soon educated women infant Feeding Practices of Multiparous Women attending the antenatal clinic in a tertiary care hospital

A cross-sectional study was carried out on multiparous women attending the ante natal clinic of a tertiary care hospital in the government setting. Information was primarily gathered regarding infant feeding practices in their previous childbirth. More than 2/3rd of the participants were urban dwellers with 62% of them being housewives. 23.9% had exclusively breast fed their babies during first six months.19.7% had started breastfeeding with in first hour of birth .Most of the mothers knew the benefits of breastfeeding but only 39% and 34% had correct knowledge regarding initiation of breast feeding and dangers of prelacteal feeds respectively. Only 5.14% of mothers knew about birth spacing benefits of breastfeeding. Place of residence of studied women was found to be significantly associated with introduction of prelacteal feeds and type of feeding during first six months. Although majority of women breastfeed their babies certain harmful practices still persist in our community. the situation can be improved by training of grass root health workers on lactation management and making these services universally available along with intensive IEc efforts to generate demand for these services.


introduction
Malnutrition of child begins from infancy itself, if the infant does not receive enough nutrients.This may be due to poor infant feeding practices because of poor knowledge about the significance of breastfeeding.Breastfeeding is the unique source of nutrients that plays an important role in the growth, development and survival of infants.Emphasis has been laid on the importance of exclusive breastfeeding as the optimum feeding for the first six months of life and semi solid foods are recommended to be introduced after six months of age while continuing breastfeeding to meet the increased physiological requirements of the growing infant. 1,2Exclusive breastfeeding takes care of two essential elements of newborn care nutrition and infection control and the benefits of exclusive breastfeeding get diluted as its exclusivity decreases.With time there has been a change in the in the infant feeding practices and this change occurred initially in the industrialized countries .sooneducated women

A b s t r A c t
A cross-sectional study was carried out on multiparous women attending the ante natal clinic of a tertiary care hospital in the government setting.Information was primarily gathered regarding infant feeding practices in their previous childbirth.More than 2/3 rd of the participants were urban dwellers with 62% of them being housewives.23.9% had exclusively breast fed their babies during first six months.19.7% had started breastfeeding with in first hour of birth .Most of the mothers knew the benefits of breastfeeding but only 39% and 34% had correct knowledge regarding initiation of breast feeding and dangers of prelacteal feeds respectively.Only 5.14% of mothers knew about birth spacing benefits of breastfeeding.Place of residence of studied women was found to be significantly associated with introduction of prelacteal feeds and type of feeding during first six months.Although majority of women breastfeed their babies certain harmful practices still persist in our community.the situation can be improved by training of grass root health workers on lactation management and making these services universally available along with intensive IEc efforts to generate demand for these services.

Key words:
and dangers of Prelacteal feeds was poor to the scale of approximately 39% and 34% respectively.57.26% mothers had correct knowledge about positioning the baby at breast while 47% mothers knew the correct time for the initiation of complementary feeding.Knowledge about birth spacing benefits of breastfeeding was extremely poor to the tune of only 5.13%.
Table IV the association between introduction of Prelacteal feed and the place of residence of mothers was found to be statistically significant (p < 0.05)A significant association was also found between the place of residence and the type of feeding during first six months (p < 0.05).Table V.
As far as the working status of mothers was concerned a statistically significant association was observed between mixed and artificial type of feeding and the working status of mothers (Table IV).
As far as duration of breastfeeding is concerned, most of the mothers (68.75%) continued it for less than one proforma was used for the same purpose in order to get information on general characteristics besides various aspects of infant feeding and also to assess their knowledge about the same.The study extended over a period of six months.

results
Mean age of the mothers was 25.72 ± 6.42 years.Of the total 585 mothers interviewed majority (72.65%) belonged to urban areas, 61.53% of them were housewives rest being working.Regarding the parity 52.99% were G 3 and the inter pregnancy interval between the last and the present pregnancy was <2 years in almost 55% of cases.Majority of the mother's breastfed their babies during first six months but only 23.96% of these breastfed babies received exclusive breastfeeding during first six months while as 45.83% were predominantly breastfed and 30.21% received mixed feeding.Table I Out of the 480 mothers who breastfed their babies in first six months ,only 19.79% started it within first hour of birth and majority of mothers resorted to demand feeding (65.62%) rather than scheduled feeding.Table III depicts the knowledge of mothers about different aspects of infant feeding.Majority of the mothers were aware about the importance of colostrum and breastfeeding after LSCS.
While as knowledge about time of initiation of breastfeeding

conclusion
On the basis of our results it is obvious that although breastfeeding is being practiced by majority of our mothers but certain harmful infant feeding practices are still prevalent in our community which need to be addressed on priority in order to ensure optimum exclusive breastfeeding and complementary feeding.This can be achieved by training our medical and paramedical personnel in lactation management and by counseling the mothers these problems can be overcome to a large extent.Moreover extreme IEC efforts through mass media and education of mothers during ante natal visits and immunization sessions are needed.year while as only 22.92% mothers continued it for up to two years.
Table II shows the time of initiation of complementary feed by the mothers wherein it is observed that only 32.48% mothers initiated complementary feeding at the right time with cereals, fruits, bananas being the main complementary foods used in more than half of the cases (56%) either alone or in combination.

discussion
Nutrition in early childhood is an important determinant of optimal growth and development.Many harmful infant feeding practices still hold ground in the community having their roots in ignorance and cultural ethos.These problems need to be identified and addressed on urgent basis to ensure a healthy childhood for millions of children in the world.Similar effort has been made in the present study.
In our study we found that prelacteal feeds were given by 64.95% of mothers which is in contrast to the observations of Kulkarni et

infant Feeding Practices of Multiparous Women attending the antenatal clinic in a tertiary care hospital Anjum
Fazilli*, Imtiyaz A Bhat*, Iqbal M*, Abid A*, Rohul Jabeen* *Department of Community Medicine, Sheri Kashmir Institute of Medical Sciences , Srinagar , Kashmir, India.

Table 5 . Relation between residence and type of infant feeding
Complementary feeds were started at six months in 32.48% of the infants .This is higher than that observed by Gajanan et al. (17.83%),15but much lower than that observed by Kulkarni et al. (82.5%).10 al. in an urban community of Kalamboli ,Mumbai.108.55%mothersdiscardedcolostrum the reason given by most of them being Caesarean Section delivery or that they were advised by the elders.This is in accordance with the observations of Kulkarni et al 10 from Mumbai who reported acceptance of colostrum to be 95.1% while it was slightly lower (81.6%) as reported by Parmar et al.11In the present study exclusive breastfeeding was seen in 23.96% while as PredominantBreastfeeding was seen in 45.83% of the mothers .This is in contradiction to the findings of Banappumath et al12who reported it to be 60% and Kulkarni et al. who reported it to be still higher(70.2%).65.62% of mothers resorted to demand feeding which is lower than that reportedby Kulkarni et al. (94.2%) and Bandopadhyay SK et al. (84.1%) in their study.13Breasrfeedingwas started in the present study within one hour of birth in only 19.7% cases which is lower than that reported NFHS3 31.9%.About 70.83% of mothers had initiated breastfeeding within 24 hours f birth which is much higher than that reported by Yadav RJ et al. in Bihar(28.5%). 1468.75% of mothers continued breastfeeding for less than one year while 22.92% continued it beyond 2 years.