R. Chanmalkar, M.Sc. (N)

Date : Date :
Place : Place :
 v

COPY RIGHT

DECLARATION BY THE CANDIDATE

I hereby declare that the Rajiv Gandhi University of Health Sciences,

Karnataka shall have the rights to preserve, use and disseminate this dissertation /

thesis in print or electronic format for academic / research purpose.

Date : Signature of the Candidate

Place : Bangalore - 40.
Cicy Joseph,

© Rajiv Gandhi University of Health Sciences, Karnataka

 Acknowledgement

My Grace is
sufficient to thee.
11 Cor. 12:9

I express my gratitude to Almighty

God. For His grace and blessings,
who has been the guiding force
behind all my efforts.

I wish to acknowledge my beloved parents, Mr & Mrs. C.P. Joseph, my sisters and brother in-
laws for their prayer, love, affection, valuable suggestions, constant encouragement and support
which had been a source of inspiration throughout my studies without whom. I might not have
become what I am.

I express my sincere gratitude to Mrs. P. Chithra Asso. Professor Pediatric Nursing, Sarvodaya
Collage of Nursing, my guide for her guidance and support which had been incorporated to study

I acknowledge the guidance and suggestions of Prof. G.R. Chamnalkar, Principal and H.O.D, of
Pediatric Nursing, Sarvodaya Collage of Nursing, who had given me a clear sense of direction
through out the Study. I express sincere gratitude for his notable advice.

I am thankful to Mr. Narayanaswamy, Chairman, Sarvodaya group of Institutions for giving me

and opportunity to undertake the course at Sarvodaya Collage of Nursing, Bangalore.

My heart felt thanks to Mrs. Chithra, Vice Principal & H.O.D. of Research Methodology and
Mrs. Victorial Selvakumari Asst. Professor, Sarvodaya Collage of Nursing for their guidance and
support for the Study.

I extend my sincere thanks to Mr. Amal Xavier, Principal, Oriental College of Nursing for his help
and guidance for the study.

I extend my gratitude to all M.Sc(N) faculty members of Sarvodaya Collage of Nursing for their
encouragement and support.

I express my sincere thanks to all the staffs of Jayanagar General Hospital for their support and
permission to conduct the Study

I express my sincere gratitude to all the participants who had spent their valuable time and
cooperation in the research study.
I am highly obliged to all the experts for their valuable suggestions and sincere effort in validating
the research tool.

I am grateful to Prof. B.S. Srinivasan, statistician, for extending necessary guidance and support
for Statistical analysis of data.

I am thankful to Mr. Vijayanarasimha for his valuable editorial support.

I am thankful to library staffs of Sarvodaya College of Nursing and Indian Medical Association for
extending necessary library facilities through out my research study

My Special Thanks to Mr. Rajendra Prabhu for his support, encouragement, suggestions through
out my study.

I wish to extend my thanks to my classmates and friends for their supportive and positive
interactions.

The word of appreciation to the staffs of Shalini Graphics for the enthusiastic effort, sincere help in
typing the manuscript meticulously with much valued computer skills

The investigator owes a deep sense of gratitude to all those who have contributed to the
successful completion of the study.

DATE : CICY JOSEPH

 ABSTRACT

Background and Objectives

A descriptive survey approach was adopted to assess knowledge and practice

of mothers regarding breastfeeding in Jayanagar General Hospital at Bangalore.

The objectives of the study are

1. To assess the knowledge of mothers regarding breastfeeding.

2. To assess the practice of mothers regarding breastfeeding.

3. To find out the association between knowledge of mothers with selected

demographic variables.

4. To find out the association between practice of mothers with selected

demographic variables.

5. To prepare a health education pamphlet regarding breastfeeding,

The conceptual framework used for the study is health promotion model by

Pender.

Methods

In view of the nature of the problem a structure interview schedule was

prepared lo assess the knowledge and practice of mother on breastfeeding, which had

3 sections. The data was collected from Jayanagar General Hospital Bangalore. A

pilot study was conducted with 6 mothers who were having children
between the age group of birth to 1 year.

Purposive sampling technique was used to select 60 mothers having

children within one year of age based on inclusion and exclusion criteria. The

data was collected and analyzed using descriptive and inferential statistics.

Result

The overall analysis of knowledge score was 59% with total mean 12.3 and

standard deviation 2.25.

The overall analysis of practice percentage score was 49% with total mean 5.16

and standard deviation 1.54.

No significant association was found between knowledge of mother regarding

breastfeeding with selected demographic variables

Significant association was found only between monthly income with practice of

breastfeeding.

Interpretation & conclusion

The study concludes that mothers are having inadequate knowledge and improper

practice of breastfeeding. So there is a need to impart the knowledge and provide proper

guidance on practice of breastfeeding to prevent infant morbidity.

Keywords

Breastfeeding; Colostrum.
 TABLE OF CONTENTS

Sl.No. Content Page No.

1 Introduction 1-11

2 Objectives 12

3 Review of Literature 13-30

4 Methodology 31-44

5 Results 45-60

6 Discussion 61-65

7 Conclusion 66-68

8 Summary 69-70

9 Bibliography 71-76

10 Annexures 77-102
 LIST OF ABBREVIATION USED

1. WHO : World Health organization

 List of Tables

SI No Tables Pages

1 Blue print on knowledge related to breast feeding 39

2 Blue print on practice related to breast feeding 39

3 Frequency and percentage distribution of mothers according 50

their husbands education

4 Frequency and percentage distribution of mothers according 52

their monthly income

5 Frequency and percentage distribution of mothers according 52

their family type

6 Area wise analysis of knowledge level of mothers regarding 54

breast feeding

7 Distribution of knowledge level of mothers on breast feeding 56

in mean, range, SD and mean percentage

8 Area wise analysis of practice level of mothers regarding 57

breast feeding

9 Distribution of practice level of mothers on breast feeding in 57

mean, range, SD and mean percentage

10 Association between knowledge of mothers with selected 58

demographic variables

11 Association between practice of mothers with selected 59

demographic variables
 List of Figures

SI Figures Pages
No

1 Conceptual frame work 10

2 Schematic representation of Research design 33

3 Percentage distribution of sample according to their age 47

4 Percentage distribution of sample according to their religion 48

5 Percentage distribution of sample according to their educational status 49

6 Percentage distribution of sample according to their occupation 51

7 Percentage distribution of mothers according to their place of 53

residence

8 Percentage distribution of mothers according to their source of 54

information
 1

1. INTRODUCTION

“With the birth of every child

man may calculate that God is
still hopeful about the world
He created”
-Wordsworth

Children bring fragrance and meaning to life. They are a gift to us from God

and we are the garderners to meet their needs. We can provide the best to them by

proper nourishments, love, attention, care and good health. Today’s children are

citizen of Tomorrow and to have a strong-shouldered man a child should be free from

morbidity. Mahler, who was the Director General of the W.H.O. in 1984, stated that

“children are a priceless resource and a nation which neglects them does so at its

peril”. Healthy children are the greatest resource and pride of the nation, the children

ought to be healthy and happy to become productive adults of the future. To give

them a happy and healthy childhood, he must safeguard their total health right from

the beginning. The health of the newborn is directly related to the health status of its

mother during pregnancy and a healthy mother will bring forth a healthy child. After

birth the health of the baby depends upon the nurturing practice adopted by the

family.

The ideal food for the young infant is human milk, which has the specific

characteristics that match the growing infants nutritional requirements during the first

year of life. It has diverse and compelling advantages to infants, mothers, families

and society. These include health, nutritional, immunological, developmental,

psychological, social economic and environmental benefits1.

 2

Breast-feeding may be the single most important thing a mother can do for the health

of her infant in the first year of life. For most of the world’s childrens exclusive

breast-feeding makes the difference between life and death and it is the infants

“passport to life”. A breast fed baby enjoys not only the comfort of warm breast but

with all her senses she drinks in her mother’s love2

Breast-feeding is an endangered practice that requires the support of everyone

in society to nurture it back to its full, potent strength. It requires a commitment on

the part of health care institutions, decision makers, government and individuals in the

community to ensure a total baby friendly environments3.

In a culture that has come to accept bottle feeding and artificial feeding

products as the norm. The trend for mother to be modern and feed their infants with

formula, spread to third world countries with a disastrous result. Bottle feeding causes

the death of one and a half million babies every years and ill health in countless

others4.

Researcher has attempted to identify the decision-making process and

characteristics of women, who breast feed. The variable that may be modifiable

includes knowledge and practice of the mother’s and these are the important

determinant of maternal infant feeding method5. The present study aims at assessing

the knowledge and practice of mothers regarding breast feeding.

NEED FOR THE STUDY

Breast milk is a natural resource that is too valuable to lose; to ignore it is to

promote mortality, suffering, personal, national and economic stress. The scientific

literature reviewed recently for policy makers shows that breast-feeding can save
 3

more infant lives and prevent more morbidity that any other intervention strategy.

Currently breast-feeding saves six million infant lives each year by preventing

diarrhoea and acute respiratory infections. This alone is responsible for one forth to

one third of the observed fertility suppression and can provide high quality nutrition at

a fraction of the cost of artificial feeding 6.

Breast milk is the best and most appropriate food until the child is 10-24

months of age. Breast-feeding should be initiated within the first half an hour after

birth. The first milk (colostrum) produced in the process of lactation is the most

suitable food for the newborns, since it contains high concentration of nutrients and

anti-infective substances. Exclusive breast-feeding in the first six months and

extended breast-feeding in the second year of life not only saves lives but also saves

money for the family and the nation. Customs, superstition and ignorance etc,

sometimes deprive the child from this benefit7.

Preparation of mothers for breast feeding should start from antenatal period,

because it is necessary that all pregnant women should know the different aspects of

breast feeding such as initiation, durations, benefits and right techniques8.

The colostrum is of particular nutritional and health value to the infants and it

is the infant first immunization9.

Mahapatra et al conducted a study on breast feeding practice among 206

mothers in Orissa observed that 92% of mothers discarded their colostrum, considered

that it is unhealthy for the babies10.

Among the major child health challenges facing the world at the turn of the

new millennium is the problem of exorbitantly high neonatal mortality. The global
 4

burden of newborn death is estimated to be a staggering 5 million per annum. Only 2

percentage (0.1 million) of these death occur in the developed countries, the rest 98

percentage (4.9 million) take place in the developed countries. The highest neonatal

mortality rates are seen in countries of South Asia resulting in almost 2.0 million new

born deaths in the region each year, with India contributing 60 percent (1.2 million) of

them. Countries of the Sub-Saharan Africa experience another million newborn

deaths annually11.

Study conducted by Banapurmath et al on breast feeding practices in villages

of central Karnataka reported that, out of 1050 mother’s only 3 infants (0.3%) were

offered breast feeding within 1 hour after delivery. By 72 hours post delivery, 90.9%

of infants had begun breast-feeding. All infants had received prelacteal feeds and

28.6% mothers discarded their colostrum. The exclusive breast-feeding rate was 94%

at 1st month, 83.5% at 2nd month, 72.5% at 3rd month, and 61.2% at 4th month.

Among infants younger that 6 months old 49.4% were bottle-fed.

The healthy people 2010 goal for breast feeding is to increase at least 75% of

the population of mothers who breast fed their babies in the early postpartum period and

increase to at least 50% of the proportions of mothers who continue breast feeding until

their babies are five to six months old12

Major reasons for introducing bottle feeding were not enough milk (58.1%)

subsequent pregnancy (35.8%) and ill health of the mother (20.7%). These findings

show that rural mothers in Central Karnataka delay initiation of breast-feeding, reject

the colostrum and use prelacteal foods and bottle feedings.

 5

From the observation in the pediatric ward the researcher found that the

mothers were not aware of the facts regarding breast feeding of their infants. They

were often shifted to neonatal intensive care unit due to various problems, like

lethargy, poor feeding from the post natal ward. So the researcher is interested to

identify the knowledge and practice of mothers about breast-feeding.

STATEMENT OF THE PROBLEM

A descriptive study to assess the knowledge and practice related to breast

feeding among mother’s in general hospital, Jayanagar, Bangalore.

OPERATIONAL DEFINITION

1) Descriptive study – In this study refers to give brief description of knowledge

and practice regarding breast-feeding.

2) Knowledge – It is the correct response of the mother to the knowledge items

regarding anatomy and physiology of breast, initiation of breast-feeding,

advantages of breast-feeding, duration of breast-feeding, diet during breast-

feeding, hygiene during breast feeding and practices as per the interview

schedule.

3) Practice – Verbal responses of the mothers to practice items related to breast-

feeding.

4) Breast-feeding – It refers to feed the baby from the mothers breast

 6

5) Pamphlet – In this study refers to self-learning information on breast feeding

which includes, anatomy and physiology, initiation, duration, advantages,

diet, techniques, hygiene and contra indications of breast feeding.

HYPOTHESIS

H0- Their will not be significant association between demographic variables and

knowledge and practice score of mothers.

ASSUMPTIONS

1. Mother’s have inadequate knowledge regarding breast feeding

2. Mother’s knowledge and practice influenced by certain demographic

variables.

INCLUSION CRITERIA

1. Mother’s who have children within the age group of birth to one year.

2. Mother’s who are willing to participate in study

3. Mother’s who will be able to speak Kannada and English

EXCLUSION CRITERIA

1. Mothers who are not present at the time of data collection.

 7

DELIMITATIONS

The study findings could be generalized only to the Jayanagar General Hospital

setting, Bangalore.

PROJECTED OUTCOME

The mother should improve the knowledge and practice of breast feeding after the

distribution of pamphlet.

CONCEPTUAL FRAMEWORK

The conceptual or theoretical framework in nursing research can help to

provide a clear and concise idea of knowledge in the area.

The theoretical framework for the present study is developed from Noel. J.

Pender’s health promotion model.

Noel. J. Pender’s health promotion model is directed at increasing a client’s

level of well-being. The health promotion model directs the multi dimensional nature

of persons as they interact within their environment to pursue health to seek optimal

health. The model focuses in the following 3 areas.

1) Clients cognitive perceptual factors (individual perception)

2) Modifying factors (demographic and social)

3) Participation in health promoting behavior.

 8

The present study, the concept from Pender’s health promotion model is

utilized where client’s cognitive perceptual factors like individual knowledge and

practice of mothers regarding breast feeding which is measured by structured

interview schedule.

The second area of the model focus is on modifying factors (demographic

variables), which includes age, religion, education, occupation income family type,

place of residence and source of information. The focus of the model is to explain the

factors that influence the breast feeding process of mothers.

The third area of model focus on health promoting behavior, which can be

improved by providing pamphlet on breast feeding about following aspects.

¾ Anatomy and Physiology of breast

¾ Initiation of breast feeding

¾ Duration

¾ Hygiene

¾ Diet

¾ Advantages

¾ Contra indications

¾ Practices (Techniques)

If the mother has adequate knowledge and practice (cognitive, perceptional

factors) towards breastfeeding, she is likely to engage in breastfeeding practices

(health promotion behavior).

 9

If the knowledge and practice of mothers towards breast feeding is inadequate,

the health promotion behavior is interrupted which leads to illness and infections in

the child.

This model is useful to the nurse as a framework for client assessment.

However, the health promotion model expands the principles of the health belief

model and states that individuals are likely to change their behavior to feel better

physically, psychologically, socially and spiritually.

 10

Health promoting behavior

Cognitive perceptual factors Modifying factors Developing pamphlet on Breastfeeding
* Knowledge and practice of Demographic variable - Anatomy & physiology of breast
mothers regarding breast - Age - Initiation of breastfeeding
feeding is measured by - Religion - Duration
structured interview schedule - Education - Techniques
- Occupation - Hygiene
- Income - Diet
- Type of family - Advantages
- Source of - Contraindication
information

Cues to action
• Advices from others
• Mass media exposure
- Newspaper
- Magazine
- Television
- Radio

Figure1.Conceptual framework based on Noel. J Pender’s health promotion model

 11

This chapter indicates the necessary of mothers being knowledgeable

regarding breastfeeding. It discusses the need for the study, statement of the problem,

objectives, operational definitions and conceptual framework.

 12

2. OBJECTIVES

STATEMENT OF THE PROBLEM

A Descriptive study to assess the Knowledge and Practice related to Breast

Feeding among mothers in General Hospital, Jayanagar, Bangalore.

OBJECTIVES OF THE STUDY

1) To assess the knowledge of mothers regarding breast feeding

2) To assess the practice of mothers regarding breast feeding

3) To find out the association between knowledge of mothers with selected

demographic variables.

4) To find out the association between practice of mothers with selected

demographic variables.

5) To prepare a health education pamphlet regarding breast feeding

 13

3. REVIEW OF LITERATURE

Review of literature is a key step in research process. It enhances the depth of

the knowledge and inspires a clear insight into the cruse of the problem.

Review of literature is a systematic identification, location scruting and

summary of written materials that contain information on research problem13

Review of literature is an essential step in the research projects. It provides

basis for future investigation, justifies the needs for studying throws lights on the

feasibility of the study, reveals constrains of data collection and related the findings

from one study to another with a hope to establish a comprehensive study of scientific

knowledge in a professional discipline from which valid and pertinent theories may

be developed.

Review of literature for the present study has been organized under the

following headings.

1) Studies related to breastfeeding.

2) Studies related to health education regarding breastfeeding.

1. Studies related to breastfeeding.

The Advantages of breastfeeding are well organized and breastfeeding is

increasing in popularity. Mothers require information and support in their efforts to

establish breastfeeding. The nurse plays an important role in this process. The optimal
 14

time for initiating breastfeeding depends on the mother’s physical and psychological

status and on her wishes.

A Study conducted by Kronborg H, Vaeth M. (2004) on Danish Mothers. The

study was undertaken to examine to what extent psychosocial factors are related to the

length of breastfeeding. A total of 471 (88%) mothers participated in this study. The

study revealed that 98.7% initiated breastfeeding; 99 mothers 51% of those who

stopped, stopped within the first five weeks. In Cox regression analysis the duration

of breastfeeding showed a positive association with mother schooling (p= 0.002), her

intention to breastfeed (p=0.001), previous experience with breast feeding (p<0.001),

self-efficacy with respect to breastfeeding (p<0.001), her confidence in breastfeeding

(p=0.012) and knowledge about the breastfeeding (p=0.001). These finding shows

that the effect of the mother’s knowledge depended on the parity of the child14.

A cross-sectional survey conducted by Li.L, Zhang.M, Binns.C.W. (2003) on

Chinese mothers’ knowledge and attitudes about breastfeeding in Perth, Western

Australia. A sample of 506 Mandarin speaking women was recruited and interviewed

in Perth, Western Australia. The study revealed that majority came from mainland

China (81.6%), were aged between 23 and 59 years, and had some tertiary education

(76.3%). Most of the mothers 90.9%) indicated that they supported breastfeeding for

all infants and most had some knowledge about the benefits of breastfeeding. The

main reasons that mothers considering stopping breastfeeding were not having enough

breast milk and going back to work or study. The higher the family income, lower the

preference toward breastfeeding. These findings highlighted the significance of social

 15

and cultural factors that impact on the women’s decisions to initiate and maintain

breastfeeding15.

A Study conducted by Nanthini Subbaiah (2003) on a study to assess the

knowledge, attitude, practice and problems of postnatal mothers regarding

breastfeeding. It consists of 100 postnatal mothers who had normal deliveries in the

selected hospitals of Madurai revealed that overall knowledge regarding breastfeeding

the study population was 47.4±11.84 (Ranges 25 – 78). All the members in sample

liked to breastfeed their babies and were aware of the benefits or breastfeeding only

14 members of the sample were antenatally prepared for breastfeeding 77 members of

the population remarked that breast milk is the ideal food for the baby and 22 of them

said it contains protective substances 91 of them knew that they should feed the baby

with colostrums but only 50 of the population knew the reason for feeding colostrums

92, of the total population fed their babies soon after delivery. But only twenty three

(23) knew the reason for feeding breast milk soon after delivery. None of the study

population was aware of the relationship of early feeding with involution of uterus.

Necessity to feed from both breasts each time was known to 75 of the population.

Only Hindu multipara mothers (54)f had more knowledge when compared with Hindu

primipara mothers(8) on this aspect of breastfeeding (χ2 value is 5.23 p< 0.05). 34 of

the population had correct attitude of giving breast milk to the premature child there is

significant difference in the attitude between primi (6) and multipara (13) mothers

living in nuclear family set up on this aspect of breast feeding (χ2 value is 4.29

P < 0.05). 79 of the population had wrong notices that the mother should not breast

feed when she is pregnant. 56 of the population opined that breastfeeding should be

continued when baby is ill and remaining 44 had misconception that the baby should
 16

not be fed with breast milk when he is ill. 90 of the mothers felt that breastfeeding

does not disfigure the mothers body structure16.

A study conducted by Vijayalakshmi .S and Raman (2002) on effectiveness of

appropriated breastfeeding technique in prevention of nipple sore in primi postnatal

mothers revealed that the knowledge gain and skill gain in experimental group and

that the nipple sore is high in control group than in experimental group. The over all

mean score of the experimental group was 42.14 in the pretest and 77.38 in the post-

test where as for the control group, the over all mean score was 40.48 in the pretest

and only 51.19 in the post-test17.

A longitudinal study of breastfeeding and weaning practices during the first

year of life in Dunedin, New Zealand conducted by health AL, et al (2002) revealed

that among 74 mother 88% (n=65) initiated breastfeeding 42% (n=31) were

exclusively breastfeeding at 3 months and 34% (n=25) were partially breastfeeding at

12 months. Intention to breastfeed increased the likelihood of successful breastfeeding

initiation, mothers who reported that they did not have enough breast milk tended to

exclusively breastfeed for a shorter period of time. Tertiary education and exclusively

breastfeeding at 1 month were associated with a longer duration of breastfeeding

perception of breastfeeding in public as embarrassing was associated with a shorter

duration of breastfeeding. 45% 9n=33) were given on milk foods before 4 months of

age, and 69% 9n=51) were given unmodified cow’s milk as a beverage before 12

months18.
 17

Dewan.N et al (2002) conducted a study on breastfeeding knowledge and

attitudes of teenage mothers in Liverpool the study included a sample of 40 teenage

primigravida and 40 non-teenage primigravida. The study revealed that teenagers had

poorer knowledge about breastfeeding than the non-teenagers and fewer teenagers

considered breast milk the best food for their baby. More teenagers than non-

teenagers planned to bottle-feed [23 (57.5%) vs. 9 (22.5%), P=0.002] and only one

teenager had knowledge about colostrums. Teenagers were more often single had

lower level of education, higher unemployment, and higher smoking frequency and

less contact with a person who had previously breast – feed19.

A cross-sectional study conducted by Woldegebriel. A. (2002) on mothers’

knowledge and belief on breastfeeding. The study was carried – out on 317 mother-

child pairs of 0-2 years old children at Adigrat town. The study revealed that almost

all mothers, 308 (92%) of them considered human milk as the best milk for good child

growth compared to cow’s milk and / or formula milk. A higher proportion, 253

(80%) of mothers considered breast milk alone sufficient to feed a baby up to the age

of 6 months. The majority, 310 (97%) suggested not to breast feed when a mother

gets pregnant. Three quarters of mothers preferred not to breast feed when the mother

gets sick. The majority 288 (91%) of mothers suggested not to breast fed when the

child gets sick20.

A descriptive study conducted by Barton S.J. (2001) on infant feeding

practices of low income rural mothers at rural southeastern Kentucky the study

revealed that at birth 52% of mothers chose to use formula, 41.2% chose breast

feeding and 8% were both breastfeeding and formula feeding. By 1 month, 71% of

mothers were formula feeding and only 29% were breastfeeding. At 4 to 6 months
 18

Postpartum 80% of mothers were formula feeding and 20% were breastfeeding.

Mothers with more children higher family income and more education were more

likely to breastfeed. Almost all mothers began solid foods before the infant was 4

months old21.

Sepoua, et al (2001) conducted a study on How is breast feeding valued in the

urban and semi urban central African milieu the study revealed that 734 mothers of

newborn babies aged a between 14 and 45 years, including 534 in bangu and 200 in

bossangoa. breastfeeding was chose by 96.5% of mothers, however exclusive

breastfeeding was only carried out by 17% of mothers. Feeding on demand was

widely spread both in bangi (92.7%) and in bossangoa (92%). Breast milk was the

first food received at birth by 84.5% of newborn babies. At the neonatal period, water

supplementation was more frequent (78.1%) including 23% (at birth) than that of

solid or semi-liquid food (62%). The value given to breast milk was just nutritious; its

other virtues were not well known22.

Giovannini M, et al (2001) conducted a study on epidemiology of

breastfeeding in Italy, the study revealed that our of 1601 mothers who reunited

systematically as representative of deliveries across all regions of Italy, indicated than

85% of mothers breastfed their infants. The rates of breastfeeding at 3689 mother at 3

months, 72% practiced breastfeeding on demand 43% of the mothers did not receive

any information. Radio, TV (media) was mentioned as sources of information by only

2% of the mothers. Maternal factors significantly associated with breastfeeding and its

duration was: a) having been breastfed as infants. B) Being nonsmokers and c) being

given information about lactation at the time of discharge from their hospital ward
 19

maternal characteristics (age, weight, and height), parental socio-economic indicators

(profession and education and neonatal care (rooming in practice) were not

significantly associated with breastfeeding23.

A study conducted by Alikasifoglu M, et al (2001) on factors influencing the

duration of exclusive breastfeeding in a group of Turkish women. 91 mothers

included in the study which reveals 49 (54%) infants were exclusively breastfed at 4

months of age Cox regression analysis shared a negative association between formula

supplementation during the hospital stay and duration of exclusive breastfeeding. The

median age for starting non-breast milk liquids was 1 month for those who received

formula in the hospital and 3 months for those who did not (p = .001). The hospital

practices were more predictive of the duration of exclusive breastfeeding in this study

group than mother’s knowledge of infant feeding or psychosocial factors24.

Mc Lennan J.D (2001) conducted a study on early termination of breast

feeding in per urban Santo Domingo, Dominican Republic, which consist of sample

of 220 mothers revealed that duration of breast feeding was similar for self-report and

for mothers perceptions of typical community practice, there was no statistically

significant correlation between these two variables, Mother driven” reasons for early

termination of breastfeeding, such as fear of loss of figure25.

Das. D.K. et al (2000) conducted a study on knowledge and attitude of the

mothers regarding breastfeeding in rural Bangladesh. 242 mothers in 7 villages were

interviewed to assess their knowledge and attitude regarding breastfeeding by using

questionnaires. 83.5% mothers know that colostrums good for the baby, and it is the
 20

first food for their babies, most of the mothers did not have correct knowledge about

exclusive breastfeeding and the appropriate time for introduction of weaning foods,

and only 3% of them knew to prepare proper meaning foods, indicating the need for

nutrition education in this area26.

Okolo, S.N. et al, (2000) conducted a study on current breast feeding

knowledge and practices of mothers in rural Nigeria, 310 mothers in five rural

communities were interviewed by using a questionnaire, 162 mothers were illiterate,

148 mothers had secondary school education. Other practices investigated such as

exclusive breastfeeding; demand feeding, rooming in and first breastfeed were not

influenced by the mothers’ level of education. 53% of the mothers not given their

babies colostrums, 47.7% mothers gave their babies colostrums. The practice of

discarding, colostrums and replacing prelacteal feeds, late initiation of breastfeeding,

has implications for health education programs and neonatal feeding strategies27.

Ahmed. S. et al, (1999) conducted a study on infant feeding practices in rural

India to assess the knowledge and practices of mothers regarding breast feeding in

Bangladesh. 2015 mothers interviewed. Only 12% of mothers used colostrums as first

food for new born, 27% exclusively breastfeed babies till 5 months, while rest of the

mothers gave prelacteal foods to their infants, woman between 20 and 24 years of age,

who had their deliveries attended by medically trained personnel and those who

already knew about the appropriate duration of exclusive breastfeeding, were also

more likely to practice exclusive breast feeding for the first five months. The study

suggests that steps should be taken to strengthen further the on going breast feeding
 21

programmed for improving breast feeding knowledge and practice in rural

Bangladesh28.

The study conducted by Senanayaka M.P et al (1999) on 200 mothers

regarding their knowledge about breast feeding practices in Colombo reveals that

69% of mothers introduced supplementary fluids within the first 4 months, because of

advice from grand mothers relatives, 45% introduced water. 90% of mothers attended

antenatal clinics. 70% of mothers who gave supplementary fluids were aware of the

importance of exclusive breast feeding majority of mother’s supplemented breast milk

with water during the first 4 months the advice of grand mothers had a significant

influence on early feeding practices. Exclusively breastfed infants were found to

maintain water homeostasis under the hot, humid climatic conditions of this study29.

Swaran Lata (1999) had undertaken a study on breastfeeding practices among

59 female health functionaries in Himachal Pradesh. Finding reveals that 92% of the

subjects had initiated breastfeeding by twenty-four hours. Of the remaining four, two

initiated after one day, one after two days and one after three days. Average period of

initiation is five hours. Majority (76.3%) breastfed more than one year only six

percent breast fed the newborn for less than six months. Average period of continuing

breastfeeding is 19 months. Practice of giving prelacteal feed is prevalent among

health functionaries; as high as 50% of the subjects gave one or other pre lacteal feed.

Commonest pre lacteal feed is honey (84%) Ghutti (8%) water and cow’s milk is 4%

each30.
 22

A study conducted by Aggar wala A., et al (1998) on breastfeeding among

urban women of low economic status, factors influencing introduction of

supplemental feeds before four months of age reported that, out of 75 mothers 62.7%

were breast fed with in the first day of life the rest were breast fed by the 3rd day.

51.3% were started on supplementary feeding with in 6 weeks. 72% were started on

supplementary feeding with in 2 months. Duration of exclusive breastfeeding was

unrelated to maternal education or nutrition, socioeconomic status, family support,

motivation for breastfeeding, birth order. (49.4%), 6 of 13 mothers related work

resumption as the reason for artificial feeding most mothers used cow or buffalo milk,

most used bottles, and few has proper hygiene most diluted the supplements with

water31.

Dr. Ramakrishna M.N. (1998) conducted as study with the objective to assess

the knowledge and practice of mothers regarding breastfeeding in relation to

educational and economic status in a rural coal mine area of Andrapradesh. A cross

sectional survey was conducted among 498 feeding mothers having a child upto two

year of age. Analysis revealed that about 97% of the mothers knew that breast milk is

superior to artificial milk. 99.4% of the mothers were of the opinion that breastfeeding

beyond one year is good and 77.3% of the mothers knew the importance of

colostrums. Majority (69.67%) of the mothers initiated breastfeeding within two to

three hours32.

Chhabra .P, et al (1998) conducted a study on breastfeeding based on recall

about the exact feeding status in urban Delhi. 650 mothers of infants in 0 - 12 months

of age, attending a health center were interviewed about current feeding patterns of
 23

the infants. It was observed that breastfeeding and maintained at a high level (more

than 90%) through out infancy while exclusive breastfeeding rapidly declined at 1

month (74%) and at 4 months 46% of infants were exclusively breastfeed. Majority

(76.9%) of the infants received pre-lacteal feeds. Hospital born infants received their

first feed earlier and was less likely to receive pre-lacteal feeds as compared to those

born at home. Thus, the practice of exclusive breastfeed has to be promoted amongst

pregnant and lactating mothers, as also knowledge regarding infant feeding should be

imparted in schools and colleges33.

Jabeen et al (1998) conducted a study on epidemiological correlates of

breastfeeding practice on 101 infants, at Srinagar. It was observed that better

educational, occupational and economic positions favored partial breastfeeding where

as illiteracy, unemployment and low family income favored exclusive breastfeeding.

It has also been observed that where the father was only employed the proportion of

exclusive breastfed infants of 0 – 30 months are more than (61.45%) those where both

parents were employed (20%) 34.

Wadhava et al (1998) conducted a study on awareness and practice of breast

feeding among 335 mothers at Nagpur, the result showed that 42.4% of the mothers

initiated breastfeeding after 24 hours of child birth. 66.3% of the mothers gave

prelacteal feeds. 70.7% of the mothers had given colostrums to their babies. It was

observed that more mothers from nuclear families as compared to those from joint

families who followed the practice of colostrums feeding. However, only 19% infants

above four months were being exclusively breast fed35.

 24

Parmar et al (1998) conducted a study on knowledge, attitudes and practices

regarding breastfeeding at Chandigarh among 250 mothers. Analysis revealed that

only 61.6% of the mothers started early breastfeeding 42% of the mothers gave

prelacteal feeds, 49% of the mothers from rural area gave prelacteal feed as compared

to 36.6% of the mothers living in urban areas. 18.4% of the mothers discarded

colostrums, 31% of the mothers from rural area and only nine percent from urban

areas discarded colostrums 63% of the subjects had the opinion that colostrums was

not good fro their child 36.8% of the mothers started bottle feeds to their babies, of

these 66% of the sample did so before six months of age36.

Gupta et al (1997) had undertaken a study on breastfeeding practices among

489 urban and 505 rural mothers at Himachal Pradesh. The analysis showed that only

10.2% of the urban mothers and 11.28% of the rural mothers began breastfeeding

within one hour of birth. Prelacteal feeds were given, as a cultural practice is both

communities that were present in 47.7% and 65.14% of the subjects of urban and rural

area respectively. Mother’s education had no effect on giving prelacteal feeds37.

Bella Hassan (1997) conducted a study on misperceptions about breastfeeding

among 285 Saudi female college students. Analysis showed that nearly half of the

students (48.4%) believed that breast feeding would improve the mother’s breast and

figure. 33% of the sample believed that it would spoil the mother’s figure. 4.2% of the

subject thought it would have no effect and 14.5% of the students did not know the

answer. Nearly two third of the students (63%) thought that breastfeeding was useful

as a contraceptive measure, 32% of the sample claimed the contrary, and 5% of the

sample said they did not know38.

 25

Dr. Sharma Saroj and Dr. Suksham Chopra (1997) had undertaken a study to

assess knowledge, attitudes and practice of breastfeeding among 200 working mothers

in Haryana. The findings revealed that the majority of mothers (82%) were aware that

breastfeeding should be started within twenty-four hours after birth. Seventy two

percent of mothers had given prelacteal feed is the form of ‘gurti’ or ‘honey’. Only

28% of the mother’s breast fed the infant within three hours of birth. Colostrums were

considered good for infant’s health by more than fifty percent of the mothers. 34.5%

stated that they breast fed the infant on demand besides, 57% of the mothers had

initiated bottle feeding within the first three months of childbirth. Moreover, 40% of

the mothers had initiated semi-solid foods before the age of four months39.

Pragte Chhabra and O.P Aggarwal (1997) had undertaken a study on lactation

amenorrhoea and its determinants in 650 women in an urban resettlement colony at

Delhi. Women who had delivered normal full term infants from birth to 12 months

back formed the study subjects. The prevalence of amenorrhoea was 100%

immediately after post partum, while after one month 62% of the subjects were

amenorrhoeic, it declined to 32% at 12 months postpartum. The median duration of

lactational amenorrhoea in the study subjects was 8.25 months. Amenorrhoea in

mothers was significantly related to their breastfeeding status. Women who were

breastfeeding were more likely to be amenorrhoeic (P<0.01). The significance was

higher when exclusive breastfeeding was considered (P<0.001)40.

Pandey et al (1997) conducted a study on breastfeeding indicators form a rural

community in West Bengal among 211 mothers. Results of the survey revealed that
 26

two third *75%) of the children below four months of age were exclusively breastfed.

Another 25% of children in the same category were given water and other fluids

besides breast milk. Proportion of bottle fed children below the age of six moths was

17.6% it rose to 23.3% in one year41.

Dr. Sultan Ahmad and Shah Alam (1996) conducted a study on determinants

of breast feeding in an urban area of Bangladesh among 385 mothers, analysis reveals

that mean and median duration of breastfeeding were found to be 23.8 months and

25.4 months respectively. The median duration of breastfeeding was observed to

increase with an increase in the age of the mother. The median duration of breast-

feeding for 102 women with no education was 26.5 months as compared to 21.5

months for those with ten or more years of education42.

Charles O Eregie (1996) had undertaken an investigation on certain factors

associated with exclusive breastfeeding in Nigeria. 378 infants less than six completed

months were recruite3d for the study. Result showed that 29% of infants born to multi

parous mothers were exclusively breast fed, compared with 24.7% of infants born to

primiparous mothers. There was no significant association between maternal parity

and exclusive breastfeeding. A significant association was found between sex and

exclusive breastfeeding. 20.7% of male infants were exclusively breastfed compared

with 33.7% of female infants43.

A study conducted by Chandrashekar .S, (1995) on Infant feeding knowledge

and attitudes in a rural area of Karnataka. A sample of 300 mothers whose babies’

ages from 3 days to 17 months were included in the study. The study revealed that
 27

most of the mothers opinioned that breastfeeding had to be initiated within 24 hours

of birth. However, only 32% felt that breast milk should be the first feed, whereas

68% considered prelacteal feeds a necessity. 71% of the mothers considered 3 to 5

months to be the optimum duration of exclusive breastfeeding. 90% felt that cow’s

milk was an ideal supplement. 78.3% subscribed to the view that breastfeeding should

continue beyond one year. A sizeable proportion expressed the need to discontinue

breastfeeds during babies’ or maternal illness, particularly diarrhea44.

Sunit Reddy (1995) had undertaken a study on opinions and awareness of

breastfeeding among 125 mothers. Analysis revealed that 90% of the women believed

that breast milk is best irrespective of their education and economic status, 58% of the

women considered breastfeeding was disadvantageous for women working in

organized sectors, 68% of the women felt that they lost their charm and figure due to

breastfeeding45.

Surekha Kishore et al (1995) had undertaken a study on determinants of

breastfeeding practices among 200 mothers in rural community of Wardha. The

finding revealed that 59.2% of the mothers initiated breastfeeding within six hours of

child birth. 7.5% of the sample initiated within one hour of birth, 28.5% of the

mothers initiated after 24 hours. Initiation of breastfeeding had an increasing trend

along with education of the mothers. Paritywise only 9.9% of the primipara and 6.2%

of the multipara initiated breast feeding within an hour of child birth, however most of

them (52.2%) initiated breastfeeding within six hours. 16.9% of the primiparous

mothers initiated breast feeding after 24 hours where as 4.5% of the multiparous

mothers initiated breastfeeding after 24 hours of child birth. It was observed that as
 28

the income increases the percentage of mothers feeding colostrums also increase. It

was also observed that multipara mother’s breast fed their child for a longer duration

as well as initiated breastfeeding early46.

2. Studies Related to health education regarding breastfeeding.

As nature designed breast milk to nurture specially for baby’s wellbeing and

also helps in promoting mothers health, so mothers should be made aware regarding

breastfeeding through health education.

A cross-sectional study conducted by Ludivigsson. J.F (2003) on

breastfeeding in Bolivia, information and attitudes. 420 – 502 Bolivian mothers with

an infant less than or equal to 11 years of age were included in the sample the study

revealed that the attitudes of the mother, her partner and the infant’s grand mother

toward breastfeeding did not influence the infant feeding pattern. Women who had

received breastfeeding information from health care personnel before birth or on the

maternity ward breastfed exclusively for a longer duration (adjusted P=0.0233) and

avoided prelacteal food to a greater extent (adjusted odds ratio = 0.42; 955 confidence

interval for adjusted odds ration (95% CI AOR) = 0.23 – 0.72), information from a

doctor before birth or on the maternity ward was associated with less use of prelacteal

food (AOR = 0.53; 95% CI AOR = 0.31 – 0.93), an increased use of colostrums

(AOR = 3.30 ; 95% CI AOR = 1.16 – 9.37). But was not linked to the duration of

exclusive breastfeeding (P = 0.1767)47.

 29

A study conducted by Spinelli A, et al (2003) on Do antenatal classes benefit

the mother and her baby? , at total of 9004 women resident in 13 regions of Italy who

delivered in a 4 month period were interviewed. The outcomes studied were

attendance at antenatal classes, Cesarean section, bottle feeding, satisfaction with the

experience of childbirth, knowledge of contraception, breast feeding and baby care.

A total of 2065 (23.0%) women attended antenatal classes. Women without previous

children, those with a higher level of education and office workers were more likely

to attend classes. Women who attended antenatal classes had a much lower risk of

Ceasarean section and were about half as likely to bottle feed while in hospital

compared with non-attenders. They received better information on contraception,

breastfeeding and baby care. Women who attended classes and applied the techniques

learned were more satisfied with the experience of childbirth. The study concluded

that the antenatal classes seem to improve women’s knowledge and competence48.

A study conducted by Chaturvedi and Banait (2000) on knowledge and

attitude regarding breastfeeding in mothers attending antenatal clinics at Kasturba

Hospital Sevagram. The sample consisted of 600 mothers who delivered at Kasturba

Hospital were interviewed by using semi –structured open and close ended

questionnaires. The findings of the study revealed that 303 mothers (50.%) had

attended antenatal clinics of KHS (booked), where as 276 (46%) had antenatal

checkups at other health centers and 21 (3.5%) did not had any checkups. Only 54.5%

booked mothers and 30.3% unbooked mothers were informed regarding benefits of

breastfeeding during antenatal visits. The booked mothers wanted to initiate

breastfeeding early and did not want to give water supplementation and compared to

unbooked mothers regarding benefits or breastfeeding, feeding of colostrums,

 30

avoiding prelacteal feeds, additional nutritional requirement during lactation and

continuation of breastfeeding during maternal illness, pregnancy and maternal drug

intake49.

Study conducted by Froozani M.D. et al (1999) on effect of breastfeeding

education on the feeding pattern and health on infants in their first education on the

feeding pattern and health on infants in their first months in the Islamic republic of

Iran reported that, out of 120 mothers 59 mothers in the study group received breast

feeding education and the remain 61 in the control group. Exclusive breast feeding

relates were significantly higher in the study group (54%) than in the control group

(6.5%) but 5% 18% of infants respectively in the study and control groups had

stopped breastfeeding by the age of 4 months. The mean number of days of diarrhea

experienced by infants in the study group were significantly lower (p < or = 0.004)

than in the control group. At the end of 4 months, the mean weight and length of the

infants were significantly (both P < 0.05) in the study group the findings indicate that

there is a need for continuous breastfeeding education for mothers50.

This chapter on review of literature has dealt with literatures related to

breastfeeding and health education on breastfeeding, which highlighted the need of

development of health education pamphlet. The developed pamphlet will help the

mothers to improve their knowledge regarding breastfeeding and also well being of

the infant.
 31

4. METHODOLOGY

Methodology of research organizes all the component of the study is a way

that is most likely to lead to valid answer to the sub-problems that have been posed 51.

This chapter deals with the methodology adopted for this study. It includes

research design, research approach, study setting and sampling technique, sampling

criteria, content validity, and development of tool, description of tool, pilot study,

reliability, data collection procedure and plan for data analysis.

This study was done to assess the knowledge and practice of mothers

regarding breastfeeding in Jayanagar General Hospital Bangalore.

RESEARCH APPROACH

Research approach indicates the procedure for conducting the study. In order

to accomplish the objectives of the study, a descriptive study approach was adopted.

Descriptive approach describes situations as they exist in the world and

provides an accurate data of the characteristics of particular individuals, situations, or

groups. The outcome of descriptive research provides a basis for future quantitative

research51.
 32

RESEARCH DESIGN

Research design is an investigator’s overall plan for obtaining answers

to the research questions13.

For the present study, a descriptive design was adopted as it is a virtue of a

situation that naturally happens. In many aspects of nursing there is a need for a clear

picture or description of the phenomena before causality can be examined51.

 33

POPULATION SAMPLE TOOL

Mothers who 60 mothers in Jayanagar Structured
have children General Hospital, interview
within the age Banglaore, schedule to assess
group of birth to purposive sampling the knowledge
one year. technique was used. and practice

PLAN FOR ASSESSMENT

INTERVENTION - Knowledge and practice
regarding breastfeeding.
Development of
- Identification of the
Pamphlet
learning needs to
statistical analysis.

Figure 2. Schematic Representation of Research Design

 34

SETTING OF THE STUDY

The setting is the location where a study is conducted51. The study was

conducted in pediatric and postnatal ward of Jayanagar of general hospital. The

hospital is 500 bedded with multi specialty such as surgery, medicine, orthopedic,

psychiatry, pediatric, and OBG.

This setting is selected because of availability of the samples, feasibility of

conducting study, geographical proximity and ethical clearance.

VARIABLES

Variables are qualities, properties or characteristics of persons, things or

situation that change or vary51

Independent Variable:

Mothers who have children within the age group of birth to 1 year.

Dependent Variable:

Knowledge and practice related to breastfeeding.

Extraneous Variable:

Age, religion, education of the participant, education of the husband,

occupation of the participants, monthly income, type of family, place of residence,

source of information.
 35

POPULATION

The population referred to us is the target population, which represents the

entire group or all the elements like individuals or objects that meet certain criteria for

inclusion in the study51

Pediatric and postnatal ward is equipped with 100 beds. Average 120-140

children’s will admit to the pediatric ward and 160-200 deliveries conducted per

month. The mothers with normal delivery discharged after 3-4 days of delivery.

SAMPLE

Sample refers to subset of the population that is selected to participate in a

particular study51.

In this study, the sample consists of 60 mothers who have children within the

age group of birth to one year in the pediatric ward and postnatal ward of Jayanagar

General Hospital, Bangalore.

SAMPLING TECHNIQUE

Non-probability samples are selected based on the judgment of the researcher

to achieve particular objectives of the research at hand52.

 36

Purposive sampling technique is a strategy in which the researchers’

knowledge of the population and its elements are used to select sample which are

typical to the population51.

Purposive sampling technique, a type of non-probability sampling approach

was found to be appropriate for the present study.

SAMPLING CRITERIA

Inclusion Criteria:

- Mothers who have children within the age group of birth to one year.

- Mothers who are willing to participate in the study.

- Mothers who will be able to speak Kannada & English.

Exclusion Criteria:

- Mothers who are not present at the time of data collection.

SELECTION AND DEVELOPMENT OF TOOL

Based on the research problem and objectives of the study, the following steps

were undertaken to select and develop the data collection tool.

a) Selection of the tool :

A structured interview schedule selected on the basis of the objectives of the

study, as it was considered to be the most appropriate instrument to elicit responses

from the participants.

 37

b) Development of tool :

The instrument selected in a research should be as far as possible in the

vehicle that would best obtain data for drawing conclusions, which were pertinent to

the study53

A structured interview schedule was prepared to assess the knowledge and

practice of breastfeeding among mothers.

The tool was developed ;

- After reviewing the related literature.

- Based on the experience of the investigator and

- Based on the consultation with the subject experts.

DESCRIPTION OF THE TOOL

The interview schedule was constructed in three parts with a total number of

40 items. The researcher developed a structured interview schedule which contains

items of the following aspects.

Section – I

Socio- demographic data

Consist of age, religion, education of the participant, education of the

husband, occupation of the participant, monthly income, type of family, place of

 38

residence, source of information. The details of socio-demographic data is given in

annexure 6.

Section – II

Questionnaire on knowledge of breastfeeding

Consist of 20 items which includes anatomy and physiology of breast,

initiation of breastfeeding advantages, duration, diet, hygiene and contra-indication.

Each item has four options with one correct answer with a score of one, thus the total

score is twenty in section II.

Section – III

Questionnaire on practice of breastfeeding

It includes initiation of breastfeeding position and techniques. Each item has

four options with one correct answer with a score of one. Thus the total score is ten in

section – III. The details of the questionnaire on knowledge and practice of

breastfeeding are given in annexure 7.

A blue print of the tool was prepared by the researcher which includes content

areas, number of question, serial number of questions, and weightage in percentage

for each content area.

 39

Table 1: Blue Print on Knowledge related to breastfeeding

Sl No. Items No. of Serial No. Weightage of %

Questions

1. Anatomy and 5 1–5 25

Physiology

2. Initiation 2 6–7 10

3. Advantage 2 8–9 10

4. Duration 4 10 – 13 20

5. Diet 2 14 – 15 10

6. Hygiene 2 16 – 17 10

7. Contraindication 3 18 – 20 15

Table 2: Blue Print on Practice related to breast feeding

Sl No. Items No. of Serial No. Weightage of

Questions %

1. Initiation of 3 21 – 23 30

breastfeeding

2. Position used in 2 24 – 25 20

breastfeeding

3. Technique 5 26 – 30 50
 40

CONTENT VALIDITY

Validity refers to whether a measurement instrument accurately measures

what it is supposed to measure54

Validity of the tool was established in consultation with guide and experts

from the field of pediatrics and obstetrics and gynecology. The recommendations and

suggestions were considered and tool was reframed accordingly.

TRANSLATION OF THE TOOL

Initially the tool was prepared in English and then translated into Kannada and

translated to English to check the appropriateness of the Kannada tool by the expert.

PILOT STUDY

Pilot study is a small scale version or trial run of the major study. To assess

the feasibility in conducting main study and to obtain information for improving the

project, pilot study was undertaken.

After obtaining a formal permission from the medical superintendent of

Jayanagar General Hospital Bangalore, Study was conducted on 6 mothers who have

children within the age group of birth to one year, from 1st December to 10th

December 2004. A Purposive sampling and the inclusion criteria was taken in to
 41

consideration during sample selection. The consent was taken by explaining the

purpose of the study. Structured interview schedule consisting 10 items on

demographic variables 20 questions on knowledge and 10 items on practice. The

structured interview schedule took 30-40 minutes for each individual. The tool was

found to be feasible to collect required information. The subjects have not

experienced any difficulty in understanding the tool.

RELIABILITY OF THE TOOL

The reliability of the measuring instrument is a major criterion for assessing

the quality and adequacy13. The reliability of instrument is the degree of consistency

with which is measure the attribute it is supposed to be measuring13.

In order to establish the reliability of the tool, it was administered to six

mothers other than the study sample. The split half method was used to test the

reliability of the tool. The test was first divided in to two equivalent halves and

correlation for the half test was found by using Karl Pearson’s correlation co-

efficient formula and significance of correlation was tested by using probable error

(r ½ = 0.76 ). The reliability co-efficient of the whole tool was then estimated by

spearman Brown prophecy formula. The tool was found reliable (r = 0.86).

DEVELOPMENT OF HEALTH EDUCATION PAMPHLET

On the basis of mothers knowledge and practice level, health education

pamphlet on breastfeeding was developed and validated by subject experts.

Steps followed to develop pamphlet includes.

 42

Preparation of the first draft.

The first draft of the pamphlet was prepared on the basis of obtained knowledge

score, literature related to breastfeeding and opinion from subject experts. The

content was organized under the following headings.

- Introduction

- Anatomy and physiology of the breast.

- Initiation of breastfeeding

- Duration

- Techniques of breastfeeding

- Diet

- Hygiene

- Advantages

- Contraindication

Content Validity of Pamphlet

Validity of the Pamphlet was established in consultation with guide and

experts from the field of pediatrics and obstetrics and gynecology. The

recommendations and suggestions were considered and pamphlet was modified

accordingly.

TRANSLATION OF HEALTH EDUCATION PAMPHLET

The health education pamphlet initially prepared in English and it was

translated by the language experts in to Kannada.

 43

PRE-TESTING OF HEALTH EDUCATION PAMPHLET

The validated health education pamphlet in Kannada was tested in Jayanagar

General Hospital in Bangalore among 6 mothers who fulfilled the inclusion criteria.

The subjects found the language of the health education pamphlet simple and

understandable.

DATA COLLECTION METHOD

A formal written permission was obtained from the Medical Officer of

Jayanagar General Hospital, Bangalore. The data collected from March 1st 2005 to

April 15th 2005, from mothers who fulfilled the inclusion criteria. The structured

interview schedule was conducted for 30 – 40 minutes. Before conducting the study,

consent was taken from them by explaining the purpose of the study.

PLAN FOR DATA ANALYSIS

The cases were selected on the basis of purposive sampling technique. The

information was gathered in the pre-prepared and pre-tested Performa by interviewing

all the mothers selected. The data was tabulated according to various parameters like

age, sex, religion, education of the participant, education of the participant husband,

occupation of the participant, monthly income, and family type. place of residence,

source of information. Data was represented by using various graphical devices like

bar diagram, pie diagram, etc.

 44

The analysis was made by using the important parameters like percentage,

mean, SD and chi-square test. The values are compared at 5% level of significance for

the corresponding degree of freedom. P<0.05 was considered as not significant and

P>0.05 was considered as significant. (Formulae used are appended in annexure 14)

A descriptive study approach was adopted in order to assess the knowledge

and practice regarding breastfeeding of 60 mothers in Jayanagar General Hospital,

Bangalore. A structured interview schedule to assess the knowledge and practice

regarding breastfeeding was prepared. Validity and reliability of the same was tested.

Data was collected from the sample after obtaining permission for the concerned

authority. Collected data analyzed using descriptive and inferential statistics and

presented in the form of tables and graph.

 45

5. RESULT

The term analysis refers to a number of closely related operations which are

performed with the purpose of summarizing the collected data, organizing the data in

such a manner that they answer the research questions.

In order to find the meaningful answer to the research questions the collected data

must be processed and analyzed in some orderly coherent fashion. So that pattern and

relationship can be discerned.

A descriptive study approach was adopted to assess the knowledge and practice of

mothers regarding breast feeding. Data collected from 60 subjects were tabulated

analyzed and interpreted by using descriptive and inferential statistics based on the

objectives of the study.

The objectives of the study were:

1) To assess the knowledge of mothers regarding breast feeding.

2) To assess the practice of mothers regarding breast feeding.

3) To find out the association between knowledge of mothers with selected

demographic variables.
 46

4) To find out the association between practice of mothers with selected

demographic variables.

5) To prepare a health educations pamphlet regarding breast feeding.-

The findings were presented under five sections

Section I - Demographic Characteristics of mothers

Section II- Analysis of knowledge of mothers on breast feeding

Section III Analysis of practice of mothers on breast feeding

Section IV Association between knowledge of mothers with selected

demographic variables

Section V Association between practice of mothers with selected

demographic variables
 47

Section I Demographic Characteristics of mothers

80 73%

70

60
Percentage

50

40
19%
30
8%
20

10

0
15-20 21-25 26-25
Age in years

Fig. 3 Percentage distribution of sample according to the age

Percentage distribution of mothers according to their age shows that 73% of

samples belong to the age group of 21-25 years, 19% of them were in the age between

26-30 years and 8% of samples were in the age between 15-20 years.(Fig. 3)
 48

5%
38% 57%
Hindu

Christian

Muslim

Fig. 4 Percentage Distribution sample according to their religion.

Distribution of samples according to the religion shows that 57% of mothers were

Hindus, 38% of them were Christians and 5% of mothers were Muslims. (Fig.4).
 49

80 illiterate
72%
70
Primary
60

50
P e r c e n ta g e

Middle School
40

30 High School
18%
20
7% Higher Secondary and
10 3% above
0%
0

Fig. 5 Percentage distribution of samples according to the educational status.

Analysis related to educational status of mothers revealed that 72% of the

respondents had middle school education, 18% of them had primary education 3% of

them had high school education, 7% of them were illiterate and none of the samples had

education over higher secondary. (Fig.5)

 50

Table 3: Frequency and Percentage distribution of mothers according to their

husbands education.

Sl. Education Frequency Percentage

No.
1 Illiterate 02 3.0

2 Primary 07 12.0

3 Middle School 49 82.0

4 High School 02 3.0

5 Higher Secondary and above 00 0.0

Total 60 100

Table 3 represents that 82% of the samples responded that their husbands had

middle school education, 12% of them had primary education, 3% of them had high

school education, 3% of the respondent’s husbands were illiterate and none of the

participant’s husbands had education over higher secondary.

 51

97%
100
90
80
70 Unemployed
60
Percentage

Government
Private
50
Self-employed
40
30
20
10 3%
0 0% 0%

Fig 6: Percentage distribution of samples according to their Occupation.

Occupation wise analysis shows that 97% of the participants were unemployed and 3% of

the participants were self-employed (Fig.6)

 52

Table 4: Frequency and Percentage distribution of mothers according to

their monthly income.

Sl. Income Frequency Percentage

No.
1 1000 0.7 11.7

2 1000-2000 53.0 88.3

3 2000 and above 0 0

Total 60 100

Table 4 denotes 88% of respondents belong to Rs.1000 - 2000 income group,

12% of them belong to the income group of Rs.1000.

Table 5: Frequency and Percentage distribution of samples according to their

family type

Sl. No. Family Type Frequency Percentage

1 Nuclear 48 80

2 Joint 12 20

3 Extended 0 0

Total 60 100

Table 5 explains 80% of the samples were from nuclear family and 20% of the mothers

were belongs to joint family.

 53

0%

13%
Urban

87%
Rural

Tribal

Fig. 7: Percentage Distribution of mothers according to their Place Residence

Residential wise analysis shows that 87% of the samples were belongs to rural area and

13% of them were from urban area (Fig.7)

 54

100
95%
80
Health personnel
60
P e rc e n ta g e

Friends
Mother-in-law
40 Others
Husband
20
5% 0% 0% 0%
0

Fig. 8: Percentage distribution of samples according to their source of

information

Analysis reveals that 95% of the mothers gained information from health

personnel and 5% of mothers gained information from friends (Fig. 8)

 55

Section II :- Analysis of knowledge of mothers on breast feeding

This section deals with the distribution of knowledge score of mothers regarding

breast feeding in terms of mean, range, standard deviation and mean percentage.

Table 6: Area wise analysis of knowledge level of mothers regarding breast

feeding.

N=60

Range
No. of Maximum Mean
SI No Area of Mean S.D
Items Score %
Score

1 Anatomy and 5 5 2-5 3.5 1.4 49.9

physiology

2 Initiation 2 2 0-2 1.0 0.7 75.8

3 Advantages 2 2 0-2 1.0 0.7 53.3

4 Duration 4 4 0-4 2.2 1.7 63.3

5 Diet 2 2 0-2 1.0 0.7 50.0

6 Hygiene 2 2 0-2 1.0 0.7 72.0

7 Contraindication 3 3 0-3 1.0 1.4 42.0

Table 6 indicates mothers are having high knowledge in the area of initiation

(75.8%) and low knowledge (42%) in the area of contraindication of breast feeding.
 56

Table 7: Distribution of knowledge level of mothers on breast feeding in

mean, range, SD and Mean percentage N=60

Maximum Mean
Range of Score Mean Score S.D
Score %

15 9-15 12.3 2.25 58.9

Table 7 represents the overall mean knowledge score of mothers is 12.3(58.9%),

this indicates that mothers are having inadequate knowledge regarding breast feeding.
 57

Section III :- Analysis of practice of mothers on breast feeding

This section deals with the distribution of practice score of mothers regarding

breast feeding in terms of mean, range, standard deviation and mean percentage.

Table 8 : Area wise analysis of practice of mothers regarding the breast feeding.

N=60

Range
No. of Maximum Mean
SI No Area of Mean S.D
Items Score %
Score
1 Initiation 3 3 0-3 1.5 1.4 73.3
2 Position 2 2 0-2 1.0 0.7 37.5
3 Technique 5 5 1-4 2.5 1.4 45.0

Table 8 indicates mothers are having high practice score in the area of initiation

(73.3%) and low practice score (37.5%) in the area of position during breast feeding

Table 9: Distribution of practice level of mothers on breast feeding in mean,

range, SD and Mean percentage N=60

Maximum Mean
Range of Score Mean Score S.D
Score %

6 3-6 5.16 1.54 48.8

Table 9 represents the overall mean practice score of mothers is 5.16(48.8%), this

indicates that mothers are having improper practice of breast feeding.

 58

Section IV

Table 10 : Association between knowledge of mothers with selected demographic

variables N=60

SI No Demographic Degree of Calculated Table Level of Inference

Variables Freedom Vale χ2 Value P Significance
1 Age of the 1 2.3 3.84 0.05 NS
mother
2 Religion 1 0.0075 3.84 0.05 NS

3 Education of 1 2.97 3.84 0.05 NS

the participant
4 Education of 1 0.33 3.84 0.05 NS
Participant
husbands
5 Occupation of 1 0.35 3.84 0.05 NS
the
participants
6 Income per 1 0.15 3.84 0.05 NS
month
7 Family Type 1 0.01 3.84 0.05 NS

8 Place of 1 0.26 3.84 0.05 NS

Residence
9 Source of 1 0.07 3.84 0.05 NS
Information
N.S:-not significant

Table 10 reveals that there is no significant association between the demographic

variables such as age, religion, Education of the participant, Education of Participant
husbands, Occupation of the participants, Income per month, Family Type, Place of
Residence, Source of Information with knowledge score because the obtained χ2 value is
less than table value at 0.05 level of significant. Hence the null hypothesis accepted.
 59

Section V

Table 11: Association between practice mothers with selected demographic

variables.

SI Demographic Degree of Calculated Table Level of Inference

No Variables Freedom Vale χ2 Value P Significance
1 Age of the 1 0.21 3.84 0.05 NS
mother
2 Religion 1 1.48 3.84 0.05 NS

3 Education of 1 0.77 3.84 0.05 NS

the participant
4 Education of 1 0.01 3.84 0.05 NS
Participant
husbands
5 Income per 1 6.5 3.84 0.05 S
month
6 Occupation of 1 0.0007 3.84 0.05 NS
the participants
7 Family Type 1 0.13 3.84 0.05 NS

8 Place of 1 1.73 3.84 0.05 NS

Residence
9 Source of 1 0.11 3.84 0.05 NS
Information
N.S:-not significant, S: - Significant
 60

Table 11 reveals that there is no significant association between the demographic

variables such as age, religion, Education of the participant, Education of Participant

husbands, Occupation of the participants, Family Type, Place of Residence, and Source

of Information with knowledge because the obtained χ2 value is less than table value at

0.05 level of significance. Hence the null hypothesis accepted. There is a significant

association between monthly income, with the practice, because obtained χ2 value is

greater than the table value at 0.05 level of significance. Hence the null hypothesis

rejected.

This chapter has dealt with analysis and interpretation of the results of the study.

Descriptive and inferential statistics were employed to analyse the data. The analysis was

carry out on the basis of objectives and hypothesis of the study. Frequency and

percentage were used to represent the sample characteristics and knowledge and practice

were analyzed through mean, SD, and mean percentage. The associations of knowledge

and practice score with selected demographic variables were assessed by using χ2 test.
 61

6. Discussion

A descriptive study approach was conducted to assess the knowledge and practice

of mothers regarding breastfeeding. Data was colleted from 60 mothers. Purposive

sampling technique was used to select the sample. Collected data was analyzed by using

descriptive and inferential statistics and presented in the form of tables and graphs

The findings were discussed under five sections

Section I - Demographic Characteristics of mothers.

Section II - Analysis of knowledge of mothers on breast feeding.

Section III - Analysis of practice of mothers on breast feeding.

Section IV - Association between knowledge of mothers with selected

Demographic variables.

Section V - Association between practices of mothers with selected

Demographic variables.

Section I Demographic Characteristics of mothers

Percentage distribution of samples with reference to the age showed that 73% were in the

age group of 21-25 years, 19% were in the age group of 26-30 years and 8% were in the

age group of 15-20 years. (Fig. 3)

 62

With reference to religion the percentage distribution of respondents showed that 57%

were Hindus, 38% were Christians and 5% were Muslims. This findings was supported

By Nandhini Subbaih showed (85%) were Hindus. (Fig. 4)

Distribution of respondents according to the educational status reveals that 93% of the

samples were literates and 7% were illiterates. (Fig.5)

Percentage distribution of samples with regard to their husbands educational status

reveals that 97% were literates and 3% were illiterates. (Table. 3)

With regard to the occupational status of samples showed that 97% were unemployed and

3% were self employed. (Fig.6)

Percentage distribution of samples with regard to family income per month reveals that

88.3% have income between Rs.1000-2000 and 11.7% of them have below Rs.1000.

(Table 4).

With reference to the type of family reveals that 80% were from nuclear family and 20%

were from joint family.(Table 5)

Distribution of samples according to their place of residence showed that 87% were from

rural area and 13% were from urban area. (Fig.7)

 63

With reference to source of information, percentage distribution of respondents revealed

that 95% gained information from health personnel and 5% gained information from

friends. (Fig. 8)

Section II

Knowledge level of participants on breastfeeding

Area wise analysis denotes that maximum (75.8%) mean percentage was in the

area of ‘initiation of breast of breastfeeding’ and the minimum (42%) was in the area of

contraindications of breastfeeding. (Table. 6) The similar findings was supported by the

findings of the study by Kronborg H, Vaeth M. (2004) reveals that 98.7% had the

knowledge on initiation of breastfeeding.

The similar findings were supported by the findings of the study by Dr.

Ramakrishna M.N (1998) reveals that 97% of mothers had knowledge regarding the

importance of breast milk.

The mean knowledge score obtained by the mothers was 12.3 (58.9%) with

standard deviation 2.25 and the knowledge score were in the range of 9-15. (Table .7)
 64

Section III

Practice level of the participants on breast feeding.

Area wise analysis revealed that the maximum (73.3%) mean percentage was in

the area of ‘initiation of breastfeeding’ and the minimum (37.3%) was in the area of

‘position’. (Table .8)

The mean practice score obtained by the mothers was 5.16 (48.8%) with standard

deviation 1.54 and the practice score were in the range of 3-6. (Table .9)

Section IV

Association between knowledge of mothers with selected demographic variables

No significant association was found between knowledge of mother regarding

breastfeeding with selected demographic variables like age, religion, educational

qualification, occupation, family income, type of family, place of residence and source of

information. Hence the null hypothesis was accepted. (Table .10)

 65

Section V

Association between practice of mothers with selected demographic variables

Significant association was found only between monthly income with practice of

breastfeeding and no significant association was found between practice of breastfeeding

with remaining demographic variables like age, religion, educational qualification,

occupation, type of family, place of residence and source of information. (Table .11)
 66

7. CONCLUSION

Assessment of the level of knowledge of mothers revealed that overall

knowledge score is 12.3 (59%) and the practice score of mothers is 5.16 (49%).

These findings showed that mothers have inadequate knowledge regarding

breastfeeding and improper practice of breastfeeding.

Area wise analysis of knowledge score was more (75.8%) in the area of initiation

of breastfeeding and least (42%) in the area of contra indication of breastfeeding.

Area wise analysis of practice score was more (73.3%) in the area of initiation

of breastfeeding and least (37.5%) in the area of position during breastfeeding.

No significant association was found between knowledge of mother regarding

breastfeeding with selected demographic variables like age, religion, educational

qualification, occupation, family income, type of family, place of residence and source of

information. Hence the null hypothesis was accepted.

Significant association was found only between monthly income with practice of

breastfeeding. There was no significant association between practice of breastfeeding in

mother with the remaining demographic variables like age, religion, educational

qualification, occupation, family type, place of residence and source of information.

Hence the null hypothesis was accepted.

 67

Nursing Implications

The findings of the study have implication in various fields of nursing.

Nursing Practice
Nurses play role in imparting knowledge to the antenatal mothers regarding

breastfeeding in the first antenatal visit onwards. Since nurses cannot spend longer time

with individual antenatal mothers. Development of health education pamphlet will aid

in gaining knowledge regarding breastfeeding. Thus knowledge will influence better

practice.

The findings of the study indicate that all health team members should be

made aware of the need of observing, supervising, teaching and improving

breastfeeding knowledge and practice.

Nursing Education

Nursing education emphasis on preparing prospective nurses to impart

health education by using various methods of educational technology.

Nursing Administration

Institutions providing maternity services and care for new born should review

their policies and practices relating to breastfeeding. The institutions should

develop policies regarding breastfeeding, guidelines, care expectant and mothers,

and infants. Nursing administrator should involve in formulating the policies for health

education in the hospital setting as well as community.

 68

Nursing Research

Research plays important role in the establishment of the maternity and pediatric

women's health science. The present descriptive study was given base to conduct the

future quantitative and qualitative research on the knowledge and practice of mothers

regarding breastfeeding.

Limitations

1. The findings of the study could not be generalized due to selection of

single hospital.

2. The findings of the study were limited to 60 samples from Jayanagar General

Hospital Bangalore.

Recommendations

¾ Similar study can be under taken with a large sample to generalize the findings.

¾ A comparative study can be done between urban and rural mothers

regarding breastfeeding pattern.

¾ A comparative study can be done between unemployed and employed mothers

regarding breastfeeding.

¾ Follow up study can be conducted to evaluate the effectiveness of

pamphlet.
 69

8. SUMMARY

A descriptive study approach was undertaken to assess to the knowledge and

practice of mothers regarding breastfeeding. Purposive sampling technique was used to

select a sample of 60 mothers using structured interview schedule. The data obtained

were analyzed using both descriptive and inferential statistics. The findings are

summarized as follows.

Majority of the samples belong to the age group of 21-22 years and 57% of them

were Hindus. Highest percentage (93%) of mothers was literates and 97% participants

husbands were literates.

Distributions of respondents with reference to occupational status showed that

highest (97%) were unemployed and majorities (88.3%) have monthly income between

Rs. 1000-2000.

Distribution of mothers according to the type of family revealed that highest

percentage (80%) were from nuclear family, (87% ) were from rural area and 95% were

getting information from health personal.

Total knowledge score was 58.9% with total mean and standard deviation of 12.3

+ 2.25. This indicates mothers have inadequate knowledge of breastfeeding.

 70

Area wise analysis showed that highest percentage (75%) of knowledge score was

in the area of initiation of breastfeeding with mean + standard deviation as 1+ 0.7

Total practice score was 48.8% with total mean and standard deviation of 5.16 +

.54. This shows mothers have improper practice of breastfeeding.

Area wise analysis revealed that highest percentage (73.3%) of practice score was

in the area of initiation of breast feeding with mean + standard deviation as 1.5 + 1.4

No significant association was found between knowledge of mother regarding

breastfeeding with selected demographic variables.

Significant association was found only between monthly income with practice of

breastfeeding. No significant association was found between practice of breastfeeding in

mother with the remaining demographic variables like age, religion, educational

qualification, occupation, type of family, place of residence and source of information.

 71

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and Weaning". The Nursing Journal of India. 2000, 91:179.

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Its Determinants in Women in An Urban Resettlement Colony" Indian

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Urban Area of Bangladesh”. The Journal of Family Welfare, 1996, 42:1-6.

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Exclusive Breast Feeding". International Child Health, 1997,8:45-50.

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Karnataka", Indian Journal of pediatrics., 1995, 62(6): 707 - 712.

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Rural Community of Wardha". Indian Journal of Maternal and Child, 1995,

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BMC Pediatr., 2003., 3(1): 4

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 76

breast feeding in mothers attending antenatal clinics at Kasturbga

Hospital Sevagram"., Indian Journal of Pediatrics., 2000., 67 (4);

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pattern and health on infants in their first education on feeding pattern,” 1999,

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Methods, Appraisal and Utilization, Tokyo: W.B.Saunder's Compay, 1997,

790-796pp.

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Prentice-Hall of India Pvt. Ltd.,1999. 81 p.

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2002.
 77

ANNEXURE - 1

Letter Seeking permission for conducting Research.

From,
Cicy Jospeh
IInd Year M.Sc Nursing
Sarvodaya College of Nursing,
Bangalore.

To,
The Medical Superintendent,
Jayanagar General Hospital
Bangalore.

Through,
The Principal
Sarvodaya College of Nursing
Bangalore.

Sub: Seeking permission for conducting research study.

Respected Sir,

I am a student of M.Sc Nursing in Sarvodaya College of Nursing affiliated to

Rajiv Gandhi University of Health Science, Bangalore with a specialization in pediatric
Nursing.

I have to conduct a research study for the purpose of partial fulfillment of my

course. “A Descriptive study to Assess the knowledge and Practice related to Breast
Feeding among mother in general hospital, Jayanagar, Bangalore”.

I request you to kindly give permission for conducting study in your institute.

Thanking You,

Yours Faithfully

CICY JOSEPH
Place:
Date:
 78

ANNUXURE 2
LETTER FOR CONTENT VALIDITY OF THE TOOL

From :
CICY JOSEPH
Second Year M.Sc. Nursing Student
Sarvodaya College of Nursing
Bangalore – 560 040.

To :

SUB : EXPERT OPINION ON CONTENT VALIDITY OF TOOL.

Respected Sir / Madam,

I am a student of Masters of Science at Sarvodaya College of Nursing Bangalore.

working on dissertation, “A Descriptive study to assess the Knowledge and Practice
related to Breast Feeding among mothers in general hospital, Jayanagar, Bangalore” as a
partial fulfillment of Masters of Science in Nursing Degree of Rajiv Gandhi University of
Health Sciences, Bangalore.

OBJECTIVES OF THE STUDY:

1. To assess the knowledge of mothers regarding breast feeding

2. To assess the practice of mothers regarding breast feeding
3. To find out the association between knowledge of mothers with selected
demographic variables.
4. To find out the association between practice of mothers with selected
demographic variables.
5. To prepare a health education pamphlet regarding breast feeding

In this connection, I have prepared the research tool for assessing the knowledge and
practice of mothers regarding breast feeding. I would be obliged you would give me your
valuable suggestions would regarding the items and please sign in the certificate of
validation tool. I would appreciate your reply by December 15, 2004.

Thanking you in anticipation

Yours faithfully,

(CICY JOSEPH)
 79

ANNUXURE 3

LETTER SEEKING PERMISSION FOR VALIDATION OF A TOOL

From :
CICY JOSEPH
Second Year M.Sc. Nursing Student
Sarvodaya College of Nursing
Bangalore – 560 040.

To :

Forwarded Through :
THE PRINCIPAL
Sarvodaya College of Nursing
Bangalore – 560 040.

SUB : REQUEST TO VALIDATE THE RESEARCH TOOL

Respected Sir / Madam,

I, Miss. Cicy Joseph am a second year M.Sc. Nursing Student (Pediatric Nursing)
student at Sarvodaya College of Nursing, Bangalore. I would be obliged, if you could
kindly accept to validate my research tool on the topic.

TITLE OF THE TOPIC :

A Descriptive study to assess the Knowledge and Practice related to Breast

Feeding among mothers in general hospital, Jayanagar, Bangalore.

If you would kindly agree to persue my research tool by endorsing your valuable
suggestions on this topic, I would be obliged if you could kindly affirm your acceptance
by December 15,2004. I will send you the details of the study with the tool prepared on
hearing from you. Kindly fill up acceptance form.

Thanking you in anticipation

Yours faithfully,

(CICY JOSEPH)
 80

ANNUXURE 4

CERTIFICATE OF VALIDATION

To certify that the instruments :

1. Demographic variables

2. Checklist Format

Constructed by Cicy Joseph, II Year Master of Science in Nursing SCON,

Bangalore to be used in her study titled “A Descriptive study to assess the Knowledge

and Practice related to Breast Feeding among mothers in general hospital, Jayanagar,

Bangalore” has been found to be valid by me.

She has lots / none / few / some / of modifications required to be made in her

tools.

Signature :

Designation :

Date :

Place :
 81

ANNEXURE - 5
LETTER SEEKING CONSENT OF THE SUBJECTS FOR
PARTICIPATION IN RESEARCH STUDY.

Dear Participant,

I am a Post Graduate Nursing Student at the Sarvodaya College of

Nursing, Bangalore, Conducting as study to “A Descriptive study to
assess the knowledge and Practice related to Breast Feeding
among mothers in general hospital, Jayanagar, Bangalore”.
as a partial fulfillment of Master of Science in Nursing Degree of Rajiv Gandhi
University of Health Sciences, Bangalore.

I request you to answer to the questions asked with the most appropriate
responses. The information given by you will be kept confidential and used only for the
study purpose. Kindly sign the consent form given below.

Thanking you,
Yours faithfully,

(CICY JOSEPH)

CONSENT FORM
I ….......................................... herewith consent for the above said study knowing that all
the information provided by me will be treated with utmost confidentiality by the
investigator.

Date :
Place : Signature of the Participant
Name :
Address :
 82

ANNEXURE- 6
STRUCTURED INTERVIEW SCHEDULE ON
BREAST FEEDING
SECTION - I
SOCIO DEMOGRAPHIC DATA

The Interviewer introduced herself and explains the purpose of the study. She will ask
questions listed in the schedule using one to one technique. She places a tick mark (9)
against the items as per the response given by the participants in the box provided.

1. Name

2. Age

3. Religion:

1. Hindu [ ]
2. Christian [ ]
3. Muslims [ ]
4. Others [ ]

4. Education of the participant

1. Illiterate [ ]
2. Primary [ ]
3. Middle School [ ]
4. High School [ ]
5. Higher Secondary and above [ ]

5. Education of the husband

1. Illiterate [ ]
2. Primary [ ]
3. Middle School [ ]
4. High School [ ]
5. Higher Secondary and above
 83

6. Occupation of the participant.

1. Unemployment [ ]
2. Government [ ]
3. Private [ ]
4. Self employment [ ]

7. Family Income per month

1. 1000 [ ]
2. 1000-2000 [ ]
3. 2000 and above [ ]

8. Family Type

1. Nuclear [ ]
2. Joint [ ]
3. Extended [ ]

9. Place of residence

1. Urban [ ]
2. Rural [ ]
3. Tribal [ ]

10. Advise regarding antenatal / postnatal care to the mother is given by

1. Mother-in-law [ ]
2. Friends [ ]
3. Husband [ ]
4. Health personnel [ ]
4. Others [ ]
 84

ANNEXURE-7
SECTION - II
KNOWLEDGE RELATED TO BREAST FEEDING

I. Anatomy and Physiology

1. The parts of breast are

1. Breast tissue, nipple and area around the nipple [ ]

2. Breast tissue, nipple [ ]
3. Breast tissue [ ]
4. Don’t Know [ ]

2. The functions of the breast are

1. Aesthetic function [ ]
2. For feeding baby [ ]
3. Producing milk [ ]
4. No Special function [ ]

3. The Production of milk is by

1. When baby sucks [ ]

2. Pressing the nipple [ ]
3. Pressing the black area around the nipple [ ]
4. Don’t Know [ ]

4. First milk is produced

1. During pregnancy [ ]
2. Immediately after delivery [ ]
3. After three days of delivery [ ]
4. Don’t know [ ]
 85

5. Colostrum is a

1. Thick yellow fluid produced for 3 days [ ]

2. White fluid produced through out the period of breast feeding [ ]
3. First breast milk [ ]
4. Don’t know [ ]

II. Initiation of Breast feeding

6. Advantage of colostrum

1. Protects against Infection [ ]

2. First food for baby [ ]
3. Clears the baby’s first stool [ ]
4. Don’t know [ ]

7. What will you do if baby spits breast milk while breast feeding

1. Express the milk first and then feed [ ]

2. Stop breast feeding [ ]
3. Go and consult doctor [ ]
4. Don’t know [ ]

III. Advantages of breast feeding

8. Breast feeding is beneficial to the baby because it.

1. Promotes bonding [ ]
2. Protects from injury (infection) [ ]
3. Increases fairness of the skin [ ]
4. Don’t know [ ]
 86

9. Breast feeding is beneficial to the mother because it.

1. Promotes Immunity [ ]
2. Protects from further conception [ ]
3. Prevents constipation [ ]
4. Don’t know [ ]

IV. Duration of breast feeding

10. How often do you feed the baby during day and night.

1. Every 1-2 hours [ ]

2. Every 2-3 hours [ ]
3. Every 3-4 hours [ ]
4. Don’t know [ ]

11. Duration of breast feeding at one time.

1. 10-15 minutes [ ]
2. 20-30 minutes [ ]
3. As long a baby sucks [ ]
4. Don’t know [ ]

12. Baby should be fed in each feeding by

1. Both breast in same feeding [ ]

2. Alternative one breast. [ ]
3. Only one breast at a time. [ ]
4. Don’t know [ ]

13. Duration of breast-feeding along with home made food

1. Upto 6 months [ ]
2. Until 1 year [ ]
3. 2 years and above [ ]
4. Don’t know [ ]
 87

V. Diet during Breast feeding

14. The purpose of using additional foods and fluids before each feed.

1. To produce more milk [ ]

2. To avoid tiredness [ ]
3. To feed as long as baby need [ ]
4. Don’t know [ ]

15. Food which should take for successful lactation.

1. More fluid [ ]
2. Milk, egg, green leafy vegetables [ ]
3. Rice, pepper, Ginger and garlic [ ]
4. Don’t know [ ]

16. Maternal preparation for breast feeding during pregnancy assessed by

1. Growth and development of breast. [ ]

2. Identifying breast problems and taking remedial measures. [ ]
3. Not doing anything. [ ]
4. Don’t know [ ]

17. Breast care is by

1. Washing the breast and nipple with warm water. [ ]

2. Frequently cleaning the breast before feeding. [ ]
3. Daily taking bath. [ ]
4. Don’t know. [ ]

18. Engorgement of the breast occurs due to

1. Baby is not feeding [ ]

2. Infrequent feeding. [ ]
3. Feeding of artificial milk [ ]
4. Don’t know. [ ]
 88

19. You can prevent engorgement of breast by

1. Frequently emptying and breast feeding. [ ]

2. Not feeding in the night. [ ]
3. Stop breast feeding. [ ]
4. Don’t know [ ]

20. Care of the Sore nipple is by

1. Washing the breast with the plain water and keep it dry. [ ]
2. Washing the breast with soap and water. [ ]
3. Proper techniques of breast feeding [ ]
4. Don’t know. [ ]
 89

ANNEXURE- 8

SCORING KEY

ITEMS CORRECT
ANSWER
1 1
2 3
3 1
4 1
5 1
6 1
7 1
8 2
9 2
10 1
11 1
12 3
13 3
14 1
15 2
16 2
17 1
18 1
19 1
20 3
21 3
22 1
23 2
24 1
25 1
26 2
27 1
28 1
29 1
30 1
 90

ANNEXURE- 9

LIST OF EXPERTS
1) Prof. G.R. Chamnalkar 9) Mr. B.S. Srinivasan
Principal and H.O.D. Pediatric Nursing Professor of Biostastics
Sarvodaya College of Nursing J.S.S. Medical College
Bangalore. Mysore-570015.

2) Mrs. P.Chitra
Associate Professor
Pediatric Nursing
Sarvodaya College of Nursing
Bangalore.

3) Dr. Pappu Vithalachar

Pediatric Department
General Hospital Jayanagar
Bangalore.

4) Dr. Vasudeva Rao

Pediatric Department
General Hospital Jayanagar
Bangalore.

5) Mrs. Kallie Kurshelvi (OBG Nursing)

Principal, Vijayanagar College of Nursing
Bangalore.

6) Mrs. K.Thamarai Selvi

Asst. Professor, O.B.G.
Sarvodaya College of Nursing
Bangalore

7) Mrs. Sangeetha
Asst. Professor. O.B.G.
Sarvodaya College of Nursing
Bangalore

8) Mrs. Chithra
Professor and H.O.D.
Department of Research Methodology
Sarvodaya College of Nursing
Bangalore
 91

ANNEXURE- 10

CRITERIA RATING SCALE FOR VALIDATING THE STRUTURED

INTERVIEW SCHEDULE ON BREAST FEEDING

Respected Madam/Sir,
Kindly go through the content and place right mark ( ) against questionnaire in
the following columns ranging from very relevant to not relevant, when found to be not
relevant and needs modification kindly give your opinion the remarks column.

Very Needs Not

SI No. Item Relevant Remarks
Relevant Modification Relevant
Section – I

Demographic
data
1
2
3
4
5
6
7
8
9

Very Needs Not

SI No. Item Relevant Remarks
Relevant Modification Relevant
Section – II

Knowledge
questionnaire
regarding
breast feeding
1
2
3
4
5
6
7
8
9
 92

10
11
12
13
14
15
16
17
18
19
20

Very Needs Not

SI No. Item Relevant Remarks
Relevant Modification Relevant
Section – III

Practice
statements
regarding
breast
feeding
21
22
23
24
25
26
27
28
29
30

SUGESSION:------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------

SIGNATURE OF THE VALIDATOR

 93

ANNEXURE -11

JzɺÁ®Ät¸ÀĪÀ §UÉÎ gÀZÀ£ÉªÀiÁrzÀ ¸ÀAzÀ±Àð£ÀzÀ «ªÀgÀ

¥ÀnÖ

¸ÁªÀiÁfPÀ d£À¸ÀASÁå ªÀiÁ»w

¸ÀAzÀ±ÀðPÀgÀÄ ªÉÆzÀ®Ä vÀªÀÄä£ÀÄß d£ÀjUÉ ¥ÀjZÀ¬Ä¹,

¸ÀAzÀ±Àð£ÀzÀ §UÉÎ ªÀiÁ»w ¤ÃqÀÄvÁÛgÉ. CªÀ¼ÀÄ PɼÀUÉ
w½¹zÀ ¥Àæ±ÉßUÀ¼À£ÀÄß MAzÉÆAzÁV PÉý, d£ÀjAzÀ §AzÀ
¥ÀæwQæAiÉÄAiÀÄ£ÀÄß PɼÀUÉ PÉÆlÖ ¸ÀÆPÀÛªÁzÀ eÁUÀzÀ°è
(✓) §gÉAiÀÄÄvÁÛgÉ.

¨sÁUÀ-1

1. ºÉ¸ÀgÀÄ

2. ªÀAiÀĸÀÄì

3. zsÀªÀÄð
1. »AzÀÄ [ ]
2. Qæ²ÑAiÀÄ£ï [
]
3. ªÀÄĹèA [ ]
4. EvÀgÉ [ ]

4. ¨sÁUÀªÀ»¸ÀĪÀªÀgÀ «zÁåºÀðvÉ
1. C£ÀPÀëgÀ¸ÉÜ [
]
2. ¥ÁæxÀ«ÄPÀ ²PÀët [
]
3. ªÀiÁzsÀå«ÄPÀ ²PÀët [
]
4. ¥ËæqsÀ²PÀët
5. ¦AiÀÄĹ ªÀÄvÀÄÛ CzÀgÀ ªÉÄïÉ

5. ¥ÀwAiÀÄ «zÁåºÀðvÉ
1. C£ÀPÀëgÀ¸ÉÜ [
]
 94

2. ¥ÁæxÀ«ÄPÀ ²PÀët [
]
3. ªÀiÁzsÀå«ÄPÀ ²PÀët [
]
4. ¥ËæqsÀ²PÀët [
]
5. ¦AiÀÄĹ ªÀÄvÀÄÛ CzÀgÀ ªÉÄïÉ
[ ]

6. ¨sÁUÀªÀ»¸ÀĪÀªÀgÀ GzÉÆåÃUÀ
1. ¤gÀÄzÉÆåÃV [
]
2. ¸ÀPÁðj [ ]
3. SÁ¸ÀV [ ]
4. ¸ÀéAvÀ GzÉÆåÃUÀ
[ ]
7. PÀÄlÄA§zÀ wAUÀ¼À DzÁAiÀÄ
1. gÀÆ 1000 [
]
2. gÀÆ 1000-2000 [ ]
3. gÀÆ 2000 QÌAvÀ ºÉZÀÄÑ [
]

8. PÀÄlÄA§ ªÀUÀð
1. «¨sÀPÀÛ PÀÄlÄA§ [
]
2. C«¨sÀPÀÛ PÀÄlÄA§ [
]
3. «¹ÛvÀªÁzÀ PÀÄlÄA§ [
]

9. ªÁ¸À¸ÀܼÀ
1. £ÀUÀg À [
]
2. UÁæªÀiÁAvÀgÀ
[ ]
 95

3. §ÄqÀPÀlÄÖ [
]

10. ºÉjUÉAiÀÄ ªÉÆzÀ®Ä ªÀÄvÀÄÛ £ÀAvÀgÀzÀ DgÉÊPÉAiÀÄ

§UÉÎ w¼ÀĪÀ½PÉ ¤ÃrzÀªÀgÀÄ.
1. CvÉÛ [
]
2. UɼÀwAiÀÄgÀÄ
[ ]
3. UÀAqÀ [ ]
4. DgÉÆÃUÀå PÁAiÀÄðPÀvÀðgÀÄ
[ ]
5. EvÀgÀgÀÄ. [
]
 96

Annexure -12
¨sÁUÀ -2
I. gÀZÀ£É ªÀÄvÀÄÛ PÁAiÀÄð
1. ¸ÀÛ£ÀzÀ ¨sÁUÀUÀ¼ÀÄ
1. ¸ÀÛ£À¨sÁUÀ, vÉÆlÄÖ, ªÀÄvÀÄÛ vÉÆnÖ£À ¸ÀÄvÀÛ
[ ]
2. ¸ÀÛ£À¨sÁUÀ, vÉÆlÄÖ
[ ]
3. ¸ÀÛ£À¨sÁUÀ [
]
4. UÉÆwÛ®è [
]

2. ¸ÀÛ£ÀzÀ PÁAiÀÄð
1. ¸ËAzÀAiÀÄð ªÀzsÀðPÀ
[ ]
2. ºÁ®Ät¸À®Ä [ ]
3. ºÁ°£À GvÀàwÛ [
]
4. UÉÆwÛ®è [
]

3. ºÁ°£À GvÁàzÀ£É
1. ªÀÄUÀÄ«£À »ÃgÀÄ«PɬÄAzÀ [
]
2. vÉÆlÖ£ÀÄß MwÛzÁUÀ
[ ]
3. vÉÆnÖ£À ¸ÀÄvÀÛzÀ ¨sÁUÀªÀ£ÀÄß CzÀÄ«ÄzÁUÀ
[ ]
4. UÉÆwÛ®è [
]

4. ªÉÆzÀ®Ä ºÁ°£À GvÁàzÀ£É

1. UÀ¨sÁðªÀ¢ü ¸ÀªÀÄAiÀÄzÀ°è
[ ]
2. ºÉjUÉAiÀiÁzÀ vÀPÀët
[ ]
3. ºÉjUÉAiÀiÁzÀ ªÀÄÆgÀ£Éà ¢£ÀzÀ°è
[ ]
 97

4. UÉÆwÛ®è [
]

5. PÉƯÉƸÀÖçªÀiï
1. ªÀÄÆgÀÄ ¢£ÀUÀ¼À°è GvÁàzÀ£ÉAiÀiÁUÀĪÀ zÀ¥ÀàªÁzÀ
ºÀ¼À¢ zÀæªÀ [ ]
2. ¸ÀÛ£À¥Á£ÀzÀ ¸ÀªÀÄAiÀÄzÀ°è GvÁàzÀ£ÉAiÀiÁUÀĪÀ ©½
zÀæªÀ [ ]
3. ªÉÆzÀ® ¸ÀÛ£À ºÁ®Ä [
]
4. UÉÆwÛ®è [
]

II. ¸ÀÛ£À¥Á£ÀzÀ ¥ÁægÀA¨sÀ

6. PÉƯÉƸÀÖçªÀiï£À G¥ÀAiÉÆÃUÀUÀ¼ÀÄ
1. ¸ÉÆÃAPÀÄ ¤gÉÆÃzsÀPÀ [
]
2. ªÀÄUÀÄ«£À ªÉÆzÀ® DºÁgÀ
[ ]
3. ªÀÄUÀÄ«£À ªÉÆzÀ® ªÀÄ®zÀ ±ÀÄzÀÞvÉ
[ ]
4. UÉÆwÛ®è [
]

7. ºÁ®Ät¸ÀĪÁUÀ ªÀÄUÀÄ ºÁ®£ÀÄß GUÀĽzÀgÉ ¤ÃªÉãÀÄ

ªÀiÁqÀÄwÛÃj !
1. ªÉÆzÀ®Ä ºÁ®£ÀÄß »Ar DªÉÄÃ¯É PÀÄr¸ÀÄvÉÛêÉ.
[ ]
2. ºÁ®Ät¸ÀĪÀÅzÀ£ÀÄß ¤°è¸ÀÄvÉÛêÉ
[ ]
3. ªÉÊzÀågÀ §½ ºÉÆÃUÀÄvÉÛêÉ.
[ ]
4. UÉÆwÛ®è [
]
 98

III . JzɺÁ®Ät¸ÀĪÀ G¥ÀAiÉÆÃUÀUÀ¼ÀÄ

8. JzɺÁ®Ät¸ÀĪÀÅzÀjAzÀ ªÀÄUÀÄ«UÉ DUÀĪÀ
G¥ÀAiÉÆÃUÀªÉãÉAzÀgÉ
1. §AzsÀPÉÌ GvÉÛÃd£À
[ ]
2. ¸ÉÆÃAPÀ£ÀÄß vÀqÉUÀlÄÖvÀÛzÉ.
[ ]
3. ZÀªÀÄðzÀ PÁAwAiÀÄ£ÀÄß ªÀȢݸÀÄvÀÛzÉ.
[ ]
4. UÉÆwÛ®è [
]

9. ºÁ®Ät¸ÀĪÀÅzÀjAzÀ vÁ¬ÄUÉ DUÀĪÀ

G¥ÀAiÉÆÃUÀªÉãÉAzÀgÉ,
1. gÉÆÃUÀ ¤gÉÆÃzsÀPÀ ±ÀQÛAiÀÄ£ÀÄß ºÉaѸÀÄvÀÛzÉ.
[ ]
2. ªÀÄÄA¢£À UÀ¨sÀðzÀj¸ÀĪÀ°è CAvÀgÀªÀ£ÀÄß
¤ÃqÀÄvÀÛzÉ. [ ]
3. ªÀÄ®§zÀÞvÉAiÀÄ£ÀÄß vÀqÉUÀlÄÖvÀÛzÉ.
[ ]
4. UÉÆwÛ®è. [
]

IV. ¸ÀÛ£À¥Á£ÀzÀ CªÀ¢ü

10. ªÀÄUÀÄ«UÉ gÁwæ ºÀUÀ®Ä JµÀÄÖ ¸À® ºÁ®Ät¸ÀÄwÛÃgÁ

1. ¥Àæw 1-2 UÀAmÉUÀ½UÉƪÉÄä
[ ]
2. ¥Àæw 2-3 UÀAmÉUÀ½UÉƪÉÄä
[ ]
3. ¥Àæw 3-4 UÀAmÉUÀ½UÉƪÉÄä
[ ]
4. UÉÆwÛ®è. [
]

11. ¥Àæw¨sÁj ºÁ®Ät¸ÀĪÀ CªÀ¢ü

 99

1. 10-15 ¤«ÄµÀ. [ ]
2. 20-30 ¤«ÄµÀ. [ ]
3. ªÀÄUÀÄ »ÃgÀĪÀvÀ£ÀPÀ.
[ ]
4. UÉÆwÛ®è. [
]

12. ªÀÄUÀÄ«UÉ ¥Àæw¨Áj ºÁ®Ät¸ÀĪÁUÀ

1. JgÀqÀÄ ¸ÀÛ£ÀUÀ¼À ºÁ®Ä
[ ]
2. MAzÀgÀ £ÀAvÀgÀ MAzÀgÀ ºÁ®Ä
[ ]
3. ¥Àæwà ¨Áj MAzÉà ¸ÀÛ£À [
]
4. UÉÆvÀÛ®è. [
]

13. ªÀÄ£É DºÁgÀzÀ MnÖUÉ ¸ÀÛ£À¥Á£ÀzÀ CªÀ¢ü

1. DgÀÄ wAUÀ¼À vÀ£ÀPÀ
[ ]
2. MAzÀÄ ªÀµÀðzÀ vÀ£ÀPÀ
[ ]
3. JgÀqÀÄ ªÀµÀð ªÀÄvÀÄÛ CzÀgÀ ªÉÄïÉ
[ ]
4. UÉÆwÛ®è [
]

V. ¸ÀÛ£À¥Á£ÀzÀ ¸ÀªÀÄAiÀÄzÀ°è vÉUÉzÀÄPÉƼÀî¨ÉÃPÁzÀ

DºÁgÀ

14. ºÁ®Ät¸ÀĪÀ ªÉÆzÀ®Ä C¢üPÀªÁzÀ DºÁgÀ ªÀÄvÀÄÛ zÀæªÀ

¥ÀzÁxÀðUÀ¼À£ÀÄß PÉÆqÀĪÀ
GzÉÝñÀ
1. ºÉaÑ£À ºÁ®Ä GvÀàwÛUÁV
[ ]
2. DAiÀiÁ¸ÀªÀ£ÀÄß ¥ÀjºÀj¸À®Ä
[ ]
3. ªÀÄUÀÄ«UÉ ¸ÁPÁUÀĪÀgÉUÉ ºÁ®Ät¸À®Ä
[ ]
 100

4. UÉÆwÛ®è [
]

15. ¸À¥sÀ®ªÁzÀ ¸ÀÛ£Àå¥Á£ÀPÉÌ vÉUÉzÀÄPÉƼÀî¨ÉÃPÁzÀ

DºÁgÀ
1. ºÉZÀÄÑ zÀæªÀ ¥ÀzÁxÀðUÀ¼ÀÄ
[ ]
2. ºÁ®Ä, ªÉÆmÉÖ, ºÀ¹gÀÄ ¸ÉÆ¥ÀÄà vÀgÀPÁjUÀ¼ÀÄ
[ ]
3. C£Àß, ªÉÄt¸ÀÄ, ±ÀÄAp, ªÀÄvÀÄÛ ¨É¼ÀÄî½î
[ ]
4. UÉÆwÛ®è [
]

16. UÀ¨sÁðªÀw ¸ÀªÀÄAiÀÄzÀ°è ¸ÀÛ£À¥Á£ÀzÀ §UÉÎ vÁ¬ÄAiÀÄ

¥ÀƪÀð¹zÀÝvÉ, w½zÀÄPÉƼÀÄîªÀÅzÀÄ,
1. ¸ÀÛ£ÀzÀ ¨É¼ÀªÀtÂUɬÄAzÀ
[ ]
2. ¸ÀÛ£ÀzÀ vÉÆAzÀgÉUÀ¼À£ÀÄß w½zÀÄ CzÀPÉÌ ¨ÉÃPÁzÀ
aQvÉì¬ÄAzÀ [ ]
3. K£ÀÄ ªÀiÁqÀ¢gÀĪÀÅzÀjAzÀ
[ ]
4. UÉÆwÛ®è [
]
17. ¸ÀÛ£ÀzÀ DgÉÊPÉ
1. ©¹ ¤Ãj¤AzÀ ¸ÀÛ£À ªÀÄvÀÄÛ vÉÆlÖ£ÀÄß
vÉƼÉAiÀÄĪÀÅzÀjAzÀ [ ]
2. ¸ÀzÁ ¸ÀÛ£À¥Á£ÀzÀ ªÉÆzÀ®Ä ¸ÀÛ£ÀªÀ£ÀÄß
vÉƼÉAiÀÄĪÀÅzÀjAzÀ [ ]
3. ¢£Á®Ä ¸ÁߣÀ ªÀiÁqÀĪÀÅzÀjAzÀ
[ ]
4. UÉÆwÛ®è [
]

18. ¸ÀÛ£À UÀnÖAiÀiÁUÀĪÀÅzÀÄ

1. ªÀÄUÀÄ«UÉ ºÁ®Ät¸À¢gÀĪÀÅzÀjAzÀ
[ ]
2. ¸ÀjAiÀiÁV ºÁ®Ät¸À¢gÀĪÀÅzÀjAzÀ
[ ]
 101

3. PÀÈvÀPÀ ºÁ®Ät¸À¢gÀĪÀÅzÀjAzÀ
[ ]
4. UÉÆwÛ®è. [
]

19. UÀnÖ¸ÀÛ£ÀªÀ£ÀÄß vÀqÉUÀlÖ®Ä

1. ¥ÀzÉ ¥ÀzÉ ¸ÀÛ£ÀUÀ¼À£ÀÄß SÁ°ªÀiÁqÀĪÀÅzÀjAzÀ
[ ]
2. gÁwæ ºÁ®Ät¸À¢gÀĪÀÅzÀjAzÀ
[ ]
3. ¸ÀÛ£À¥Á£ÀªÀ£ÀÄß ¤°è¸ÀĪÀÅzÀjAzÀ
[ ]
4. UÉÆwÛ®è. [
]

20. vÉÆnÖ£À ºÀÄuÁÚzÁUÀ ¤ÃªÀÅ vÉUÉzÀÄPÉƼÀÄîªÀ DgÉÊPÉ

1. ¸ÀÛ£ÀUÀ¼À£ÀÄß ±ÀÄzÀݪÁzÀ ¤Ãj¤AzÀ

vÉƼÉAiÀÄĪÀÅzÀjAzÀ [ ]
2. ¸ÀÛ£ÀUÀ¼À£ÀÄß ¸ÉÆÃ¥ÀÄ ªÀÄvÀÄÛ ¤Ãj¤AzÀ
vÉƼÉzÀÄ [ ]
3. ¸ÀjAiÀiÁzÀ PÀæªÀÄ¢AzÀ ºÁ®Ät¸ÀĪÀÅzÀjAzÀ
[ ]
4. UÉÆwÛ®è. [
]

¨sÁUÀ – 3

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ANNEXURE -13
¸ÀA±ÉÆÃzsÀ£ÉAiÀÄ°è ¨sÁUÀªÀ»¸À®Ä C£ÀĪÀÄw ¥ÀvÀæ

ªÀiÁ£ÀågÉ,

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CAUÀªÁV ¸ÀA±ÉÆÃzsÀ£ÉAiÀÄ£ÀÄß PÉÊUÉÆArzÉÝãÉ. £À£Àß
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vÁAiÀÄA¢gÀ°è ¸ÀÛ£À¥Á£ÀzÀ §Ä¢Ý ªÀÄvÀÄÛ DZÀgÀuÉUÀ¼À
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 107

Annexure – 14

FORMULAE USED IN THIS STUDY

1. S.D = √ ∑(X-X)2
n

N(AD-BC)2
2. χ2 =
(A+B)(B+C)(A+D)(B+D)

2r
1
3. r =
1+r

∑(X-X) (Y-Y)
4. r =

√∑ (X-X)2 √ ∑ (Y-Y)2

5. Yate’s correction = (|ad-bc|-N/2)2 x N

(a+b) (c+d) (a+c) (b+d)

 INTRODUCTION milk duct leads to ducts are branching out ƒ Do not give honey, sugar water, II.
towards the minute sac i.e. alveoli which glucose water, and cow’s milk to Sitting Position
Every year one million infants die, million produces the milk. Areola is the dark skin newborn baby. the mother
cradles the baby
of others are impaired because they are not immediately around the nipple is very in her arm. Her
adequately breast fed. To reduce illness & sensitive. This is very important for the Duration: hand supports the
baby’s head and
death among infants, the baby should be reflexes, which helps milk to come. Areola Baby should be fed at least 5-10 minutes neck.
given breast-feeding. has small swelling called Montgomery’s for each feed and should be fed on both
Breastfeeding: It is a natural resource tubercle. Which produce an oily fluid and breasts. Breast milk alone is sufficient for
ready to serve for 24 hours. Breast milk is lubricate the nipple while feeding. the newborn baby not even water up to 6
the best food for the baby . It is complete During pregnancy breast changes takes months. Popularly known as exclusive
food available in right quantity at the right place, where breast will increase in size, breast –feeding.
time. Easily digestible & well absorbed. It nipple becomes erect and area around Breast-feeding should be continued for 2 III.
contains all the nutrients required for all nipple will become dark. years & above. Baby should be given Football hold sitting or
leaning back, the baby is
round development of the baby. demand feeding. under the mother’s arm
Development of breast: At puberty girls Production of breast milk: with is feet pointing back.
His abdomen. Touches
breast begin to develop, first the area Breast milk production is a demand and Techniques of breast feeding: the side of the mother’
around the nipple increases in size until supply system. More demand result in Position: chest. The baby’s body is
supported by the
they become protuberant and conical in more supply. From the milk producing Mother can feed the baby in following mother’s arm. This
shape. By the end of adolescence breasts cells (alveoli) milk flows down through positions position is good for
feeding twins
are fully developed the small ducts into the sinuses just behind I Side lying position simultaneously.
the areola (black portion of breast just II Sitting position
ANATOMY & PHYSIOLOGY OF behind the nipple) from here baby actually III Football hold
BREAST transfers milk into his mouth with the help
Attachment:
of lips and tongue. Transfer of milk is a I.
Side lying
physiological process, which a baby and position lying on
mother, learn soon. The size of breasts has her side, with
mother, the
nothing to do with quantity or equality of mother support
breast milk. It is the frequency of suckling the baby’s head
and neck with her
& the ability of the mother to eject the arm. This
milk through the let down reflex. position is
comfortable for
night feeds and
Initiation of breastfeeding: when the mother
has a cesarean
Breastfeeding should be initiated as early operation.
as after delivery with in 30 minutes.
Anatomy & Physiology Colostrum: It is a first milk produced for 3
Breast is a glandular tissue, which produce days which is thick yellow colour fluid
milk. Each breast consists of about twenty ƒ Rich in nutrients Good attachment at the breast ensures sufficient
production, release, and flow of milk
segments of glandular tissue from which a ƒ Provides immunity
Burping : ƒ Economic
ƒ Prevents breast cancer
While sucking baby will swallow air that
should be removed to prevent indigestion Contraindications:
by putting the baby upright on the Mother should not feed the baby in
shoulder and patting the back. following condition
After feeding baby should be kept in right ƒ Cancer breast
side lying position. ƒ During radiation therapy.
There is a contraindication for
Hygiene:
breastfeeding the baby in breast infection,
Mother should start taking care during
tuberculosis, fever, Aids, inverted nipple
pregnancy itself by assessing the growth &
& small breast.
development of nipple. Identifying breast
ƒ Worries, tension, offering artificial
problems & taking remedial measures she
milk in between breast-feeding
should take bath daily.
leads to decrease in milk
ƒ Clean the nipple with plain water
production and accumulation of
ƒ Do not wash nipple with soap and
milk. To prevent this baby should
water. Otherwise it causes cracking
be given frequent feeding & even
of Nipple there by it become
How to ensure that baby is getting during night times also baby
painful while feeding.
adequate milk? should be breastfed.
Advantages:
ƒ Baby will gain weight. Conclusion:
Breastfeeding is advantageous for both
ƒ Passes urine for ad least 6 times a It has been recognized that there is a need
mother and baby.
day. for Promotion of exclusive breast feeding
For baby:
ƒ Leaves the breast easily, it won’t in the First 6 months of life and sustained
ƒ Easily digestible
breastfeeding together with adequate
cry often. ƒ Provides nutrition illness
complementary foods up to 2 years of age
ƒ Protection from illness
& beyond to reduce illness & death in
Diet: ƒ Gives immunity
children.
To avoid tiredness and for production of ƒ Emotional relationship between
more milk. Mother should take balanced infant and mother infant and
diet. Sources mother.
Milk, egg, green leafy vegetables, fish. ƒ Intelligence Developed by
Cereals & pulses. She should take more ƒ Sterile and hygienic Ms. Cicy Joseph
fluids. II YearM.Sc. Nursing
For Mother: Sarvodaya College of
ƒ It helps in rapid involution of Nursing
uterus & controls bleeding
ƒ Helps the mother in sliming.
ƒ Convinent for the mother
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