A Cross sectional study to assess the knowledge and
attitude of primipara mothers regarding breast feeding, MES medical college
hospital at Perinthalmanna
Ms. Lakshmi K
Professor, MES
College of Nursing, Perinthalmanna, Kerala.
ABSTRACT:
Objectives:
This study was aimed to assess the knowledge and attitude of primipara
mothers regarding breast feeding. Methodology: quantitative non
experimental-descriptive research design was adopted. The study was conducted
in MES medical college hospital with the sample size of 50 primipara mothers by
using non probability- purposive sampling technique. Results: The
knowledge score of primipara mothers regarding breast feeding were 4 (8.0%) had
inadequate knowledge, 35 (70%) had average knowledge, 11 (22%) had adequate
knowledge. The attitude score of the primipara mothers regarding breast feeding
reveals that 2 (4.0%) had neutral attitude, 48 (96%) had positive attitude
towards breast feeding. Correlation of knowledge and attitude of primipara
mothers regarding breast feeding represents that mean knowledge and attitude
score of primipara mothers regarding breast feeding was 14.3 and 48.74
respectively. Correlation coefficient(r) value is 0.041, which indicates
statistically non significant. find the association between the knowledge and
attitude with selected demographic data illutrates that there is a significant
association of knowledge score with their type of family (p <0.05) and there
is no significant association of knowledge score with the age, education,
occupation, religion, residence, age at marriage, sex of the baby, previous
knowledge on breast feeding ( p > 0.05). there is no significant association
of attitude score with the with demographic data (p >0.10). conclusion: This
study was identified that 70% of the primipara mothers had average knowledge
and 96% had positive attitude towards breast feeding. It implies that majority
of the primipara mothers was received previous information regarding breast
feeding in this study had a major role to enhance the knowledge and attitude of
primipara mothers regarding breast feeeding.
KEYWORDS:
primipara mothers, breast feeding.
INTRODUCTION:
The
vital considerations for the infants in tropical countries are breastfeeding
and avoidance of infection. All the babies, regardless of the type of delivery,
should be given early and exclusive breastfeeding up to 6 months of age. Exclusive
breast-feeding means giving nothing orally other than colostrums and breast
milk. Medicines and vitamins are allowed.1
Breast
feeding is the “gold standard” for infant feeding. Breast milk is the
ideal food with easy digestion and low osmotic load. It is a readily available
food to the newborn at body temperature and without any cost. Psychological
benefit of mother-child bonding and also helps in involution of the uterus.1
According
to the National Family and Health Survey- 4, on average only 56% of Indian
mothers practiced EBF for the full 6 months.2 There is evidence to
suggest that infants who are breastfed exclusively have 13% reduced risk of
mortality compared to non-exclusively breastfed infants in low and middle
income countries.3 In India only about 44% of babies-that is 12
million out of 26 million –begin breast feeding within one hour of their birth.
A
study was conducted to assess the knowledge, attitude and practice of primipara
mothers regarding breast feeding among 50 primipara mothers at elite mission
hospital, Thrissur. Non probability convenient sampling was used to select the
sample. The knowledge, attitude and practice were assessed by using knowledge
questionnaire related to breast feeding, IOWA infant feeding attitude scale and
breast-feeding checklist respectively. The study result revealed that the most
of the primipara mothers are not having adequate knowledge regarding
breastfeeding and that reflected on their practice of breast feeding. Mothers
had favourable to very favourable attitude towards breast feeding.4
OBJECTIVES:
1.
Assess the knowledge and attitude
of primipara mothers regarding breast feeding.
2.
Correlate the knowledge and
attitude of primipara mothers regarding breastfeeding
3.
Find out the significant
association between knowledge and attitude of primipara mothers regarding
breast feeding with selected demographic variables.
Hypotheses:
1.
There is a significant correlation
between the knowledge and attitude of primipara mothers regarding breast feeding.
2.
There is a significant association
between the knowledge and attitude of primipara mothers regarding breast
feeding with selected demographic variables.
MATERIAL
AND METHODS:
The
research approach adopted for this study was quantitative, non-experimental descriptive
research design. The study was conducted in MES medical college hospital with
sample size of 50 primipara mothers in the postnatal ward. Samples were
selected by non-probability purposive sampling
techniques.
Inclusion criteria:
a)
Primipara mothers
b)
Mothers of healthy newborns
c)
Babies born between 37 and 42
weeks of gestation.
d)
Underwent Normal vaginal
deliveries and lower segment caesarean section.
Exclusion criteria:
1.
Multipara mothers
2.
Preterm deliveries and preterm babies.
3.
Babies born with any birth defects
like cleft lip, cleft palate, congenital heart diseases, down syndrome etc.
4.
Mothers with intrapartum and postpartum
complications
5.
Newborn weight < 2.5kg and
admitted in neonatal ICU.
Description of the tool:
The
data was collected in three sections as follows
Section A:
Questionnaire
to collect the socio demographic data. It consists of age in years, education,
occupation, religion, residence, type of food pattern, family income per month,
type of family, age at marriage, types of delivery, sex of the baby, birth
weight of the baby, exposure to previous knowledge of breast feeding.
Section B:
Structured
questionnaires to assess the knowledge of primipara mothers regarding breast
feeding. It consists of 25 items with each item has four options. Each correct
answer carries one mark and wrong answer carries zero mark. Total score is 25.
Grading of knowledge score of inadequate 0-8(<50%), moderate 9-16 (51 to 75%),
adequate
17-25 (>75%).
Section C:
The
modified Iowa infant feeding attitudes scale was used to assess the attitudes
of primipara mothers regarding breast feeding. It consist of 12 statement
scored using a 5- point likert scale range from strongly agree to strongly
disagree. Approximately half of the statements were positively worded (i.e. 1,
3, 5, 7, 9, 10, 11, and 12). Negative statements scored were revered in the
likert scale. Total score ranges from 12 -60 with higher the scores indicates
more positive attitudes on breast feeding. Total scores were divided into three
groups (1) positive attitude to breast feeding (41- 60), neutral (21-40), and
negative attitude to breast feeding (0-20).
Data collection procedure:
Informed
consent was obtained after explaining the purpose of the study and ensured that
the data collected would be kept confidential. Tool were prepared in English
and changed to the local language Malayalam. Obtain permission from
hospital authorities.
RESULTS
AND FINDINGS:
Table: 1, Section A: percentage distribution of mothers
based on their socio demographic data N= 50
|
S. No
|
Demographic variables
|
Frequency (N)
|
Percentage (%)
|
|
1
|
Age in years
|
|
|
18 and below
|
0
|
0
|
|
|
19-26
|
33
|
66
|
|
|
27-34
|
12
|
24
|
|
|
35 and above
|
5
|
10
|
|
2
|
Education
|
|
|
Below primary school
|
0
|
0
|
|
|
Primary school
|
2
|
4
|
|
|
Middle school
|
4
|
8
|
|
|
High school
|
30
|
60
|
|
|
Graduate and others
|
14
|
28
|
|
3
|
occupation
|
|
|
House maker
|
32
|
64
|
|
|
Private employee
|
14
|
28
|
|
|
Government employee
|
1
|
2
|
|
|
Others
|
3
|
6
|
|
4
|
Religion
|
|
|
Hindu
|
13
|
26
|
|
|
Muslim
|
35
|
70
|
|
|
Christian
|
1
|
2
|
|
|
Others
|
1
|
2
|
|
5
|
Residence
|
|
|
Rural
|
17
|
34
|
|
|
Semiurban
|
26
|
52
|
|
|
Urban
|
7
|
14
|
|
7
|
Type of food pattern
|
|
|
Vegetarian
|
6
|
12
|
|
|
Non vegetarian
|
43
|
86
|
|
8
|
Family income per month in rupees
|
|
|
< 10000
|
18
|
36
|
|
|
10001 -15000
|
15
|
30
|
|
|
15001-20000
|
11
|
22
|
|
|
>20001
|
6
|
12
|
|
9
|
Type of family
|
|
|
Nuclear
|
15
|
30
|
|
|
Joint/extended
|
35
|
70
|
|
10
|
Age at marriage
|
|
|
< 18 years
|
9
|
18
|
|
|
>18 years
|
41
|
82
|
|
11
|
Type of delivery
|
|
|
Normal vaginal delivery
|
29
|
58
|
|
|
Caesarean delivery
|
21
|
42
|
|
12
|
Sex of the baby
|
|
|
Male
|
27
|
54
|
|
|
Female
|
23
|
46
|
|
13
|
Birth weight
|
|
|
<2.5kg
|
9
|
18
|
|
|
2.6 -3.5 kg
|
35
|
70
|
|
|
>3.6kg
|
6
|
12
|
|
14
|
Previous knowledge regarding breast feeding
|
|
|
Yes
|
31
|
62
|
|
|
No
|
19
|
38
|
Table
1 shows majority of primipara mothers were in the age group of 19-26, 33(66%).
Most of the mothers were educated upto high school, 30(60%). Regarding the
occupation, many of the primipara mothers were house maker 32(64%). Almost,
35(70%) primipara mothers were Muslim. More than 26(52%.) of primipara mothers were
residing in semi urban. Nearly 43(86%) of mothers belongs to nonvegetarian.
Most of the mothers family income, 18(36%) were below ten thousands. Majority
belong to joint family, 35(70%). 41(82%) of mothers married after 18 years.
Most of the mothers had normal vaginal delivery, 29(58%). Most of the delivered
babies were male, 27(54%). 35(70%) of the baby’s birth weight were between 2.6
– 3.5kg. Previous knowledge regarding breast feeding was received 31 (62%).
Table 2: Mean and standard deviation of knowledge and
attitude scores of primipara mothers regarding
breast feeding N =50
|
|
Minimum
|
Maximum
|
Mean
|
Standard deviation
|
|
Knowledge score
|
6
|
24
|
14.3
|
3.713
|
|
Attitude score
|
33
|
57
|
48.74
|
4.935
|
Table 3: Grading of knowledge and attitude score of
primipara mothers regarding breast feeding
|
|
Grading of scores
|
Frequency (N-50)
|
Percentage (%)
|
|
Knowledge score
|
0-8 (Inadequate)
|
4
|
8.0
|
|
9-16 ( Average)
|
35
|
70.0
|
|
17-25( Adequate)
|
11
|
22.0
|
|
Attitude score
|
0-20 ( Negative)
|
Nil
|
Nil
|
|
21-40( Neutral)
|
2
|
4.0
|
|
41-60( Positive)
|
48
|
96.0
|
Table
3: shows that 4(8.0%) had inadequate knowledge, 35(70%) had average knowledge,
11(22%) had adequate knowledge. The attitude of the primipara mothers regarding
breast feeding reveals that 2(4.0%) had neutral attitude, 48(96%) had positive
attitude towards breast feeding.
The second objective was to correlate between the
knowledge and attitude of primipara mothers regarding breastfeeding
Table 4: To correlate between the knowledge and
attitude of primipara mothers regarding breastfeeding
|
Variable
|
Mean
|
r value
|
Level of significance
|
|
knowledge
|
14.3
|
0.041
|
0.780
|
|
Attitude
|
48.74
|
Table
4: represents that mean knowledge and attitude score of primipara mothers
regarding breast feeding was and 48.74 respectively. Correlation coefficient(r)
value is 0.041, which indicates statistically non-significant. The third
ojective was to find the significant association between the knowledge and
attitude with selected demographic data.
Table 5: Association between the knowledge and attitude
with selected demographic data.
|
Demographic variables
|
Chi-sq. (knowledge)
|
P value
|
df
|
Significant
|
Chi-sq. (attitude)
|
P value
|
df
|
Significance
|
|
Age in years
|
5.0202
|
P<0.05
|
6
|
NS
|
1.093
|
p< 0.10
|
6
|
NS
|
|
Education
|
4.85
|
8
|
NS
|
1.324
|
8
|
NS
|
|
occupation
|
2.437
|
6
|
NS
|
1.615
|
6
|
NS
|
|
Religion
|
1.602
|
6
|
NS
|
1.073
|
6
|
NS
|
|
Residence
|
4.13
|
4
|
NS
|
2.412
|
4
|
NS
|
|
Type of family
|
11.202
|
2
|
S
|
1.53
|
2
|
NS
|
|
Age at marriage
|
2.651
|
2
|
NS
|
0.113
|
2
|
NS
|
|
Type of delivery
|
2.562
|
2
|
NS
|
1.409
|
2
|
NS
|
|
Sex of the baby
|
1.455
|
2
|
NS
|
1.299
|
2
|
NS
|
|
Previous knowlwdge on breast feedeing
|
2.442
|
2
|
NS
|
0.626
|
2
|
NS
|
NS = non significant, S =significant
Table
5: illutrates that there is a significant association of knowledge score of
primipara mothers regarding breast feeding with their type of family (p
<0.05) and there is no significant association of knowledge score of primipara mothers regarding breast
feeding with the age, education occupation, religion, residence, age at
marriage, sex of the baby, previous knowledge on breast feeding (p > 0.05).
there is no significant association of attitude score with the age, education ,
occuoation, religion, residence, type of family, age at marriage, sex of teh baby, previous
knowledge on breast
feeding ( p
>0.10).
CONCLUSION:
This
study identified that more than half of the primipara mothers had average
knowledge and positive attitude towards breast feeding. It implies that
majority of the primipara mothers was received previous information regarding
breast feeding in this study has a major role to enhance the knowledge and
attitude of primipara mothers regarding breast feeeding. Teaching regarding the
benefits and techniques of breast feeding in the antenatal period has a vital
role to increase the awareness of primi mothers regading breast feeding.
REFERENCES:
1.
Dc dutt’s. Textbooks of
obstetrics:9th edition. new delhi: the health science; 2019.pg no. 421-422.
2.
National Family Health Survey
(NFHS-4) 2015–16. Mumbai: International Institute for Population Sciences
(IIPS) and Macro International; 2016
3.
Sankar MJ, Sinha B, Chowdhury R,
Bhandari N, Taneja S, Martines J, et al. Optimal breastfeeding practices and
infant and child mortality: a systematic review and meta-analysis. Acta
Paediatr. 2015;104(467): 3–13.
4.
Seena girish, m. Gandhimathi. To
assess the knowledge, attitude and practice of primipara mothers regarding
breast feeding. IJANSP.2015; 2(1): 41-49. Article Link: http://medical.cloud- journals.com/index.php/IJANSP/article/view/Med-222
Received on 20.04.2021 Modified
on 10.05.2021
Accepted on 26.05.2021 ©A&V Publications All right reserved
Asian J. Nursing
Education and Research. 2021; 11(4):561-564.
DOI:
10.52711/2349-2996.2021.00131