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Indian Journal of Community Medicine Vol XXIX, No. 3, July-September. 2004

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*’ Knowledge, Attitude and Practices of Mothers about Breast-Feeding in Bihar
R.J. Yadav, P. Singh
Abstract i
Objective : The present paper aims at providing knowledge attitude and practices of mothers about breast feeding in Bihar. Design : Two stage design was
adopted with Probability Proportional to Size (PPS) sampling. Setting : Study covered 28,630 households from 1,418 villages from all 50 disti-icts of
Bihar. Subjects : About 8,000 mothers (6,676 from rural and 1,279 from urban) were studied. Methods : The method of24 hours recall was used to assess
the nutritional intake as well as the knowledge, attitude and practices about breast feeding in Bihar. Results : About 29 percent of the mothers started breast
feeding within 24 hours. About two third mothers discarded the colostrum. About one third mothers discarded the colostrum on the advice of their elders.
Most of the mothers breastfed their child upto more than one year. About 55 percent of the mothers introduced supplement to their infants between 6-
12 months. Rice was the main supplement given to children. The main reasons for starting supplements were mother-‘s insufficient milk, child‘s demand
and supplements are required for proper growth. The special foods preferred by the mothers during pregnancy and lacmtion period were mainly ghee and
milk products irrespective of their socio-economic conditions.
Key words : Probability Proportional to Size (PPS) Sampling, Breast Feedijzg

Introduction Table II : Information on Supplementary Feeding Practices (%).

The Institute for Research in Medical Statistics, (IRMS) Delhi undertook Supplements Urban Rural Combined
a study to assess nutritional intake as well as the knowledge attitude and
practices about breast feeding in Bihar. There may be some studies on the Time of start
subjects of knowledge, attitude and practices of mothers but these are on <6 Months 17.7 13.1 13.8
the basis of micro level data, the results of which can not be generalized. 6- I2 Months 53.7 54.2 54.1
Thus. there is a need to undertake large scale studies on this subject, 13-18 Months 9.8 12.0 11.7
finding of which could be used for framing appropi-iate policies for this 19-24 Months 0.2 0.2 0.2
group of population. Bihar is the state with high poverty and backwardness. Not applicable 18.6 20.5 20.2
About 40 percent of the population in the state was below poverty line.
Type of supplement
The institute covered all the blocks of each district of Bihar state. The
Milk 20.9 17.0 17.7
present paper aims at studying the knowledge attitude and practices of
Rice 33.4 39.9 38.9
mothers relating to breast feeding practices and introduction of supplements
Roti 6.5 10.3 9.7
and substitutes in Bihar.
Adults foods 8.1 5.6 6.0
Subject and Methods This is a part of the study undertaken by Institute Commercial Baby Food 11.4 5.9 6.7
for Research in Medical Statistics, Delhi in all the districts of Bihar. Two Others/ Not available 19.7 21.3 21.0
villages were selected from each block by using Probability Proportion to
Size (PPS) sampling. In each village I ward. 20 households were selected. Reason for giving supplements
The survey covered about 28,000 households from all 591 blocks of the Mothers Milk not sufficient 30.0 28.9 29.0
districts. About 8000 mothers (whose children were upto 2 years of age) Mothers ill Health 3.2 3.2 3.2
were interviewed. Information was collected on households characteristics, Child asked for 21.1 22.4 22.2
demographic profile, anthropometry. Information was also collected on Required for proper growth 16.5 14.0 14.4
breast feeding practices, special food intake during pregnancy, lactation, Cultivate habit 8.5 8.1 8.2
awareness and cause of night blindness etc. Don’t Know/Not available 20.7 23.4 23.0
Results Information on knowledge attitude and practices about breast
It has been observed that in most of the districts, higher proportion of
feeding and reason for discard of colostrum and their reasons are being
mothers started breast feeding at the second day. It has been observed that
presented in table I.
more than 70 percent of the mothers opined that a child should be breast
Table I : Breast Feeding Practices in Bihar (%) fed for more than a year except in the districts of Bokaro, Chatra. Garwah.
Urban Rural Combined Gopalganj, Khagaria, Kishanganj, Nalanda, Singhbhum (E) and Siwan where
Started of Breast feeding at mothers were of the opinion that child should be brestfed up to one yeat
First day 29.1 28.3 28.5 of age. It has also been observed that majority of mothers from rural and
Second day 34.9 36.2 36.0 urban areas were in favour of breast feding for more than one year in all the
Third day 35.5 35.5 35.5 districts.
Discard of Colostrum (Yes) 62.5 66.3 65.1
Reason for discarding colostrum Discussion This study reveals that about 29 percent of the mothers started
Not good for Health 22.3 24.1 23.8 breast feeding within 24 hours. The proportion was almost same in urban
Elders advice 34.2 37.2 36.6 and rural area. About two third mothers discarded the colostrum. About
Child can not suck 6.0 5.1 5.3
one third mothers discarded the colostrum on the advice of then elder-s.
Not applicable 31.5 33.6 34.3
The main reasons for this were the advice of elders and belief that colostrum
Age upto breast fed
~6 Months 4.2 4.2 4.2 was not good for the health of the newborn. More than two third mothers
6- 12 Months 26.1 25.1 25.7 breastfed their child upto more than one year. The trend in breast feeding
> 12 Months 69.1 70.1 70.1 between rural and urban al-eas \VPS almost same. Cereal preparations and
Institute for Research in Medical Statistics, Indian Council of Medical milk formed the major food item as supplement/substitute for children for
Research, Medical Enclove, New Delhi - I10 029, INDIA breast milk. The main reasons for starting supplements were insufficient

130
Knowledge Attitude and Practices
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Indian Journal of Community Medicine Vol. XXIX, No. 3, July-September, 2004

milk production by mother: child’s demand and supplements are rehuired Acknowledgemint The authoirs’~e~griik~~~‘~‘~~od and Nutrition Board,
for proper growth. The special foods preferred by the mothers during Department of WCD, Ministry of HRD for financial support and’
pregnancy and lactation period were mainly ghee and milk products Government of Bihar for their cooperation in conducting the survey.
irrespective of their socio-economic conditions. The reasons were better ! : ;I d. f \
References
health of mother and infant. The special foods avoided during lactation : ..f,<
t, Yadav RJ, Singh, Nutritional assessment amongst adults oiBil&:’
were not specific. t2< ,i
“’ “>Indian Journal of Preventive 61 Social Medicine, 1999: 30: IO-IX
.j. zi*\,ip.q+
Majority of the mothers were aware of night blindness and anemia. Only 2. Gbpalan 6, Ramashastry BV, Balasubramaniam SC. Table of food
few knew about protein energy malnutrition. The‘reasons for having such composition, Nutritive value of Indian foods. National Institute of
deficiencies were not known tb majority of the mothers. Nutrition, ICMR, Hyderabad, 1993.
Efforts should be made to have IEC activities targeted,\o:.qh,+x!! ,the 3.