Impact of Lactation Counseling To Mothers on Breast Feeding Practices

Background: Breastfeeding is the healthiest way to feed a baby. Like mothers love there is no substitute for breast milk. Despite of benefits of breast feeding, the breast feeding incidence and the duration of exclusive breast feeding all over world is not satisfactory. In India though breastfeeding is almost universal, the prevalence of exclusive breastfeeding as per WHO recommendation is not up to the expectations. Over one million infants worldwide die every year because they are not breastfed or because they are given other foods too early. The determination of indicators and variables related to exclusive or overall breastfeeding duration can be a valuable instrument when planning local actions and policies aimed at improving breast feeding rates. Aim: To assess the knowledge, attitude and practices of mothers regarding breast feeding and to determine the impact of lactation counseling to mothers around the time of delivery on breast feeding practices. Material and Methods: Our study was a single center cross sectional questionnaire based study conducted in a Teaching Hospital in Telangana state in India. Duration of study was from October 2016 to September 2018. It was conducted upon 600 (n=600) women i.e. Expectant mothers admitted in antenatal wards and mothers in labour room and postnatal wards of our hospital, who were otherwise healthy. These women were randomly divided in to two groups Group A and Group B. Group A (n=300), Women interviewed after delivery with a preset questionnaire which included 22 questions pertaining to knowledge, attitude and practices of breastfeeding. For Group B (n=300), women brief counseling was given just before delivery in the antenatal wards or in the labour room. Counseling was done by women who were appointed as support staffs under NRHM. These women were given basic training on ideal breastfeeding practices as per Infant and Young Child Feeding Kannaiah B, Radha Mohan M, Snigdha, Sharada. Impact of Lactation Counseling To Mothers on Breast Feeding Practices. IAIM, 2019; 6(2): 13-22. Page 14 (IYCF) guidelines by SNCU pediatricians in our hospital. Mothers in Group B were also interviewed with the same questionnaire by the same interviewer after delivery. The data from the questionnaire of the two groups were analyzed and compared using open EPI INFO statistical methods. Results: Early initiation of breast feeding was observed in 88 % (252-mothers) of Group B compared to 67 % (201-mothers) in Group A. Among the literate women 75% (98-mothers) of Group A and 94% (138-mothers) of Group B women followed early initiation of breast feeding where as in illiterate women early initiation was noticed in 31% (92-mothers) of group A and 41%(114-mothers) of group B mothers. Media played minimal role 16% (48 mothers) of group A and 9% (12 mothers) in group B in encouraging breast feeding. Support from family members & hospital staff had positive influencing on breastfeeding in the groups. 71% (213) of Group A and 89 % (254) of Group B mothers felt breast feeding should be continued for two years and beyond. Conclusion: It revealed that mothers, in virtually all cultures and communities, have considerable knowledge and experience related to all aspects of maternal and child development, and that they have a strong commitment to promoting the well-being of children, their mothers, and families. ‘To have enduring effects, interventions must have an impact on social norms’. In particular, in households in traditional societies around the world, older women or grandmothers play a leading role in decision. They also serve as the primary caregivers of women and children and will continue to play-important role in mother and child health. Thus early initiation of breast feeding, antenatal counseling, educating other family members and support of media etc. will have major role in promoting exclusive breast feeding.

Interpretation of Mantoux test in children

Tuberculosis is the most common infectious cause of death worldwide. Young children especially infants usually are more susceptible to tuberculous infection. Disease usually develops within 1 year of infection. The present study has been conducted upon 41 children in whom Mantoux test was positive (n=41). These children were coming to our outpatient department, in a Teaching Hospital, Nizamabad, Telangana State with mild fever, cough, night sweats, anorexia, and loss of weight. The age group selected for this study was 1 to 12 year, and the period of study was from August, 2013 to December, 2015. Among the 41 children under study 13 children were 1 to 4 year and 28 were 5 to 12 year. Among the total 41 cases of Mantoux positive, 16 (39%) were found to be suffering from tuberculous disease and anti tuberculous drugs were started. In these cases 7 were 1 to 4 year (n=13), and 9 were 5 to 12 year (n=28). After 3 months follow up, all the children who were on ATT became free from their symptoms. It shows association between mantoux positivity and tuberculosis is more in children between 1 and 4 year than children between the age of 5 and 12 year. Most of the other children needed antipyretics, other symptomatic drugs and antibiotics only. But in 3 cases symptoms were not relieved either with antibiotics or with trial ATT. The factors for deciding tuberculosis are history of contact, clinical picture, CBP, ESR, chest- x- ray, Mantoux test, sputum for AFB, antibiotic trial, follow up, trial ATT. All these factors are put together and then only we will decide whether to start ATT or not.