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BREAST FEEDING PRACTICES AND ITS ASSOCIATED FACTORS ON FEMALE PATIENTS ATTENDING NIL RATAN SIRCAR MEDICAL COLLEGE AND HOSPITAL 1 Conducted By: Roll No. 103 - 153 3rd Semester 2ndProfessional MBBS students (2023-2024) Project Guide: Dr. Nabanita Chakraborty Dr Sk Golam...

BREAST FEEDING PRACTICES AND ITS ASSOCIATED FACTORS ON FEMALE PATIENTS ATTENDING NIL RATAN SIRCAR MEDICAL COLLEGE AND HOSPITAL 1 Conducted By: Roll No. 103 - 153 3rd Semester 2ndProfessional MBBS students (2023-2024) Project Guide: Dr. Nabanita Chakraborty Dr Sk Golam Mortuja (Dept. of Community Medicine, Nil Ratan Sircar Medical College & Hospital) 2 CERTIFICATE: This is to certify that Mr/Ms._______________________________________, University roll no._______________, Registration no, ___________________ has completed the study on breast feeding and its associated factors on female patients attending Nil Ratan Sircar Medical College and Hospital and his/her performance was found to be satisfactory. Prof. Dr.Dibakar Haldar (Professor and HOD) (Dept. of Community Medicine, NRSMCH) Signature........................................... Dr. Nabanita Chakraborty (Assistant Professor) (Dept. of Community Medicine, NRSMCH) Signature..................................... Dr. Sk Golam Mortuja (Demonstrator) (Dept. of Community Medicine, NRSMCH) Signature............................................. 3 INDEX: SERIAL NO. TOPIC PAGE NO. 1 Introduction 5 2 Objectives 6 Materials and 3 6-7 Methods 4 Results 8-21 5 Summary 22-24 6 Conclusion 24-25 7 Limitations 25 8 Bibliography 26 4 INTRODUCTION Infant and child feeding practices from birth to the first two years of life is of utmost importance to meet the nutritional requirements. It has been proved that breastfeeding reduces the risk of childhood diseases and malnutrition..Apart from this, breastfeeding also helps to reduce non-communicable diseases like diabetes, obesity, cardiovascular diseases in future.[2-4] Moreover, breastfeeding has also been found to reduce the incidence as well as severity of several infectious diseases. Proper nutrition during infancy and early childhood remains a key for optimal growth and development.Thus it has been recommended by the global strategy for infant and young child feeding that initiation of breastfeeding should occur within the first hour after birth, and exclusive breast feeding should be continued upto first 6 months.After 6 months of age breast milk does not provide all the essential nutrients required for the child’s growth viz. iron and vitamin D, and hence complementary feeding is required.Thus WHO recommends timely introduction of complementary feeding with nutritionally rich and age-appropriate food in addition to breast feeding which is recommended to be continued upto 2 years of age. Timely introduction of complementary feeding is essential to prevent morbidity, mortality as well as malnutrition among infants.[11, 12]. Inspite of promoting exclusive breast feeding and timely introduction of complementary feeding the breastfeeding coverage in India is 54.9% whereas in West Bengal it is only 52.3%.(NFHS 4).Also timely initiation of complementary feeding was 42.7% and 52% in India and West Bengal respectively. Thus to increase the coverage of breast feeding and also to promote timely initiation of complementary feeding the current study was undertaken to 5 assess the breast feeding practices and its associated factors among mothers attending the Routine Immunization Clinic and Paediatric OPD of a tertiary care hospital. OBJECTIVES 1) To study the socio-demographic characteristics of mothers attending the Routine Immunization Clinic and Paediatric OPD of NRS Medical College and Hospital 2) To assess the breast feeding practices of the mothers mothers attending the Routine Immunization Clinic and Paediatric OPD of NRS Medical College and Hospital 3) To determine the factors associated with the current breast feeding practices MATERIALS AND METHODS Study type & Study design: Descriptive ,observational ,cross-sectional study. Study area: Routine Immunization Clinic and Paediatric OPD of NRS Medical College and Hospital. Study Population :Mothers of 9 to 24 months children NRS Medical College and Hospital. Study Period:1/6/23 to 30/6/23 Sample size:150 Sampling design: Purposive sampling Selection criteria: Inclusion criteria: 6 1) Mothers attending the Routine Immunization Clinic and Paediatric OPD who have at least one child in the 9 – 24 months age group. Exclusion criteria: 1) Mothers who refused to give consent 2) Mothers with seriously ill child Study tools: Predesigned and pretested schedule for data collection Study technique: The mothers attending the OPD and Routine Immunization Clinic were interviewed regarding their socio-demographic characteristic viz. age, religion, education, socio- economic status, residence, type of family, number of family members etc. The mothers were then interviewed about their mode of delivery and feeding practices viz. type and place of delivery, initiation of breast feeding , colostrum feeding, pre-lacteal feeding, exclusive breast feeding, initiation of complementary feeding etc. 7 Study variables: RESULTS: Table 1: Distribution of study subjects according to age group (n=150) Age group(in years) Number of mothers Percentage(%) 10 4 2.7 Total 150 100 52.7 % study subjects have 3-4 family members, whereas 37.3% of study subjects had 5-7 family members, 7.3% have 8-10 family members and 2.7% have more than 10 family members. Table 10: Distribution of study subjects according to number of children (n=150) No.of children Number Percentage(%) 1 64 42.7 2 68 45.3 3 15 10.0 ≥4 3 2.0 Total 150 100 Majority(45.3%) of study subjects have 2 children whereas 42.7% have 1 child,10% have 3 children and 2 % have 4 or more children. 12 Table 11: Distribution of study subjects according to type of delivery (n=150) Type of delivery Number Percentage(%) Normal 106 70.7 Caesarean 44 29.3 Total 150 100 Most of the mothers had normal delivery while (70.7%) while only 29.3% of mothers underwent Caesarean section. Table 12: Distribution of study subjects according to place of delivery (n=150) Place of delivery Number Percentage(%) Institution 150 100.0 Home 0 0.0 Total 150 100.0 All the mothers underwent institutional delivery. 13 Table 13: Distribution of study subjects according to type of institution where they underwent delivery (n=150) Type of institution Number Percentage(%) Government 136 90.7 Private 14 9.3 Total 150 100.0 Among institutional deliveries, 90.7% delivered at Government hospitals and 9.3% delivered in private hospitals. Table 14: Distribution of study subjects according to initiation of breast feeding after birth (n=150) Initiation of breast feeding Number Percentage(%) after birth Within 30 minutes after 24 16.0 birth 30 minutes to 1 hour after 40 26.7 birth 1-4 hours 51 34.0 >4 hours 35 23.3 Total 150 100.0 Majority of study subjects(34%) initiated breast feeding after 1 to 4 hours of delivery ,while only 16% initiated within 30 minutes of delivery. 14 Table 15: Distribution of study subjects according colostrum given or not (n=150) Colostrum feeding Number Percentage(%) Yes 117 78.0 No 33 22.0 Total 150 100.0 78% of study subjects practiced colostrum feeding. Table 16: Distribution of study subjects according to prelacteal feed given or not (n=150) Prelacteal feed Number Percentage(%) Yes 43 28.7 No 107 71.3 Total 150 100.0 Prelacteal feed was not practiced by majority (71.3%) of study population Table 17: Distribution of study subjects according to exclusive breast feeding for 6 months (n=150) Exclusive breast feeding Number Percentage(%) practiced for 6 months Yes 23 15.3 No 127 84.7 Total 150 100.0 Only 15% of study subjects practiced exclusive breast feeding for 6 months. 15 Table 18: Distribution of mothers according to reasons for not continuing exclusive breast feeding (n=127) Reasons for discontinuation Number Percentage(%) of exclusive breast feeding Breast milk insufficient 76 50.7 Working mother 68 45.3 Mother seriously ill 6 4.0 Total 127 100.0 Majority of study subjects discontinued exclusive breast feeding due to insufficient breast milk, while 45.3% discontinued as the mothers were working and another 6% discontinued as mothers were seriously ill. Table 18: Distribution of mothers according demand feeding practiced or not (n=150) Demand feeding practiced Number Percentage(%) Yes 82 54.7 No 68 45.3 Total 150 100.0 Majority(54.7%)mothers practiced demand feeding. 16 Table 19: Distribution of mothers according age of initiation of complementary feeding (n=150) Age of initiation of Number Percentage(%) complementary feeding 6 months 51 34.0 Total 150 100.0 Majority (46.7%) mothers initiated complementary feeding at the age of 6 months. Table 20: Distribution of mothers according to feeding practices during illness Feeding during illness Number Percentage(%) Decreased 64 42.7 Remained same 66 44.0 Increased 20 13.3 Total 150 100.0 42.7% mothers decreased the feeding during illness, while in 44 % mothers it remained same and 13.3% mothers increased the feeding during illness. 17 Table 21: Distribution of initiation of breast feeding after birth with type of delivery Initiation of breast feeding Type of delivery Total(%) after birth Normal Caeserian n(%) n(%) Within 30 minutes after 21(87.5) 3(12.5) 24(100.0) birth 30 minutes to 1 hour after 25(62.5) 15(37.5) 40(100.0) birth 1-4 hours 39(76.5) 12(23.5) 51(100.0) >4 hours 21(60.0) 14(40.0) 35(100.0) In normal delivery, majority of mothers(87.5%) initiated breast feeding within 30 minutes of delivery while in caesarean section majority mothers(40%)started breast feeding after 4 hours of delivery. Table 22:Distribution of colostrum feeding with education of mothers Education of mother Colostrum feeding Total(%) Yes No n(%) n(%) Illiterate 22(73.3) 8(26.7) 30(100.0) Primary level 35(76.1) 11(23.9) 46(100.0) Secondary level 44(86.3) 7(13.7) 51(100.0) Higher secondary and 16(69.6) 7(30.4) 23(100.0) above Colostrum feeding was maximally practiced by mothers who have studied upto secondary level ( 86.3%) practiced colostrum feeding. 18 Table 23 :Distribution of colostrum feeding with religion of mothers Religion Colostrum feeding Total(%) Yes Yes n(%) n(%) Hindu 68(79.1) 189(20.9) 86(100.0) Muslim 49(76.5) 15(23.5) 64(100.0) Majority of mothers belonging to Hindu religion(79.1%) practiced colostrum feeding. Table 24: Distribution of colostrum feeding with occupation of mothers Occupation Colostrum feeding Total(%) Yes Yes n(%) n(%) Housewife 103(76.8) 31(23.2) 134(100.0) Working 14(87.5) 2(12.5) 16(100.0) Colostrum feeding was practiced mostly by working mothers(87.5%) Table 25: Distribution of colostrum feeding with Type of family Type of family Colostrum feeding Total(%) Yes Yes n(%) n(%) Nuclear 77(79.3) 20(19.7) 97(100.0) Joint 40(75.4) 13(24.6) 53(100.0) Colostrum feeding was practiced mostly by mothers belonging to nuclear family (79.3%) 19 Table 26:Distribution of colostrum feeding with age of mothers Age group(in years) Colostrum feeding Total(%) Yes No n(%) n(%)