DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20201148

Barriers to exclusive breast feeding, the missing links: a cross sectional study from Puducherry, India

Gayathri G. Nair, Arul Kumaran Arunagirinathan, Nirmal S. R., Rajesh Yadav B.

Abstract


Background: Breast milk, the first natural food for a new-born, provides all the energy and essential nutrients an infant requires for the first 6 months of life. The NHFS -4 survey shows only 45.5% of children are exclusively breastfed (EBF) in Puducherry. This study aims at assessing the socio-demographic characteristics associated with exclusive breastfeeding in a tertiary hospital in Puducherry and identify the barriers in the promotion of exclusive breastfeeding.

Methods: Community-based cross-sectional study at a tertiary hospital in Puducherry. Sample size: 115 mothers of 6 months to 2-year-old children, born term gestation with a birth weight of >2.5 kg, attending the Paediatric OPD. Questionnaire-based study comprising of socio-demographic and parameters pertaining to exclusive breast-feeding.

Results: Only 44.3% of the mothers have exclusively breastfed in the first 6 months. Shorter duration of spacing between births and caesarean section had significant negative association with exclusive breast-feeding. Most of the mothers received postnatal counselling on breast-feeding (94%) of which 58% were by health care personnel. Despite that, only a sixth (19%) of them were well versed with proper breastfeeding techniques. Poor secretion (45.3%), sore/inverted nipple (23.5%) amounted to the most common of the barriers. Among working mothers, 42.9% attributed their jobs as the cause for early weaning.

Conclusions: The prevalence of exclusive breastfeeding is still low even among a literate study group. There were no significant association with socio-demographic factors found, but lacunae were identified. A more objective post-natal counselling to mothers involving their caregivers may improve the current scenario.


Keywords


Barriers, Exclusive breastfeeding, Puducherry, Socio-demographic factors

Full Text:

PDF

References


Chowdhury R, Sinha B, Sankar MJ, Taneja S, Bhandari N, Rollins N, et al. Breastfeeding and maternal health outcomes: a systematic review and meta‐analysis. Acta Paediatrica. 2015;104(S467):96-113.

Gupta A, Arora V. The State of World’s Breastfeeding -Tracking Implementation of the Global Strategy for Infant and Young Child Feeding. International Baby Food Action Network (IBFAN), Asia Pacific. South Asia report. Feb 2007.

WHO (world health organization) Breastfeeding. Available at: http://www.who.int/ maternal_child_adolescent/ topics/ child/ nutrition/breastfeeding/en/. Accessed 26 December 2019.

Infant and young child nutrition: Global strategy on infant and young child feeding. Available at: http://apps.who.int/gb/archive/pdf_files/WHA55/ea5515.pdf. Accessed 01 January 2020.

Imdad A, Yakoob MY, Bhutta ZA. Effect of breastfeeding promotion interventions on breastfeeding rates, with special focus on developing countries. BMC Public Health. 2011;11(3):24.

United Nations Children's Fund (UNICEF): Progress for Children: A Child Survival Report Card 2004. Available at: https://www.unicef.org/progressforchildren/2004v1/ Accessed 29 December 2019.

Najem B. Breast Feeding Problems in Primipara Mothers in Early Postnatal Period. Iraq J Commu Med. 2011;24(3):192-5.

CheZem J, Friesen C, Boettcher J. Breastfeeding knowledge, breastfeeding confidence and infant feeding plans: Effects on actual feeding practice. J Obstetr Gynecol Neonat Nurs. 2003;32(1):42-7.

National Family Health Survey, India. Key indicators for India from NFHS-4;2015. Available at: http://www.nfhsindia.org/pdf/India.pdf. Accessed 30 December 2019

Bandyopadhyay M. Impact of ritual pollution on lactation and breastfeeding practices in rural West Bengal, India. Inter Breastfeeding J. 2009;4(1):2.

Radhakrishnan S, Balamuruga SS. Prevalence of exclusive breastfeeding practices among rural women in Tamil Nadu. Inter J Health Allied Sci. 2012;1(2):64.

Malhotra P, Malik S, Virk N. Prospective study to assess knowledge, attitude and breast-feeding practices of post-natal mothers in Punjab, India. Inter J Contem Pediatr. 2017;5(1):139-43.

Tiwari R, Mahajan PC, Lahariya C. The determinants of exclusive breastfeeding in urban slums: a community based study. J Tropic Pediatr. 2008;55(1):49-54.

Renitha R, Babu TA, Kumar M, Srinivasan S. Breast feeding practices among health care professionals in a tertiary care hospital from South India. Indian J Public Health. 2012;56:149-51.

Chudasama RK, Patel PC, Kavishwar AB. Determinants of exclusive breastfeeding in south Gujarat region of India. J Clin Med Res. 2009; 1:102-8.

Ahmad S, Yadav M, Shukla NK, Shukla M, Soni S, Patni KN. Assessment of breastfeeding practices in a rural area of North India. Ind J Basic Applied Med Res. 2016 Mar;5:40-7.

Kashif M, Mirza S, Pandey A, Shukla KM, Mishra P. Study of breast feeding practices, problems and factors affecting exclusive breastfeeding in Barabanki District of Uttar Pradesh-A Hospital Based Study. Ind J Prevent Social Med. 2018;49(2):73-83.

Aggarwal A, Verma S, Faridi MM. Complementary feeding—reasons for inappropriateness in timing, quantity and consistency. Indian J Pediatr. 2008 Jan 1;75(1):49-53.

Pooja JM, Aditya JM, Sangamesh JM, Margol S. Study of breastfeeding practices and problems among postnatal mothers: a hospital based study. Int J Reprod Contracept Obstet Gynecol. 2017;6(8):3343-6.

Senthilvel V, Sumathi S, Singh Z, Jayanthi V. A study of breastfeeding practices among non-working women in rural area of Puducherry. Ind J Maternal Child Health. 2011;13(3):12.

Dhandapany G, Bethou A, Arunagirinathan A, Ananthakrishnan S. Antenatal counseling on breastfeeding–is it adequate? A descriptive study from Pondicherry, India. Inter Breastfeeding J. 2008;3(1):5.

Prasad KN, Ahamed N. Community based study on initiation of breast feeding and determining factors in rural area of Pondicherry. Int J Contemp Pediatr. 2015;2:208-12.

Adhikari M, Khanal V, Karkee R, Gavidia T. Factors associated with early initiation of breastfeeding among Nepalese mothers: further analysis of Nepal Demographic and Health Survey, 2011. Inter Breastfeeding J. 2014 Dec;9(1):21.

Patel A, Banerjee A, Kaletwad A. Factors associated with prelacteal feeding and timely initiation of breastfeeding in hospital-delivered infants in India. J Human Lactation. 2013 Nov;29(4):572-8.

Sandor M, Dalal K. Influencing factors on time of breastfeeding initiation among a national representative sample of women in India. Health. 2013;5:2169-80.

Ekambaram M, Bhat VB, Ahamed MA. Knowledge, attitude and practice of breastfeeding among postnatal mothers. Curr Pediatr Res. 2010;14(2):119-24.

Subbiah N. A Study to assess the Knowledge, Attitude, Practice and Problems of Postnatal Mothers regarding Breastfeeding. Nursing J Ind. 2003;94(8):177-9.

Tiwari V, Singh A. Knowledge, attitude and practice regarding breastfeeding in an urban area of Fazidabad district (U.P). Indian J Prev Soc Med. 2007;38(1):18-22.

Parmar VR, Salaria M, Poddar B, Singh K, Ghotra H, Sucharu. Knowledge, attitudes and practices regarding breast feeding at Chandigarh. Indian J Public Health. 2000;44:131-3.

Agarwal A, Arora S, Patwari AK. Breastfeeding among urban women of low-socioeconomic status: Factors influencing introduction of supplemental feeds before four months of age. Indian J Pediatr 1998;35:269-73.

Parekh C, Bavdekar SB, Shaharao V. Study of infant feeding practices: Factors associated with faulty feeding. J Trop Pediatr. 2004;50:306-8.

Mallikarjun HB, Banapurmath CR, Shobha B, Kesari N. Breastfeeding problems in first 6 months of life in rural Karnataka. Indian Pediatr. 2002;39:861-4.

Rajan BP, Sindhu S. Awareness and Difficulties Encountered By The Postnatal Mothers During Breast Feeding. Nat J Res Commu Med. 2016;5(4):262-7.

Ratnayake HE, Rowel D. Prevalence of exclusive breastfeeding and barriers for its continuation up to six months in Kandy district, Sri Lanka. Inter Breastfeeding J. 2018;13(1):36.

Li R, Fein SB, Chen J, Grummer-Strawn LM. Why Mothers Stop Breastfeeding: Mothers’ Self-reported Reasons for Stopping During the First Year. Pediatr. 2008;122:69-76.

Sur D, Mondal SK, Gupta DN, Ghosh S, Manna B, Sengupta PG. Impact of breast feeding on weight gain and incidence of diarrhea among low birth weight infants of an urban slum of Calcutta. Indian Pediatr. 2001;38:381-4.

Mihrshahi S, Oddy WH, Peat JK. Association between infant feeding patterns and diarrhoeal and respiratory illness: A cohort study in Chittagong, Bangladesh. Int Breastfeed J. 2008;3:23-8.