Mother ’ s views and perceptions regarding breast feeding as seen in a group of Sri Lankan mothers

The aim of the study was to study the views and perceptions of a group of mothers regarding breastfeeding. The study was done in the professorial unit of the de Soysa Maternity Hospital (DMH). The study involved 50 mothers. A pre-tested questionnaire was used to get the information. In spite of the improvement of attitudes and views regarding breast feeding, it was found that a considerable number of mothers still harbor unsubstantiated views and unhealthy perceptions regarding breast-milk and breast-feeding.


Introduction
If poverty, malnutrition and infection were the three heads of the same dragon, then, breast-feeding would be St.George's sword to slay that evil dragon.
Breast milk is a cheap and effective way of combating several childhood problems, especially prevalent in developing countries.

Objectives
The main objective of this study was to study the views and perceptions of mothers regarding breast-feeding and breast milk.In addition, details regarding the source of information of proven facts regarding breast-feeding were also assessed.

Method
The study was conducted in wards 03 and 15 in the De Soysa Maternity Hospital (DMH), on the 07th of December 1995.A questionnaire was used to get the required information.The questionnaire was pre-tested on a group of mothers (10 mothers in DMH).The questionnaire was self-administered and the members of the study group were available to do clarifications wherever necessary.All clarifications were standardized, ensuring uniformity._____________________________________________ 1 Pre-intern A count was maintained, starting from bed number 01 of ward 03 of the DMH, and when the count reached 50, the process was stopped.

Results
Out of the mothers who participated 88% were Sinhalese and 6% were Tamil (Table 1).Six percent of the mothers were illiterate, 4% had received university education and 60% had received secondary school education (Table 3).A monthly income of <1500/= rupees per month was seen among 6% and an income of 3000-5000/= per month was seen in 32% (Table 4).

Monthly income in
Rupees /Month % <1500.0006 1500.00 -3000.0022 3000.00-5000.0032 5000.00-8000.0022 >8000.0018 Total 100 There were 24 mothers who had breast-fed their children before, while 26 were yet to experience breastfeeding.The median duration of breast -feeding among the mothers, who had breast-fed before, was 10 months.
All the mothers thought that every child should be breast-fed and every one knew that breast milk provides nutrition to the baby.Only 64% of the mothers knew that breast-milk should be exclusively fed for four months.Only 8% of the mothers had gained this information from the antenatal clinic.Thirty eight percent of the mothers had gained this information from an elder in the family (Table 5).Regarding the total duration of breast-feeding, 56% of the mothers thought that the child should be breast-fed until the child refuses to drink breast milk any more (Table 6).Eighteen percent of the mothers thought that colostrum should not be given to the baby.Out of the mothers studied 62% thought that the mother should consume a large volume of fluids before breastfeeding the baby.Twenty percent thought that breastfeeding produces adverse effects on their figure (Table 7).
56% of the mothers knew that even if they are suffering from a minor illness they could continue to feed their baby on breast-milk.84% knew that by breast-feeding the child it is possible to gain benefits other than nutrition to the child.Only 64% were aware that by breast-feeding the baby one might not conceive a second time during the period of breastfeeding.4% of mothers had gained this information from the antenatal clinic, whereas 22% had obtained it from an elder in the family (Table 8).
The mean duration of lactational-amenorhoea was four months, among the mothers who had previous experience of breast-feeding.

Discussion
In this study it was noted that the median duration of breast-feeding among mothers was 10 months.All the mothers thought that breast-milk should be given to every child and all of them knew that breast-milk is nutritious to the baby.In a similar study done in Kandy in 1980, it was found that only 70% of the mothers thought that breast milk is nutritious to the child 1 .
Sixty four percent of the mothers knew that breastmilk should be exclusively fed for four months.In a study done in the plantation sector in 1998 only 32.4% of the mothers exclusively breast-fed their babies 2 .
Only 8% of the mothers had gained information regarding exclusive breast-feeding from our antenatal clinic.In the study done in Kandy, only 2% of the mothers had gained this information from an antenatal clinic 1 .
38% had gained this information from an elder in the family whereas in the study done in Kandy, only 5% got this information from an elder in the family 1 .
In spite of the health education given to the mothers, 18% of the mothers still thought that colosturm should not be given to the baby.
Myths such as, a large volume of fluids should be consumed by the mother before breast-feeding the baby; breast-feeding produces adverse effects on the figure of the mother; and cows milk is more nutritious to the baby than breast-milk are still harbored by the mothers.
84% knew that by breast-feeding the child it is possible to gain benefits other than nutrition to the child.Additional benefits such as protection against diarrhoeal diseases and respiratory tract infections were clearly shown to be related to exclusive breastfeeding in a previous study in Sri Lanka 3 .
64% knew about lactational-amennorhoea and only 4% had come to know about this from an antenatal clinic.22% had obtained this information from an elder in the family.Mean duration of lactationalamennorhoea was 4 months among mothers with previous experience of breast-feeding.
In this study the professorial unit of one hospital in Colombo was used.The pregnant mothers attending this unit do not represent the whole population of pregnant mothers in our country.Hence the conclusions in this study cannot be applied to the whole country in general.More work perhaps, on a multi-centre basis would be required to assess the national picture.

Conclusions
In spite of the improvement in attitudes, knowledge and behaviour regarding breast-feeding a considerable number of mothers in Sri Lanka still harbor unsubstantiated views and unhealthy perceptions regarding breast-milk and breast-feeding.Further, the antenatal clinic had made a poor contribution toward a goal of keeping our mothers well informed regarding breast milk and breastfeeding

Table 7
Perceptions of mothers regarding breast-milk and breast-feeding

Table 8
Source of information regarding the knowledge of lactational amenorrhoea