Bridging the gap-determinants of successful breastfeeding among mothers of rural India

Alok M. Janardhan, Sandhya Alok, Leelavathi Janardhan, Y. M. Sudhakar


Background: Breastfeeding is the most crucial intervention with exponential positive impact on the maternal and infant health, that can change the community health outcome. Although a general awareness regarding breastfeeding cannot be undermined, there is significant gap in its optimal understanding, and practice in the rural community.

Methods: Questionnaire-based cross-sectional study conducted in a rural nursing home and clinic. Mothers aged 15-45 years who were actively breast feeding or have breastfed in the past, visiting for various reasons.

Results: Out of 300 mothers included in the study, most mothers were aged 20-30 years (66%), stay-at-home (77%), below-poverty-line (81%) with school-level education (43%). 77% mothers knew about breastfeeding initiation within 1 hour of life, 75% knew exclusive breastfeeding must be practiced for 6 months. 74% knew that breastmilk reduces risk of allergies in baby, 58% were aware of its thermoregulatory benefits in neonates, 41% knew about its contraceptive benefits. 17% mothers felt embarrassed to breastfeed in public, 28% felt breastfeeding is a hindrance to occupation. 51% mothers fed by partial emptying of both breasts in each feed, 28% practiced burping of children for 20 minutes, 5% stored expressed breastmilk at room temperature, none knew about storage of breastmilk in fridge.

Conclusions: Mothers lack awareness about thermoregulatory benefits, reduced allergy risks and lactational contraceptive benefits of breastfeeding. They lag significantly, regarding complete emptying of each breast during feeds, adequate burping of baby, expression and storage of breastmilk. Significant gap between knowledge and practice of successful breastfeeding noted.


Knowledge, Attitude, Practice, Successful breastfeeding

Full Text:



World Health Organization. Available from- Accessed on 27 August 2020.

UNICEF. Breastfeeding- a mother’s gift for every child. Available from- on 27 August 2020.

UNICEF. Available from- 2012. Accessed on 14 July 2020.

International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-4), India, 2015-16: Karnataka. Mumbai: IIPS. 2017.

Chen CH, Chi CS. Maternal intention and actual behavior in infant feeding at one month postpartum. Acta Paediatr Taiwan. 2003;44:140-4.

Lydia Furman. Breastfeeding is powerful medicine. Pediatrics. Updated on 22 April 2020. Available from Accessed on 27 August 2020.

Vijalakshmi P, Susheela T, Mythili D. Knowledge attitudes and breastfeeding practices of postnatal mothers: A cross-sectional survey. Int J health sci. 2015;9(4).

Sakleshpur Population Census 2011-2020. Available from- Accessed on: 27-august-2020. Accessed on 27 August 2020.

Kumar S, Jha SK, Singh A, Rawat CMS, Awasthi S, Bano M et al. Knowledge, Attitude and Practices (KAP) Regarding Breastfeeding: A Community based Cross Sectional Study from Rural Uttrakhand. Healthline J. 2015;6(2).

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

World Health Organization. Infant and young child feeding Model Chapter for textbooks for medical students and allied health professionals. Accessed on 27 August 2020.

Ketbi MIA, Noman SA, Ali AA, Darwish E, Fahim MA, Rajah J. Knowledge, attitudes, and practices of breastfeeding among women visiting primary healthcare clinics on the island of Abu Dhabi, United Arab Emirates. Int Breastfeed J. 2018;13:26.

Vinay BS, Sandeep M, Sridhar PV. Assessment of knowledge, attitude and practice of breast feeding among postnatal mothers at Mandya Institute of Medical Sciences, Mandya, India. Int J Contemp Pediatr. 2016;3(2):504-8.

Krishnendu M, Devaki GJ. Knowledge, Attitude and Practice Towards Breastfeeding among Lactating Mothers in Rural Areas of Thrissur District of Kerala, India: A Cross-Sectional Study. Biomed Pharmacol J. 2017;10(2):683-90.

Chinnasami B, Sundar S, Kumar J, Sadasivam K, Pasupathy S. Knowledge, Attitude and Practices of Mothers Regarding Breastfeeding In A South Indian Hospital. Biomed Pharmacol J. 2016;9(1):195-9.

Madhavi, Wickremasinghe P, Jayasooriya R, Nawarathne K, Ranaweera N. Mothers' knowledge and practices on thermoregulation of neonates in Sri Lanka. Eur int j applied sci technol. 2014;1:55-69.

Neravi A, Udayashree V, Gundmi A. The knowledge, attitude, practice of contraception in breastfeeding mothers. Int J Reprod Contracept Obstet Gynecol. 2018;7(7):2862-8.

Altamimi E, Nsour RA, Dalaen DA, Almajali N. Knowledge, Attitude, and Practice of Breastfeeding Among Working Mothers in South Jordan. Workplace Health Safety. 2017;65(5):210-7.

Mogre V, Dery M, Gaa PK. Knowledge, attitudes and determinants of exclusive breastfeeding practice among Ghanaian rural lactating mothers. Int Breastfeed J. 2016;11:12.

Deshmukh V, Rasool U, Kalyankar B, Gaikwad R, Yelikar K. Knowledge, attitude and practice of breast feeding at a tertiary care centre in the government medical college and hospital, Aurangabad, India. Int J Reprod Contracept Obstet Gynecol. 2016;5(6):1912-5.

Mohammed ES, Ghazawy ER, Hassan EE. Knowledge, attitude and pra ctices of breastfeeding and weaning among mothers of children up to 2 years old in a rural area in El-Minia Governate, Egypt. J Family Med Prim Care. 2014;3(2):136-40.

Chaudhary RN, Shah T, Raja S. Knowledge and practice of mothers regarding breastfeeding: A hospital-based study. Knowl Pract Breast Feed. 2011;9:194-200.