Introduction: breastfeeding differs from one country to another and

Introduction:            Breastfeeding is the way ofproviding ideal food for healthy growth and development of infants and itsadvantages range from physiological to psychological for both mothers andinfants. It is well known that breastfeeding influences a child’s healthpositively and improves nutritional status.The American Academy of Paediatrics recognizesbreastfeeding and human milk as the “normative standards for infant feeding.The WHO recommends that for the first six months of life, infants should beexclusively breastfed to achieve optimal growth, development, and health.Thereafter, infants should receive nutritionally adequate and safecomplementary foods, while continuing to breastfeed for up to two years ormore. Exclusive Breast Feeding (EBF) is defined as infant feeding with humanmilk without the addition of any other liquids or solids.

Weaning is the termusually used to describe the process of cessation of breastfeeding after aperiod of successful breastfeeding. This usually involves addition of food toinfant’s diet and/or replacement of breast milk in infant’s diet with anothertype of milk (formula or whole milk). Maternal physiology, infant nutritionalneeds, infant development, especially the development of biting and chewing,and cultural issues all play a role in the timing of weaning.The prevalence of breastfeeding differs from onecountry to another and from one society to another, this of course is due tocultural and religious believes.  Despite strong evidences in support ofEBF for the first six months of life, its prevalence has remained lowworldwide and it is estimated that only about one-third of infants wereexclusively breastfed for the first six months of life.In India, breastfeeding appears to be influencedby social, cultural, and economic factors.

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In 1991, Breastfeeding Promotion Networkof India (BPNI) was born to protect, promote and support breastfeeding. (8) Further, the Government of India has undertakenNational Rural Health Mission, which intends to implement Integrated Managementof Neonatal and Childhood Illnesses (IMNCI) through the existing healthcaredelivery system.  The promotion and acceptance of practices, such asexclusive breastfeeding, are especially important in developing countries withhigh levels of poverty, and that are characterized by a high burden of diseaseand low access to clean water and adequate sanitation.While, a number of studies have assessedknowledge, attitude and practice of breastfeeding in different parts of theworld; such studies are limited among Indian mothers. However, there wereno reported studies of breastfeeding knowledge and attitudes of mothers usingthe IIFAS (Iowa Infant Feeding Attitudes Scale) from India, which may bedifferent from other cultures. Further, maternal attitude is also a concept ofinterest to health professionals who support breastfeeding.

In this regard, we are proposing a study toexamine  the infant feeding practices, knowledge and attitude towardsbreast feeding among Indian postnatal mothers’ using the IIFAS.Objectives:1.     To access the knowledge, attitude and practices of mothers,of rural parts of central Karnataka, regarding breastfeeding, complementaryfeeding and weaning.

2.     To documentwhy the mothers were unable to practice exclusive breastfeeding.Methodology:This is a cross-sectional study.

The studypopulation comprises of  postnatal mothers who visit the Paediatric Out Patient Department with theirchildren for vaccination or for the treatment of other minor illnesses atAdichunchanagiri Hospital and Research centre, B.G. Nagar, Mandya district,Karnataka. Studyparticipants will be selected through a random sampling method of the databaseof children attending the Paediatric outpatient department.

Those who meet theinclusion criteria will be interviewed. The study criteria; a) mothers of healthyinfants aged 6 months, b) born between 37 and 42 gestation weeks, c) and without major birth defects such ascongenital heart disease, cleft lip/cleft palate and Down syndrome and d) whovolunteer  to participate. Mothers of preterm babies, and multiplegestations will be excluded. Approximately 200 postnatal mothers will beinterviewed.          References:1.

 Batal M, Boulghourjin C, Abdullah A, Afifi R. Breast-feeding andfeeding practices of infants in a developing country: A national survey inLebanon. Public Health Nutr. 2005;9:313–9.

2. Horta BL, Bahl R, Martines JC, Victora CG. Evidence on thelong-term effects of breastfeeding: Systematic reviews and meta-analyses1. Lastaccessed on 17 July 2013..3.

 Van Rossum CT, Büchner FL, Hoekstra J. Quantification of health effects of breastfeeding: Review ofthe literature and model simulation: RIVM report 350040001/2005. Bilthoven: RIVM; 2006.

4. WHO. Exclusive breastfeeding for six months best for babieseverywhere’.

 World HealthOrganization; 2011. (Cited 2014 July 21).5. American Academy of PediatricsSection of Breastfeeding.

Policy statement: Breastfeeding and the use of humanmilk. Pediatrics. 2012;129:e827–416.

Gibney MJ, Elia M, Ljungqvist O, Dowsett J. Ch. 1. 2nded. UK: Blackwell; 2006. Clinical Nutrition; p. 2.7.

 Li R, Zhao Z, Mokdad A, Barker L, Grummer- Strawn L.Prevalence of breastfeeding in the United States: The 2001 National ImmunizationSurvey. Pediatrics. 2003;111:1198–201.8. . LiR, Zhao Z, Mokdad A, Barker L, Grummer- Strawn L. Prevalence of breastfeedingin the United States: The 2001 National Immunization Survey.

 Pediatrics. 2003;111:1198–201.9. NRHM. NationalRural Health Mission (2005–2012) Mission document.

 New Delhi:MOHFW, Government of India, New Delhi; Ministry of Health and Family Welfare(MoHFW); 2006.10. Madhu K, Sriram C, Ramesh M.

Breast FeedingPractices and Newborn Care in Rural Areas: A Descriptive Cross-SectionalStudy. Indian J Community Med. 2009;34:243–6.

11. Khasawneta M, Khadu Y, Amarin Z,Alkafeste A. Knowledge, attitude and practices of breastfeeding in the NorthJordan. Int Breast Feed J. 2006;23:1–17.

12. Chaudhary RN, Shah T, Raja S. Knowledge andpractice of mothers regarding breast feeding: A hospital based study.

 Knowl Pract Breast Feed. 2011;9:194–200.13.Kishore K. Knowledge, Attitude and Practices of weaning among mothers inGulbarga, MD thesis; Department of Pediatrics, MR Medical College, Gulbarga,Ranjiv Gandhi University of Health Sciences; Karnataka, Bangalore.

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