Published: 2021-12-27

Knowledge, attitude and practice of breastfeeding among mothers in a rural area of Thrissur district

Neetha M. Kurian, C. R. Saju, Jini Muttath Paul


Background: Universalizing early and exclusive breastfeeding is viewed as a major public health intervention to reduce the child mortality. Mothers’ knowledge and attitude towards breastfeeding may influence practices. The study intended to find the level of knowledge, attitude and practice regarding breast feeding, and factors influencing them among mothers.

Methods: A cross sectional study was undertaken among all the mothers having a child of age 2 years and below. Data collection was done by interviewing a total of 710 eligible mothers, using a semi–structured validity tested questionnaire. Descriptive statistics was used for analysis.

Results: The mothers had high knowledge and attitude, but poor practice levels and there exists a gap between actual and desired breast-feeding practices among them. Study has found that high knowledge and practice of breastfeeding of mothers was significantly associated (p<0.05) with their age, education, religion, socioeconomic status, parity, antenatal class on breast feeding. Positive breastfeeding attitude had significant association (p<0.05) with age, educational level and parity of the mother. A strong correlation was found to exist between knowledge and attitude scores and good correlation between attitude-practice and knowledge-practice scores of the mothers.

Conclusions: Poor breastfeeding practice despite high level of knowledge and attitude was exhibited by respondents, emphasizing the need for breastfeeding intervention programs especially during antenatal and early postpartum period. Existing programs supporting breastfeeding at primary care level should be strengthened. For adherence to the correct practice of breast feeding, behavior change communication should be directed towards the family members as well.


Breastfeeding, Practice, Kerala

Full Text:



World Health Organization. Breastfeeding. Available at: child_adolescent_

health/topics/prevention_care/child/nutrition /breastfeeding/en. Accessed on 14 October 2014.

United Nations Children’s Fund. Breastfeeding can save over 1 million lives yearly. New York: UNICEF, 2004. Available at: media_22646.html. Accessed on 11 August 2014.

Butte N, Lopez-Alarcon MG, Garza C. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life. Geneva, World Health Organization. 2002. Available at: Accessed on 11 August 2014.

Alive, Thrive. Exclusive breast feeding. New York. Available at: exclusive. Accessed on 11 August 2014.

Oddy WH, Sherriff JL, de Klerk NH, Kendall GE, Sly PD, Beilin LJ, et al. The relation of breastfeeding and Body Mass Index to asthma and atopy in children: a prospective cohort study to age 6 years. Am J Public Health. 2004;94:1531-7.

Horta BL, Bahl R, Marties JC, Victoria CG. Evidence on the long-term effects of breastfeeding:systematic reviews and meta-analysis. World Health Organization, Geneva. 2007. Available at: Accessed on 11 August 2014.

Kramer MS, Chalmers B, Hodnett ED, Sevkovskaya Z, Dezikovich L, Shapiro S. Promotion of breastfeeding intervention trial : a randomized trial in the Republic of Belarus. J Am Med Assoc. 2001;285(4):413-20.

Bernardo LH, Cesar G. Long term effects of breastfeeding, a systematic review. WHO. 2013. Available at: 10665/79198. Accessed on 11 August 2014.

Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90.

Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev. 2012;8:CD003517.

Dewey KG, Cohen RJ, Brown KH, Rivera LL. Effects of exclusive breastfeeding for four versus six months on maternal nutritional status and infant motor development: results of two randomized trials in Honduras. J Nutr. 2001;131(2):262-7.

Hurst N. Breastfeeding. Manual of Neonatal Care, 7th edition. Lippincott Williams & Williams. 2011;263-8.

Gupta A, Holla R, Dadhich JP, Suri S, Trejos M, Chanetsa J. The status of policy and programmes on infant and young child feeding in 40 countries. Health Policy Plan. 2013;28(3):279-98.

World Breastfeeding Trend Initiative India Report. 2012. Available at: http://www.worldbreastfeeding Generate Reports/report/WBTi-India-2012.pdf. Accessed on 11 August 2014.

International Institute for Population Science, Mumbai for Govt. of India NFHS (IV). Available at: XTuLs99aYMKh-j7jKCr. Accessed on 11 August 2014.

Ghosh S, Gidwani S, Mittal SK, Verma RK. Socio-cultural factors affecting breast feeding and other infant feeding practices in an urban community. Indian Pediatr. 1976;13(11):827-32.

Gupta A, Gupta R. Obstetric and infant feeding practices in Punjab: effect of educational intervention. Indian Pediatr. 1992;29(3):333-5.

Tiwari S, Bharadva K, Yadav B, Malik S, Gangal P, Banapurmath CR, Zaka-Ur-Rab Z, Deshmukh U, Visheshkumar -, Agrawal RK. Infant and Young Child Feeding Guidelines, 2016. Indian Pediatr. 2016;53(8):703-13.

Girish HO, Abhishek Acharya, Aswin Kumar. Knowledge and practice of breastfeeding among antenatal mothers at Kannur. J Evol Med Dent Sci. 2013;2(46):8996-9001.

Vyas SV, Sharma P, Kandpal DS, Jayanti S, Anurag S, Nautiyal V. A community based study of breastfeeding practices in a rural area of Uttarakhand. Nat J Comm Med. 2012;3(2).

Bhatt S, Pooja P, Kantharia N, Dahat A, Rahul P. KAP of postnatal mothers for early initiation of Breastfeeding in Obstetrics ward of a tertiary care hospital of Vadodara city. Nat J Comm Med. 2012;74183760.

Maillik S, Dasgupta U. Knowledge of breastfeeding and timely initiation of it amongst post natal mothers. An experience from Baby friendly hospital teaching hospital of a metropolitan city. J Dent Med Sci. 2013;4(1):25-30.

Kulkarni J, Rekahde N, Sharma S. Knowledge and practice of mothers about breast feeding. Available at: 7895a5b82567fcabc36c0850.pdf. Accessed on 11 August 2014.

Dawal S, Immandar IF. Study on prelacteal feeding practices and its determinants in a rural area of Maharashtra. Sch J App Med Sci. 2014;2(40);1422-7.

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(3):243-6.

Ekambaram M, Vishnu BB, Asif M, Ahamed P. Knowledge, attitiude and practice of breastfeeding among postnatal mothers. Curr Pediatr Res. 2010;14(2):119-24.