INTRODUCTION:

Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The chief function of a lactation is to provide nutrition and immune protection to the young after birth¹.

Due to lactation, the mother-young pair can survive even if food is scarce or too hard for the young to attain, expanding the environmental conditions the species can withstand. and between mothers and populations. It is influenced by genetic and environmental factors, by infant sex and infective status, as well as by maternal lifestyle, including dietary habit¹. It is widely reported that maternal diet influences the nutritional composition of breast milk. Eating a healthy diet while you are breastfeeding is important because what you eat determines the energy, protein, nutrient and vitamin content of your breast milk. From conception to exclusive breast feeding (first 6 months) the baby completely depends on mother's nutritional status. If the mother is underweight or not gaining optimal weight during pregnancy the nutrients that are transferred to the baby will be of poor quality and quantity. From conception to exclusive breast feeding (first 6 months) the baby completely depends on mother's nutritional status. If the mother is underweight or not gaining optimal weight during pregnancy the nutrients that are transferred to the baby will be of poor quality and quantity³. On the other hand, if the mother is overweight, it will hamper the blood circulation to the uterus and restricts the quantity of nutrients transferred to the placenta and to the baby. There is a considerable increase in the nutritional needs of the mother. The growth and development of the baby is determined by the food taken by the mother.³

NEED FOR THE STUDY:

Like in pregnancy, adequate nutrition of the mother during lactation is of vital importance since during the first few months of life, the infant derives all the nutrition from the mother's milk. The child does not need anything over breast milk for the initial six months. Generally, the child is breastfed for six to nine months. As the mother has to nourish a fully developed and rapidly growing infant, she needs extra nutrients to meet the baby's needs in addition to her own requirements. Any inadequacies in her diet influences both the quantity and quality of milk secreted, though the effect on quantity is more.⁴

A well-nourished mother on an average secretes about 850ml milk/day, whereas in case of a severely-malnourished mother, the level may go down to as low as 400ml/day. However, the quality of breast milk does not suffer as much with reduced nutrition. Even if the diet is not able to meet her own nutritional needs, the mother draws on her body reserves to meet the needs of lactation at the cost of her own health. Dietary deficiencies of water-soluble vitamins lead to lower levels of these vitamins in breast milk. The protein, calcium and carbohydrate content is not altered even if the mother is malnourished.⁴

It is therefore extremely important for the lactating mother to take adequate nutrients so that she can not only nourish her child but also maintain her own nutritional status. Thus, nutritional needs are increased during lactation for sufficient breast milk production, for providing adequate nutrients to the infant and to meet the mother's daily needs⁴.

Pradhan.A et al⁵ (2017) conducted a study to assess the knowledge and practice on selected aspects of postnatal care among postnatal mothers. A descriptive approach with descriptive correlation research design was used to assess the knowledge and practice on selected aspects of postnatal care among postnatal mothers. The study was carried out in Banashankari Referral Hospital, Bangalore. The purposive sampling technique was used to select the 60 samples of postnatal mothers. The collected data were analyzed by using descriptive and inferential statistics. Thirty-Three (55%) respondents were having moderately adequate knowledge regarding selected aspects of postnatal care, 24(40%) were having inadequate knowledge and only 03(05%) of respondents had adequate knowledge. The level of practice was out of 60 respondents, 29(48.33%) respondents were having inadequate practices, 26(43.33%) were having moderately adequate practices and only 05(08.34%) of them had adequate practices on selected aspects of postnatal care. The postnatal mothers had moderately adequate knowledge and practices on selected aspects of postnatal care. The study suggests that the postnatal mothers require educational instructions for improving the knowledge and practice.⁵

Pangshatabam Bidyarani Devi⁶ conducted a study to assess the effectiveness of structured teaching programme on knowledge and practice regarding diet during lactation among lactating mothers in selected hospital at Bangalore. The research design used for this study was pre-experimental one group pre test and post test design. The study originated with a sample of 60 lactating mothers as a sample size for explicating the to assess the effectiveness of structured teaching programme on Knowledge and Practice regarding diet during lactation among lactating mothers in selected Hospital at Bangalore. A structured questionnaire was selected as appropriate method of data collection for the study. The collected data were organized, tabulated, analyzed and interpreted by means of tables and graphs. It is observed from the present study that the mean as well as the standard deviation of the knowledge on diet during lactation during the pretest is 4.33 and 1.32 and during the posttest it is 11.83 and 1.89. The difference in the mean knowledge score on diet during lactation is statistically highly significant (<0.001). The study shows that the lactating mothers are having inadequate knowledge (98.3%) on diet during lactation⁶.

The above study have proved that mothers do not have enough knowledge about diet during lactation and they expect adequate information regarding diet during lactation. Therefore, it’s a necessity to teach the mothers about diet during lactation.

PROBLEM STATEMENT:

A study to assess the effectiveness of Planned Teaching program on knowledge regarding diet during lactation among primi lactating mothers in selected community area, Satna.

OBJECTIVES:

1. To assess the level of knowledge regarding diet during lactation among primi mothers in selected community area, Satna.

2. To assess the effectiveness of planned teaching programme on knowledge regarding diet during lactation among primi mothers in selected community area Satna.

3. To find out the association between the pretest knowledge score of primi mothers regarding diet during lactation with their selected demographic variables.

HYPOTHESIS:

H₁: There is a significant difference between the pre test and post knowledge score of primi mothers regarding diet during lactation.

H₂: There is a significant association between the pre test knowledge score of primi mothers with their selected demographic variable at 0.05 level of significance.

METHODOLOGY:

Research approach: Quantitative evaluative approach.

Research design: Pre experimental one group pre test post test design.

Setting: Data collected from selected community area, Satna.

Sample and sampling technique: 40 primi mothers were selected by using simple random sampling method.

Variables:

Independent variable: Planned teaching program regarding diet during lactation.

Dependent variable: Knowledge regarding diet during lactation.

Description of Tool:

Part I: Demographic data.

Part II: Structured knowledge questionnaire regarding diet during lactation.

Validity of tool:

5 experts, comprising of 4 nurse educators from the department of Obstetrics and Gynecology and 1 Statistician, established content validity of the tool.

Reliability of tool:

The data of the structured knowledge questionnaire was analysed by split half method and the reliability coefficient was calculated using Spearman Brown Prophecy formula. The reliability co- efficient of the tool was found to be 0.93. Hence the tool was found to be reliable.

Data collection:

A pretest was conducted by using structured knowledge questionnaire and on the same day the planned teaching program regarding diet during lactation was administered to them. After 7 days, post test was conducted with the same questionnaire for the same group of primi lactating mothers to assess the effectiveness of planned teaching program.

Analysis and interpretation of data:

The collected data were analyzed in terms of both descriptive and inferential statistics.

RESULTS:

Table.1: Section 1: Analysis of sample characteristics

Sl. No	Demographic characteristics	Frequency	Percentage
1.	Age(yrs)
	19-22 year	10	25%
	23-26 year	20	50%
	27-30 year	10	25%
2.	Residential area
	Rural	20	50%
	Urban	20	50%
3.	Type of family
	Joint	10	25%
	Nuclear	30	75%
4.	Type of food
	Vegetarian	10	25%
	Non vegetarian	30	75%
5.	Educational status
	Illiterate	5	12.5%
	Primary	5	12.5%
	Secondary	20	50%
	Graduate/ postgraduate	10	25%
6.	Mode of delivery
	Normal vaginal	30	75%
	Instrumental delivery	0	0%
	Caesarian	10	25%
7.	Monthly income
	Less than 5000 Rs	0	0%
	5001-10,000 Rs	10	25%
	Above 10,001Rs	30	75%
8.	Source of information
	Medical and nursing personal	5	12.5%
	Friends and relatives	5	12.5%
	Social media	10	25%
	No source of information	20	50%

The mean score is increased in the post test. The mean score in the post test is 24.4 and the mean score in the pre test is 10.5. The variation is decreased in post test when compared to pre test.SD in the post test is 2.8 and in the pre test is 1.45. The mean is improved by 13. The calculated value of t is 30.2 which is highly significant. The results undoubtedly confirm that the planned teaching program was effective in improving the knowledge on diet during lactation among primi lactating mothers.

Table 3: Section III: Association between the demographic variables and knowledge of primi lactating mothers regarding diet during lactation in Pre-test.

Sl. No	Characteristics	Chi-square value	Df	Result	P-value
1.	Age	7.2	2	Sig	0.03
2.	Residential area	6.4	1	Sig	.011
3.	Type of family	4.8	1	Sig	0.03
4.	Dietary pattern	0.53	1	NS	0.47
5.	Educational status	8.8	3	Sig	0.03
6.	Mode of delivery	0	2	NS	0
7.	Monthly income of family	4.8	2	NS	0.09
8.	Source of information	11.8	3	Sig	.008

NS – Not significant at 5% level (i.e., P > 0.05)

Sig – Significant at 5% level (i.e., P < 0.05)

From the table, age, residential area, type of family, educational status and source of information are significant. The remaining characters are not significant.

DISCUSSION:

The main objective of the study was to determine the effectiveness of planned teaching program on knowledge regarding diet during lactation among primi lactating mothers by comparing pre test and post test knowledge score.

The pre-test findings of the study revealed that the overall score in the pre-test was mean10.5, standard deviation 1.45 and mean score percentage was 26.25%. This shows that the knowledge of mothers regarding diet during lactation was inadequate.

These findings are consistent with the findings of S R Rajitha. She conducted a pre-experimental study to assess the effectiveness of a structured teaching program on knowledge regarding diet during lactation among postnatal mothers in CSI mission hospital, Neyyoor. The sample consisting of 50 postnatal mothers was selected by using purposive sampling technique. The tool comprised of knowledge questionnaires and Likert five-point attitude scale. The pre-test knowledge level was 60.24+13.84 and the post-test knowledge level was 80.72+13.9. The mean difference was 20.48 and the ‘t’ value was 7.383. The pre-test attitude level was 53.04+7.9 and the post-test attitude level was 81.38+5.29. The mean difference was 28.34 and the ‘t’ value was 21.077. The obtained ‘t’ value was higher than the table value. Hence, it was highly significant at 0.05 level. The study concluded that, structured teaching program on diet during lactation was effective in terms of improving the knowledge and attitude of postnatal mothers⁷.

These findings provokes for imparting adequate knowledge and the need for teaching programs to improve knowledge of mothers on diet during lactation.

CONCLUSION:

In this study, pre test findings shows that the primit mothers had inadequate knowledge regarding diet during lactation. The mean score in the post test is 24.4, SD in the post test is 2.8 and the mean is improved by 13.9. The calculated value of t is 30.2 which is highly significant. The results undoubtedly confirm that the planned teaching program was effective in improving the knowledge on diet during lactation among primi lactating mothers. Knowledge of diet during lactation will help them to prepare for breast feeding, and maintain the health status during postnatal period. Therefore, it is very essential to give adequate information to the primi lactating mothers about diet during lactation.

REFERENCES:

1. Lactation; https://en.wikipedia.org/wiki/Lactation

2. Normal human lactation closing the gap-NCBI published 2018. www.ncbi.nlm.nih.gov

3. Nutrition during breast feeding health engine blog. health engine. Com.au.20sep.2007. https://healthinfo.healthengine.com.au/nutrition-during-breastfeeding

4. Nutrient needs in lactation: by maulishreejhawer, dr. simipaknaikar. MD on Jan 14,2019. www.medindia.net.

5. Pradan, A., and Rani, U. Knowledge and Practice on Selected Aspects of Postnatal Care Among Postnatal Mothers. Journal of Universal College of Medical Sciences. 2018; 5(1): 37–41. https://doi.org/10.3126/jucms.v5i1.19059

6. Pangshatabam Bidyarani Devi. Study to assess the effectiveness of structured teaching programme on knowledge and practice regarding diet during lactation among lactating mothers in selected hospital at bangalore. International Journal of Novel Research and Development. 2023; 8(4). Https://www.ijnrd.org/papers/ijnrd2304263.pdf

7. S R R. Effectiveness of structured teaching program on diet during lactation among postnatal mothers. Int. J. Heal. Clin. Res. [Internet]. 2018 Nov.30 [cited 2024Sep.18];1(1):9-18. Available from: https://www.ijhcr.com/index.php/ijhcr/article/view/8

Received on 19.09.2024 Revised on 23.10.2024

Accepted on 17.11.2024 Published on 20.11.2024

Available online on December 28, 2024

Int. J. of Advances in Nursing Management. 2024;12(4):199-202.

DOI: 10.52711/2454-2652.2024.00044

Parameter	Mean	S. D	SEM	Range	Mean%	t –value	Result
Pre-test	10.5	1.45	0.23	8-14	26.25%	30.2	Sig P<0.05
Post-test	24.4	2.8	0.46	17-30	61%
Improvement	13.9