‘’Breastfeeding is a mother’s gift to herself, her baby and the earth’’. - Pamela k. wiggins

Breast feeding is an extra ordinary gift of nature for both babies and mothers in many aspects. It is globally accepted to be the best and complete food for the new born as it satisfies the specific nutritional needs. Widespread evidences are there to support the advantages of breast feeding to the infants, mothers, families and society which is also including physical, emotional, psychological, developmental, nutritional, immunological, social, economic and environmental benefits.¹

WHO defines exclusive breastfeeding as the practice of feeding milk (including expressed milk) and allows the baby to receive vitamins, minerals and medicine. Water, breast-milk substitutes, other liquids and solid food are excluded.² World Health Assembly in 2001 resolved that exclusive breastfeeding for the first six months is the most appropriate infant feeding practice.³ The government of India recommends the initiation of breast-feeding should begin immediately after childbirth, preferably within one hour. Early initiation of breast feeding is encouraged for a number of reasons. It is also beneficial for mothers   because it stimulates breast milk production and facilitates the release of oxytocin, which helps in contraction of uterus and reduces postpartum blood loss.⁴ 

The universally recommended breast feeding is from birth to the age of six months exclusive breast feeding and it constitutes appropriate feeding for the infant development. The introduction of breast milk is especially encouraged immediately after birth and until the third day, when the mother secrets colostrum. Colostrum provides all the nutrients that are needed by the infant in this early period. It is compositionally distinct with concentration of protein, vitamin A and B12 being higher than the mature milk. Colostrum also contains a high concentrate of an immunoglobulin’s especially immunoglobulin-A(IgA) which has protective role against pathogens in gut.⁵

The benefits of breastfeeding for health, wellbeing of the mother and baby are well documented. WHO recommends early (i,e. within  one hour of giving birth) initiation of breastfeeding could reduce neonatal mortality by 22%, which would contribute to the achievement of the Millennium Development Goals. Globally, over one million new-born, infants could be saved each year by initiating breastfeeding within the first hour of life. Approximately 1.45 million lives each year by reducing deaths mainly due to diarrheaeal disorders and lower respiratory tract infections in children.⁶

The primary cause of neonatal deaths is: neonatal infection (52%), asphyxia (20%), and low birth weight (17%). Most of the infectious deaths are diarrhoea and pneumonia. These all the risks can be reduced by exclusive breast feeding.⁷

NEED FOR THE STUDY:

Breast milk is the best source of nutrition for the baby and appropriate feeding practice is very much important for survival, growth, development, and nutrition of infant and children. Inappropriate feeding practice leads to a crucial issue of infant’s mortality due to malnutrition and diarrheal problem. So, the best way to comes out from this problem is promotion of adequate practice of breast feeding. Breast feeding saves many lives by preventing malnutrition and decease risk of infection.⁸

A study was conducted on knowledge and practices of exclusive breastfeeding in the sub urban setting in Sri Lanka. Sample size was 217 mothers with a baby aged <1 year. The data collection method was planned interview schedule. The result if this study shows that, 72percent of the study sample had exclusively breastfeed them for 6 months. The mothers indicated that having to return to work (50%) and their opinions regarding amount of milk being inadequate (44%) and nutrients being inadequate (18%) as the reason for not exclusively breastfeeding up to the recommended age. It was concluded that knowledge of the mother affects the exclusive breastfeeding of the new-born.⁹ 

A cross-sectional study was conducted to identify factors associated with exclusive breastfeeding in government health clinics in klang, Malaysia. The sample size was 682 and   data were collected by face to face interviews using a pretested Planned questionnaire. It was found that the prevalence of exclusive breast feeding among mother with infants aged between one and six months was 43.1%. In multivariate model exclusive breastfeeding was positively associated with rural residence. It was concluded that multiparous mothers were strongly associated with exclusive breastfeeding¹⁰.

STATEMENT OF THE PROBLEM

A study to assess the effectiveness of planned teaching program on knowledge regarding breast feeding among postnatal mothers in Sohawal Village, Satna, Madhya Pradesh.

OBJECTIVES:

• To assess the pre-existing knowledge of mothers regarding exclusive breastfeeding.
• To evaluate effectiveness of Planned teaching program on knowledge regarding exclusive breastfeeding among postnatal mothers.
• To find out association between pre-existing knowledge and selected demographic variables.

HYPOTHESIS:

• H₁ - There will be a significant difference between pre-test knowledge score and post-test knowledge score regarding exclusive breastfeeding among postnatal mothers.
• H₂ -There will be a significant association between pre-test knowledge score and selected demographic variables.

ASSUMPTIONS:

• Postnatal mothers may not have enough knowledge regarding breast feeding.
• Postnatal mothers may not be aware of technique of breast feeding.

DELIMITATIONS:

The study is limited to;

• Mothers from selected hospital
• Mother who are willing to participate in the research study.
• Mother who can understand Hindi or English language.

Research Approach:

A Quantitative Research Approach was adopted for the present study. 

Research Design: Quasi-experimental design was adopted for the present study. 

Setting: Sohawal Village of District Satna, M.P.

Population:

Target population: All postnatal mothers.

Accessible population: Postnatal mothers of Community area, Sohawal, Satna.

Sample: In the present study sample were postnatal mothers who were admitted at Community area. Sohawal, Satna.

Sample size: Sample size for the present study is 30 postnatal   mothers.

Sampling technique:  Purposive sampling technique was used to select postnatal mothers.

Criteria for selection of samples:

Inclusion criteria: Postnatal mothers who were able to understand Hindi and English languages.

Exclusion criteria: Postnatal mothers who were unwilling to participate in the study.

Variables:

Independent variable: 

• In the present study planned teaching program on exclusive breast feeding is independent variable.

Dependent variable:

• In present study, knowledge level on exclusive breast feeding is dependent variable.

Research tool:

Tool-I: Socio-Demographic data of mothers: Demographic data include items to collect background of the mother which include age of mother, religion of the mother, education status of the mothers, occupation of mother, type of family, monthly income, area of residence, number of children.

Tool -II: Planned knowledge questionnaire It includes multiple choice questions to assess knowledge regarding exclusive breastfeeding which includes 30 items. Each correct answer was awarded as one mark. Total maximum score was 30.

Planned teaching program:

Teaching plan is a guide for the teacher because it helps to cover the topics comprehensively with proper sequence of points and without missing anything. The content of STP was prepared and organized under various heading. The content of the STP includes meaning and concepts of breast feeding, physiological changes take place. given to child, initiation of breast feeding, what is colostrum, colour of colostrum, colostrum needs for baby, time duration for breast feeding, advantages of breast feeding to baby, benefits for lactating mother.

Data collection procedure:

Data collection procedure is the procedure in which we gathered the information needed to address the research problem. The formal permission was taken from the authorities of the (PHC) Community area, Sohawal, Satna. The investigator obtained the consent from the participants by explaining the purpose of the study. The investigator collected data for 1 month. After the pre-test, the structured teaching program was conducted. The duration of teaching program was 45 minutes. After 21days gap, post test was conducted to the same clients to evaluate the effectiveness of the Planned teaching program

Table-1: Frequency and percentage distribution of knowledge among postnatal mothers.                                                                                                                                                                                           (N=30)

Table No-2: Comparison of means of Pre-test and post-test knowledge score of mothers regarding exclusive breastfeeding.                                                                                                                       (N=30)

Table-3: Association between level of knowledge and selected demographic variables.                                                                                                                                                                                                                                                                                                                (N=30)

Independent t test              One Way An ova test                               *significant at 0.05 level 

MAJOR FINDINGS OF THE STUDY:

I:  Description of demographic variables:

Among 30 postnatal mothers, regarding educational status, 33.3% mothers were completed primary education, 86.6% of the mothers were housewives, 67% belongs to joint family, 40% of families had monthly income less than Rs. 10000, 86.6% were Hindus and 86.6% of the mothers were not exposed to pervious teaching on breast feeding.

II: Frequency and percentage distribution of level of knowledge among postnatal mothers:

Among 30 postnatal mothers, in pre test, 10% had good knowledge, 40% had average knowledge and 50 % had poor knowledge. And in post test, 26.67% had good knowledge, 53.33% had average knowledge and 20 % had poor knowledge.

III: Effectiveness of the planned teaching program on knowledge regarding exclusive breast feeding:

Findings of the present study showed that that mean of post-test knowledge score (23.00±3.464) of mothers was higher than mean pre-test knowledge score (18.03±5.170). The mean difference was 4.971± 2.80. The paired‘t’ test was used to compare mean of pre-test and post-test knowledge score. Therefore, null hypothesis was accepted and research hypothesis was rejected. So, there is significant improvement in knowledge score can be attributed to the planned teaching program provided as an intervention administered by pre-test and post-test assessment

IV: Association between level of knowledge and selected demographic variables:

There was statistically significant association of knowledge score with educational status, occupation of mother, area of residence and exposure to previous teaching but there was no statistically significant association of knowledge score with family income, type of family and religion of mother. 

The study is concluded that the most of the mother had low level of knowledge regarding exclusive breastfeeding. Also, it can be concluded that the awareness program was found effective to increase in the knowledge level of mothers and improve in practice of exclusive breastfeeding

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