Effectiveness of Video Assisted Learning Programme on Knowledge regarding Complementary Feeding among Breast Feeding Mothers

Ambalika Dutta¹, Kakali Mondal²

¹Staff Nurse Grade II, Tamralipto Govt. Medical College and Hospital, Tamluk, East Medinipur, West Bengal.

²Senior Lecturer, Govt. College of Nursing, ID & BG Hospital Campus, Kolkata – 10.

*Corresponding Author Email: sealkakali@gmail.com

ABSTRACT:

A quantitative pre-experimental study was conducted with the aim to assess the effectiveness of a video-assisted learning program on knowledge regarding complementary feeding among breastfeeding mothers and also to find out the association between knowledge score and selected demographic variables in the paediatric ward of the selected hospital of Purba Medinipur, West Bengal and the conceptual framework of the study was based on King's Goal Attainment Theory. One group pre-test & post-test research design was adopted for the study and data were collected by a structured knowledge questionnaire from 80 breastfeeding mothers selected by the non-probability purposive sampling technique having children of 6-24 months of age and the children were admitted to the paediatric ward. The data was analysed by descriptive statistics with frequency and percentage distribution and inferential statistics with paired ‘t’ test and chi-square test. The study finding revealed that the mean post-test knowledge score (22.55) of breastfeeding mothers was higher than their mean pre-test knowledge scores (14.23) after administration of the video-assisted learning program, as evident from the corresponding 't' value [t= 4.69, p = 0.03], which concluded that the video-assisted learning program on knowledge regarding complementary feeding was effective. The study also revealed that age, religious belief, type of family, educational qualification and economic status of breastfeeding mothers had a significant impact on knowledge score but the mother’s place of residence and occupation of parents did not have a significant impact on the knowledge score of breastfeeding mothers regarding complementary feeding. The study has implications in nursing education, practice, nursing administration, and nursing research. It was recommended that a similar study can be done on a large sample.

KEYWORDS: Knowledge, Video assisted learning Programme, Breast Feeding Mothers.

INTRODUCTION:

Today’s children are tomorrow’s citizens and a healthy nation makes up a wealthy nation.

Children constitute a major proportion of the global population today. They are truly the foundation of a Nation.

Complementary feeding ensures healthy growth and development of children through the variety of nutritious food introduced in addition to breast milk. It is needed to provide energy and essential nutrients required for continuous growth and development of the children. The nutrients in recommended complementary foods complement those in breast milk, hence the name. Complement means they go well together; each has a role to play.¹

BACKGROUND OF THE STUDY:

“A healthy child is a sure future” is one of the themes of World Health Organization.

According to World Population Review, India comprises of 25.31% of children of 0-14 years of total global population²and in West Bengal 23.5% of child population was below 15 years of age as per NFHS-5 Data sheet. According to the National Family Health Survey-5 (NFHS-5), India has unacceptably high levels of stunting, despite marginal improvement over the years. In 2019-21, 33.8% of children below five years were stunted (height for age), 20.3% of children below five years were facing wasting (weight for height) and 32.2% were underweight. However, NFHS-5 data shows that only 59.4% children are breastfed within one hour of birth, 53.3% are exclusively breastfed for six months, 67.8% are provided timely complementary foods at 6-8 months of age, and only 24% breastfeeding children below two years receive an adequate diet. This means that only 1 in 10 children across India between the ages of 6 and 23 months are fed optimally as per the recommended practices of WHO’s global standards (NFHS-5, 2019-21).³ The data confirms that the complementary feeding practices being followed are poor so adequate knowledge for proper practice need urgent attention.

Infancy is the period when foundation of health is laid. The changes in the infant between birth and the age of one year are dramatic. The first two years of life are considered as the “critical window” for the optimum growth and development of a child.⁴ The health and nutritional status of the infant and its subsequent growth and development through childhood depends upon successful feeding practice right from birth. Human breast milk is the most desirable diet for the first 6 months (Exclusive breast feeding)⁵ but on reaching 6 months, breast milk alone is not able to provide all necessary nutrients to the child. Hence a process called complementary feeding is practiced after 6 months of age.⁶ Globally, over 2 in 5 children (41%) aged 6–23 months did not consume fruits or vegetables during the previous day. Data sounds the alarm on the crisis of child’s food poverty in early childhood.⁷

Complementary feeding is a complex process involving adjustment to a range of nutritional, immunological, biochemical, and psychological changes. Complementary feeding is the systematic process of introduction of suitable food at the right time in addition to mother’s milk in order to provide needed nutrients to the baby. The average weight of an infant at birth is 2.5- 3.9kg. Baby’s weight doubles almost at the end of 5 month. In fact, from birth to 1 year is the time of fastest growth for the baby.⁸

Need of the Study:

According to the World Health Organization (WHO) in 2019, globally 40% of children aged 6–59 months were anaemic. In developing countries, 46–66% of children under the age of five are affected by anaemia. According to NFHS-5 data, 69% of children aged 6-59 months were anaemic (<11.0g/dl) (%). According to the WHO, iron deficiency is the single most important nutritional risk factor in India, accounting for more than 3% of all Disability-Adjusted Life Years (DALYs) lost. In infants (aged 0–12 months) and preschool children (aged 1–5 years), iron-deficiency anaemia results in developmental delays and behavioural disturbances.⁹

A study by Ms.L. Saranya et al. on video assisted teaching on knowledge regarding complementary feeding among mothers in selected OPD in Chennai. Among 120 mothers about 3% of mothers had inadequate and 93% of mothers had moderately adequate and 6% of mothers had adequate knowledge level regarding knowledge on complementary feeding. From this study findings it can be concluded that mothers have lack of knowledge regarding complementary feeding.¹⁰

Usually, complementary feeding requires a lot of patience, and can take time, depending upon the age of the baby. The experience is different from everyone. In India the tradition of prolonged breast feeding and introduction of complementary foods from 6 months of age through an “annaprashan ceremony” occurs.¹¹

In general, mothers have very little knowledge about the nutritive value. It is the responsibility of health workers to provide appropriate information to the mothers in the community, hospital and clinics, at various levels of child development.¹² Appropriate complementary feeding practice depends on accurate information and support from the family, community and health care system. Inadequate knowledge about right foods and complementary feeding practices is often a greater cause of malnutrition during infancy and early childhood. Hence, influence the investigator to do this study.¹³

Hypothesis:

H₁- The mean post-test knowledge score is significantly higher than mean pre-test knowledge score regarding complementary feeding among breast feeding mothers after introduction of video assisted learning programme as evident from structured knowledge questionnaire at 0.05 level of significance.

MATERIAL AND METHODS:

Research design:

The research design selected for this study was one group pre-test post-test, pre-experimental study design.

Setting of the study:

Tamralipto Govt. Medical College and Hospital, Purba Medinipur.

Sample:

80 breastfeeding mothers having children of 6-24 months of age and the children were admitted in paediatric ward of selected hospital of Purba Medinipur were selected.

Sampling Technique:

Non-probability purposive sampling technique was used.

Data Collection Tools:

Demographic characteristics of the breast-feeding mothers measured by semi-structured questionnaire including 10 items (age of the mother, religious belief, place of residence, type of family, number of children, educational qualification of mother, occupation of mother, occupation of father, socioeconomic status, previous source of knowledge regarding complementary feeding)¹⁴and Knowledge regarding Complementary Feeding was measured by structured knowledge questionnaire containing the area (duration of exclusive breast feeding, definition of complementary feeding, importance of complementary feeding, appropriate age of complementary feeding with continuation of breast feeding, principles of complementary feeding, type, amount, frequency and consistency of giving complementary foods according to age of the baby, food and kitchen hygiene, effects of untimely introduction of complementary feeding).¹⁵

Ethical clearance:

Formal ethical clearance was sought from the Institutional Ethics Committee.

RESULTS:

Data Analysis and Interpretation:

Table 1 Frequency and percentage distribution demographic characteristics of breast-feeding mothers n=80

Variables	Frequency(f)	Percentage (%)
Age of mothers (in years)
<25	71	89
≥25	9	11
Religious belief Hinduism	38	47
Islam	42	53
Place of residence Rural	69	86
Semi-urban	11	14
Type of family Joint	56	70
Nuclear	24	30

Data presented in the table 4 depict that there was a significant association between knowledge score of breast-feeding mothers their age, religious belief, type of family and mother’s educational qualification and economical status of breast-feeding mothers.

Discussion of the Findings Related to the other Study:

Findings Related to Demographic Characteristics of the Breast-Feeding Mothers:

This study included a total of 80 breast feeding mothers in which 89% of mothers were falling in the age group of ≥25 years, 53% of mothers believed in Islam, 75% of mothers had single child, 70% mothers received a primary level of education, 61% mothers were housewives and fathers 90% being daily labourers, 46% mothers were classified as upper class in socioeconomic status. Similar observation was reported in a study by Manisha, Dr. Saba Khan (2021)¹⁶that more than half of the mothers belong to the 19-25 years of age group. Majority of respondents followed the Hindu religion. Half of the respondents had only 1 child. 70% of the respondents were undergraduate, 20% post-graduated and remaining were graduated. Most of the mothers belong to the lower-income group. 80% of the mothers were homemakers.

Findings Related to Effectiveness of Video Assisted Teaching Programme on Complementary Feeding:

In this study the pretest mean knowledge score of the participants was 14.23 (SD=3.24), while the post-test mean knowledge score was 22.55 (SD=2.98). The difference in mean knowledge scores between the pre-test and post-test was found to be statistically significant (t=4.69, p=0.03), indicating that the video-assisted learning programme led to a significant improvement in knowledge regarding complementary feeding among breast feeding mothers. This is consistent with findings in a study by Mr. Kadali Sam Prasad (2019).¹⁷ The obtained “t” value was 12.68 which was significant at 0.05. Level. The paired t test was carried out and it was found to be variably significant at p>0.001 level, hypothesis was accepted.

Findings Related to Association between Knowledge Score with Selected Sociodemographic Variables of Participants.

In the present study there was a significant association between knowledge score of breast-feeding mothers with their age, religious belief, type of family and mother’s educational qualification and economical status of breast-feeding mothers. Similar findings were reported by Lalit Bisht, Neha Suyal (2022)¹⁸ in Nainital. Their study result shows that there was a statistically significant association found between the level of knowledge and demographic variables such as age, education, and source of information of mothers at p<0.01 level. Hence, hypothesis which stated that "there is a significant association with the selected demographic variable of mother of the infant was" proved.

CONCLUSION:

From the study findings it can be concluded that the baseline knowledge of breast-feeding mothers regarding complementary feeding was not enough as measured by structured knowledge questionnaire. Mothers were likely following local customs in terms of their choice of complementary foods and feeding methods. The video assisted learning programme regarding complementary feeding among breast feeding mothers was effective for increasing the knowledge.

Therefore formal, informal teachings, media, health education programmes should be organized frequently to educate the mother about satisfactory complementary feeding practice along with continuation of breast feeding up to 2 years of age of the baby to prevent and control nutritional deficiencies and malnutrition among the infants.¹⁹

REFERENCES:

1. Laishram DD. Knowledge regarding weaning practices among primi mothers in selected community areas, Bangalore. Int J Nurs Educ Res. 2020; 8(2): 266-268.

2. World Population Review. Children in the world by country, 2024 [Internet]. 2024 [cited 2025 Jul 21]. Available from: https://worldpopulationreview.com/country-rankings/children-in-the-world-by-country.

3. Ministry of Health and Family Welfare (India). National Family Health Survey-5 (NFHS-5) data fact sheet, 2019–2020: West Bengal [Internet]. New Delhi: MoHFW; 2020 [cited 2025 Jul 21]. Available from: https://rchiips.org/nfhs/factsheet_NFHS-5.shtml

4. United Nations Children’s Fund (UNICEF). Monitoring the situation of children and women: diets 2022 [Internet]. Canada: UNICEF; 2022 [cited 2025 Jul 21]. Available from: https://data.unicef.org/

5. Maheshwari L, Swapna Mary A, Laishram DD. A study to assess the effectiveness of structured teaching programme on knowledge and attitude regarding breastfeeding and weaning practices among post-natal mothers in Channasandra Urban, Bangalore City. Asian J Nurs Educ Res. 2023; 13(2): 130-134.

6. Nguyen TTH, Lindmark U, Bengtson A. Knowledge of child nutrition when breastfeeding – a study of mothers living outside Hanoi. Asian J Nurs Educ Res. 2013; 3(4): 273-278.

7. Chinchu R, Chaudhari TA, Sijo ME. Descriptive study to assess the knowledge on practice regarding breastfeeding among postnatal women seeking medical services in Shri Vinoba Bhave Civil Hospital, Silvassa. Int J Nurs Educ Res. 2015; 3(3): 248-52.

8. Deepa, Dekyi, Nirmala Kumari, Choudhary P, Saini P, Yadav R, et al. Knowledge and expressed practice regarding weaning among mothers of children aged between 6 months to 2 years. Asian J Nurs Educ Res. 2019; 9(4): 488-492.

9. World Health Organization. Global anaemia estimates, 2021 [Internet]. Geneva: WHO; 2021[cited2025Jul21]. Available from: https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children

10. Saranya L, et al. Effectiveness of video assisted teaching on knowledge regarding weaning among mothers in selected OPD in Chennai. Ann Rom Soc Cell Biol. 2021; 25(4): 9492-6.

11. Institute for Health Metrics and Evaluation. GBD profile: India 2013 [Internet]. Seattle (WA): IHME; 2015 [cited 2025 Jul 21]. Available from: http://www.healthdata.org/results/country-profiles

12. Upashe SP. Study to assess the knowledge on essential newborn care among primipara mothers – a case of Government District Hospital, Tumkur, Karnataka, India. Int J Nurs Educ Res. 2014; 2(1): 1-5.

13. Mary JJ. A study to assess the knowledge and attitude regarding breastfeeding among antenatal women attending antenatal OPD in Christian Medical College, Vellore. Asian J Nurs Educ Res. 2013; 3(3): 188-189.

14. Dhanani PL, Sam Prasad KS, Jeenath Justin Doss K. A study to assess the effectiveness of planned teaching programme on knowledge regarding weaning among primigravid mothers in selected rural area at Bhuj, Gujarat. Asian J Nurs Educ Res. 2021; 11(1): 133-135.

15. Edgie N, Varia A, Varia K, Prajapti A, Mackwana P, Thakor M, et al. A study to assess the knowledge regarding weaning among under five children’s mothers at Waghodia, Vadodara, Gujarat with a view to develop health education programme. Int J Adv Nurs Manag. 2018; 6(4): 304-308.

16. Khan S, Manisha. Assessment of knowledge and practice of mothers of weaning food. Int J Creat Res Thoughts. 2021; 9(11): 2320-82.

17. Kadali SP. Effectiveness of video assisted teaching programme on knowledge regarding weaning among mothers of infant. Int J Nurs Educ Res. 2019; 7(3): 325-326.

18. Bisht L, Suyal N. Effectiveness of structured teaching programme on the level of knowledge regarding weaning among mothers of infants in a rural community area in Nainital. Int J Community Med Public Health. 2022; 9(10): 3684-7.

19. Bevoor D, Moreshwar S, Madhale M. A study to evaluate the effectiveness of planned teaching programme on knowledge on prevention and control of malnutrition among mothers of under five children residing in Vantmuri Primary Health Centre of Belgaum City, Karnataka. Int J Nurs Educ Res. 2015; 3(3): 317-20.

Received on 27.05.2025 Revised on 10.07.2025

Accepted on 18.08.2025 Published on 25.10.2025

Available online from November 04, 2025

Asian J. Nursing Education and Research. 2025;15(4):210-214.

DOI: 10.52711/2349-2996.2025.00043

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

Knowledge score	Pre test		Post test
Knowledge score	Frequency	Percentage (%)	Frequency	Percentage (%)
Poor (< Mean-1 SD)	23	28.75	14	23.33
Moderate (Mean +1 SD to Mean – 1SD)	39	48.75	44	73.33
Good (>Mean +1 SD)	18	22.50	22	36.67

Test	Mean ±SD	Mean Difference	‘t’ value	p value
Pre-test	14.23 ±3.24	8.32	4.69*	0.03
Post-Test	22.55 ± 2.98	8.32	4.69*	0.03

Variables	Knowledge score	Knowledge score	χ2	p value
Variables	<Median	≥Median	χ2	p value
Age of mothers in years <25	27	44	4.36*	0.03
≥25	4	5	4.36*	0.03
Religious beliefHinduism	14	24	3.94*	0.03
Islam	16	26	3.94*	0.03
Type of family Joint	21	35	4.11*	0.04
Nuclear	9	15	4.11*	0.04