International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 4(24), December, 2012

Pages: 113-118

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EFFECTIVENESS OF HEALTH EDUCATION ON INCREASING KNOWLEDGE ABOUT BREAST FEEDING PRACTICES AMONG POST-NATAL WOMEN

Author: Chandrashekhar R., Shashidhar Basagoudar, Sujata Muneshwar

Category: Healthcare

Abstract:Objectives: 1.To study the knowledge about breast feeding practices among post-natal women. 2. To assess the effectiveness of health education session in increasing the knowledge about breast feeding practices among the post-natal women. Material and methods: An interventional study involving health education as the intervention conducted through audio-visual aid and lecture method. Knowledge was assessed as pre-test and post-test using prestructured questionnaire through interview method. Effectiveness was assessed through the increase in post test score compared to pre-test score. Results: Study showed that there was significant difference (p=0.000) between average score of pre test knowledge (14.25) and post test knowledge (18.40). Pre-test score ranged from 8 to 17 whereas post-test score ranged from 15 to 20. Conclusion: There was poor knowledge regarding some aspects of breast feeding practices among post-natal women. Health education session was effective in improving the knowledge about breast feeding practices among the postnatal women.

Keywords: health education, audio-visual media, breast feeding, knowledge.

Full Text:

INTRODUCTION Breastfeeding is the normal way of providing nutrients for healthy growth and development of infants as the breast milk contains all the nutrients that a baby needs. 1 Breastfeeding should begin within an hour after birth. The first milk which is called “colostrum” is the most suitable food for the baby because it contains high concentration of protein and other nutrients. It should be "on demand", as often as the child wants day and night. Exclusive breast feeding should be done till 6 months of age. Followed by complimentary feeding and breast feeding should be continued till the age of 2 years. A child who is breast fed has greater chances of survival than a child artificially fed.2 Prolonged breast feeding does protect the infant from early malnutrition and some infections. It has been rightly said that breast feeding acts as first immunization. Adequate breastfeeding could save many young lives. But globally less than 40% of infants under six months of age are exclusively breastfed.3 In India 51% of the mothers will not give colostrum to the newborn soon after birth.4 According to NFHS-3 survey, in India, 46% of the under 3 year children are underweight and 38% are stunted.5 Lack of exclusive breast feeding and improper breast feeding is one of the major contributory factor for this high prevalence of malnutrition and its associated morbidities and mortality. For having a good practices related to breast feeding and to save the many infant lives, it is essential to have proper knowledge regarding the breast feeding practices. Raichur being one of the backward districts of Karnataka has shown poor values in various health related indicators. Hence a study was conducted in this area to assess the knowledge of post natal women regarding breast feeding and impact of health education session in increasing the knowledge. MATERIAL AND METHODS Study was carried out at the Urban health training centre (UHTC), Amtalab, Raichur, which is run by the department of Community medicine, Raichur Institute of medical sciences. All the Anganwadi workers coming under the catchment area of our UHTC were informed about the health education session and given the responsibility of motivating the postnatal women to the UHTC on the prefixed day (which was chosen during breast feeding week August 2012). Study was conducted among all those postnatal women who have attended the breast feeding awareness programme. Oral consent of the post-natal women for participation in the study was obtained after explaining about the study. Data was collected regarding demographic profile and knowledge of breast feeding practices through the prestructured questionnaire by interview method. Data was collected by prior trained interns and Post graduates. After the pre test interview, health education session was conducted involving all the participants. It was conducted through a video session and lecture method covering all the aspects of exclusive breast feeding, importance of breast feeding, complimentary feeding, hazards of bottle feeding etc. To assess the impact of the health education session a post test was conducted through the same questionnaire used for pre test. Change in terms of total score was assessed using Wilcoxon signed rank test and individual question was assessed using chi-square test. For both the test p value of <0.05 was considered as significant. Data was analyzed using SPSS 16 software. RESULTS A total of 67 postnatal women who have attended the session were the study population. Among the 67 women studied mean age of the women was 24.16. Majority of the women were illiterate (43.3%). 67.2% of the women were belonging to the nuclear family. 38.8% of the women were having one child & 26.9% of the women were having 2 children. (Refer table no.1) Initial assessment of the women revealed that only 47.76% of the women were aware that pre-lacteal feed should not be given to the newborn. 71% of the women were aware that water is not required during the first 6 month of life but only 58.2% of the women were aware that even in summer, infants up to the age of 6 months do not require external water. 64.17% of the women were aware that bottle feeding can cause the diarrhoea. 68.65% of the women were aware that demand feeding is better than the timed feeding. Majority (94%) of the women were aware that breast feeding provides all the nutrients. 73% of the women were aware that complimentary feeding should be started at 6 months of age. (Refer table no.2) After the health education session there was significant change in the knowledge related to prelacteal feeding (95.5%), giving colostrum (98.5%), effect of breast feeding on uterine bleeding (85%), Breast feeding protect from hypothermia (82%), feeding during illness (97%), water not needed during summer (94%), water not needed during first 6 months of life (98.5%), demand feeding (89.5), Breast feeding act as first immunization (77.6%), Breast feeding is a cheaper method (97%), bottle feeding can cause diarrhoea (86%), complimentary feeding should be started at 6 months of age (94%). Even though there was change in knowledge related to “ideal time of initiation of breast feeding”, “breast milk provides all the nutrients”, “smashed food should be given at the initiation of complementary feeding”, “breast feeding should be continued till 2 years of age” were found to be statistically not significant. (Refer table no.2) As shown in the table 3, mean pre-test score was 14.25 whereas mean post test score was 18.40 and there was significant increase in the knowledge level after the health education session compared to the pre-test. As shown in Figure 1 the pre-test score ranged from 8 to 17 where as post test score ranged from 15 to 20. As shown in the table 4, there was not much difference in pre-test score with respect to the Religion & type of family and also there was significant increase in the knowledge after health education irrespective of their religion and type of family. Pre- test score was lesser in case of illiterates compared to literates but the gap was lessened in the post test. DISCUSSION In our study 86% of the women knew the ideal time of initiation of breast feeding but according to NFHS-3 only 23.4% of the women have initiated breast feeding within one hour after birth in India and 35.6% in Karnataka.5 It may be because of poor conversion of knowledge into practice or may be our area having better knowledge on this aspect. According to NFHS-3 only 55.8% of the children’s have received complimentary feeding during 6-9 months of age in India but in Karnataka it was 72.5%.5 In our study 73.13% of the women were aware that complimentary feeding should be initiated at 6 months of age. In this aspect our study findings are similar to NFHS-3 survey and support the data that Karnataka is better compared to national average in this aspect. In our study 68.65% of the women were aware about the demand feeding, 47.76% about the prelacteal feeding, 71.64% about the water during first six months where as in study conducted by Maheswari et al, 45% of the post-natal women were aware about the demand feeding, 74% were aware about the pre-lacteal feeding, 84% about the water during first six months.6 In a study conducted by Maseer Khan et al, only 45% were aware about the demand feeding and only 20% were aware about the water during first six months.7 According to Hungama survey 58% of the mothers fed water to their infants before 6 months.4 Here our study re-highlights the fact that there is still need to educate the people regarding pre-lacteal feeding, demand feeding and importance of exclusive breast feeding in first 6 months. Majority of the women were having prior awareness about giving smashed food at initiation of complementary feeding, breast feeding till 2 years of age and breast milk contains all the nutrients. Hence there was no statistical significance with respect to change in knowledge to these questions. It also implies that poor knowledge can’t be generalized for all the aspects of breast feeding. A study in Surat demonstrates there was no difference in the practice of early weaning with respect to type of family and literacy status of mother.8 In our study even though we didn’t study the practice but it was obvious that religion, type of family & literacy are not hurdles in increasing the knowledge among the postnatal woman regarding breast feeding. In a randomized controlled trial conducted in primiparous women by Khresheh R et al, postnatal education and support program significantly improved breastfeeding knowledge which was measured by differences between mean pre- and post-test scores.9 in a study conducted in Islamic republic of Iran by M.D. Froozani et al, breast feeding education in post-natal woman revealed that Exclusive breastfeeding rates were significantly higher in the study group (54%) than in the control group (6.5%).10 Even though in the present study control group was not chosen as like in above studies but our study was successful in showing the effectiveness of health education as demonstrated by rise in post-test score. CONCLUSION A well conducted health education session should have a prior assessment of the knowledge of the participants so that the health education can be stressed more on the factors about which participants have misconceptions or no knowledge. It is obvious in our study that many participants were prior aware about the some of the important aspects of breast feeding but they were poor in some areas like pre-lacteal feeding and water is not required in summer for children below 6 months of age etc. Our health education session was succeeded in increasing the knowledge in those areas where the participant’s knowledge was limited. Hence a well conducted health education session with proper audio-visual media helps in increasing the knowledge about breast feeding practice among post-natal women. We conclude that reugular health education session about breast feeding practices needs to be conducted for the post-natal women with focus on areas with poor knowledge. Drawback: As the study didn’t conduct the followup, sustainability of the knowledge and actual practices can’t be concluded from the present study. ACKNOWLEDGEMENT Authors would like to thank all the staff of UHTC and Department of Community Medicine, RIMS, Raichur. Authors would like to thank all the women who have participated in this study. Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also greatful to authors/editors/publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

References:

1. Ghai OP, Paul VK, Bagga A. Ghai, essential paediatrics. 7th ed. Delhi: CBS publishers; 2009. p.122-8.

2. Park K. Textbook of preventive and social medicine. 21 st ed. Jabalpur: Banarsidas Bhanot; 2011. p. 491-7.

3. World health organization. 10 facts on breast feeding, available on http://www.who.int/features/factfiles/breastfe eding/en/index.html [cited on October 10, 2012]

4. Hungama survey report 2011 , available on http://hungamaforchange.org/HungamaBKDe c11LR.pdf [cited on October 10, 2012]

5. Ministry of health and family welfare. National family health survey -3. vol 1. 2007. p. 180-2.

6. Ekambaram M, Bhat VB, Padiyath Ahamed MA. Knowledge, attitiude and practice of breastfeeding among postnatal mothers. Curr Pediatr Res 2010; 14 (2): 119-124.

7. Maseer Khan, Kulkarni PK, Zebunnisa, Chandrasekhar. Study on breast feeding practices among postnatal women in a tertiary care hospital in south Indian city. Int J Pharm Bio Sci 2012 July; 3(3): (B) 272 – 279.

8. Chudasama RK, Patel PC, Kavishwar AB. Determinants of Exclusive Breastfeeding in South Gujarat Region of India. J Clin Med Res 2009; 1(2):102-108.

9. Khresheh R, Suhaimat A, Jalamdeh F, Barclay L. The effect of a postnatal education and support program on breastfeeding among primiparous women: a randomized controlled trial. Int J Nurs Stud 2011 Sep; 48(9):1058- 65.

10. Froozani MD, Permehzadeh K, Dorosty Motlagh AR, Golestan. Effect of breastfeeding education on the feeding pattern and health of infants in their first 4 months in the Islamic Republic of Iran. Bulletin of the World Health Organization 1999; 77 (5): 381-5.


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One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

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This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

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A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
A study by Saurabh Suvidha entitled \"A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst\" is awarded Best article of Vol 14 issue 21
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A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17
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A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
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A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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