Introduction: the timing of weaning. The prevalence of

Introduction:            Breastfeeding; a way of providingideal nourishment for adequate growth and development of neonates and theadvantages range from physiological to psychological for both mothers andneonates. It is well known that breastfeeding influences a child’s healthpositively and improves nutritional status.The American Academy of Paediatrics recognizes breastfeedingand human milk as the “normative standards for infant feeding. The WHOrecommends that for the first six months of life, infants should be exclusivelybreastfed to achieve optimal growth, development, and health.

The infantsshould thereafter, receive nutritionally adequate and safe complementary foods,while continuing to breastfeed for up to two years or more. Exclusive BreastFeeding (EBF) is defined as infant feeding with human milk without the additionof any other liquids or solids. Weaning is usually used to describe thestopping of breastfeeding after a period of successful breastfeeding. Thisusually involves addition of solid food to infant’s diet and/or replacement ofbreast milk with another type of milk (formula or whole milk). Maternalphysiology, infant nutritional requirements, infant development, especially thatof biting and chewing, and some cultural issues play an important role in thetiming of weaning.The prevalence of breastfeeding differs from one country toanother and from one society to another, this is due to cultural and religiousbelieves.

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 Even though strong evidences to support EBF for the first sixmonths of life have been recognised, its prevalence has remained low worldwide.  In India,breastfeeding appears to be influenced by social, cultural, and economicfactors. In 1991, Breastfeeding Promotion Network of India (BPNI) wasintroduced to protect, promote and support the practice breastfeeding.  Furthermore, the Government of India has undertaken the National Rural Health Mission,which is to implement Integrated Management of Neonatal and Childhood Illnesses(IMNCI) through the already existing healthcare delivery system.  Thepromotion and acceptance of these practices, such as exclusive breastfeeding,are specifically important in developing countries with high levels of poverty,and that suffer a high burden of disease and poor access to clean water andadequate sanitation.While, a significant number of studies have been made toassess the knowledge, attitude and practice of breastfeeding in different partsof the world; such studies are low in number among Indian mothers.

There arenot many reported studies of breastfeeding knowledge and attitudes of mothersusing the IIFAS (Iowa Infant Feeding Attitudes Scale) from India. Moreover,maternal attitude is also a concept of interest to those who supportbreastfeeding.In this regard, we are proposing a study to examine  theinfant feeding practices, knowledge and attitude towards breast feeding amongIndian postnatal mothers’ using the IIFAS.Objectives:1.      To access the knowledge, attitude and practices of mothers, of ruralparts of central Karnataka, regarding breastfeeding, complementary feeding andweaning.2.      To documentwhy the mothers were unable to practice exclusive breastfeeding.

Methodology:This is a cross-sectional study. The studypopulation comprises of  post natal motherswho visit the Paediatric Out Patient Department with their children forvaccination or for the treatment of other minor illnesses atAdichunchanagiri Hospital and Research centre, B.G. Nagar, Mandya district,Karnataka. Study participants will beselected through a random sampling method of the database of children visiting thePaediatric outpatient department. Those who meet the inclusion criteria will beinterviewed. The study criteria; a) mothers of healthyinfants aged 6 months or less than a year old, b) born between 37weeks and 42weeks ofgestation period, c) and without major birth defects such ascongenital heart disease, cleft lip/cleft palate, Down syndrome and d) those who volunteer toparticipate.

 Mothers of preterm infants, and/or multiplegestations will be excluded. Approximately 200 postnatal mothers will beinterviewed.          References:1. BatalM, Boulghourjin C, Abdullah A, Afifi R. Breast-feeding and feeding practices ofinfants in a developing country: A national survey in Lebanon. PublicHealth Nutr.

 2005 (1);9:313–9.2. HortaBL, Bahl R, Martines JC, Victora CG. Evidence on the long-term effects ofbreastfeeding: Systematic reviews and meta-analyses1. Last accessed on 17July 2013..3. Van Rossum CT, Büchner FL, Hoekstra J.

 Quantification of health effects of breastfeeding: Review ofthe literature and model simulation: RIVM report 350040001/2005. Bilthoven: RIVM; 2006.4. WHO. Exclusive breastfeeding for six months best for babieseverywhere’. World HealthOrganization; 2011. (Cited 2014 July 21).

5. American Academy of Pediatrics Section of Breastfeeding.Policy statement: Breastfeeding and the use of human milk. Pediatrics.

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1. 2nded. UK: Blackwell; 2006. Clinical Nutrition; p. 2.7. Li R, Zhao Z, Mokdad A, Barker L, Grummer- Strawn L.Prevalence of breastfeeding in the United States: The 2001 National ImmunizationSurvey.

 Pediatrics. 2003;111:1198–201.8. . Li R, Zhao Z, Mokdad A,Barker L, Grummer- Strawn L. Prevalence of breastfeeding in the United States:The 2001 National Immunization Survey. Pediatrics.

 2003;111:1198–201.9. NRHM. National Rural Health Mission(2005–2012) Mission document. New Delhi: MOHFW, Government ofIndia, New Delhi; Ministry of Health and Family Welfare (MoHFW); 2006.10.

 Madhu K, Sriram C, Ramesh M. Breast Feeding Practicesand Newborn Care in Rural Areas: A Descriptive Cross-Sectional Study. Indian J Community Med. 2009;34:243–6.

11. Khasawneta M, Khadu Y, Amarin Z, Alkafeste A. Knowledge,attitude and practices of breastfeeding in the North Jordan. Int Breast Feed J. 2006;23:1–17.12.  Chaudhary RN, Shah T, Raja S. Knowledge and practice ofmothers regarding breast feeding: A hospital based study.

 Knowl Pract Breast Feed. 2011;9:194–200.13. Kishore K.Knowledge, Attitude and Practices of weaning among mothers in Gulbarga, MDthesis; Department of Pediatrics, MR Medical College, Gulbarga, Ranjiv GandhiUniversity of Health Sciences; Karnataka, Bangalore. 2008.

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