Role of mother’s education and antenatal counselling on breast feeding practices among women in coastal Karnataka: a community based cross sectional study

Chethana K., Maria Nelliyanil, Manjula Anil, Jayaram S.


Background: Breastfeeding has been a universal practice. A number of factors influence the breastfeeding practices of the mothers. This study was conducted to assess the breast-feeding practices and its association with mother’s education and antenatal counselling.

Methods: A community based cross sectional study was conducted among 167 mothers with infants who were residing in field practice area of a medical college. A pretested semi-structured validated questionnaire was administered to assess the breast-feeding practices followed. Towards the end of each interview the investigator observed the mothers as they breast fed their children to assess the appropriateness of positioning and attachment. Chi-square test and Fischer’s exact probability test were used to test the associations.

Results: 19.8% of the mothers were illiterate. 64.1% had received antenatal counselling on breast feeding. 62.3% initiated breast feeding within one hour. Colostrum was discarded by 6% of the mothers and 28.7% gave pre-lacteal feeds. 72.3%, 86.1% and 77.3% of them practiced appropriate position of feeding, held their children in the appropriate position and had good attachment to the breast, respectively. Mother’s education had a statistically significant association with pre-lacteal feeds administration, exclusive breastfeeding and breast-feeding position. Antenatal breast-feeding counselling had a statistically significant association with appropriate positioning of the child, attachment and practicing burping.

Conclusions: Breast feeding practices in the current study was far from satisfactory. Mother’s education and antenatal breast-feeding counselling had a major role in the feeding practices.


Antenatal counselling, Breast feeding, Colostrum, Exclusive breast feeding, Prelacteal feed

Full Text:



Sunderlal, Adarsh, Pankaj. Textbook of Community Medicine. 4th ed. New Delhi: CBS Publishers; 2018: 201-202.

World Health Organization. Breast feeding. Available at: feeding/en/. Accessed on 6 October 2019.

Parthasarathy A, Menon PSN, Nair MKC, Kundu R. editors. IAP Textbook of Pediatrics. 6th ed. New Delhi: Jaypee Brothers Medical Publishers; 2016: 143-152.

Azuine RE, Murray J, Alsafi N, Singh GK. Exclusive breastfeeding and under-five mortality, 2006-2014: a cross-national analysis of 57 low- and-middle income countries. Int J MCH AIDS. 2015;4(1):13-21.

Infant and young child feeding. Model chapter for textbooks for medical students and allied health professionals. Geneva: World Health Organization; 2009: 1-3.

Guidelines for enhancing optimal infant and young child feeding practices. Ministry of health and family welfare. New Delhi: Government of India; 2013:7-8.

Patel A, Badhoniya N, Dibley M. Breastfeeding and infant feeding practices in India - a review of demographic and health surveys and national family health surveys. MCH Community Newsletter. Breastfeeding Month Special; 2008: 4-5.

Nayak S, Padodara J, Patel S, GharatV, Patel S, Choksi V, et al. Breastfeeding practices in urban community of Surat city. National J Comm Med. 2010;1(2):111-3.

Khairnar MR, Wadgave U, Shimpi PV. Updated BG Prasad socioeconomic classification for 2016. J Indian Assoc Public Health Dent. 2016;14:469-70.

District level household and facility survey. Fact Sheet Karnataka. Ministry of health and family welfare. Mumbai: Government of India; 2007-08.

Amit VM, Dinesh K, Patel M, Singh US. Determinants of breast-feeding practices in urban slums of a taluka headquarter of district Anand, Gujarat. National J Comm Med. 2012;3(3):534-7.

Aguayo VM, Gupta G, Singh G. Early initiation of breast feeding on the rise in India. BMJ Global Health. 2016;1e000043.

Ekambaram M, Bhat VB, Ahamed MAP. Knowledge, attitude and practice of breastfeeding among postnatal mothers. Curr Pediatr Res. 2010;14(2):119-24.

Shafee M, Leena MS, Firdous R, Jogdand GS. Knowledge, attitude and practices (KAP) of mothers regarding breast feeding in South India. Indian J Matern Child Health. 2010;13(2):1-8.

Kumar D, Agarwal N, Swami HM. Socio-demographic correlates of breast-feeding in urban slums of Chandigarh. Indian J Med Sci. 2006;60:461-6.

Benakappa DG, Raju M, Shivananda, Benakappa AD. Breast-feeding practices in rural Karnataka with special reference to lactation failure. Int Pediatr. 2007;31(4):113-8.

Mise PJ, Mise AJ, Mise SJ, Siddappa M. Study of breastfeeding practices and problems among postnatal mothers: a hospital-based study. Int J Reprod Contracept Obstet Gynecol. 2017;6:3343-6.

Takalkar A, Saiprasad GS, Kumar T, Narendra M. Breastfeeding practices in rural community of Andhra Pradesh. Indian J Matern Child Health. 2010;12(2):1-8.

Joseph N, Kotian S, Mahantshetti NS, Unnikrishnan B, Naik V, Mallapur MD, et al. Infant rearing practices in south India: a longitudinal study. J Family Med Primary Care. 2013;2(1):37-43.

Madhu K, Chowdhary S, Ramesh M. Breastfeeding practices and new-born care in rural areas: a descriptive cross-sectional study. Indian J Comm Med. 2009;34(3):243-6.

Sinhababu A, Mukhopadhyay DK, Panja TK, Saren AB, Mandal NK, Biswas AB. Infant- and young child-feeding practices in Bankura District, West Bengal, India. J Health Popul Nutr. 2010;28(3):294-9.

Dasgupta U, Mallik S, Bhattacharyya K, Sarkar J, Bhattacharya SK, Halder A. Breast feeding practices: positioning, attachment and effective suckling- A hospital-based study in West Bengal Kolkata. Indian J Matern Child Health. 2012;15(1):1-11.

Krishnan L, Kaliaperumal S, Kommu PPK, Akila B. Real and perceived problems in timely initiation of breastfeeding in a baby friendly hospital. Indian J Matern Child Health. 2012;15(2):1-9.

Kamath SP, Garg D, Khan MK, Jain A, Baliga BS. Perceptions and practices regarding breastfeeding among postnatal women at a district tertiary referral government hospital in Southern India. Scientifica. 2016:2016.

Bagul AS, Supare M. The infant feeding practices in an urban slum of Nagpur. J Clin Diagno Res. 2012;6(9):1525-7.

Dhandapany G, Bethou A, Arunagirinathan A, Ananthakrishnan S. Antenatal counselling on breastfeeding - is it adequate? A descriptive study from Pondicherry, India. Int Breastfeed J. 2008;3:5.

Srivastava NM, Awasthi S. Breastfeeding practices for newborns among urban poor in Lucknow, northern India: A prospective follow-up study. Clin Epidemiol Global Health. 2014;2(2):66-74.

Parashar M, Singh S, Kishore J, Patavegar BN. Breastfeeding attachment and positioning technique, practices and knowledge of related issues among mothers in colony of resettlement Delhi. ICAN. 2015;7:317-22.

Ahmad MO, Sughra U, Kalsoom U, Imran M, Hadi U. Effect of antenatal counselling on exclusive breastfeeding. J Ayub Med Coll Abbottabad. 2012;24:116-9.

Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. On behalf of the lancet breastfeeding series group. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387:491-504.

Sinha B, Chowdhury R, Sankar MJ, Martines J, Taneja S, Mazumder S, et al. Interventions to improve breastfeeding outcomes. A systematic review and meta-analysis. Acta Pædiatrica. 2015;104:114-35