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A cross-sectional study regarding knowledge about breastfeeding among primi pregnant mothers attending for antenatal checkup in a medical college, Tripura.


Breastfeeding is an important public health strategy for improving infant and child morbidity and mortality, improving maternal morbidity and helping to control health care costs. Breastfeeding is associated with a reduced risk of otitis media, gastroenteritis, respiratory illness, sudden infant death syndrome, necrotising enterocolitis, obesity and hypertension. (1) The World Health Organisation (WHO) and United Nations Children's Fund (UNICEF) recommend that every infant should be exclusively breastfed for the first six months of life with breastfeeding continuing for up to two years of age or longer. (2) A recent trial has shown that early initiation of breastfeeding could reduce neonatal mortality by 22%, which would contribute to the achievement of the Millennium Development Goals. (3) Exclusive Breastfeeding (EBF) reduces infant deaths caused by common childhood illness such as diarrhoea and pneumonia, fastens recovery during illness and helps space births. (4) Studies have showed that breastfed babies are more intelligent, improves their academic performance and they become smarter than formula fed babies. (5) It is no doubt that no other food can replace mother's milk. (6) Many studies done in India revealed that the knowledge of the mothers was inadequate in areas of time of initiation of breastfeeding, colostrum feeding, duration of exclusive breastfeeding and continuation of breastfeeding while baby is sick. (7) There was no study conducted in our medical college to assess the knowledge of primi mothers about breastfeeding attending for antenatal check-up, therefore this study was aimed to assess the knowledge regarding breastfeeding among primi mothers attending for antenatal check-up in our institution.


To assess the knowledge about breastfeeding among primi pregnant mothers attending for.first time antenatal checkup at outdoor of Obstetrics and Gynaecology Department of Tripura Medical College, Tripura.


This hospital-based cross-sectional study was carried out in the Department of Obstetrics and Gynaecology, Tripura Medical College and Dr. BRAM Teaching Hospital, Tripura. The duration of the study was 4 months (January 2016 to April 2016). The primi pregnant mothers attending the Outpatient Department of Obstetrics and Gynaecology for first time were recruited in the study. The sample size was calculated to 100 using 4 pq/[L.sup.2] formula, where p (Prevalence) = 50%, q = 1-p and L (Absolute precision) = 10%. All the participants were explained about the study and written consent were taken. Any primi pregnant mother not willing to give consent were excluded. A pre-tested interview proforma were used for data collection. The proforma were translated to local language.

The proforma were consisting of two parts, Part-I consists of information regarding socio-demographic and part-II regarding knowledge about breastfeeding. Total 10 questions were used to assess the knowledge. For each correct answer 1 (one) point and for each wrong answer 0 (zero) point were allotted. Out of total 10 points if Participant scored [greater than or equal to]6, it is taken as having adequate knowledge and if the participants scored <6, it is taken as having poor knowledge regarding breastfeeding. Purposive sampling used to select the participants. The data was entered and analysed using SPSS software version 20. Results were expressed in frequency.


In the present study, (Table No. 1) the age of majority participants (49%) were in less than 25 years. Majority (74%) were from Hindu religion. Majority of the participants (43%) and their husbands (42%) studied up to primary level. Most of the participants were from joint family (68%) and total monthly income were around 10,000 Rs/- (61%). Majority of them (95%) were housewife.

In this study, majority of the participants (89%) answered that breast milk should be given just after birth. Only 10% of the participants said honey should be given just after birth; 63% of participants said that the first feed should be given within one hour of normal vaginal delivery; 74% said colostrum should be given and 13% of the participants said colostrum should be discarded and 13% have said that they do not have any idea about colostrum. Majority (63%) of the participants said weaning should start after 6 months. Majority (93%) agreed that breastfeeding should be continued after 6 months; 86% of the participants said breastfeeding have additional advantage; 80% of the participants agreed that breastfeeding should be continued during sickness of the baby. About the timing of feeding, 60% of the participants said baby should feed on semi demand; 77% of the participants said no other food should be given to the baby except breast milk in first 6 months.

In the present study (Table 3), it was observed that majority (88%) of the participants were having adequate knowledge about breastfeeding.


In the present study, it was observed that 89% of the participants knew that breast milk should be given as 1st feed to the new born; 63% of the participants in our study knew 6. that 1st feeding to the new born should be started within 1 hour. Similar result has been seen with other studies. (8,9) But study done in West Bengal (10) showed only 37.3% have knowledge that 1st feeding should be given within 1 hour. Majority (74%) of the participants in our study knows that colostrum should be given to the new born. Similar result observed in a study conducted in Mangalore. (8) At present study, 69% of the participants said that exclusive breastfeeding should be continued up to 6 months. At other studies, it is ranged from 28% to 71.6%. (8,9) 80% of the participants in our study said breastfeeding should be continued during sickness of the baby and similar result has 10 been observed in other study. (10) Only 27% of our study participants said baby should put on demand feeding like other study. (11) In our study 88% of the participants had adequate knowledge regarding breastfeeding, but in other 11 studies is ranged from 23% to 96.4%. (10,12)


(1.) James DC, Lessen R, American Dietic Association. Position of the American dietetic association: promoting and 12 supporting breastfeeding. J Am Diet Assoc 2009; 109(11)):1926-42.

(2.) WHO and UNICEF. Global strategy for infant and young child feeding. World Health Organization, Geneva, 2003.

(3.) Edmond KM, Zandoh C, Quigley MA, et al. Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics 2006;117(3):380-6.

(4.) Exclusive breast feeding recommendations. ing.Htm.

(5.) Lucas A, Morley R, Cole TJ, et al. Breast milk and subsequent IQ in children born preterm. Lancet 1992;339(8788):261-4.

(6.) Smith LG. Breastfeeding and bottle feeding. Journal of Tropical Pediatrics 2000;32(2):407-15.

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

(8.) Shetty SB, Shetty SK. KAP study of factors promoting breastfeeding in nursing mothers and pregnant women. NUJHS 2013;3(3):34-7.

(9.) Noor S, Rajesh AH, Babu GK. A study on breast feeding practices among mothers of urban slums of Rourkela. IOSR Journal of Dental and Medical Sciences 2015;14(5):77-80.

(10.) Ray D, Rahaman A, Dasgupta A. Breastfeeding knowledge among antenatal mothers: a cross-sectional study in a rural area of West Bengal. IOSR Journal of Dental and Medical Sciences 2015;14(5):93-97.

(11.) Harnagle R, Chawla PS. Study of knowledge, attitude and practices of lactating mothers on breast feeding, weaning immunization and dietary practices at Jabalpur cantonment. India Int J Curr Microbiol App Sci 2013;2(11): 393-403.

(12.) Simon MC, Sebastian NM, Alex N, et al. Knowledge regarding breast feeding among primi mothers in a selected hospital of Bangalore, Karnataka. American International Journal of Research in Humanities, Arts and Social Sciences 2014;8(1):87-91.

Bappaditya Som [1], Kaushik Tripura [2]

[1] Assistant Professor, Department of Obstetrics and Gynaecology, Tripura Medical College and Dr. BRAM Teaching Hospital, Hapania.

[2] Assistant Professor, Department of Community Medicine, Tripura Medical College and Dr. BRAM Teaching Hospital, Hapania.

Financial or Other, Competing Interest: None. Submission 19-07-2016, Peer Review 25-09-2016, Acceptance 03-10-2016, Published 08-10-2016.

Corresponding Author: Dr. Bappaditya Som, Assistant Professor, Department of Obstetrics & Gynaecology, Tripura Medical College & Dr. BRAM Teaching Hospital, Hapania, West Tripura-799014. E-mail:

DOI: 10.14260/jemds/2016/1368
Table 1: Distribution of the Participants according to Socio-

Socio-Demographic Variables        Frequency (n = 100)

Age (Years)

< 25                                       49
26-30                                      29
31-35                                       9
[greater than or equal to] 36              13


Hindu                                      74
Muslim                                     20
Buddhist                                    5
Christian                                   1


Uneducated                                  9
Primary                                    43
Secondary                                  33
Higher Secondary                            1
Graduate & above                           14

Husband's Education

Uneducated                                 11
Primary                                    42
Secondary                                  12
Higher secondary                            9
Graduate & Above                           25


Housewife                                  95
Private Job                                 5

Monthly Total Family Income

[less than or equal to] 10000              61
11000-20000                                26
21000-30000                                10
31000-40000                                00
41000-50000                                 1
[greater than or equal to] 51000            2


Nuclear                                    32
Joint                                      68

Table 2: Knowledge regarding Breastfeeding among Participants

Knowledge Regarding                     Frequency
Breastfeeding                            (n=100)

What should be Given as a 1st Feed to
the New Born

Breast Milk                                89
Honey                                      10
Water                                      01

Timing for First Feed for NVD

With-in 1 hour                             63
After 1 hour                               20
No idea                                    17

Colostrum Should be Given to New

Yes                                        74
No                                         13
No Idea                                    13

Duration for Exclusive Breastfeeding

Less than 6 Months                          3
6 Months                                   69
More than 6 Months                         23
No Idea                                     5

Timing for Weaning

Before 6 months                            12
6 months                                   17
After 6 months                             63
No Idea                                     8

Breastfeeding Should Continue After 6

Yes                                        93
No                                          2
No Idea                                     5

Breast Milk Have Additional

Yes                                        86
No                                          5
No Idea                                     9

Breastfeeding Should Continue During
New Born Sickness

Yes                                        80
No                                         13
No Idea                                     7

Timing for Breastfeeding

When Baby Cries                            27
Fixed Timing                               13
Semi Demand                                60

Others Food Can Be Given Before 6

Yes                                        15
No                                         77
No Idea                                     8

Table 3: Level of Knowledge regarding
Breastfeeding among Participants

Level of Knowledge


Adequate Knowledge      88
Poor Knowledge          12
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Author:Som, Bappaditya; Tripura, Kaushik
Publication:Journal of Evolution of Medical and Dental Sciences
Article Type:Report
Date:Oct 10, 2016
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