International Journal of Community Medicine and Public Health

Siddiqui A et al. Int J Community Med Public Health. 2021 Dec;8(12):5983-5988

http://www.ijcmph.com pISSN 2394-6032 | eISSN 2394-6040

DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20214601
Original Research Article

Knowledge and attitude of antenatal women attending tertiary care

hospital regarding breastfeeding
Aaliya Siddiqui*, Pallavi S. Uthkarsh

Rajiv Gandhi Institute of Public Health and Centre of Disease Control, Bangalore, Karnataka, India

Received: 10 October 2021

Revised: 14 November 2021
Accepted: 16 November 2021

*Correspondence:
Dr. Aaliya Siddiqui,
E-mail: aaliyas886@gmail.com

Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: Breastfeeding is the most natural way of infant feeding to satisfy nutritional, metabolic and
psychological needs of the baby. Breastfeeding significantly reduces the risk of death especially from diarrhoea and
pneumonia in infants as compared to formula fed babies. Breastfeeding has advantage to both the baby and the
mother. Early initiation of breastfeeding lowers the mother’s risk of postpartum haemorrhage and anaemia, boosts
mother’s immune system and reduces the incidence of diabetes and cancer.
Methods: All women attending Jayanagar General Hospital for ante-natal checkups during study period were
interviewed personally by an investigator after obtaining an informed consent. Data regarding socio-demographic
details and data on knowledge, attitude of breastfeeding were collected by using a pre-tested semi- structured
questionnaire.
Results: The sample of the present study comprised of 204 antenatal women of whom 89.7% belonged to age group
less than or equal to 30 years. Majorities 73.5% of them were Muslims .Most of the participants 87.7% were
unemployed. Almost 72.54% of the participants were multipara. Almost 42.2% of the participants were of the opinion
that the duration of breastfeeding is 2 years or more. 65.7% of the participants stated that complementary feeding
should be started after 6 months. Knowledge about technique of expressed breast milk was poor.
Conclusions: Multiparous women have better knowledge than primipara regarding breastfeeding. Socio demographic
characteristics such as age, parity found to be significantly associated with knowledge. There is a need for counselling
primi antenatal women regarding breastfeeding associated with knowledge. There is a need for counselling primi
antenatal women regarding breastfeeding.

Keywords: Breastfeeding, Knowledge, Attitude, Primipara, Multipara

INTRODUCTION deaths could be avoided in India by optimal breastfeeding

practices.4 Infants who are not breastfed are 6-10 times
Breastfeeding has been accepted as the most vital more likely to die within the 1st month of life than infants
intervention for reducing infant mortality and providing who are breastfed.5 16% of neonatal deaths could be
optimal growth and development of children.1 saved if all infants were breastfed from day 1.6 Optimum
Breastfeeding is needed for the physiological and growth can be achieved by EBF to infants till 6 months of
psychological needs of an infant.2 Suboptimal age as per the World Health Organization (WHO)
breastfeeding, more so non-exclusive breastfeeding recommendations.7 Under five mortality was estimated to
(EBF) in the first 6 months of life results in 1.4 million be 8.795 million, among these, pneumonia accounted for
deaths and 10% of the disease burden in children younger 18% and diarrhoea for 15%, deaths.8 Breastfeeding is an
than 5 years of age.3 More than 15% of 24 lakhs child unequalled method of providing ideal nutrition for the

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healthy growth and development of infants. It is a Inclusion criteria

fundamental right of every child. Infants suffer from
malnutrition if they do not receive adequate nutrients.9 All women coming for ante-natal checkups during study
period at Jayanagar General Hospital.
Objectives
Exclusion criteria
Objectives of the study were to assess the knowledge of
antenatal women attending tertiary care regarding Ante-natal women who have not given consent; ante-natal
breastfeeding; to assess the attitude of antenatal women women who were seriously sick; and ante-natal women
attending tertiary care hospital regarding breastfeeding; attending Jayanagar General Hospital for reason other
and to explore associations with knowledge and socio than ante-natal checkups were excluded.
demographic characteristics.
The study does not require any investigations or
METHODS interventions to be conducted on patients or other humans
or animals.
Study area
RESULTS
The study was conducted at the Jayanagar General
Hospital, 4th B block beside Rajiv Gandhi Health The sample of the present study comprised of 204
Institute, Tilak Nagar, Bengaluru, Karnataka. antenatal women of whom 89.7% belonged to age group
less than or equal to 30 years. Majorities 73.5% of them
Study type were Muslims. Most of the participants 87.7% were
unemployed. Almost 72.54% of the participants were
The type of the study was cross-sectional. multipara.

Study period Almost 35% initiated breastfeeding within an hour of

delivery. Less than one fourth of the participants stated
The study was conducted for a period of 6 months. that colostrum helps in proper growth of the children.
28.9% had knowledge that colostrum helps in fighting
Study population against infection. There were many women (15.9%) who
lacked knowledge about colostrum. 46.1% of participants
The study population consisted of women attending opined that pre lacteal feed should not be given to the
Jayanagar General Hospital for ante-natal checkups. baby. One quarter of the mothers were exclusive breast
feeders.
Sampling design
Table 1: Distribution of antenatal women attending
The design of the study was convenient sampling. tertiary care hospital according to age.

Sample size Age (years) Frequency Percent

Less than or equal to 30 183 89.7
Sample size was calculated by using the formula. 31 to 40 21 10.3
Total 204 100.0
𝑁 = 4 𝑝𝑞/𝑑 2
Table 2: Distribution of antenatal women attending
Where p is proportion of knowledge of mothers towards tertiary care hospital according to education.
breastfeeding that is 85% based on review of literature; q
is 1-p, d is 5 total sample size calculated is 204 with 10% Education Frequency Percent
non-response rate, and total sample size taken is 224. More than high school 135 66.2
Less than or equal to
69 33.8
Methods of data collection high school
Total 204 100
All women attending Jayanagar General Hospital for
ante-natal checkups during study period were interviewed Table 3: Distribution of ante natal women attending
personally by an investigator after obtaining an informed tertiary care hospital according to religion.
consent. Data regarding socio-demographic details and
data on knowledge, attitude of breast feeding was Religion Frequency Percent
collected by using a pre-tested semi-structured Hindu 54 26.5
questionnaire through face to face interview by an Muslim 150 73.5
investigator. Total 204 100.0

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Table 4: Distribution of antenatal women attending started after 6 months. Correct knowledge about storage
tertiary care hospital according to the occupation. of expressed breast milk was present in 14.2%.

Occupation Frequency Percent Table 7: Knowledge of antenatal women attending

Employed 25 12.3 tertiary care hospital regarding exclusive breast
Unemployed 179 87.7 feeding.
Total 204 100.0
Exclusive breast
Frequency Percent
Table 5: Distribution of antenatal women attending feeding (months)
tertiary care hospital according to the parity. Less than 6 36 17.6
6 108 52.9
Parity Frequency Percent More than 6 47 23.0
Primipara 56 27.5 No idea 13 6.37
Multipara 148 72.54 Total 204 100.0
Total 204 100.0
Table 8: Knowledge of antenatal women attending
Table 6: Knowledge of antenatal women attending tertiary care hospital regarding expressed breast milk.
tertiary care hospital regarding time of initiation of
breastfeeding. Expressed breast
Frequency Percent
milk
Time of initiation of Yes 51 25.0
Frequency Percent
breast feeding (hour) No 153 74.5
Within 1 72 35.3 Total 204 99.5
1-6 39 19.1
6- 24 54 26.47 Table 9: Knowledge grade of the antenatal women
No idea 39 19.1 attending tertiary care hospital regarding
Total 204 100.0 breastfeeding.

Almost 42.2% of the participants were of the opinion that Knowledge

Grade Frequency Percent
the duration of breastfeeding is 2 years or more. 65.7% of score
the participants stated that complementary feeding should 0-3 Poor 54 24.5
be started after 6 months. Knowledge about technique of 4-7 Average 94 42.7
expressed breast milk was poor. Almost 65.7% of the More than 8 Good 56 25.5
participants stated that complementary feeding should be
Table 10: Association between religion and prelacteal feed.

Religion (%) Chi square

Pre lacteal feed P value
Hindu Muslim Total value
Should be given to baby 5 (4.5) 105 (95.4) 110 (53.9)
Should not be given to baby 49 (52.1) 45 (47.8) 94 (46.07) 58.960 0.000
Total 54 (26.4) 150 (73.5) 204 (100)

DISCUSSION Occupation of the antenatal women attending tertiary

care hospital
Age of the antenatal women attending tertiary care
hospital In the current study, nearly 87.7% of the subjects were
unemployed, which is comparable to the cross sectional
In the current study, nearly 91.17% of the subjects study conducted by Sultania et al in the year 2019, where
belonged to the age group less than or equal to 30 years it was found that 91% of their study sample were
which is similar to a study conducted by Mangalgi and unemployed, also a study conducted by Nishimura et al
Sudheendra in the year 2017 where it was found that 80% from South India, Mysore, revealed that 97.5% of the
of the subjects belonged to the age group less than or study subjects were unemployed, which is in contrast to a
equal to 30 years whereas a study conducted by Dixit et al study conducted by Mohit et al wherein, 54.2% of the
from Uttar Pradesh reported that 43.6% of the study study subjects were unemployed.12,13
subjects belonged to the age group less than or equal to
25 years.10,11

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Parity of the antenatal women attending tertiary care significant difference between knowledge of exclusive
hospital breastfeeding mainly because the study conducted by Das
et al were done in the rural areas of Eastern India where
In the current study, nearly 27.5% of the study subjects the prevalence of exclusive breastfeeding is more as
were primipara, which is comparable to the study compare to the urban areas.
conducted by Sultania et al from Banaras, India, in which
25% of the study subjects were primipara, where as a Initiation of complementary feeding
study by Nishimura et al reported that 53.8% of the study
subjects were primipara.12,22 In the current study, nearly 65.7% of the study population
knew about the initiation of complementary feeding at the
Religion of the antenatal women attending tertiary care age of six months, which is similar to the study conducted
hospital by Hasnain et al, where it was found that the knowledge
of initiation of complementary feeding is 54% whereas a
In the current study, nearly 73.5% of the study population study conducted by Choudhary et al found that the
belong to the Muslim religion. But in contrast, study knowledge of initiation of complementary feeding is
conducted by Ghure et al, Indore, Madhya Pradesh, India 62.3%.16,18
in the year 2018 revealed that 95.4% of the study
population were Hindu.14 The study conducted by Prelacteal feed
Sultania et al from Banaras, India revealed that 24% of
the subjects were Muslims which was contrasting to the In the current study, it was found that 54% mentioned that
present findings.12 The high Muslim patients in the pre lacteal feed should be given which was in contrast to
current study is due the fact that the hospital is located in the study conducted by Roy et al where it was found that
the predominant Muslim locality of Bangalore. 40.1%reported that pre-lacteal feed should not be given to
newborn babies.19
Education of the antenatal women attending tertiary
care hospital A study conducted by Sultania where it was found that
27% of the study population reported that pre lacteal feed
In the current study, nearly 66% of the study population should be given to new born babies.12 The prevalence of
received education till more than high school. A study Pre lacteal feed is low in the study conducted by Sultania
conducted by Rudrappa et al from Mysore reported that et al. This is mainly the study conducted in Banaras
30% of the study subjects received education till primary where the Hindu population is predominant and the pre
school whereas 24% of the study population received lacteal feed is mainly prominent in Muslims.
education till secondary school.21 The study conducted by
Sultania from Banaras, India revealed that 13% of the Duration of breastfeeding
study subjects were literate up to high school which was
in contrast to the present findings.12 This is mainly In the current study, it was found that 42.2% of them
because the current study is conducted in Karnataka knew that duration of breastfeeding is for 2 years and
where the literacy of the female is high as compared to more which was in contrast to the study conducted by
Banaras which is in Uttar Pradesh. Choudhary et al in the year 2015 where it was found that
62.1% of the study subjects knew that duration of
Time of initiation of breastfeeding breastfeeding is 2 year or more. 16 A study conducted by
Chandrashekhar, Udupi, Karnataka reported that 78.3%
In the current study, nearly 35.3% of the study population of the study subjects subscribed to the view that
knew about initiating breastfeeding within an hour. The breastfeeding should be continued beyond 1 year.20
study conducted by Dhanlakshmi et al from Mysore
revealed that the knowledge regarding early initiation of Knowledge grade of the antenatal women attending
breastfeeding were poor among 70% mothers.15 A study tertiary care hospital
conducted by Chaudhary et al revealed that 10% of the
study subjects knew about the initiation of breastfeeding In the current study, 42.7% and 24.5% of the study
within an hour.16 subjects secured ‘average' and ‘poor' grade respectively,
while 25.5% secured ‘good' grade. This is comparable to
Exclusive breastfeeding the study conducted by Girish and Gandhimathi in the
year 2015 at Elite Mission Hospital, Kerala where it was
In the current study, nearly 52.9% of the study population found that 32% of the study population secured good
knew about exclusive breastfeeding which is similar to grade whereas 46% and 22% of the subjects secured
the study conducted by Choudhary et al in the year 2015 average and poor grade where as a study conducted by
where it was found that 59.1% knew about exclusive Ghure et al from Madhya Pradesh, India reported that
breastfeeding where as a study conducted by Das et al, 81.1% of the study subjects had good knowledge.14,21
Eastern India reported that 80% of the study subjects had
the knowledge of exclusive breastfeeding.16,17 There is a

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Association between knowledge grade and other Funding: No funding sources

variables Conflict of interest: None declared
Ethical approval: The study was approved by the
There is no significant association between knowledge Institutional Ethics Committee
grade and the demographic characteristic such as
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