DETERMINANTS OF BREASTFEEDING PRACTICES IN DISTRICT ALIGARH.

Authors :

Dr Tabassum Nawab,

Prof. Zulfia Khan,

Dr M Athar Ansari,

Dr R Ahmed,

Dr E. Waqarib.

Department of Community Medicine, JNMCH, Aligarh.

Background:

• Exclusive breastfeeding - single most effective intervention for child survival.

• Universalising early & exclusive breastfeeding - major public health intervention to reduce mortality in the neonates and infants.

• Improving complementary feeding can reduce anemia and stunting .

Objectives :

1) To study the pattern of feeding of infants.

2) To study the factors determining the feeding practices.

3) To recommend ways to improve the same.

METHODOLOGY:

• Design: cross-sectional• Setting: antenatal & immunization clinic of Rural & Urban Health

Training Centers , Department of Community Medicine, Antenatal OPD & Pediatric OPD, JNMCH, Aligarh.

• Study unit: mothers of children aged >6 months till 5 years of age , attending these clinics.

• Inclusion Criteria:

A female having any child aged >6 months till 5 years , irrespestive of her current pregnancy status.

• Exclusion Criteria: A female having a child aged <=6 months or >5 years. Mother who did not give consent for interview.

• Study tool: A predesigned & pretested oral questionnaire. In case a female had more than one child in the required age group, she

was interviewed regarding the feeding practices in the youngest child.

• Sample size:

In total 354 mothers were interviewed during 15 days of survey.

• Sampling: Consecutive sampling was done , with 25 mothers per day.

• Analysis: was done using SPSS 17. Chi square test was applied to test statistical significance.

RESULTS

Table no.1.Distribution of study population by antenatal history and infant feeding practices

Frequency Percentage

Any ANC during index pregnancy 298 84.2

Received Advice for Breastfeeding during pregnancy196 55.4

Prelacteals given147 41.5

Breastfeeding started During 1st hour after birth 105 29.7

Exclusive Breastfeeding for 6 Months 152 42.9

Appropriate Complementary Feeding(started at completion of 6 months) 217 61.3

Table no.2.DETERMINANTS OF BREASTFEEDING PRACTICES

PLACE OF RESIDENCE

RURAL,n(%) URBAN,n(%) Chi-square df P-value

Breastfeeding started within 1 hr 17(16.2) 88(83.8) 12.991 4 0.011a

Prelacteals not given 39(45.3) 155(57.8) 5.604 2 0.061b

Exclusive breastfeeding for 6 Months 29(33.7) 123(45.9) 4.853 2 0.088b

Appropriate complementary feeding 44(20.3) 173(79.7) 4.920 1 0.027a

a - SIGNIFICANT, P < 0.05 b -NOT SIGNIFICANT,

Table no.3 EDUCATION LEVEL OF MOTHER

Up to primary education

Up to high school >High school Chi-

squaredf

P-value

Breastfeeding started within 1 hr 61(30.2) 27(28.7) 17(29.3) 14.370 8 0.073b

Prelacteals not given 89(52.4) 72(57.1) 33(56.9) 1.841 4 0.765b

Exclusive breastfeeding for6 month 77(38.1) 41(43.6) 34(58.6) 6.670 4 0.812b

Appropriate Complementary feeding 94(54.1) 82(65.1) 43(74.1) 8.485 2 0.014a

Table no. 4.DETERMINANTS OF BREASTFEEDING PRACTICES

PLACE OF BIRTH

Home Govt hospital Pvt hospitalChi-square

df P-value

Breastfeeding started within 1 hr 27(25.7) 55(52.4) 23(21.9) 34.699 8 0.000a

Prelacteals not given 41(21.1) 117(60.3) 36(18.6) 66.719 4 0.000a

Exclusive for 6 month 42(34.4) 82(52.6) 28(36.8) 12.618 4 0.013a

AppropriateComplementary feeding

49(40.2) 54(34.6) 34(44.7) 6.686 2 0.088b

Table no.5 Any ANC during index pregnancy

no yes Chi-square df P-value

Breastfeeding started within 1 hour 8(7.6) 97(92.4) 19.571 4 0.001a

Prelacteals not given 22(11.3) 172(88.7) 6.832 2 0.033a

Exclusive breastfeeding for 6 month 15(9.9) 137(90) 8.820 2 0.012a

AppropriateComplementary feeding

27(49.1) 102(35.1) 2.380 1 0.123b

a - SIGNIFICANT, P < 0.05 b -NOT SIGNIFICANT,

Table no. 6.DETERMINANTS OF BREASTFEEDING PRACTICES

ADVICE FOR BF DURING ANC

YES NO Chi-square df P-value

Breastfeeding within 1 hr 74(70.5) 31(29.5) 20.966 4 0.000a

Prelacteals not given 121(60.8) 73(47.1) 7.218 2 0.027a

Exclusive breastfeeding for 6 month 98(64.5) 54(35.5) 7.465 2 0.024a

Appropriate complementary feeding 70(35.2) 67(43.2) 2.380 1 0.123b

a - SIGNIFICANT, P < 0.05 b -NOT SIGNIFICANT,

CONCLUSION:

• Breastfeeding was started within 1 hr - 29.7% of infants • Exclusive Breastfeeding - 41.24% infants only.• Complementary feeding was started at appropriate time - 61.3% infants.• Breastfeeding started within 1 hr is affected significantly by urban residence, any

ANC, advice for BF given during pregnancy & institutional delivery.• Prelacteals administration is affected by any ANC, advice for BF given during

pregnancy & institutional delivery.• Exclusive breastfeeding for 6 Months is affected significantly by education of

mother, any ANC, advice for BF given during pregnancy & institutional delivery.• Appropriate complementary feeding is affected significantly by education of

mother and place of residence.

CONCLUSION:• Majority of the mothers living in urban areas started breastfeeding within 1 hour

after birth.• Complementary feeding was started appropriately in mothers who were urban and

were educated >high school.• Mothers who had even a single contact with health personnel, who received health

education regarding breastfeeding during pregnancy and who underwent institutional delivery were more likely to have good breastfeeding practices.

RECOMMENDATIONS:• IEC activities should be directed towards education of mothers .• Atleast three contact with the health personnel during antenatal period, as

recommended under RCH, and health education regarding breastfeeding during pregnancy should be ensured.

BAB-E-SYED

Thank you!