INTRODUCTION:

Every child has the right to grow up in a healthy home, school, and community. The future development of our children and of their world depends on their enjoyment.^1,2A baby becomes a child and then reaches puberty, passes through the life of his or her parent, and disappears into an adult, a person, with his or her life and future.^3,4

Childhood is a very crucial period as far as development is concerned, due to the rapid changes that take place during this phase such as brain development, acquisition of various skills, and physical development. ‘Childhood’ is the period from birth to one year of age, when the language begins to thrive. It is the time of - happy "first" - first smile, first success catch, and the first proof of separation anxiety, first word, first step, and first sentence.⁵

During pregnancy and early life, the baby is affected by both internal physiologic and neurologic factors as well as external factors such as light, sound, touch, posture, taste, and movement. An infant’s ability to develop consistent and predictable responses to these internal and external motivations during the first five years of life is influenced by physical growth, brain development, environment, and the actions of the infant’s caregivers.⁶

Growth is a continuous process that begins in pregnancy and progresses at a different rate until about two decades later. The process of "growth" is accompanied by an increase in body size and/or weight to varying degrees. The multifactorial complexity is still remarkably predictable. Refers to the size of the whole body in any of its parts and can be measured in inches or inches and pounds or pounds. Development of maturity is termed the continuous growth of skills. It creates a quality change in a child's performance. The word maturity is often used as a synonym for development. Maturity produces an increase in ability, the ability to work at a higher level depending on a child's genetics.⁷

Developmental events are certain activities that most children can do at a particular age. Although each record is age-specific, the actual age at which a newborn child reaches that age may differ slightly. Every Child is unique.⁵

Approximately, 200 million children worldwide do not achieve their full potential in their first five years.^8,9 In India, approximately 10% of young children are growth retarded. The achievement of major events is often delayed. Some children have chronic motor impairments, such as cerebral palsy or other conditions, which are more common as children reach the age of five and older.¹⁰

Assessment of a Child’s development is a team effort in which the family plays an important role. The mother can even notice minor changes in the growth and development of her child. Also, parents are the child's first teachers and play a vital role in their child's learning and development.¹¹

Parental knowledge is considered as an indicator of parents' explanations of their children's behaviour and provides the basis for appropriate expectations of the child's developmental stage. Parental knowledge regarding parenting is crucial to a child's overall development.¹²The home is the first great training school in behavior or misbehavior and parents secure as the child's first teacher.¹³

A study of 392 mothers was conducted to assess maternal information about child development and to identify their source of information between the urban community of Faisalabad and Jaranwala, Pakistan. The results of the study revealed that only 14 mothers (3.57%) claimed that their source of child development was formal education/experience and 37 mothers (9.44%) reported that they had received information about child development on television, radio, newspapers, and talking to a pediatrician while 341 mothers reported receiving information through interviews with relatives and siblings.¹⁴

Researchers have shown that mothers who are more informed about their children's growth tend to be more supportive of their growth and development. Information about the various stages of a child's development can be helpful to detect developmental delays and health problems.^11,15,16

According to a study, the median difference of mother’s knowledge was 40.75% in the area of general information regarding growth and development, 34.66% in the area of physical growth, 25.33% in the area of fine motor development, 36% in the area of gross motor development, 32.25% in the area of sensory development, and 38.5% in the area of psychological development.¹⁷

Mother's knowledge regarding a child's development influence the way mothers raise their children. A study examined maternal factors that predict global levels of knowledge and content area. In total, women correctly answered 65% of the information questions addressed to the topic. Mothers did not know much about the baby's sleep patterns and developmental abilities at six-month of age. Maternal Knowledge about developmental milestones was associated with maternal education, race, number of children, and childcare assistance.¹⁰Another study reported that the highest pre-test mean score is between level 11-20 “poor” which is obtained by 56% but in the pre-test none of the mothers had secured within 31-40 and 41-50. The high post-test mean score maximum number 36(72%) of mothers had secured the score within 41-50, thus their knowledge level was Interpreted as Excellent.¹⁹

A mother who is well informed about a particular area may seek and/or receive information about developments in that area. For example, a mother who is preoccupied with preparing her child for school may focus on her strengths in improving school readiness and be especially concerned about children's language and intellectual development. ²⁰A study reported that most of the parents understood developmental milestones and their importance to find out the growth and developmental abnormalities easily.²¹

There is the availability of very little information about the mother's knowledge of child development in developing countries.²²Therefore, it is required to find the mother's knowledge of the developmental milestones or Growth and development.

MATERIALS AND METHODS:

Study design:

Descriptive (cross-sectional) research design.

Research setting:

The study was conducted in the pediatric OPD and gynecological unit (Postnatal Ward) of Dayanand Medical College and Hospital. The questionnaire was pre-tested on 10 mothers to assess its feasibility and clarity. Then the study was conducted on 100 mothers of neonates who were willing to participate and unable to understand English or Hindi or Punjabi. The sampling technique used was convenience.

Data Collection:

Data collection was done in May and June 2018. After explaining the purpose of the study, written consent was taken from the mothers before data collection. Data was collected from mothers who fulfill the inclusion criteria with the help of a structured knowledge questionnaire.

Data Collection tools:

The tool for data collection was divided into the following parts:

Part A: Socio-demographic characteristics of mothers:

Information like mothers’ age, marital status, religion, educational status, occupation, number of children, monthly income, type of family, and habitat was collected.

Part B: Knowledge questionnaire on developmental milestones:

Structured knowledge questionnaire comprised of 20 multiple choice questions regarding developmental milestones of infants.

Criterion measure

Level of knowledge	Scores	Percentage
Excellent	17-20	81-100
Good	13-16	61-80
Average	9-12	41-60
Poor	0-8	<40

Maximum Score = 20

Minimum Score = 0

Reliability of the tool:

The reliability of the tool(s) was established with the use of the split-half method. The reliability of the questionnaire was 0.7; it was calculated by the following formula:

r =

r' is the estimated reliability of the entire test i.e. was 0.8

Statistical Analysis:

Analysis of data was done in accordance with the objectives of the study. It was done with descriptive and inferential statistics which include t-test, ANOVA. The various statistical measures used for analysis were frequency distribution, measures of central tendency (mean), and measures of dispersion (standard deviation) to find out the statistical significance.

Ethical consideration:

Informed written consent was taken from mothers. The study was conducted after approval from the ethical committee of Dayanand Medical College and Hospital, Ludhiana, Punjab India.

RESULTS:

From 100 participants half of the mothers were having neonates of age between1-7 days, 16% of mothers were having neonates of age between 7-14 days,9% of mothers were having neonates of age between 15-21 days and the rest of the mothers were having neonates of age between 22-28 days i.e. 24%. Of 31% mothers were between the age group of 21-25 years, 5% were between the age of 26-30, 13% were between the age of 31-35 years and rest 6% were in the age group between 36-40 years. More than half of mothers i.e. 53% were educated up to graduation and above, 20% of the mothers were educated up to secondary education, 13% mothers were matriculated, 10% mothers were educated up to elementary, only a few mothers i.e. 4% were illiterate. More than half of mothers i.e.76% were not working and only 24% of mothers were working. More than half of the mothers i.e. 69% had one child, 29% of mothers had two childrenand the rest 2% of the mothers had three or more children. and 55% of the mothers were livingin a joint family, 44% were living in a nuclear family, and only 1% living in a separated family. As per religion, 43% belonged to the Hindu religion, belonged to the Sikh religion, and the rest of them i.e. 2% belonged to the Muslim religion. Half of the mother’s i.e. 57% belonged to urban areas and less than half of the mother’s i.e. 43% belonged to rural areas. As per their socioeconomic status, most of the mother’s i.e. 61% belongs to middle class, 35% of mothers belonged to the upper-middle class, 3% belong to the lower middle class and 1% belongs to the lower class.(Table 1)

Table 1: Distribution of mothers of neonates as per their socio-demographic characteristics-: N=100

Socio-demographic characteristics

Age of newborn (in days)

01-07

07-14

15-21

22-28

Mean age=11.64±9.43

Age of mother(in years)

21-25

26-30

31-35

36-40

Mean age = 27.79±3.94

Education of mother

Illiterate

Elementary

Matriculation

Secondary

Graduation and above

Occupation of mother

Not Working

Working

Total no. of children of mother

One

Two

Three or more

Type of family

Nuclear

Joint

Separated

Religion

Hindu

Sikh

Muslim

Residence

Rural

Urban

Socio-economic status (according to kuppuswamy scale 2018 )

Upper middle class

Middle class

Lower middle class

Lower class

From 100 mothers more than half of the mother’s i.e. 60% (13.78±0.94) had an average level of knowledge and 22% (6.91±1.16) of mothers had a poor level of knowledge and 18% (10.38±1.03) of mothers had a good level of knowledge (Table 2)

Table 2 Distribution of mothers as per their level of knowledge regarding developmental milestones of infants. N=100

Level of knowledge

Percentage

Scores

f (%)

Mean ± SD

Excellent

Good

Average

Poor

81-100

61-80

41-60

≤40

17-20

13-16

9-12

0-8

10.38±1.03

13.78±0.94

6.91±1.16

Maximum score = 20 Mean knowledge score = 10.240±2.40

Minimum score = 00

The mean percentage knowledge of mothers was highest i.e. 75.25% in the general information component followed by knowledge in developmental delay (53.33%), physical development (52.66%), social development (43.50%), motor development (41.75%), and least mean knowledge percentage i.e. 37.50% in language development. (Table 3)

Table 3: Distribution of various components of knowledge regarding developmental milestones among mothers of neonates

N = 100

Components of knowledge	Maximum scores	Mean ± SD	Mean % age
General information	4	3.010±0.758	75.25
Physical development	3	1.580±0.923	52.66
Motor development	4	1.670±0.985	41.75
Language development	4	1.500±0.822	37.50
Social development	2	0.870±0.705	43.50
Developmental delay	3	1.600±0.791	53.33

The socio-demographic variables like age of mother, education, occupation, number of children, type of family, religion, residence, and socioeconomic status are not associated with knowledge of mothers regarding developmental milestones. (Table 4)

Table 4: Association of knowledge regarding developmental milestones of infants with their socio-demographic characteristics.

N=100

Personal profile

Knowledge score

Mean ±SD

F/t value

p-value

Age of neonate (in days)

01-07

8-14

15-21

22-28

10.63±2.31

10.25±2.02

9.56±3.13

9.66±2.49

1.149

0.333

Age of mothers (in years)

21-25

26-30

31-35

36-40

10.09±2.48

10.16±2.37

10.00±2.45

12.16±1.60

1.405

0.246

Education of mother

Illiterate

Elementary

Matriculation

Secondary

Graduation and above

8.75±1.50

10.20±2.09

9.46±1.98

9.40±2.68

10.86±2.35

2.372

0.058

Occupation of mother

Not working

Working

10.41±2.33

9.71±2.59

0.542

0.463

Total no. of children

One

Two

Three or more

10.16±2.44

10.24±2.18

13.00±4.24

1.372

0.259

Type of family

Nuclear

Joint

Separated

10.55±2.39

10.09±2.33

5.00

2.959

0.057

Religion

Hindu

Sikh

Muslim

10.79±2.16

9.89±2.49

2.83±2.00

2.672

0.074

Residence

Rural

Urban

9.67±2.49

10.67±2.25

0.606

0.438

Socioeconomic Status

Upper Middle Class

Middle Class

Lower Middle Class

Lower Class

10.80±2.23

10.03±2.47

9.00±1.73

7.00

1.696

0.173

DISCUSSION:

The findings of the present study revealed that more than half of mothers i.e. 60% have an average level of knowledge and 22% of mothers had a poor level of knowledge and 18% of mothers had a good level of knowledge. A study on the level of knowledge regarding infant milestones among mothers of infants in 2016 revealed 36.6% of mothers have moderate knowledge, 63.3% of mothers have inadequate knowledge and no mother has adequate knowledge.²³

Furthermore, the current study revealed that mother’ s had the highest knowledge in general information regarding growth and development i.e. 75.25% followedby knowledge in developmental delay (53.33%), physical development (52.66%), social development (43.50%), motor development (41.75%) and having least mean percentage i.e. 37.50% in language development. Similar findings were reported in a study on Jordanian mothers’ knowledge about developmental milestones. Findings revealed that mothers have the highest knowledge score (79.3%) in social development and the least knowledge score (55%) in language development.¹²In contrast to the present study findings a studyon the knowledge of mothers regarding developmental abilities of children found that mothers’ knowledge about cognitive language and motor abilities was stronger than their knowledge about abilities in play and social development.²⁰

The study revealed that there is no association between the knowledge of mothers regarding developmental milestones and socio-demographics variables such as age, educational status, occupation of mother, type of family, religion, residence, and socioeconomic status.

In contrast to the present study findings, a study carried out to assess the knowledge of Iraqi mothers regarding the developmental milestones of their children and to find out if there was any association between the knowledge and certain demographic variables and findings revealed that there was a significant association between the mother’s age and their knowledge level and mothers in the age group 20-29 years were having highest knowledge score.¹¹

CONCLUSION:

It is concluded that more than half of mothers i.e. 60% had an average level of knowledge, 22% of mothers had a poor level of knowledge and 18% of mothers had a good level of knowledge and also it is concluded that there is no association between the knowledge levels of mothers with the selected socio-demographic variables.

CONFLICT OF INTEREST:

The authors have no conflicts of interest regarding this study.

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Received on 25.01.2022 Modified on 17.04.2022

Int. J. of Advances in Nur. Management. 2022; 10(4):315-320.

DOI: 10.52711/2454-2652.2022.00071