The best gift nature has provided is the mother’s milk. Itis complete nourishment for babies. Breastfeeding is recognized worldwide as beneficial for both the mother and child, as breast milk is considered the best source of nutrition for an infant. The World Health Organization (WHO) recommends that infants be exclusively breastfed for the first six months, followed by breastfeeding along with complementary foods for up to two years of age or beyond.

Exclusive breastfeeding is defined as a practice where by the infants receive only breast milk and not even water, other liquids, tea, herbal preparations, or food during the first six months of life, with the exception of vitamins, mineral supplements, or medicines. Breastfeeding protects babies against various diseases like diarrhea, pneumonia, and allergies and boosts their immunological response. Study from Ghana found that22% of deaths among newborns were prevented if allnewborns started breastfeeding within 1 hour of birth, irrespective of whether they were exclusively breastfed later or not; further analysis by the researchers now suggested this figure could be 31% for developing countries.

According to NFHS-5 data, initiation of breastfeeding within one hour of birth in India is only41.8 per cent even after a tremendous increase in institutional births from 38.7 per cent (2005-06) to 78.9per cent (2015-16). Exclusive breastfeeding rates amongst infants 0-6 months of age, from 54.9 per cent(2015-16) to 63.7 per cent (2019-21). Initiation of breastfeeding within 1 hour rates across India varied from25.4% to 75.4%, exclusive breastfeeding (0-6 months) rates varies from 35.8% to 77.2%. Absence of remarkable progress in these indicators suggest thatcertain gaps still exist which restrict achievement of national development goals. These gaps could have resulted from unawareness and lack of knowledge regarding appropriate IYCF practices. Appropriate intervention in terms of awareness programmes may helpin achieving the national development goals.Hence we planned this study with the objective to assess the knowledge, attitude and practice of breastfeeding among lactating mothers in a tertiary referral centre in central Karnataka.

METHODS

It was a crosssectional descriptive study conducted in the Department of Paediatrics, Sri Siddhartha medical college,Tumkur for aperiod of 3 months, July 2025 - September 2025. Studypopulationincluded 100 lactating mothers in post natalward.

Inclusion criteria

Healthy breastfeeding mothers in the post natal ward.

Exclusion criteria

Mothers with medical/surgical illness, mothers whosebabies are admitted in NICU.

Data collection

By using self-administered breastfeeding knowledgequestionnaire.

Study procedure

The questionnaire was self-administered in local language. Mothers meeting inclusion criteria were given questionnaire to answer. Illiterate mothers were asked and responses were recorded. Demographic details likeage, parity, educational status, working status, income,type of delivery, weight of baby and sex of baby were recorded. Mother’s knowledge and practices of breastfeeding were assessed. Assessment of onset and adequacyof breast feeding was assessed. General characteristics of the patients were presented in terms of percentage. Numerical variables of breastfeeding practices, breastfeeding knowledge were tabulated and assessed.

RESULTS

100 lactating mothers in post natal ward were interviewed. Table 1 shows the characteristics of participants in the study.

Majority of the mothers were in the age group of 20-25years (72%), 65% of mothers were from rural area, 56%of mothers belonged to nuclear family, more than half ofthe mothers were school dropouts, majority of the mothers were home makers. Nearly 90% of the mothers belonged to lower and lower middleclass family. Multipara mothers contributed to 57% of the study sample. Only 8% of the babies were delivered by LSCS. Maleand female babies were equal in number. 30% babies were low birth weight. On assessment of breastfeeding practices, only 27% mothers practiced initiation of breastfeeding after birth.62% of mothers-initiated breastfeeding after 30 minutes of birth. Only 1/3rd of mothers fed baby on demand, 10%mothers gave prelacteal feeds, honey was the most commonly given prelacteal feed. 90% of the mothers fed their baby colostrum, more than half of mothers didn’tpractice burping after feeding, lying was the most commonly fed position followed by sitting position.

Majority of the mothers cleaned their breast with waterbefore feeding. Most of the mothers wiped baby’s mouth after breastfeeding. 86% of the mothers gave top feed in addition to breast milk. Almost all babies were fed till 5-10 minutes, only 27% of mothers followed restricted dietduring breastfeeding. On assessment of knowledge about breast milk and

breastfeeding, 90% of mothers knew that breast milk isideal feed for newborn, 56% of mothers knew immediate initiation of breastfeeding in newborn, less than half ofmothers knew about importance of colostrum, 88% of mothers knew that colostrum should be fed to newborn, half of the mothers were aware of demand feeding, 56%of mothers thought baby should be fed for 5-10 minutes, only half of the mothers were aware of exclusive breastfeeding, 48% of mothers thought breastfeeding should be stopped by 12-23 months.

DISCUSSION

It was observed in the present study that 97% of mothers-initiated breastfeeding within first day of birth. Only 27%of mothers-initiated breastfeeding immediately within 30minutes of birth, which is significantly low compared to NFHS-4 data where 41.6% babies were breastfed within1 hour of birth. [6] A delay in initiation will lead to a delayin the development of oxytocin reflex, which is very important for the contraction of the uterus and the breastmilk reflex. 97% mothers-initiated breastfeeding within first day of birth. Our finding is much higher than(37.1%) the national data.

[6]Studies show that the earlier breastfeeding begins the earlier and more effective the consolidation of the process, and therefore, a better impact on the after-birth period, which helps in the earlier initiation of the secretion of breast milk.10% mothers gave prelacteal feeds, honey was the most commonly given prelacteal feed. Similar findings were reported in previous studies.9-12 Pre-lacteal feeds are given believing they act as laxatives or as a means of clearing the meconium. Unfortunately, the mothers arenot aware that the pre-lacteal feeds could be a source ofcontamination. [13]Honey, which is used as prelacteal foodin infants is not recommended to be given below the age of one year, because of the risk of infection by Clostridium botulinum.90% of mothers fed colostrum to baby which is a good practice. Similar findings were reported in previous studies. [13,14] But only half of the mothers were aware of its importance or role.

Colostrum is rich in vitamins,minerals, protein and immunoglobulins that protect the child from infections. [15]The most common reason stated by mothers for discarding colostrum was that theythought colostrum was not good for the child. Only one third of mothers were aware of demand feeding. Nearly half of mothers were practiced burping after feeding, burping helps to prevent regurgitation of feeds. Majority of the mothers practiced good hygienic practices, they cleaned their breasts while feeding. This prevents infection in mothers and helps them to sustain breastfeeding. Quarter of mothers had restricted diet while breastfeeding, rest all mothers increased their diet while breastfeeding. Similar findings were reported in previous studies. [16] The reason behind restriction of diet in mothers could be belief that food consumed by mother may harm the baby by developing symptoms like cold, cough and increased frequency of stools. Only half of the mothers were aware of exclusive breastfeeding till 6 months, this can be attributed to thefact that the majority of the study population were mothers belonging to low socioeconomic class with a lowlevel of literacy.

Exclusive breastfeeding for the first six months, which is highly recommended, is often a necessity in poor communities that cannot afford formula or cow’s milk.Creating an awareness of its advantages will further strengthen and support this common practice in rural communities and avoid the early introduction of complementary foods for sociocultural reasons. Thus, no opportunity should be missed by doctors and healthworkers to educate the rural women on the benefits of breastfeeding. One potential limitation of this study could be the small localized population. Hence, the findings in this study cannot be generalized.

CONCLUSION

Despite the higher rates of early initiation of breastfeeding and exclusive breastfeeding, there was low awareness of the benefits of exclusive breastfeeding. Creating an awareness of the advantages of exclusive breastfeeding will further strengthen and support this common practice in rural communities and avoid early introduction of complementary foods for sociocultural reasons.

REFERENCES

1. Ku C, Chow SKY. Factors influencing the practiceof exclusive breastfeeding among Hong KongChinese women: a questionnaire survey. J Clin 2010;19(17-18):2434-45.
2. Hanif HM. Trends in breastfeeding andcomplementary feeding practices in Pakistan, 1990-2007. Int Breastfeed J. 2011;6:15.
3. Nkala TE, Msuya SE. Prevalence and predictors ofexclusive breastfeeding among women in Kigomaregion, Western Tanzania: a community basedcross-sectional study. Int Breastfeed J. 2011;6:17.
4. Benefits for Infants. Advantages of Breastfeeding.Available at: breastfeeding.com/all_about/all_about_more.html. Accessed on 6 August 2025.
5. Srivastava D. Breastfeeding: the First Hour SavesOne Million Babies! World Breastfeeding Week2007, August 2-4. Breastfeeding PromotionNetwork of India, Delhi, 2007.www.bpni.org/WBW/2007/UNICEF-India-Health.html. Accessed on 6 August 2025.
6. Government of India. Ministry of Health and FamilyWelfare. National Family Health Survey-4, 2015-2016. Available from: http://rchiips.org/nfhs/nfhs-4Reports/India.pdf. Accessed on 4 August 2025.
7. Breastfeeding and infants and young childrenfeeding practices. Report card: India States andUTs, 2019. Available from:https://nhm.gov.in/New_Updates_2018/NHM_Components/RMNCHA/CH/Schemes/Maa/Brestfeeding_and_IYCF_Report_Cards.pdf.
8. Iarukov A, Nin’o A, Iarukova N, Doicheva E, KolevD. The early breast feeding of newborn infants.Akush Ginekol. 1992;31:13-5.
9. Mandal PK, Sardar JC, Chatterjee C, Lahiri SK,Ghosh PK. A study on breast feeding practicesamong infants in a rural area of west Bengal. IndianJ Prev Soc Med. 2007;38:28-31.
10. Chaturvedi M, Nandan D, Gupta SC. Rapidassessment of infant feeding practices in Agradistrict. Indian J Community Med. 2007;32:227.
11. Sharma D, Sharma S. Bottlenecks to breastfeedingin Rural Rajasthan. Indian J Community Med.2005;30:155-6.
12. Pathi S, Das BC. Breast feeding practices in a ruralICDS block of Khallikote, South Orissa. Indian JCommunity Med. 2005;30:154.
13. Deshpande JD, Giri PA, Phalke DB, Phalke VD,Kalakoti P, Syed MM. Socio-cultural practices inrelation to breastfeeding, weaning and child rearingamong Indian mothers and assessment of nutritional status of children under five in rural India. AMJ.2010;3:618-24.
14. Khan Z, Mehnaz S, Khalique N, Ansari MA,Siddiqui AR. Poor perinatal care practices in urbanslums: Possible role of social mobilizationnetworks. Indian J Community Med. 2009;34:102-7.
15. Davies MC, Arinolan G, Sanusin R, Osotimehin B.Immunoglobulin classes and nutritional factors inplasma and breast milk of lactating mothers inNigeria. Iran J Immunol. 2006;3:181-6.
16. Agarwal M, Idris MZ, Mohan U. Quality ofreproductive health care at primary care level.Indian J Community Med. 2001;26:119-26.