Breastfeeding is the most natural and effective way of providing nutrition to infants and is associated with reduced morbidity and mortality [1,2]. Exclusive breastfeeding (EBF) for the first six months is recommended globally due to its protective effects against infections, especially diarrhoea and respiratory illnesses [1,3].

Despite these recommendations, suboptimal breastfeeding practices such as delayed initiation, discarding colostrum, and pre-lacteal feeding remain common in developing countries including India [4,5]. Early initiation of breastfeeding within one hour of birth significantly reduces neonatal mortality [6].

Colostrum, often referred to as “first vaccine,” provides essential antibodies and nutrients critical for neonatal immunity [7]. However, misconceptions regarding its quality still persist in certain communities [8].

Urban populations are expected to have better access to healthcare services and information; however, studies indicate that awareness does not always translate into appropriate practices [9,10]. Cultural beliefs, family pressure, and perceived insufficient milk production continue to influence feeding behaviours [11,12].

Hence, this study was conducted to assess breastfeeding practices and maternal perception in an urban setting of Rewa district.

Objectives

1. To assess mothers’ knowledge regarding breastfeeding.
2. To evaluate breastfeeding practices among mothers of infants aged 0–6 months.
3. To identify barriers to exclusive breastfeeding.

MATERIALS AND METHODS

A cross-sectional study was conducted over a period of one month among mothers of infants aged 0–6 months attending Shyam Shah Medical College and nearby Anganwadi centres in Rewa, Madhya Pradesh. A total of 100 participants were included in the study using a convenient sampling technique. Data were collected after obtaining informed consent from the participants using a pre-tested, structured questionnaire designed to assess knowledge, perception, and practices related to breastfeeding. The collected data were entered and analysed using appropriate statistical methods. Descriptive statistics such as frequencies and percentages were calculated, and suitable statistical tests were applied wherever necessary to assess associations.

RESULTS

A total of 100 mothers of infants aged 0–6 months were included in the study. As shown in Table 1, the majority of mothers (89.5%) were aware of exclusive breastfeeding, while 10.5% had no awareness. All participants (100%) correctly knew that exclusive breastfeeding should be continued up to 6 months. Awareness regarding colostrum was universal (100%); however, only 89.5% believed that it should be given to the newborn, while 10.5% considered otherwise. Knowledge regarding expression of breast milk was relatively low, with only 42.1% of mothers being aware of it. Regarding the total duration of breastfeeding, 57.9% of mothers reported that it should be continued beyond 2 years, while 26.3% suggested up to 2 years and 15.8% reported less than 2 years.

According to Table 2, early initiation of breastfeeding within 2 hours of birth was observed in 47.4% of mothers, while 31.6% initiated feeding between 2–4 hours and 21.1% after 4 hours. Colostrum was actually given by 89.5% of mothers, whereas 10.5% did not provide it. Pre-lacteal feeding was practiced by 63.2% of mothers. Among those who provided pre-lacteal feeds, cow’s milk, formula milk, and other feeds were equally used (26.3% each), while 21.1% reported not giving any such feed. Exclusive breastfeeding was practiced by only 42.1% of mothers, whereas 57.9% did not follow exclusive breastfeeding. Regarding the method of top feeding, spoon and bowl was the most common method (47.4%), followed by bottle feeding (10.5%) and other methods (21.1%).

As depicted in Table 3, a majority of mothers (63.2%) reported difficulties in initiation of breastfeeding, while 36.8% did not face any difficulty. Support from healthcare staff for positioning and attachment during breastfeeding was reported by 57.9% of mothers, whereas 42.1% did not receive such support. The major reasons for not practicing exclusive breastfeeding included perceived inadequate milk production, delayed initiation of lactation, family pressure for top feeding, and maternal fatigue. With respect to child health outcomes, 78.9% of infants had not experienced any episode of diarrhoea since birth, while 10.5% had one episode and 10.6% had three or more episodes.

Table 1: Awareness and Knowledge Regarding Breastfeeding (N = 100)

Table 2: Breastfeeding Practices among Mothers (N = 100)

Table 3: Barriers, Support and Child Health Outcomes (N = 100)

DISCUSSION

The present study demonstrates that although awareness of exclusive breastfeeding was high (89.5%), only 42.1% of mothers practiced it, indicating a substantial knowledge-practice gap. Similar findings have been reported in other Indian studies and national surveys [2,9].

Early initiation of breastfeeding within 2 hours was observed in 47.4% of cases, which is lower than recommended standards. Studies have shown that delayed initiation is associated with increased neonatal morbidity and mortality [6,13].

A high prevalence of pre-lacteal feeding (63.2%) was observed, which aligns with findings from other regions of India [5,14]. This practice interferes with exclusive breastfeeding and increases the risk of infections [3].

Although all mothers had heard about colostrum and 89.5% fed it, a small proportion still discarded it, consistent with earlier studies highlighting cultural misconceptions [7,8,15].

Perceived inadequate milk production and delayed lactation were major reasons for non-exclusive breastfeeding, similar to studies conducted in urban and rural settings [11,16]. Family influence also played a significant role in feeding decisions [12].

Lack of proper counselling was evident, as 42.1% mothers reported no assistance from healthcare staff. Effective counselling interventions have been shown to significantly improve breastfeeding practices [17,18].

The findings emphasize that improving knowledge alone is insufficient; behavioural change communication and family involvement are essential to bridge the gap between awareness and practice [19,20].

CONCLUSION

Although mothers demonstrated good awareness regarding breastfeeding, inappropriate practices such as delayed initiation, pre-lacteal feeding, and low exclusive breastfeeding rates persist.

Recommendations

Strengthening antenatal and postnatal counselling is important to improve breastfeeding practices, ensuring mothers receive proper guidance on exclusive breastfeeding and its benefits. Early initiation of breastfeeding within one hour of birth should be encouraged at all healthcare facilities.

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