INTRODUCTION:

Breastfeeding or nursing is the feeding of babies and young children with milk from a woman's breast. Health professional recommend that breastfeeding begin within the first hour of a baby's life and it be allowed as often and as much as the baby wants. During the first few weeks of life babies may nurse eight to twelve times a day (every two to three hours). The duration of a feeding is usually ten to fifteen minutes on each breast. The frequency of feeding decreases as the child gets older. Some mothers pump milk so that it can be used later when their child is being cared for by others. Breastfeeding benefits both mother and baby as Infant formula does not have many of the benefits.¹

Benefits of breastfeeding for the mother include less blood loss following delivery, better uterus shrinkage, weight loss, and less postpartum depression. It also increases the time before menstruation and fertility returns, known as lactation amenorrhea. Long term benefits may include a decreased risk of breast cancer, cardiovascular disease, and rheumatoid arthritis. Breastfeeding is less expensive for the family than infant formula.²

Exclusive breastfeeding has many benefits for the baby and mother. Most important of which is the protection from gastric and intestinal contagious infections that cannot be noticed not only in developing countries but also in industrialized countries as well the mother’s milk is also one of the important sources of energy and nutrients for children aged between 6 months and 23 months. It can provide half of the energy needs or more than that for children aged 6- 12 months, and one-third of the energy needs of children aged 12-24 months. The mother’s milk as well as an important source of energy and nutrients during infection, as it limits the death rates of children suffering from malnutrition.³

Breastfeeding promotion refers to coordinated activities and policies to promote health among women, newborns and infants through breastfeeding. The World Health Organization (WHO) recommends infants should be exclusively breastfed for the first six months of life to achieve optimal health and development, followed by complementary foods while continuing breastfeeding for up to two years or beyond. However, currently fewer than 40% of infants under six months of age are exclusively breastfed worldwide. Public health awareness events such as World Breastfeeding Week, as well as training of health pofessionals and planning, aim to increase this number.⁴

Health outcomes in developed countries differ substantially for mothers and infants who formula feed compared with those who breastfeed. For infants, not being breastfed is associated with an increased incidence of infectious morbidity, as well as elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome. For mothers, failure to breastfeed is associated with an increased incidence of premenopausal breast cancer, ovarian cancer, retained gestational weight gain, type 2 diabetes, myocardial infarction, and the metabolic syndrome. Obstetricians are uniquely positioned to counsel mothers about the health impact of breastfeeding and to ensure that mothers and infants receive appropriate, evidence-based care, starting at birth.⁵

From the above facts and figures it is evident that postnatal Mothers of infants knowledge has a significant influence on the favorable attitude of mothers towards Breast feeding practices. Breast feeding plays a vital role for the infant nutrition’s especially for the first few weeks of pregnancy and will protect the baby from various infections and promotes immunity level. Hence mothers of infant age group 0-1 years have a key role towards Breast feeding practices. Hence the researcher thought to conduct the study on Post natal mothers Knowledge and attitude on Breast feeding.

NEED OF THE STUDY:

There is a growing concern recently about the changing patterns of breastfeeding, especially in societies in rapid transition, such as Saudi Arabia. Breastfeeding is the normal way of providing young infants with the nutrients they need for healthy growth and development.⁶

In an estimated 35% of all deaths of children under five years of age, under-nutrition is the underlying cause of death. Including underweight, suboptimal breastfeeding, and vitamin and mineral deficiencies. The proportion of underweight children in developing countries declined from 28% to 17% between 1990 and 2011. Although this rate of progress is close to the rate required to meet the relevant target, significant variations persist between and within regions.⁷

Malnutrition stands behind 35 % of disease burden on children under the age of five. It is worth mentioning that the feeding of infants and young children of the key areas to improve child survival and promote the growth and development of children healthily. The first two years of a child’s life is particularly important, where he managed the ideal nutrition during this period of reduced morbidity and mortality, and reduce the risk of chronic diseases, and improve the overall development of the child. In fact, the best practices in the areas of breastfeeding and complementary feeding are important degree awarded by the ability to save the lives of 1.5 million children under the age of five every year.⁸

OBJECTIVES:

1. To assess the pretest knowledge and attitude regarding breast feeding among postnatal mothers of infants.

2. To assess the posttest knowledge and attitude regarding breast feeding among postnatal mothers of infants.

3. To evaluate the effectiveness of planned teaching programme on knowledge and attitude regarding breast feeding among postnatal mothers of infants.

4. To find out the association between pretest knowledge and attitude of post natal mothers of infants regarding breast feeding with selected socio- demographic variables such as age, religion, education, occupation, type of family, number of children, family income, source of information, etc.

METHODOLOGY:

RESEARCH APPROACH:

Quantitative Pre-experimental approach was used in the present study.

RESEARCH DESIGN:

One group Pretest – Posttest research design was adopted.

RESEARCH SETTING:

The study was conducted in selected rural areas (villages, Bhadson, Saiya, fatehpur, Babarpur and kakrala) of Patiala, Punjab.

TARGET POPULATION:

The population of the study were all postnatal mothers of infants age group (0 - 1years) residing in selected rural areas of Patiala, Punjab.

SAMPLE SIZE:

Total samples selected comprising of 50 postnatal mothers residing in selected rural area of Patiala, Punjab. (N= 50)

SAMPLING TECHNIQUE:

Simple random sampling technique was used to select the samples.

CRITERIA FOR SELECTION OF SAMPLE: Inclusion Criteria:

Postnatal mothers who

· Were residing in selected rural area of Patiala.

· could understand and read Punjabi, Hindi

· had of infant age group (0 - 1years)

Exclusion criteria:

Postnatal mothers who

· Were not present at the time of study.

DESCRIPTION OF THE TOOL:

In this study, the investigator has prepared a tool comprising of three parts.

SECTION- A:

Socio- demographic variable.

SECTION- B:

interview schedule to assess knowledge of postnatal mother of infants regarding breast feeding.

SECTION- C:

Likert Scale to assess the Attitude regarding breast feeding among postnatal mothers of infants residing in selected rural areas of Patiala, Punjab.

SECTION -A:

Socio-demographic variables: It consist of 8 items for obtaining information about as age , religion, education , occupation , type of family, number of children in family, family income and source of information of postnatal mothers of infants

SECTION –B:

Self Structured Interview schedule to assess Knowledge on Breast feeding among Post natal mothers of infants.

Multiple choice questions were prepared three distracters with one correct answer. It consists of 36 items.

CRITERION MEASURE:

For each correct response score “one” will be assigned.

For each wrong response score “zero” will be assigned.

The total minimum and maximum score of knowledge assessment found to be “zero” and “36” respectively.

Inference was drawn as below:

Good: 75% and above

Average: 51-74 %

Poor: 50 and below

SECTION –C:

Likert Scale to assess the attitude regarding breast feeding among postnatal mothers residing in selected rural areas of Patiala, Punjab.

It consists of 15 items in the first draft to assess the attitude of postnatal mothers regarding Breast feeding.

SCORING PATTERN:

1 Score 0Disagree

2 Score 1Partially agree

3 Score 2 Agree

4 Score 3 Strongly Agree

Content Validity:

The prepared tool along with the objective of the study, self-structured interview schedule to assess knowledge and attitude check list blue print were submitted to experts for content validity. Five experts from the field of Community health nursing and one from the field of statistics. The experts were requested to give their opinion regarding adequacy, relevance and appropriateness of the content.

Reliability:

The reliability of the tool is computed by using Split half technique method. The reliability was established by using split half method and it was found to be r= 0.93and Validity coefficient of tool found to be r= 0.92 indicate that the tool was statistically significant and thus the tool was reliable.

DISCUSSION:

The findings of the study were based on its objectives and are discussed under the following headings:

First Objective:

To assess the pre-test knowledge score and attitude score regarding breast feeding among postnatal mothers of infants residing in selected rural areas of Patiala, Punjab.

Out of 50 postnatal mothers 32 (64%) of the postnatal mothers had poor knowledge, 12 (24%) of the postnatal mothers had average knowledge and 06 (12%) postnatal mothers had good knowledge.

Out of 50 postnatal mothers, majority 33(66%) of the postnatal mothers had favorable attitude towards breast feeding, 17(34%) postnatal mothers had unfavorable attitude towards breast feeding.

Second objective: To assess the posttest knowledge score and attitude score regarding breast feeding among postnatal mothers of infants residing in selected rural area of Patiala, Punjab

Out of 50 postnatal mothers 43 (86%) of the postnatal mothers had good knowledge, 07 (14%) of the postnatal mothers had average knowledge and none of the postnatal mothers had poor knowledge.

Out of 50 postnatal mothers, majority 50 (100%) of the postnatal mothers had favorable attitude towards breast feeding and none of the postnatal mothers had unfavorable attitude towards breast feeding.

Third objective:

To evaluate the effectiveness of planned teaching programme on knowledge and attitude regarding breast feeding among postnatal mothers of infants residing in selected rural area of Patiala, Punjab.

The mean percentage difference between the pretest and posttest levels of knowledge was 34.56, the mean and standard deviation was 12.44±1.77. The calculated paired t test value was 23.28, df=49, P<0.05. Hence the structured teaching programme was effective. Hence, hypothesis H¬¬1 of the study is accepted.

The mean percentage difference between the pretest and posttest levels of attitude was 19.95, the mean and standard deviation was 8.98±5.01. The calculated paired t test value was 13.78, df=49, P<0.05. Hence the structured teaching programme was effective. Hence, hypothesis H¬¬2 of the study is accepted.

Fourth objective:

To find out the association of pre-test knowledge and attitude score of post natal mothers regarding breast feeding with selected demographic variables such as age, education, occupation, class, family income, type of family, residential area etc.

Association between the pretest levels of knowledge with selected demographic variables was obtained. The chi square test was used to find the association, the calculated chi square value for the, education of mother χ2=12.35, df=4, S*, occupation of the mother,χ2=12.35, df=4, S* and number of children χ2=10.53, Df=3, S* was found to be significant. The other demographic variables did not show the significant association. Hence, hypothesis H3 of the study is accepted for the above demographic variables.

CONCLUSION:

The Pretest level of knowledge of postnatal mother regarding breast feeding, It states that out of 50 postnatal mothers 32 (64%) of the postnatal mothers had poor knowledge, 12 (24%) of the postnatal mothers had average knowledge and 06 (12%) postnatal mothers had Good knowledge. Out of 50 postnatal mothers 43 (86%) of the postnatal mothers had good knowledge, 07 (14%) of the postnatal mothers had average knowledge and none of the postnatal mothers had poor knowledge in the Post test.

Therefore, it was concluded that majority of the postnatal mothers had good knowledge and one - third of postnatal mothers had average knowledge regarding breast feeding.

The Pretest level of attitude of postnatal mother regarding breast feeding. It states that out of Out of 50 postnatal mothers, majority 33(66%) of the postnatal mothers had favorable attitude towards breast feeding, 17(34%) postnatal mothers had unfavorable attitude towards breast feeding. Out of 50 postnatal mothers, majority 50 (100%) of the postnatal mothers had favorable attitude towards breast feeding and none of the postnatal mothers had unfavorable attitude towards breast feeding in the Post test. There was a significant association between Pretest knowledge and demographic variables of postnatal mothers such as education, occupation, and number of children.

FINDINGS OF STUDY:

In the Pretest knowledge level, Majority 32 (64%) of the postnatal mothers had poor knowledge and minority 06 (12%) of the postnatal mothers had good knowledge. In the Pretest attitude level, Majority 33 (66%) of the postnatal mothers had favorable attitude and minority 17 (34%) of the postnatal mothers had had unfavorable attitude.

In the Post- test knowledge level, Majority 43 (86%) of the postnatal mothers had good knowledge and minority 07 (14%) of the postnatal mothers had average knowledge. In the Post test attitude level, all the postnatal mothers of infants had favorable attitude and none of the postnatal mothers had unfavorable attitude towards breast feeding.

The association between the pre test levels of knowledge with selected demographic variables. The chi square test was used to find the association, the calculated chi square value for the, education of mother χ2=12.35, df=4, S*, occupation of the mother, χ2=12.35, df=4, S* and number of children χ2=10.53, Df=3, S*. The other demographic variables did not shown the significant association. The association between the pre test levels of attitude with selected demographic variables. The chi square test was used to find the association, the calculated chi square value for the, education of mother χ2=16.98, df=4, S*, number of children χ2=13.73, df=3, S* and source of information χ2=8.02, df=3, S*. The other demographic variables did not show the significant association.

RECOMMENDATIONS:

On the basis of the findings of the study following recommendations have been made.

· A similar study can be replicated on large sample to generalize the findings.

· An experimental study can be conducted with control group for the effective comparison of the results.

· A study can be carried out to evaluate the efficiency of various teaching strategies like self-instructional module, pamphlets, leaflets, and computer assisted instruction on Breast feeding.

· A study can be conducted by including other additional socio- demographic variables that may influence the level of knowledge of the postnatal mothers.

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Received on 21.08.2018 Modified on 05.09.2018

Int. J. of Advances in Nur. Management. 2019; 7(1):01-05.

DOI: 10.5958/2454-2652.2019.00001.5