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ORIGINAL ARTICLE
Year : 2012  |  Volume : 1  |  Issue : 2  |  Page : 64-67

Prevalence of exclusive breastfeeding practices among rural women in Tamil Nadu


Department of Community Medicine, Vinayaka Missions Kirupananda Variyar Medical College, Salem, Tamil Nadu, India

Date of Web Publication27-Sep-2012

Correspondence Address:
Shankar Radhakrishnan
Department of Community Medicine, Vinayaka Missions Kirupananda Variyar Medical College, Chinna Seeragapadi, Salem - 636 308, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-344X.101667

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  Abstract 

Background: Poor infant feeding practices and their consequences are one of the world's major problems and a serious obstacle to social and economic development. Various studies have shown that infant feeding could be influenced by socioeconomic status, maternal education, place of living and many other factors. Hence a prevalence study on exclusive breastfeeding was conducted in rural Tamil Nadu. Aim and Objective: To assess the prevalence of exclusive breastfeeding practices and the factors influencing them among women in a rural area in Tamil Nadu. Materials and Methods: It is a cross-sectional study conducted in Attyampatti Panchyat Union, Salem district, Tamil Nadu, from March 2011-June 2011. All the 291 children in the age group of six months to two years in Attyampatti Panchayat Union were included in the study, irrespective of any sample. The data was analyzed using SPSS package. Results: Among the study population 52.6% were male children and 47.4% were females. Only 99 (34%) children were exclusively breastfed for six months. The majority of women (60.5%) initiated breastfeeding within half an hour after delivery. Various demographic factors like the education of the mother, type of delivery, type of family, occupation, number of children, monthly income, family size, age at marriage and religion had a direct influence on exclusive breastfeeding, which in turn influenced the weight of the baby and immune status of the child. Most of the mothers (44.7%) inferred that the main reason for giving bottle feed is because of inadequate breast milk secretion. Conclusion: The prevalence of exclusive breastfeeding is low in this particular area. Hence promotion of exclusive breastfeeding and focus on the factors affecting them is highly warranted in this area.

Keywords: Exclusive breastfeeding, prevalence, rural area


How to cite this article:
Radhakrishnan S, Balamuruga S S. Prevalence of exclusive breastfeeding practices among rural women in Tamil Nadu. Int J Health Allied Sci 2012;1:64-7

How to cite this URL:
Radhakrishnan S, Balamuruga S S. Prevalence of exclusive breastfeeding practices among rural women in Tamil Nadu. Int J Health Allied Sci [serial online] 2012 [cited 2019 Sep 16];1:64-7. Available from: http://www.ijhas.in/text.asp?2012/1/2/64/101667


  Introduction Top


Breastfeeding has been conclusively demonstrated as one of the important determinants for comprehensive growth and development of infants, more so among low birth weight infants. For any neonate, 'Breast is best' is now a universal concept. In spite of a worldwide campaign for promotion of breastfeeding, achievements are not up to the desired target. There are many factors which may affect feeding practices in our country. Various studies have shown that infant feeding could be influenced by socioeconomic status, maternal education, place of living and many other factors. [1],[2]

"Poor infant feeding practices and their consequences are one of the world's major problems and a serious obstacle to social and economic development. It is not only a problem of the developing world, it occurs in many parts of the developed world as well." [3]

The Government of India for the first time had included specific goals to improve infant feeding practices for reducing the Infant Mortality Rate (IMR), malnutrition and promoting integrated early child development in the 10 th Five-Year Plan. It also aimed to increase the rate of initiation of breastfeeding within 1 h to 50% from the current level of 15.8%, and to increase the exclusive breastfeeding rate to 80% during the first six months from the current level of around 41%. [4]

Though there have been global movements towards protecting, promoting and supporting breast milk as a part of optimal feeding practices among newborn babies, there exist many discrepancies between what has been recommended and what is being practiced in reality. [ 5 ] Therefore, the present study was undertaken to identify the prevalence of breastfeeding and various factors influencing it and the prevailing infant feeding practices in a rural area in Tamil Nadu.


  Aim and Objective Top


  1. To assess the prevalence of exclusive breastfeeding practices among women in a rural area in Tamil Nadu.
  2. To assess the factors influencing exclusive breastfeeding among the study population.

  Materials and Methods Top


A cross-sectional study was conducted in Attyampatti Panchyat Union, Salem district, Tamil Nadu, from March 2011-June 2011 after getting approval from the college ethical committee. All the women having children in the age group between six months to two years in Attyampatti Panchayat Union were included in the study, irrespective of any sample. The total population of Attayampatti Town Panchayat is 10,000. A total of 291 children were there in the age group of six months to two years. A validated ≠ semi-structured questionnaire was used related to demography, feeding practices of infants, reasons for bottle feeds, sickness episodes and vital data like height and weight were collected. The data was analyzed using SPSS Version 16. Statistical analysis like Chi square and multiple logistic regression were used.


  Results Top


Among the study population 52.6% were male children and 47.4% were females.

[Figure 1], bar chart, shows that there is an almost equal distribution of both sexes among children in all age groups from six months to two years.
Figure 1: Age and sex-wise distribution of the study population

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[Table 1] shows that only 99 (34%) children were exclusively breastfed for six months.
Table 1: Duration of exclusive breastfeeding among the study population

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Among males 51.5% and among females 48.5% were exclusively breastfed and this difference is not statistically significant. Hence sex is not a factor which influences exclusive breastfeeding.

[Table 2] shows that the majority of women (60.5%) initiated breast feeding within half an hour after delivery.
Table 2: Duration of initiation of breast feeding

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[Table 3] shows various demographic factors like education of the mother (literate/not literate), type of delivery (normal/caesarean), type of family (nuclear/non-nuclear), occupation (occupied/non-occupied), the total number of children the mother's of the study population were having (< 2/= and > 2), monthly income (< 5000/ = and > 5000), family size (< 4/ = and > 4), age at marriage (< 18/ = and > 18) and religion (Hindu/non-Hindu) having direct influence on exclusive breastfeeding. This was found to be statistically significant for type of delivery, type of family, family size and number of children.
Table 3: Multiple logistic regression for various demographic factors influencing exclusive breastfeeding. The dependant variable is exclusive breastfeeding

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[Figure 2] shows the reasons for bottle-feeding, where most of the mothers inferred that the main reason for giving bottle feed is because of inadequate breast milk secretion (64.6%). Other reasons were-poor weight gain (7.4%), unable to breastfeed (11.5%), and bottle feeding more nutritious than breast milk (12.4%). [Table 4] shows that among children, who were exclusively breastfed, 62.6% did not have any episode of illness. Only 26.2% had one to three episodes of illness and 11.1% had more than three episodes. On the contrary, among those who had not been exclusively breastfed, 40.6% had one to three episodes of illness, and 26.6% had more than three episodes of illness. This shows exclusive breastfeeding is protective to the baby as it helps to combat diseases by increasing the immune status of the child.
Figure 2: Reasons for bottle feeding in the study population

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Table 4: Breastfeeding practices and episodes of illness among the study population

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  Discussion Top


Medhi et al. in an article on Assam tea garden workers showed the prevalence of exclusive breastfeeding to be 69.35% up to six months of age, [6] and the results of a similar study done by C.R. Banapurmath et al. in Davanagere district showed that 73% of infants in the age group of 0-3 months were exclusively breastfed and 60% in the 4-6 months' age group. [7] A meta-analysis by Arun Gupta and Y. P. Gupta showed that more than half the children (54%) in the age group of 0-3 months were exclusively breastfed whereas this percentage was much lower (26%) for children in the age group of 4-6 months. [8] A similar study done by Rajesh et al. in Gujarat revealed that 37% of the infants were exclusively breastfed and also inferred that the factors influencing breastfeeding were parental education, number of deliveries by the mother and the maternal age. Whereas in our study exclusive breast feeding for the first six months is seen in 34%. [2]

According to the National Family and Health Survey - 3, 35.6% mothers in Karnataka had initiated breastfeeding within 1 h; especially for the urban population, it was 36.9%. The national average of mothers who had initiated breastfeeding within 1 h after the birth was 23.4%. [9] Similarly, a study done by Patricia et al. revealed that 11.6% infants in urban area and 9.4% infants in rural area were put to breast within the first hour; 33.3% infants in urban area and 25.6% infants in rural area were breastfed within the first day. [10] A similar study done by Ranjana Fotedar et al. revealed that 20% women initiated breastfeeding newborns within 1 h, 50% women initiated breastfeeding their newborn baby within 6 h, while 30% women initiated breastfeeding their newborn baby after 24 h [11] whereas in our study 60.5% women initiated breastfeeding within half an hour after delivery.

A study by Rajmahal et al., noted that mothers belonging to the higher socioeconomic status had a greater chance of feeding colostrum than the poor-income groups [12] and a similar study by P.V. Gopujkar et al. inferred that the higher the educational status of the family, of the father, mother or both, the lower the percentage of infants exclusively breastfed for even three months. The infants of 68% of educated mothers in Mumbai, 32% in Kolkata and 44% in Chennai were being exclusively breastfed till they were three months old as against 80%, 57% and 61% in corresponding poorly educated groups [13] whereas in our study neither the education nor the income had an impact over exclusive breastfeeding.

A study by R. Parmar et al. stated the various reasons for starting bottle feeding before six months, which were: insufficient milk (59.7%), working mother (13%), to habituate the baby to bottle (12%) maternal illness and child illness (6.5%). [1] A study by Aggarwal et al. concluded that the most common reason for early food supplementation was insufficient breast milk (49.4%). [14] Similarly, a study by Chintan Parekh et al. stated that the predominant reasons for the practice of bottle feeding were inadequate breast milk secretion, unable to breastfeed and poor weight gain of baby. [15] The present study had also proven the same.

In our study, among children who were exclusively breastfed, 62.6% did not have any episode of illness. Only 26.2% had one to three episodes of illness and 11.1% had more than three episodes. This is on par with a study by Onayade et al. in Nigeria which found that breastfed babies reported fewer symptoms and had fewer illness episodes (0.l episode per child) compared to those who started complementary feeding before six months. [16] A similar study by Deepikasur et al. on the incidence of diarrhea among low birth weight infants of an urban slum of Kolkata, showed that early weaned infants had a significantly higher risk of occurrence of diarrhea than the exclusively breastfed infants. [17] Another study by Seema Mihrshahi et al. in Chittagong, Bangladesh, had found that partially breastfed infants had a higher incidence of acute respiratory infection and diarrheal infection when compared to exclusively breastfed infants and that difference was found to be statistically significant. [18]


  Conclusion Top


The prevalence of exclusive breastfeeding was 34% for the duration of six months, which is lesser than the national average of 41%. Though many National Health Programs were working for the improvement of mother and child health the prevalence of exclusive breastfeeding has not reached 50%. A well-drafted IEC (Information, Education and Communication) activity specifically targeting adolescent girls and antenatal mothers can be implemented. With repeated reinforcement along with research. It might bring a change to the current scenario.

 
  References Top

1.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.  Back to cited text no. 1
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2.Chudasama RK, Patel PC, Kavishwar AB. Determinants of exclusive breastfeeding in south Gujarat region of India. J Clin Med Res 2009;1:102-8.  Back to cited text no. 2
    
3.Akri J. Infant feeding: The physiological basis. Bull World Health Organ 1989;67 (1 Suppl):8-9.  Back to cited text no. 3
    
4.National guidelines on infant and young child feeding. Ministry of Human Resource Development. Department of Women and Child development (Food and Nutrition Board). Government of India. http://wcd.nic.in/nationalguidelines.pdf; 2004. p. 2-3.  Back to cited text no. 4
    
5.Edmond K, Bahl R. Optimal feeding of low-birth-weight infants. Technical Review. Bull World Health Organ 200630(2);1-3.  Back to cited text no. 5
    
6.Medhi GK, Mahanta J. Breastfeeding, weaning practices and nutritional status of infants of tea garden workers of Assam. Indian Pediatr 2004;41:1277-9.  Back to cited text no. 6
    
7.Banapurmath CR, Sobti R. Status of infant and young child feeding: Davanagere (state of Karnataka). Bulletin of Breastfeeding Promotion Network of India 2003:16-8.   Back to cited text no. 7
    
8.Gupta A, Gupta YP. Status of infant and young child feeding in 49 districts (98 blocks) of India. A National Report of the Quantitative Study. Breastfeeding Promotion Network of India (BPNI). 2003;14-8.   Back to cited text no. 8
    
9.National Family Health Survey (NFHS-3). Factsheets 2005-2006. Available at URL: http://mohfw.nic.in/nfhsfactsheet.htm accessed on 24/7/2011.  Back to cited text no. 9
    
10.Haggerty, Patricia A, Rutstein SO. Breastfeeding and complementary infant feeding, and the postpartum effects of breastfeeding. Demographic and Health Surveys comparative studies17 th edn. Calverton, Md. : Macro International, 1999. 145-53.  Back to cited text no. 10
    
11.Ranjana F, Lakshminarayana J, Ramnath T, Singh Madhu B. Health and nutritional status infant feeding practices of working women in Jodhpur city. Ann Arid Zone 2002;41:183-9.  Back to cited text no. 11
    
12.Rajmahal P, Devdas, Mercy Paul VP. Trends in breastfeeding practices. Indian J Nutr Diet 1999;36:1-10.  Back to cited text no. 12
    
13.Gopujkar PV, Chaudhari SN, Ramaswami MA, Gore MS, Goplan C. Infant feeding practices with special reference to the use of commercial infant foods. Nutrition Foundation of India, Scientific Report No.4. New Delhi: Ratna Offset; 1984. p. 115.  Back to cited text no. 13
    
14.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.  Back to cited text no. 14
    
15.Parekh C, Bavdekar SB, Shaharao V. Study of infant feeding practices: Factors associated with faulty feeding. J Trop Pediatr 2004;50:306-8.  Back to cited text no. 15
    
16.Onayade AA, Abiona C, Abayomi O. The first six month growth and illness of exclusively and non-exclusively breast-fed infants in Nigeria. East Afr Med J 2004;81:146-53.  Back to cited text no. 16
    
17.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.  Back to cited text no. 17
    
18.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.  Back to cited text no. 18
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]


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