Document Type : Original Article


Assistant Professor, Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India


BACKGROUND: Addressing good breastfeeding practices among antenatal and postnatal mothers 
is important as it helps in bringing about a positive change in the behavior, attitude, and practice 
with appropriate health education. Hence, this study was done to determine the awareness level 
of antenatal and postnatal mothers about the breastfeeding practices and benefits and identify the 
factors associated with it in rural Chengalpattu, Tamil Nadu, India.
MATERIALS AND METHODS: We conducted this community‑based cross‑sectional study among 
377 antenatal and postnatal mothers in the selected rural villages of Chengalpattu between October 
2019 and September 2020. Details regarding the sociodemographic characteristics and awareness/
knowledge about the breastfeeding were collected using pretested semistructured questionnaire. 
Knowledge adequacy was summarized as proportion with 95% confidence interval (CI), and factors 
associated with knowledge were interpreted as adjusted prevalence ratio (aPR) with 95% CI using 
log‑binomial regression.
RESULTS: About 19.6% (95% CI: 15.7%–24.0%) mothers had inadequate knowledge about 
breastfeeding. Women who were unemployed (aPR = 1.60; 95% CI: 1.02–2.51), belonging to the lower 
socioeconomic status (aPR = 2.62; 95% CI: 1.80–3.82), belonging to Muslim religion (aPR = 1.63; 
95% CI: 1.14–2.35), and living in joint family (aPR = 1.58; 95% CI: 1.12–2.21) had significant higher 
risk of inadequate knowledge about breastfeeding practices compared to those who were employed, 
belonging to upper socioeconomic status, Hindu religion, and living in nuclear family.
CONCLUSION: We found that almost one‑fifth of the antenatal and/or postnatal mothers had 
inadequate knowledge about the breastfeeding benefits and practices. Health education sessions are 
required to promote the awareness about breastfeeding during antenatal and postnatal check‑ups.


s of interest.
1. World Breastfeeding Trends Initiative. 5th Report of 
Assessment of India’s Policy and Programmes on Infant 
Young Child Feeding; 2018. Available from: https://www.‑data/
country‑report/WBTi‑India‑Report‑2018.pdf. [Last accessed on 
2021 Mar 12].
2. Shamir R. The benefits of breast feeding. Nestle Nutr Inst 
Workshop Ser 2016;86:67‑76.
3. UNICEF. Breast Feeding and the Sustainable Development Goals; 
2016. Available from:
pdf. [Last accessed on 2021 Mar 12].
4. World Health Organization. Children: Reducing Mortality; 
2020. Available from:‑room/factsheets/detail/children‑reducing‑mortality. [Last accessed on 
2021 Mar 12].
5. Brown A. Breastfeeding as a public health responsibility: A review 
of the evidence. J Hum Nutr Diet 2017;30:759‑70.
6. Sankar MJ, Sinha B, Chowdhury R, Bhandari N, Taneja S, 
Martines J, et al. Optimal breastfeeding practices and infant and 
child mortality: A systematic review and meta‑analysis. Acta 
Paediatr 2015;104:3‑13.
7. Kramer MS, Kakuma R. Optimal duration of exclusive 
breastfeeding. Cochrane Database Syst Rev. 2012 Aug 
8. Kominiarek MA, Rajan P. Nutrition recommendations in 
pregnancy and lactation. Med Clin North Am 2016;100:1199‑215.
9. Mohapatra I, Roy A. Breastfeeding awareness and perception 
among antenatal mothers: A cross‑sectional study in urban 
slum population of Bhubaneswar, Odisha. J Educ Health Promot 
10. Randhawa A, Chaudhary N, Gill BS, Singh A, Garg V, Balgir RS. 
A population‑based cross‑sectional study to determine the 
practices of breastfeeding among the lactating mothers of Patiala 
city. J Family Med Prim Care 2019;8:3207‑13.
11. Kumar A, Unnikrishnan B, T R, Mithra P, Kumar N, Kulkarni V,
et al. Awareness and attitude regarding breastfeeding and 
immunization practices among primigravida attending a tertiary 
care hospital in southern India. J Clin Diagn Res 2015;9:C01‑5.
12. Sultania P, Agrawal NR, Rani A, Dharel D, Charles R, Dudani R. 
Breastfeeding Knowledge and Behavior Among Women Visiting 
a Tertiary Care Center in India: A Cross-Sectional Survey. Ann 
Glob Health. 2019 May 3;85(1):64.
13. Barman A. Applied Statistics in Research. Malaysia: UniSZA; 
14. Nimmi R. A study to assess the knowledge and awareness on 
breastfeeding among the antenatal mothers. Int J Curr Med Pharm 
Res 2017;3:1951‑2.
15. Abeje T, Negera E, Kebede E, Hailu T, Hassen I, Lema T, et al.
Performance of general health workers in leprosy control activities 
at public health facilities in Amhara and Oromia States, Ethiopia. 
BMC Health Serv Res 2016;16:122.
16. Mahdaviazad H, Keshtkar V, Emami MJ. Osteoporosis guideline 
awareness among Iranian family physicians: Results of a 
knowledge, attitudes, and practices survey. Prim Health Care 
Res Dev 2018;19:485‑91.
17. Abdullahi A, Hassan A, Kadarman N, Saleh A, Baraya YS, Lua PL. 
Food safety knowledge, attitude, and practice toward compliance 
with abattoir laws among the abattoir workers in Malaysia. Int J 
Gen Med 2016;9:79‑87.
18. Asnake MK, Ahmed M, Genebo T, Dawit MW, Mekebib B. 
Knowledge and attitude of health professionals in relation to the 
integration of leprosy control into the general health service in 
Ethiopia. Int J Lepr Other Mycobact Dis 2000;68:299‑306.
19. Girish HO, Acharya A, Kumar A, Venugopalan PP, 
Prabhakaran S, Koppad R. Knowledge and practices of 
breastfeeding among ante‑natal mothers at a Teaching Hospital 
at Kannur, Kerala: A cross‑sectional study. J Evol Med Dent Sci 
20. Garg R, Deepti S, Padda A, Singh T. Breastfeeding knowledge and 
practices among rural women of punjab, India: Acommunity‑based 
study. Breastfeed Med 2010;5:303‑7.
21. Kishore MS, Kumar P, Aggarwal AK. Breastfeeding knowledge 
and practices amongst mothers in a rural population of North 
India: A community‑based study. J Trop Pediatr 2009;55:183‑8.
22. Kumar S, Jha SK, Singh A, Rawat CM, Awasthi S, Bano M, et al. 
Knowledge, attitude and practices (KAP) regarding breastfeeding: 
A community based cross sectional study from rural Uttarakhand. 
Healthline J 2015;208:83‑2.
23. Bala K, Sahni B, Bavoria S, Narangyal A. Knowledge, attitude, 
and breast‑feeding practices of postnatal mothers in Jammu: 
A community hospital based cross sectional study. J Family Med 
Prim Care 2020;9:3433‑7.
24. Radhakrishnan S, Balamuruga S. Prevalence of exclusive 
breastfeeding practices among rural women in Tamil Nadu. Int 
J Health Allied Sci 2012;1:64‑7.
25. Bhanderi DJ, Pandya YP, Sharma DB. Barriers to exclusive 
breastfeeding in rural community of central Gujarat, India. 
J Family Med Prim Care 2019;8:54‑61.
26. Patel DV, Bansal SC, Nimbalkar AS, Phatak AG, Nimbalkar SM, 
Desai RG. Breastfeeding practices, demographic variables, and 
their association with morbidities in children. Adv Prev Med 
27. Kamran A, Shrifirad G, Mirkarimi SK, Farahani A. Effectiveness 
of breastfeeding education on the weight of child and self‑efficacy 
of mothers‑2011. J Educ Health Promot 2012:1:11.