|Year : 2012 | Volume
| Issue : 2 | Page : 149-151
Breast feeding practices among health care professionals in a tertiary care hospital from South India
Raghavan Renitha1, Thirunavukkarasu Arun Babu1, Manish Kumar2, Sadagopan Srinivasan3
1 Assistant Professor, Department of Pediatrics, Sri Lakshmi Narayana Institute of Medical Sciences, Osudu, Agaram Village, Puducherry, India
2 Senior Resident, Department of Pediatrics, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
3 Professor and Head, Department of Pediatrics, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
|Date of Web Publication||21-Aug-2012|
Assistant Professor of Pediatrics, Sri Lakshmi Narayana Institute of Medical Sciences (SLIMS), Puducherry - 605 502
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Personal breastfeeding experiences of health care professionals play a major role in influencing their attitudes and expertise regarding counseling and managing breastfeeding issues in patients. This study was done with an objective of studying the current breastfeeding practices among health care professionals (HP) and their spouses and the factors influencing them. All children < 5 years of age, residing in hospital's residential quarters, were included. A detailed breastfeeding history demographic data were obtained following a semi-structured interview with mothers. Among 81 children included for analysis, in 73 children (90.1%), an initiation of breastfeeding was within 24 hours of birth and in 36 children (44.4%), it was within first hour of life. 43 children (58.1%) were exclusively breast fed for 6 months. Mean duration of EBF was 5.3 months and total duration of breastfeeding was 13.2 months. Gender of HP, gender of the child and socio-economic factors were not found to significantly affect breastfeeding practices among HP.
Keywords: Breastfeeding practice, Exclusive breastfeeding, Health care professional, Weaning
|How to cite this article:|
Renitha R, Babu TA, Kumar M, Srinivasan S. Breast feeding practices among health care professionals in a tertiary care hospital from South India. Indian J Public Health 2012;56:149-51
|How to cite this URL:|
Renitha R, Babu TA, Kumar M, Srinivasan S. Breast feeding practices among health care professionals in a tertiary care hospital from South India. Indian J Public Health [serial online] 2012 [cited 2020 Dec 3];56:149-51. Available from: https://www.ijph.in/text.asp?2012/56/2/149/99910
Health care professionals (HP) play a major role in promoting breastfeeding among mothers in institutional setups. Successful promotion depends upon their knowledge, attitude, motivation and communication skills. Though we expect health care professionals including doctors, nurses and various other health workers to be well informed regarding breastfeeding issues, studies have shown that it is not completely true. ,
Personal breastfeeding experience or feeding by spouse has been recognized as an important source of breastfeeding information and practical experience for health professionals.  Health care professionals with personal breastfeeding experience for at least 2 weeks, are more likely to actively promote breastfeeding and can confidently assist breastfeeding in women.  Females with personal breastfeeding experiences are more confident in handling breastfeeding issues than male HPs whose spouse has breast fed.  The breastfeeding practices among health professionals can reflect their knowledge and attitudes, which may significantly play a role in managing breastfeeding problems in nursing mothers. This can also give us a feedback about the areas to reinforce while training the health care professionals.
This study was done with an objective of studying the breastfeeding practices among health care professionals and their spouses, living in staff quarters of a tertiary care hospital in South India and the factors influencing them.
This descriptive study was done during a 2 year period from September 2007 to November 2009, in the hospital campus of a tertiary care teaching hospital, located in South India. All children < 5 years of age, residing in hospital's residential quarters, were included in the study. Temporarily residing or visiting children were excluded. House to house visit was done, and qualitative and quantitative data was collected following a semi-structured interview with mothers. The purpose of the study was explained to the mothers and an informed consent was obtained before data collection. Demographic details like age and sex of the child, education, per capita income and occupation of the parents, whether father or mother was health professional etc. were recorded. A detailed breastfeeding history was obtained. Parents were enquired about the duration of exclusive breastfeeding and total breastfeeding and whether colostrum was given. The study protocol was approved by the institute ethics committee. Data entry and analysis were done using SPSS for Windows Version 16.0 (SPSS Inc, Chicago, IL, USA). Percentages were calculated for categorical variables. Means and standard deviations (SD) were calculated as required for numerical variables. The Chi-square test was used to compare two groups. For comparison of the mean of different groups, unpaired t test and one-way ANOVA were used. P value < 0.05 was considered statistically significant.
A total of 96 permanently residing, under-5 years old children were included in the study, and 15 children with incomplete data were excluded from analysis. Out of 104 families with children < 5 years of age, 67 families agreed to participate in the study. The mean age of the children in months was 28.74 ± 16.7 (1 to 59) [mean ± SD (range)]. Among 45 female health professionals, 7, 20 and 18 were doctors, nurses and other health related workers, respectively. Among 36 male health professionals, 5, 8 and 23 were doctors, nurses and other health related workers, respectively. All children except 1 were breast fed. The 1 child who didn't receive breast feeding was an adopted child. 23 out of 67 mothers (34.33 %) had previous breastfeeding experience. 36 children (44.4%) were breastfed within first hour of life and 73 children (90.1%) were breastfed within first 24 hours of life. 1 child received sugar water on first day of life. Exclusive breastfeeding (EBF) for a minimum period of 6 months was studied. Excluding 7 babies who were still receiving EBF at the time of the study, 43 children (58.1%) were exclusively breastfed for 6 months. Mean duration of EBF was 5.3 months and total duration of breastfeeding was 13.2 months. Comparison of breastfeeding characteristics between feeding by health professionals and their spouses revealed no significant differences [Table 1]. There was no difference in breastfeeding practices in relation to the sex of the child [Table 2]. Number of families falling in the socio-economic class 1 to class 5 were 12 (14.8%), 29 (35.8%), 18 (22.2%), 22 (27.2%) and 0, respectively. Breastfeeding practices were studied in different socio-economic classes and no significant difference was found between them.
|Table 1: Comparison of breast feeding characteristics between feeding by health professional and their spouse|
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|Table 2: Comparison of breast feeding characteristics with the sex of the child|
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The study found that the percentage of babies receiving breastfeeding within 1 hour of birth was 44.4 %, which was higher when compared with the national family health survey - 3 data (23.4%).  Similarly, percentage of infants receiving EBF for 6 months was 58.1%, which was again higher than the national data (46.3%).  Total duration of breastfeeding was 13.2 months, which was low when compared to similar studies from India.  Though breastfeeding beyond 6 months of age is associated with a decrease in childhood morbidity and mortality, here the target population had lesser total duration of breast feeding. 
Though it was assumed that HPs would be well-informed regarding breastfeeding, only 58% of their children received EBF for 6 months. One of the possible reasons could be that they were working and significant proportions of them were taking night shifts as well. But, this cannot be completely true because even the spouses of male HP were not significantly different from the female HP. Working mothers also had practical issues related to storing breast milk and lack of support for breastfeeding, especially in a nuclear family setup.
The perception that their infant was not satisfied by breast milk alone was the most common reason cited by mother to stop breastfeeding irrespective of the weaning age. Concerns about lactation and nutrition problems were the most cited reasons for cessation of breastfeeding during the first 2 months. 
Personal breastfeeding experience has been consistently associated with more frequent breastfeeding promotion activity and an increased self-confidence in handling related issues.  There is no convincing evidence that female HP had an increased knowledge and confidence in handling breastfeeding issues than the spouses of male HP. , In this study, the female HP exclusively breast fed for a shorter duration and stopped breastfeeding early when compared to the spouses of male HP, but there was no statistically significant difference between them.
Previously done studies to find gender differences in breastfeeding had shown contrasting results. While some studies had shown no difference, a recent study had shown that the likelihood of stopping breastfeeding was significantly higher for female children compared to male children. ,, This proves that the gender differential in breastfeeding practices favoring male children does exist. However, there were no significant differences in breast feeding between male and female children in this study. This might be due to the educational status and profession of the parents.
Mothers belonging to higher socio-economic strata and literates are known to initiate weaning early and breastfeed for a shorter duration. , In this study, there were no significant differences in breastfeeding among different socio-economic classes, partly because the numbers in individual classes were less and most of our study population was literate.
One of the limitations of this study is the relatively small sample size, which was due to the highly selective target population. Information on breastfeeding duration was based on the interview from mothers, which had the potential to introduce recall bias.
In conclusion, breastfeeding practices among health professionals were better than the national data, in terms of feeding within first hour of birth and an exclusive breastfeeding for 6 months. Gender of HP, gender of the child and socio-economic factors were not found to significantly affect breastfeeding practices in HP.
| References|| |
|1.||Guise JM, Freed GL. Resident physician's knowledge of breastfeeding and infant growth. Birth 2000;27:49-53. |
|2.||Williams EL, Hammer LD. Breastfeeding attitudes and knowledge of pediatricians-in-training. Am J Prev Med 1995;11:26-33. |
|3.||Tennent R, Wallace LM, Law S. Barriers to breastfeeding: A qualitative study of the views of health professionals and lay counsellors. Community Pract 2006;79:152-6. |
|4.||Freed GL, Clark SJ, Curtis P, Sorenson JR. Breast-feeding education and practice in family medicine. J Fam Pract 1995;40:263-7. |
|5.||Goldstein AO, Freed GL. Breast-feeding counselling practices of family practice residents. Fam Med 1993;25:524-9. |
|6.||National Family Health Survey, India. Key indicators for India from NFHS-3;.2006 [Last cited on 2010 Sep 15]. Available from: http://www.nfhsindia.org/pdf/India.pdf. |
|7.||Madhu K, Chowdary S, Masthi R. Breast feeding practices and newborn care in rural areas: A descriptive cross-sectional study. Indian J Community Med 2009;34:243-6. |
|8.||Molbak K, Gottschau A, Aaby P, Hojlyng N, Ingholt L, Silva AP. Prolonged breast feeding, diarrhoeal disease, and survival of children in Guinea-Bissau. Br Med J 1994;308:1403-6. |
|9.||Li R, Fein SB, Chen J, Grummer-Strawn LM. Why Mothers Stop Breastfeeding: Mothers' Self-reported Reasons for Stopping During the First Year. Pediatrics 2008;122:S69-76. |
|10.||Williams EL, Hammer LD. Breastfeeding attitudes and knowledge of pediatricians-in-training. Am J Prev Med 1995;11:26-33. |
|11.||Kumar S, Nath LM, Reddaiah VP. Factors influencing prevalence of breastfeeding in a resettlement colony of New Delhi. Indian J Pediatr 1989;56:385-91. |
|12.||Swenson IE, Thang NM, Tieu PX. Individual and community characteristics influencing breastfeeding duration in Vietnam. Ann Hum Biol 1993;20:325-34. |
|13.||Malhotra R, Noheria A, Amir O, Ackerson LK, Subramanian SV. Determinants of termination of breastfeeding within the first 2 years of life in India: Evidence from the National Family Health Survey-2. Matern Child Nutr 2008;4:181-93. |
[Table 1], [Table 2]