Introduction: child for feeding is built in this


a way of providing ideal nourishment for adequate growth and development of children
and the advantages range from physiological to psychological for both mothers
and children.1
It is well known that breastfeeding influences a child’s health positively and
improves nutritional status2 3.Breast
milk is the best gift a mother can give her child.

We Will Write a Custom Essay Specifically
For You For Only $13.90/page!

order now

The WHO recommends that
for the first six months of life, infants should be exclusively breastfed to
achieve optimal growth and development. The infants should thereafter, receive
nutritionally adequate and safe complementary foods, while continuing to
breastfeed for up to two years. 4

Exclusive Breast
Feeding (EBF) is defined as infant feeding with human milk without the addition
of any other liquids or solids.5The prevalence of breastfeeding differs from one country to
another and from one society to another, this is due to cultural and religious
beliefs. 6

For all new-borns,
irrespective of mode of delivery, especially those delivered by caesarean
section, skin to skin contact should be initiated in about 5 minutes of birth.
This early contact should be continued till the first breastfeed is complete,
this is called Breast Crawl. This practice was initiated by IYCF& HMB
guidelines (Infant and Young Child Feeding & Human Milk Banking Guidelines)
in 2015. 7 Since the reflexes in the new-born are
highly active in the first few minutes of delivery, especially those reflexes
for feeding, it is important that the bond between the mother and child for
feeding is built in this crucial time.

Colostrum is the first milk produced by
the mammary glands of mammals in late pregnancy just prior to giving birth and
continuing through the early days of breastfeeding. 8The
colostrum feeding has significant effects for immediate and future health of new-born
infants especially in developing countries that have high rates of
malnutrition, infectious diseases and mortality for children under the age of 5
years. 9 10 Colostrum
is very rich in proteins, carbohydrates, vitamin A, and sodium chloride and
contains lower amounts of lipids and potassium than normal milk. It has
essential immunoglobulins which build the child’s immunity, hence can be called
as the 1st natural vaccine. 11 12 13
Breast crawl helps in receiving this essential colostrum.

The prevalence of early
breastfeeding has remained low even though there has been adequate information
to promote and support early breast feeding. 14

In India, breastfeeding
appears to be influenced by social, cultural, and economic factors. In 1991,
Breastfeeding Promotion Network of India (BPNI) was introduced to protect,
promote and support the practice breastfeeding.15  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.16 The promotion and acceptance of these practices, such
as early breastfeeding and breast crawl, are specifically important in
developing countries.

While, a significant number
of studies have been made to assess the knowledge, attitude and practice of
breastfeeding in different parts of the world; such studies are low in number
among Indian mothers. There are not many reported studies of breast crawl
knowledge and attitudes of mothers using the IIFAS (Iowa Infant Feeding
Attitudes Scale) and IYCF & HMB guidelines from India. Moreover, maternal
attitude is also a concept of interest to those who support breastfeeding. 717 18 19 20

In this regard, we are
proposing a study to examine the knowledge, attitude and practices towards
breast crawl among Indian postnatal mothers’ using the IIFAS and IYCF & HMB


access the knowledge, attitude and practices of mothers, of rural parts of
central Karnataka, regarding and breast crawl.

2.      To
document why the mothers are unable to practice breast crawl.


is a cross-sectional study. The study population comprises of post-natal mothers, who delivered and are admitted in
Adichunchanagiri Hospital and Research centre, B.G. Nagar, Mandya district,

Study participants will be selected through a random sampling
method of post-natal mothers admitted in the hospital. Those who meet the
inclusion criteria will be interviewed.

 The study criteria;

 a) Mothers of newly
delivered healthy infants,

 b) Born between 37weeks
and 42weeks of gestation period,

 c) Without major birth
defects such as congenital heart disease, cleft lip/cleft palate, Down syndrome,
etc. and

d) Those who volunteer to participate.

 Mothers of preterm
infants, and/or multiple gestations will be excluded. 

200 postnatal mothers will be interviewed.

obtaining the permission from the hospital authorities, all mothers
participating will be briefed about the purpose of the study. Informed oral consent
will be obtained from each of the participants. A predesigned questionnaire
will be administered to the mothers. Data will be collected through a face-face
interview. Patient confidentiality will be maintained. Neither the mother nor
the child will be harmed in this study.


study will help us access the knowledge, attitude and practicing of breast
crawl among mothers of rural (central) Karnataka. With the above expected
results we can plan on strengthening the IYCF & HBM guidelines and educate
more mothers about the practice of breast crawl.


1.      Batal M,
Boulghourjin C, Abdullah A, Afifi R. Breast-feeding and feeding practices of
infants in a developing country: A national survey in Lebanon. Public
Health Nutr. 2005 (1);9:313–9.

2.      Horta BL,
Bahl R, Martines JC, Victora CG. Evidence on the long-term effects of
breastfeeding: Systematic reviews and meta-analyses1. Last accessed on 17
July 2013.

Van Rossum CT, Büchner FL, Hoekstra J. Quantification
of health effects of breastfeeding: Review of the literature and model
simulation: RIVM report 350040001/2005. Bilthoven: RIVM; 2006.

WHO. Exclusive breastfeeding for six months best for babies
everywhere’. World Health Organization;
2011. (Cited 2014 July 21).

Gibney MJ, Elia M,
Ljungqvist O, Dowsett J. Ch. 1. 2nd ed.
UK: Blackwell; 2006. Clinical Nutrition; p. 2.

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.

Infant and young child feeding & human milk banking
guidelines 2015. Page4 technical guidelines (c).

La Leche League International. What Is
Colostrum? How Does It Benefit My Baby?

Silva, P. (2005) Environmental Factors
and Children’s Malnutrition in Ethiopia: Policy Research. Working Paper Series
No. 3489, The World Bank, Washington DC.

Alemayehu, T., Haidar, J. and Habte, D.
(2009) Determinants of Exclusive Breastfeeding Practices in Ethiopia. Ethiopian
Journal of Health Development, 23, 12-18.

Ghai, O.P., Paul, V.K. and Bagga, A.
(2009) Textbook of Paediatrics. 7th Edition, CBC Publisher and Distributors,
New Delhi, 768.

Heather Fisher Senior Thesis Project
(2000) Colostrum: Properties, Functions, and Importance: The Relationship
between the Immunoglobulin Concentration in Holstein Colostrum and the Total
Senlm Protein in Holstein Heifer Calves.

13.  Science
Daily (Homepage on the Internet). Colostrum.

14.  Global trends in breastfeeding. Cai
X, Wardlow T, Brown DW. Int. Breastfeed J. 2012 sep 28; 7(1):12

15.  BPNI: 10 years of its work. Gupta
A. J Indian Med. Assoc. 2002 Aug; 100(8);512-5.

NRHM. National Rural Health Mission (2005–2012) Mission document. New
Delhi: MOHFW, Government of India, New Delhi; Ministry of Health and Family
Welfare (MoHFW); 2006.

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

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.

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

Kishore K. Knowledge,
Attitude and Practices of weaning among mothers in Gulbarga, MD thesis;
Department of Paediatrics, MR Medical College, Gulbarga, Rajiv Gandhi
University of Health Sciences; Karnataka, Bangalore. 2008. pp. 1–71.


I'm Morris!

Would you like to get a custom essay? How about receiving a customized one?

Check it out