Professional Documents
Culture Documents
By
ROSAMMA K. J.
In partial fulfillment
of the requirements for the degree of
Master of Science
In
Paediatric Nursing
Agrahara Dasarahalli,
November 2007
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE, KARNATAKA
work carried out by me under the guidance of Mrs. J. Lovera Grace Lilly Rani,
Date :
ii
CERTIFICATE BY THE GUIDE
partial fulfillment of the requirements for the award of degree of Master of Science
in Pediatric Nursing.
Professor
Bangalore
iii
ENDORSEMENT BY THE HOD, PRINCIPAL/HEAD OF THE INSTITUTION
partial fulfillment of the requirements for the award degree of Master of Science in
Pediatric Nursing.
Date: Date:
iv
COPY RIGHT
Karnataka, Bangalore, shall have the rights to preserve, use and disseminate this
Date:
v
ACKNOWLEDGEMENT
God Almighty, who has been my inspiration and guiding force behind all my efforts.
The present study has been completed under the inspiring guidance and
supervision of my guide Prof. J. Lovera Grace Lilly Rani, M.Sc. (N), Head Of The
deep sense of gratitude for her valuable suggestions, encouragement and keen interest
in the planning and execution of the study. I consider it a great honour and privilege
of Psychiatric Nursing, Sarvodaya College of Nursing for his valuable advice and
I owe deep gratitude to my Prof. Victorial Selva Kumari M.Sc. (N), Vice
vi
timely assistance, guidance, genuine interest and moral support at every stage of this
study.
It is my great pleasure and privilege to take up this study under the extensive
support and meticulous corrections of Prof. Hemalatha Ravi MSc (N) Paediatric
Asst. Professor, Dept of Child Health Nursing for her guidance, support and
Dept of Child Health Nursing, Sarvodaya College of Nursing for her cooperation,
interest and timely encouragement which contributed towards the completion of the
study.
KIMS for his timely assistance and valuable suggestions and directions in the
computer assistance.
The investigators would like to extend her gratitude to all the experts who
have contributed their times and effort towards validating the tool.
vii
I wish to acknowledge my gratitude to V.S Communications and
Mr. Suraj Shetty, Netcom Technologies who helped me to bring this dissertation to
Literature, M.A. M.Phil. P.G. Diploma in Guidance and counselling for editing
this manuscript. My gratitude goes to Mrs. A.B. Jayasree, M.A. Kannada for
Mrs. Geeta Das, Miss. Lavanya, Miss. Rajini and Mrs. Rosmin for their
study.
community sisters for their constant prayers, encouragement and moral support
My sincere gratitude to all those names have not mentioned but who have
Date:
viii
LIST OF ABBREVIATIONS USED
1. BF : Breast Feed
2. CF : Complimentary Feeding
3 . χ2 : Chi – Square
5. df : degree of freedom
12 SD : Standard Deviation
13. Σ : Summation
ix
TABLE OF CONTENTS
1. Introduction 1 - 15
2. Objectives 16
3. Review Of Literature 17 – 35
4. Methodology 36 – 44
5. Results 45 – 64
6. Discussions 65 – 68
7. Conclusion 69 – 72
8. Summary 73 – 76
9. Bibliography 77 – 82
x
LIST OF TABLES
practices of mothers
variables of mothers
children
xi
LIST OF FIGURES
xii
ABSTRACT
Background
including India. It is mainly due to faulty dietary habits. It is known that in addition to
illness and infection in early childhood, inadequate food intake will contributes to
3. To find out the correlation between the feeding practices of mothers and the
4. To find out the association between feeding practices of mothers and their children
Hypothesis
H1: There is a correlation between feeding practices of mothers and nutritional status
of their children.
xiii
Method
permission from the Medical Officer, Primary Health Centre, K. Gollahalli. Survey
approach and descriptive correlative design was adopted for the present study. The
sample of the study consisted of 100 mothers and their children. The tool used for the
study was structured questionnaire and the technique adopted for the study was
structured interview schedule. The obtained data was analysed by using descriptive
Results
The findings of the study revealed that most of the respondents were in the age
group between 18 – 23 years. Education wise, majority of them were education upto
high school. Occupation wise, 82 percent of them were housewives. Religion wise,
majority of them (62 percent) of them were Muslims. Most of them belonged to
mothers had only one child and 50 percent of them had duration of 5 – 9 years of
which females were 55 percent and male 45 percent. 48 percent of them belonged to
feeding practices and only 14 percent of them practiced satisfactory feeding practiced.
xiv
Interpretation and conclusion
The study showed that there were significant association between feeding
practices and mothers’ demographic variables such as age, number of under five
children, years of married life, income, type of family, birth order, age of the child,
selected nutritional parameters like present weight, height, mid arm circumference
Key Words
xv
1. INTRODUCTION
“Look to your health and if you have it, praise God and value it next to
conscience; for health is the second blessing that we mortals are capable of, a
- Izaak Walton
Children are the first call agenda of human resource development – not only
because young children are the most vulnerable, but because the foundation for life-
long learning and human development is laid in these crucial early years. It is now
requisite for economic development of any nation. Early childhood constitutes the
most crucial period in life, when the foundations are laid for cognitive, social,
India is the home to the largest child population in the world. “The
development of children is the first priority on the country’s development agenda, not
because they are the most vulnerable, but because they are our supreme assets and
also the future human resources of the country”. In these words, our Tenth Five Year
Plan (2002-07) underlines the fact that the future of India lies in the future of Indian
children. 1
There is a saying that, ‘if we have good health we would have achieved
most of the things in life’. Every child has the right to possess good health. Life
would have been uncomplicated or simple, if we could attain all that we need
automatically or without an effort. But then God has placed us in a world where we
1
have all that are needed for a healthy living and we on our part has to make use of
It is recognized that the period from birth to two years of age is a “critical
window” for the promotion of optimal growth, health and cognitive development.2
Nutrition plays an important role in the physical, mental and emotional development
of a child. Infants and pre-school children are the most vulnerable group. UNICEF
has pointed out that malnutrition is the biggest and single cause of infant and child
education and large family size. These factors influence most directly the quality of
A child’s early years have long been recognised as particularly critical time for
developing good dietary habits. It also is an important time for taking in nutrients
amounts required not only for optimal growth and development but for influencing
information about an infant’s or toddler’s nutritional needs, eating habits, cultural and
religious preferences about food and health. It is well known that inadequate food
intake in addition to illness and infection in the first two years of life contributes to
stunting and underweight in millions of children in India and around the world.4 Poor
breast feeding patterns, low nutrient density and poor quality of complementary feed
status of the child. Children completely depend on mothers for their nutrition.
2
Breast-feeding, and other dietary practices adapted by her reflect the nutritional status
of the child. Breast-fed infants and children grow normally during the first six months
of their life, and show slow growth during the transitional period of weaning because
Exclusive breast feeding for the first six months of life could save at least 1.3
million lives a year that’s about 3500 children each day according to UNICEF. The
Indian Academy of Paediatrics supports exclusive breast feeding for six months and
points out that breast feeding provides invaluable immunological protection from a
Gosh had argued that the high rates of malnutrition in India are not primarily
caused by poverty; rather the behaviours of delayed initiation of breast feeding, early
developing countries. Inadequate quantity and poor quality of food result in growth
diseases. Inappropriate feeding patterns may also contribute to child malnutrition. The
World Health Organization recommends that children under the age of four months
growth and prevents stunting among children between 6-24 months. The period of
complementary feeding is when other foods or liquids are provided along with breast
3
milk. Rates of malnutrition usually peak at this time with consequences that persist
process starting around the age of 4-5 months.8 because breast milk alone is not
sufficient to sustain growth and development for an infant of this age.9 It is also said
that introduction of food other than breast milk at an early period (before 4 months)
should be rich in protein and other nutrients. Weaning can be traumatic experiences
for the infant because it looses the oral gratification from sucking.11
and well being among children and there is no doubt regarding the importance of the
Developing country like India, accounts for about 40 percent of under nourished
children in the world and it is largely due to the result of dietary inadequacy in
relation to their needs. In the light of the above, the assessment of nutritional status of
Monitoring Bureau (NNMB) from eight central and southern states. (Andhra Pradesh,
Gujarat, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Orissa and Tamil Nadu)
also confirm a decline in clinical deficiency signs in pre-school children from 1975-79
to 1988-90 in rural areas. The overall prevalence of marasmus decreased from 1.3 to
4
0.6 per cent and kwashiorkor from 0.4 to 0.1 per cent. Among the 12,000 children
evaluated in the ‘repeat surveys’. Gujarat showed the highest prevalence of both
forms, while in the other states their prevalence was below 1 per cent. In the NNMB
and the National Council for Applied Economics Research (NCAER) linked survey
conducted in 1994 among 1828 pre-school children in the same eight states but in
different sampled areas, the overall prevalence of kwashiorkor and marasmus as 0.2
and 0.4 per cent. Fortunately, a similar declining trend was documented in the under-
privileged urban slums of these six states. The overall prevalence of marasmus has
diminished from 3.7 per cent in 1975-79 to 0.2 per cent in 1993-94. No cases of
In India nearly 75 percent of the populations reside in the village, of the total
rural population 50 percent is still under the poverty lines. Majority of children in
India are not in a position to get adequate nourishment because of very low per capita
income of their families. As per 2001 census, India has around 157.85 million
children, constituting 15.42 percent of India’s population, who are below the age of 6
years. Of these 157.86 million children, 75.95 million children are girls and remaining
81.91 million children are boys. The sex ratio among children as per Census 2001 is
927 i.e. 927 females per 1000 males. A significant proportion of these children lives
in economic and social environment which impedes the child’s physical and mental
disease, infection, inadequate access to primary health care, inappropriate child caring
and feeding practices.1 This present study is an effort to analyze the feeding practices
5
Need for the study
The child is the center of attraction in a family. The first important way the
young children feel part of the family is through a schedule that is like that of the
other family members. Being able to eat with the family goes a long way toward
making children feel that they are now truly family members.
Children are the future of any nation. In India about three – fourth of the infant
their well being through exercising utmost care in order to make them healthy and to
protect them from deadly diseases. Care of children had always traditionally been the
problem in many developing countries. This problem has serious long term
consequences for the child and adversely influences their development.15 Poor
nutrition or malnutrition is caused by not getting the proper nutrients needed for
potential of physical and mental abilities. Malnutrition makes the child more
Over the past two decades, there has been a substantial and progressive
decline in infant and child mortality rates in India. There has also been a significant
that increasing attention is now paid to the nutritional status of the survivors. The
alarming reports of some international agencies which have placed India at about the
6
bottom-rung of an arbitrary world development scale, have raised apprehensions that
improvement.13
the children must have the knowledge of existing feeding practices among mothers
and the nutritional status of their children. She must be able to identify the various
feeding practices and taboos that exists and which in turn affect the nutritional status
the most during 6–12 months of age and one of the major determinants is poor
feeding practices during first year of life. Breast feeding is extremely important
during illness, as children like to be with the mothers and continue to be breast fed.4
breast milk intake and, at the same time, improve the quantity and quality of foods
children consume.
The 6-11 month period is an especially vulnerable time because infants are
just learning to eat and must be fed soft foods frequently and patiently. Care must be
taken to ensure that these foods complement rather than replace breast milk. Energy
portion size, feeding children more frequently, and providing more energy-dense
foods. Micronutrient intake can be increased by diversifying the diet to include fruits,
vegetables, and animal products; using fortified foods; giving supplements.10 During
7
the third trimester of pregnancy through the early childhood years malnutrition
interferes with the development of the brain. This in turn affects the child’s ability to
learn. As a result children will never be as bright as nature had meant them to be.
local assessments. Local studies should identify local diets and current good practices
to be supported, test options for improving the traditional diet and related feeding
practices, and identify target audiences and effective strategies for reaching them.10
Ray, Akshil Bandhu Biswas, Sathi Kumar, concluded that : the overall prevalence
80.90 percentage and that of severe grades of malnutrition (grades III and IV) was
malnutrition was highest in 12 to less than 24 months age group being 85.7
percentage and 18.2 percentage respectively while lowest prevalence was observed
higher in females as compared to their male counterparts, amongst the families where
number of children were 2 or more as well as amongst the families where mothers
8
Breast milk is the ideal food for the infant. But after six months production of
practices and nutritional status of under-five children”. This study included 217
under-five children.
Initiation of Breast Feed: They found that 55.8 per cent were breast fed within
six hours of birth of whom 30.6 per cent under weight, 49.6 per cent stunting and 12.4
per cent were wasting. Whereas 42.2 per cent were breast fed after 6 hours. Among
them 43.7 per cent were under weight, 64.6 per cent stunting and 8.3 per cent wasting.
Colostrum Feeding: 42.2 per cent had colostrum feeding; among whom 27.5
per cent under weight, 42.1 per cent stunting, 10.5 per cent wasting. 54.8 per cent who
didn’t have colostrum feeding of whom 43.7 per cent suffered under weight, 59.0 per
Exclusive Breast Feeding: 23.5 per cent had exclusive breast feeding among
whom 27.4 percent under weight, 49.0 percent stunting and 5.6 percent wasting were
found. And 76.5 percent who did not have exclusive breast feed also suffered from
under weight, stunting and wasting i.e. 43.7 percent, 52.4 percent and 12.0 percent
respectively.
9
Proper Complimentary Feeding: 38.7 percent had proper complimentary
feeding of whom 28.6 percent under weight, 44.0 percent stunting and 8.3 percent
wasting. Also 61.3 percent who did not have proper complimentary feeding suffered
from underweight, stunting and wasting i.e. 41.3 percent, 56.4 percent and 12.0
percent respectively.17
The Institute for Research in Medical Statistics, New Delhi undertook a study
to assess the nutritional status of the population residing in Bihar. Among children,
examine the role of dietary and other related factors on nutritional status of children, a
detailed analysis was done for the data collected in the study.
The survey covered all the 50 districts including all 704 blocks, 1418 villages,
236 urban ward, 28360 households and about 11,000 children of Bihar. For selection
anthropometry etc. Children under five years of age were categorized using Gomez
This analysis indicates that the malnutrition among children depends on both
better sanitary conditions and on dietary intake. The severe and moderate level of
malnutrition among children was much higher among those with poor housing and
sanitary conditions even with the same level of dietary intake whereas inspite of lower
dietary intake, the level of malnutrition was much lower for those living in better
sanitary conditions. Thus to reduce the problem of malnutrition among children, there
10
should be dual focus on dietary intake as well as providing safe drinking water, better
sanitation and housing condition for improving their general standard of living.18
Since mothers are solely responsible for the breast feed, weaning and
preparing various type of diet for children, they should have sufficient knowledge
regarding feeding to prevent malnutrition and promote optimum health for their
broad frame work of child care including feeding practices. A good understanding of
of its people. So that nurses could assist mothers to improve or modify their feeding
practices wherever necessary to improve their children’s health status. Therefore this
study aimed at assessing the feeding practices of mothers and nutritional status of
Operational Definitions
quantity, feeding techniques, number of feeds per day that mothers use for
their children.
like present weight, height, and mid arm circumference and chest
circumference.
11
3. Children: Refers to individuals between 6 months to 3 years of age.
Hypothesis
Inclusion criteria
Exclusion criteria
2. Mothers who did not have the children along with them at the time data
collection.
Conceptual Framework
The Conceptual Framework for the study is based on health belief model.
Health beliefs are person’s ideas convictions and attitudes about health and illness.
The Health Belief Model (HBM) was one of the first models that adapted
theory from the behavioural sciences to health problems, and it remains one of the
12
most widely recognized conceptual frameworks of health behaviour. Rosenstoch
(1974) and Becker’s and Maiman’s (1975) model, address the relationship between
the persons beliefs and behaviours. It is a way of understanding and predicting how
clients will behave in relation to their health and how they will comply with health
perception, beliefs and various behaviour in order to plan the most effective care.
for this study. Mothers feeding practices regarding breast feeding, weaning and family
1. Mothers Perception
diet. Foods according to the age, feeding technique and problems during each
stage.
2. Modifying Factors
mothers age, religion, type of family, child’s age and sex, socio economic
variables like education occupation and family income and structural variables
13
like feeding practices. The mother’s perception is also influenced by cues to
action like mass media, information from elders and neighbours and information
This part indicates that mothers may try to take action to assess nutritional need of
underweight and feeding problems. Thus to improve the nutritional status of their
children. Perceived barriers like illiteracy, poor socio economic status and lack of
Projected Outcome
Study will provide an insight into satisfactory feeding practices of mothers and
the nutritional status of their children, thereby help the nurses to sow the seeds
14
CONCEPTUAL FRAMEWORK
Demographic variables:
Mothers Child Perceived benefits
Age Age - of proper breast feeding,
Religion Sex - weaning,
Perceived Type of family Place of birth - prevention of malnutrition,
susceptibility, Socio economic variables: perceived barrier
perceived Education - illiteracy
seriousness Occupation - cost of food, cultural
Family income practices, level of
Feeding Structural variables education.
practices and Practices of breast feeding weaning and family diet
nutritional
status of Likelihood of
children Mother’s prescribed threat of under weight, taking action by
malnutrition, feeding problems of children nursing personnel
to improve the
feeding practices
Cues to Action of mothers to
improve the
• Mass media nutritional status
• Information from elders and neighbours of their children
• Individual health education by health personnel
• Newspapers or magazine articles Not included in
the study
Fig 1:Adapted from Rosenstochoch’s (1974) Becker’s (1975) Health Belief Model
15
2. OBJECTIVES
3. To find out the correlation between the feeding practices of mothers and the
4. To find out the association between feeding practices of mothers and their
16
3. REVIEW OF LITERATURE
to the research project.9 The review of related literature is valuable guide to define the
Review of literature for the present study has been organised under the
following headings
feeding practices.
their children.
children
status.
practices
its relation with feeding practices in 605 tribal under five children. There was a
Exclusive breast- feeding was beneficial only up to 6 months age. After this age, it
lost its advantage. Children above one-year age exclusively fed on breast had a high
17
prevalence of malnutrition. No other factor, like sex of the child, parental literacy,
past history of illnesses had any significant effect. Health education messages should
children.24
marasmus (NM) and kwashiorkor (K) using Sudanese children aged 6-36 months.
and weaning foods was obtained. Observations were made in 20 percent of homes of
and 24 months, and NM. Using multivariate analysis the data show that late
developing nutritional marasmus, rather than kwashiorkor. In contrast the odds ratio is
1.9 for the two conditions in terms of age of cessation of breastfeeding, the
practices. The investigation was undertaken with the objective of creating an infant
and child feeding index (ICFI) from a set of complementary feeding (CF) practices
and to determine its association with growth of infants and young children (6-23
18
months). A semi-structured interview schedule was used to collect information for
204 children from one large slum and two private paediatric clinics of urban
Vadodara. Results revealed that about half (5.05 percent) of the children were stunted
Height for Age Z score, nearly one-fourth (25.5 percent) were underweight, but
wasting was low (3 percent). It is concluded that the composite index in its present
form can reflect the CF practices more holistically than just one or few behaviour
composite index which can then be used for research, monitoring, evaluation and
children in three villages of Bangladesh. A total of 479 children aged 6-60 months
classification 84 percent were stunted (36 percent mild, 33 percent moderate and 15
percent severe) and 67 percent were wasted (47 percent mild, 18 percent moderate
and 2 percent severe). Of all children 368 received BCG and 439 received partial or
full dose of DPT and Polio vaccines. Among children aged 13-60 months 75 percent
received Measles vaccine. Weaning food was started at 8.4 months. Low household
income, parental illiteracy, small family size, early or late weaning and absence of
BCG vaccination were significantly associated with severe PEM. Timely weaning,
19
Excler JL, Nicolas E, Mojon M conducted a study on Protein-energy
(MKWK) and living in an African urban area. The decline of breast feeding leads to
Poverty, ignorance and food taboos are related to a lack in weaning food varieties. A
small number of infants with KWK had a rich protein diet putting back the cause of
an hypoproteic diet on the KWK onset. Infections play a determinant role in the onset
bronchopulmonary and parasitic diseases are the most prevalent infections. Among
up and father's bonding failure. At the opposite of rural areas, the family size is
reduced. The three first birth ranges are specially concerned with young inexperienced
mothers.27
their children.
Dinesh N.K, Goel, Poonam C, Mittal did a study to determine the nutritional
status of under-five children and to assess infant feeding practices and the association
with the under nutrition in Anganwari area of urban Allahabad. Among all under five
children surveyed, 36.4 percent were under weight, 51.6 percent had stunted growth
and 10.6 percent had wasted proportions of underweight and stunting were found
20
maximum among children aged 13-24 months. Wasting was more prevalent among
children aged 37-48 months. Initiation of breast feeding after six hours of birth,
significant risk factors for underweight. Wasting was not significantly associated
with any infant feeding practices studied. They conclude that delayed initiation of
breast feeding, deprivation from colostrum and improper weaning are significant risk
factors for under nutrition among under fives. There is a need for promotion and
children.17
study on Infant feeding practices from birth to two years of age and nutritional status
infant feeding practices and child and maternal nutritional status were conducted
every six months from July 1998 to February 2001. One district from each division of
the country and two upazilas from each selected district were randomly selected.
height / length. The nutritional status of mothers were assessed by taking height and
weight and expressing as body mass index. Information on breast feeding practices,
one year in most surveys was more than 96 percent and at 2 years more than 85
percent. Despite national efforts to improve breast feeding and nutritional status of
children and mothers in Bangladesh, the indicators have yet to reach an optional level.
21
These feelings can help policy – planners understand the need for intensifying future
programmes.20
District, Tanzania. The study showed that 31 percent of the children were
undernourished, some of them severely. Children 2 - 3 years old were the most
affected. Breastfeeding duration of more than one year was common among the
mothers. Fifty-four percent of the mothers weaned their children as early as two
months after birth. The most common type of weaning food was maize porridge
(gruel) mixed with cow's milk Generally, 87 percent of households were facing some
degree of food insecurity where some of them either experienced food shortage for
3-4 months reported of eating less than three meals per day. An educated mother was
less likely to have an undernourished child, while a child from a teenage mother was
mobilize the community members to adopt practices that favour good nutrition of
children.15
practices and nutritional status of children aged 0 to 2 years in Thika, Kenya. Cross
22
households to assess time allocation for the main child care activities. The findings
revealed that mother’s knowledge about child care influences the amount and type of
care that is given to children. Time taken to perform various activities was also found
to vary with the mother's education level, her occupation, number of children less than
five years in the house and the child's age and birth order. Comparatively, children
who were malnourished had less time devoted to them for breastfeeding, food
preparation and feeding. Although mothers were the primary caregivers, the
responsibility of care giving was shared with other household members as well as
with neighbours. The amount and type of care that a child receives is determined to a
Ruel MT, Menon P affirmed that Child feeding practices are associated with
child nutritional status in Latin America. Data from the Demographic and Health
Surveys (DHS) for 5 Latin American countries, were used to explore the feasibility of
creating a composite feeding index and to examine the association between feeding
practices and child height-for-age Z-scores (HAZ). The variables used for the index
the past 24 hrs, frequency of use over the past week and feeding frequency. The index
was made age specific for 6 to 9, 9 to 12 and 12 to 36 mo-old age groups, and age-
specific feeding practices were created. Bivariate analyses showed that feeding
practices were strongly and significantly associated with child HAZ in all 7 data sets,
remained significant after controlling for potentially confounding influences, for all
countries except Bolivia. Among children whose mothers had primary schooling
compared with mothers with no schooling, or mothers with higher than primary
23
school level. The data available in DHS data sets can thus be used effectively to create
a composite child feeding index and to identify vulnerable groups that could be
information using a food frequency questionnaire. Nine focus groups and 5 deep
interviews to mothers of children less than 2 years of age were performed. Their data
percent. These practices are characterized by a universal onset of breast feeding, that
complementary feeding and bottle-feeding are highly valued due to their positive
introduction of complementary food after 4 months, the quality of the first food
introduced and the diversity of complementary food predicted better nutritional status.
They conclude that nutritional illiteracy and mothers' erroneous beliefs result in 50
children
nutritional status in a cohort of 200 infants over a period of one year in the rural area of
24
Aligarh. Weaning was late in most of the infants under study. The nutritional status of
infants up to 6 months was significantly better than that of infants more than 6 months
mothers attending the Nutrition Clinic of the Ahmadu Bellow University Teaching
determine at what age the 1st supplementary diet was introduced, the age the child
was weaned, and the weaning practices. The questionnaire dealt with various aspects
of weaning knowledge, attitudes, and practices. The mothers were referred to the
Nutrition Clinic because their babies already were suffering from protein energy
status. 36 mothers introduced supplementary feeds when their ch8ildren were between
7-9 months. All the mothers used corn, or millet gruel. A decision to wean a child
may be made if the child can crawl, walk, or has a good set of erupted milk teeth,
even if the child has not reached the traditional weaning age of 20-24 months. The
mean age of weaning was 17 months in this study. 78.5 percentage of the mothers
responded to the question about weaning food taboos, prohibitions, and their reasons
during the weaning period. Even when protein is available, a child may be denied the
these low socioeconomic facilities coupled with sociocultural factors compounded the
feeding problem, and, consequently, protein energy malnutrition was common during
25
Puri RK, Sachdeva R had done a study on supplementary foods suited for
weaning and feeding of infants were developed, using locally available foods in
Punjab. Methods of cooking employed were those used commonly by low and
middle-income families, Cereal –pulse combinations along with some sesame seed
and groundnuts were used to enhance the protein quality. The ratio used was such that
the preparation did not deviate much from the accepted tastes of the population.,
Fresh green vegetables were also used. Fifteen recipes were standardized and
acceptability trials carried out with mothers and infants or the different socio-
economic groups. The preparations were highly accepted by all. Analysis of these
were done for protein, calories, vitamin C and iron to see their contribution to the
diet. The cost per serving a very low cost a substantial amount of the above nutrients
could be given to in making these recipes will go a long way towards popularizing
such formulations.30
death in infants and toddlers and anaemia in frequently found in small children. Data
on infant and toddler feeding practices were collected from 90 mothers from the town
of Apia and 38 mothers from island in Sava. Most belonged to the low income group.
In Apia, weaning foods consisted of milk, meat, and other protein- rich foods; in
Sava, taro, orange leaf tea and rice, were the main weaning foods. Generally, semi-
solids were nor introduced before the child was more than 6 months of age. Some
cultural taboos appear to affect the children’s diet as well as that of pregnant and
lactating mothers.31
26
Malla S and Shrestha SM conducted a study on Complementary Feeding
Practices and its Impact on nutritional status of under two old children in urban areas
of the Kathmandu, Nepal. Magnitude of the malnutrition was very high in Nepal.
Child nutrition problem due to faulty child feeding practice was widely observed in
practice among the young children has been found very critical in urban areas of
Kathmandu valley. The study was based on primary data collected by applying the 30
cluster sampling method. Target population of the study were young children aged 0-
Finding of the study indicated that about 92 percent households were found practicing
carbohydrate and protein severely, therefore, not fulfilling the nutritional requirement
children were found suffering from mild to severe form of malnutrition where as
among commercial food fed, only 41 percent of children were found suffering from
such form of malnutrition. About 33 percent of the children suffering from severe
district found better compared to young children from other district. Children from
Lalitpur district were found more severely malnourished. Surprisingly baby boys
found more severely malnourished compared to baby girls. Traditional foods fed
27
Heath AL, Tuttle CR, Simons MS, Cleghorn CL, Parnell WR undertook a
study regarding breastfeeding and weaning practices during the first year of life in
Dunedin, New Zealand. To investigate infant feeding practices during the first year of
feeding, 42 percent were exclusively breastfed till 3 months, and 34 percent were
partially breastfed till 12 months. Intention to breast feed increased the likelihood of
successful breastfeeding initiation. Mothers who reported that they did not have
enough breast milk tended to exclusively breastfeed for a shorter period of time.
45 percent were given non milk foods before 4 months of age, and 69 percent were
weaning age in rural Bangladesh. Weaning beliefs and practices in two representative
rural villages in Bangladesh by interviews with 180 mothers with infants between 1
and 12 months of age. Maternal parity and family size were not found to be related to
weaning age. Family income and maternal education were consistently related to
mothers' responses and actual weaning behaviour toward infants 4-6 months old could
28
Moussa WA, Tadros MD, Mekhael KG, Darwish AE, Shakir AR
undertook a study on some simple methods of home processing and their implication
with weaning foods. One of the most practical solutions to combat Protein Energy
Malnutrition in low income groups is the intelligent mixing of cereals and legume
make available low cost weaning food of high nutritional quality. One of the main
legumes is the bulk factor. In this study some simple methods of home processing to
improve the nutritional quality of the home prepared weaning foods were tested and
Biochemical evaluation revealed that the germination of wheat raised its protein and
fat and reduced carbohydrate, while there was almost no change on lentils. Comparing
germination with a special chapati process, protein and fat content were higher in the
formula processed by the former method, while minerals were higher in the same
formula but processed by the latter method. Although further research is needed,
on children and nutrition. A total sample of 150 mothers were selected from two
villages, one of which served as experimental group and the other acted as control
group. The tool consisted of a self structured questionnaire schedule covering aspects
of childcare and nutrition. All mothers were first pre tested regarding their knowledge
29
on nursing, neonatal and infant care, health, child’s growth, behaviour and nutritional
period of one and a half years. All the mothers were then post-tested on the above
aspects. Significant differences were seen in all the aspects of childcare and nutrition
and child nutritional status in the Volta region of Ghana. The data was collected in
associations between child nutritional status and the following variables: time of
whether colostrum was given to child, age of introduction of supplementary food, and
marital status were also found to be associated with child nutritional status in bi-
variate analyses. Further analysis with Logistic regression revealed that maternal
nutrition knowledge was independently associated with nutritional status after the
effects of other significant variables were controlled for. Maternal education on the
other hand was not found to be independently associated with nutritional status. These
results imply that mother's practical knowledge about nutrition may be more
conducted a study on Nutritional status of the preschool children of the Klong Toey
30
Slum, Thailand. Cross-sectional study to examine the nutritional status of children
aged 1-5 years who live in the Klong Toey slum, Bangkok; the factors related to
nutritional status were also determined. Anthropometric measurements were made for
the study sample was 25.4 percent by weight for age, 18.1 percent by height for age,
and 6.9percent by weight for height; the prevalence among pre-school children in
8.73 percent and 5.25 percent respectively. Multiple logistic regression analysis was
used to identify the association with the nutritional status of children by height-for-
age. The results showed that family income, maternal housewifery or unemployment,
food practice, and a maternal educational level lower than primary school were
associated with the nutritional status of children. This finding implies that although
remains a threat to the health of the urban poor in Bangkok. This finding should not
slum. Nutritional status of 363 children aged six to 24 months was measured and
selected as the study site and all consenting households were involved in the study.
The study established that most mothers (97.5 percent) have access to nutrition
education. Prevalence of stunting (86.2 percent) and underweight (58.4 percent) was
high but that of wasting (1.9 percent) was low. There was no significant relationship
31
Unexpectedly, a negative relationship was found between nutritional status and
Chit TM, Kyi H, Thwin A had done a study on Mothers' beliefs and attitudes
towards child weight, child feeding and related practices in Myanmar. They identified
mother's attitude and concern regarding child weight and feeding practices and also to
interviewed ninety mothers from different areas and Divisions. Mothers were
well-nourished children were weighed at birth and 100 percent of them had received
regular weighing. 89 percent of their mothers could identify their child birth weight as
normal and all of them know the negative health consequences of Low Birth Weight.
child believe that feeding during illness is better for recovery. That proportion is high
as twice as of the remaining groups. Data regarding child feeding practices show
mothers of a well nourished child have timely and appropriate starting of these
practices. It is inferred from the recent finding that mothers who had received growth
monitoring program since delivery have better preventive behaviour for PEM and the
32
Das DK, Ahmed S had conducted a study on knowledge and attitude of the
Bangladeshi rural mothers regarding breast feeding and weaning. Two hundred and
to assess their knowledge and attitude regarding breastfeeding and weaning using
pretested questionnaires, though 83.5 percent mothers knew that colostrums is good
for the child, less than 8 percent of them gave it as the first food to their babies. Most
mothers did not have the correct knowledge about exclusive breastfeeding and the
appropriate time for introduction of weaning foods; and only 3 percent of them knew
regarding breast feeding and weaning practices. The knowledge of mothers of the
high income group of urban Baroda, related to breast feeding and weaning. Forty
mothers with children aged 4 to 18 months were studied. Knowledge and practices
regarding breast feeding and weaning were assessed using pre-tested questionnaires.
Results indicated that only half the mothers breast fed their babies on the first day.
Breast feeding was stopped when the child was 3-6 months; top feeding and solid
supplements were initiated at 4-6 months. Mainly commercial baby foods were used
for weaning. Most mothers avoided 'dals' for the child because these were believed to
be difficult to digest and produced gas in the child's stomach. Fifty percent of mothers
were not in favour of feeding the sick child with small frequent meals.41
Bhat lA, Shah GN, Dhar GM, Mehnaz S conducted a study on the impact of
maternal knowledge and practice on the nutritional status of infants. They interviewed
123 mothers of infants attending the child health clinic of the S.K. Institute of Medical
33
associated with the nutritional status of the infants. 28 children were considered to be
degrees of malnutrition. Mothers whose infants were well nourished had a higher
level of breast feeding knowledge than did those whose infants were moderate to
score on breast feeding practices. Little difference in infant nutritional status existed
between mothers who scored fair and those who scored poor, but among mothers of
well nourished infants, those who scored well were more likely to have infants of
good nutritional status than those who did not score well. These findings show a
suggesting that further improvement of health education is needed to reduce the lag
1994. A total of 1,543 mother-child pair were included in the study, of which
1.052 children were on weaning diet and 491 were exclusively breast feeding. Among
children who were already weaned, 40 percent were reported to have been started on
weaning food at the age of 4-6 months. Of the children who were reported to be
exclusively breast feeding, 34 percent were beyond the age of 7 months. The most
commonly used weaning food were cow's milk, adult food, sorghum water and cereal
gruel in descending order and the most important reasons for mothers to start weaning
were reduction of the amount of breast milk and mothers' belief that the child is at the
right age to start weaning food. The majority of the mothers used "swallow or
34
suffocate" method in feeding their children, though cups and bottles were also
35
4. METHODOLOGY
The methodology enables the researcher to project a blue print of the details, data,
indicates the general pattern of an organized procedure for gathering valid and reliable
variable setting, population, sample and sample size, sampling techniques, sampling
criteria, development of tool, description of the tool, pilot study, data collection
procedure, plan of data analysis. This study was done to assess the correlation
between the feeding practices of mothers and nutritional status of their children in a
Research approach
A research approach tells the researcher what data to collect and how to
analyze it. It also suggests possible conclusions to be drawn from the data. In view of
the nature of the problem selected for the study and objectives to be accomplished, a
descriptive survey approach was considered as appropriate for the present study.
Research Design
over factors that could interfere with the validity of the findings. It is the plan and
structure and strategy of investigation of answering the research question. It helps the
36
researcher in defining the attribute, selection of population and type of statistical
37
SELECTED AREA - RURAL
PURPOSE
RESEARCH DESIGN
DATA ANALYSIS
• Descriptive analysis
• Inferential analysis
• Interpretation of results
38
Setting of the Study
Research setting is the specific place where data collection occurs. The
selection of setting was done on the basis of feasibility of conducting the study,
availability of the subject and co-operation from the authorities. The study was
Variables
Burns and Grove explained that research variables or concepts are the
• Age
• Education
• Occupation,
• Age
• Gender
• Birth weight
39
Population
The term population refers to the target population which represents the entire
The total number of the houses in Chikkabasti - 275 and female population
805 and in Doddabasti, total houses 96 and female population only 230. The sample is
selected randomly. The target population for the present study comprises of all the
mother of reproductive age group and having children between 6 months to 3 years of
Sample
particular study.44 It is the portion of the population which represents the entire
population. In the present study samples consist of 100 mothers of reproductive age
group and 100 children of same mothers at Chikkabasthi and Doddabasthi, Bangalore.
Sampling Technique
Sampling theory point of view each individual in the population should have
Sampling Criteria
Inclusion criteria
40
Exclusion Criteria
2. Mothers who did not have the children along with them at the time of data
collection.
Instrument
The information necessary for the study was obtained by the investigator.
Treece and Treece explained that the instrument selected in the research should be as
far as possible the vehicle that would provide data for drawing conclusions to the
study and the same time add to the body of knowledge in the discipline.45 The
1. Review of literature
A blue print was prepared prior to the construction of the questionnaire based
on which the items were developed. It depicted the distribution of items according to
41
Description of the Tool
The instrument used in this study was structured interview schedule which
comprises of 3 sections.
Section I
Demographic Data
The first part of the tool consists of 14 items of which first 9 are related to
regarding feeding practices and next five items are related to child’s age, gender, birth
Section II
Check list consist of 30 items to assess the feeding practices of mothers i.e. breast
Section III
Anthropometry
Maximum Score – 30
Minimum Score – 0
Each correct item was given 1 score and wrong item was given 0 score
Content Validity
supposed to measure. Content validity refers to the degree to which the items in an
42
The prepared instrument along with the objectives, operational definitions,
blueprint, scoring key and criteria checklist for validation were submitted to 7 experts
content validity.
measures the attributes that it is supposed to measure. It refers to the extent to which
In order to establish the reliability of the tool, split half technique was used.
The tool was administered to 10 subjects and the reliability was tested by using
Reliability of the tool was 0.9340 so the tool was found to be highly reliable
Pilot Study
Pilot study is a trial run study conducted before the actual study in a different
Maruthinagar under K. Gollahalli, PHC, Bangalore from 7th August to 13th August.
The permission to conduct pilot study was obtained from the Medical Officer
K. Gollahalli PHC. Subjects were chosen by random sampling technique. The purpose
of the study was explained and informed consent was obtained from the samples. The
43
Data Collection Process
The data collection was from 3rd September to 3rd October 2007. Permission
was obtained from the Medical Officer, Primary Health centre, K. Gollahalli. The
investigator administered the tool to 100 mothers who were selected by using random
sampling technique after introducing and explaining the purpose of the study. Then
However, there few difficulties arose during the data collection period. Some
houses mothers had gone for work leaving their children with relatives. In certain
house mothers were there but children were with grand parents or gone to
Anganawadi. So the investigator had to exclude those families and go to the next and
Data was collected from 100 mothers and their children (100) from
Diagrams were used for depicting the authentic nature of at the data collected
on demographic variables and the practice aspects. Association between the selected
presented through diagrams and tables. Correlation for the present study was
44
5. RESULTS
This chapter deals with the analysis and interpretation of the data gathered to
correlate the feeding practices of mothers and nutritional status of their children.
questions, the data must be processed and analyzed systematically and testing of
Objectives
3. To find out the correlation between the feeding practices of mothers and
The obtained data were organized and presented under the following sections.
Section I
Section II
In this section mean and standard deviation of feeding practices are described.
45
Section III
Section IV
Section V
Section VI
46
SECTION- I
their children.
80
72%
70
60
No of respondents
50
40
30
20 17%
11%
10
0
<20 21-30 31-40
Age in years
Among 100 mothers 17 percent were below 20 years of age, 72 percent were
47
62%
70
60
Number of Respondents 33%
50
40
30 5%
20
10
0
Hindu Muslim Christian
Religion
Among 100 mothers 33 percent were Hindus, 62 percent were Muslims and 5
48
Extended
7%
Joint
Nuclear
36%
57%
Type of Family
family
Out of hundred mothers 57 percent had nuclear families, 36 percent had joint
49
40%
40
35
24%
Number of Respondents
30
25
13%
20
8% 10%
15 5%
10
5
0
Illiterate Primary Middle Secondary PUC Graduate
school
Educational Level
educational status.
education, 24 percent had middle school education, 40 percent had high school
50
7%
11%
82%
Govt. employee
Private employee
House wife
51
90
79%
80
Number of Respondents
70
60
50
40
30
20
12% 9%
10
0
<5000 5001-10,000 >10,000
Family Income
Among 100 mothers 79 percent had family income below Rs.5,000, 12 percent
had family income between 5,001 to 10,000 and 9 percent had above Rs.10,000.
52
50%
50
45
36%
Number of Respondents
40
35
30
25
14%
20
15
10
5
0
1-4 5-9 10-13
Duration of Married life in Years
married life
After 100 mothers 36 percent had duration of married life between 1-4years,
50percent had married life between 5-9 years and 14 percent had married life between
53
60%
40%
60
Number of Respondents
50
40
30
20
10
0
1 2
No. of under five children
Among 100 mothers 60 percent had only one childe below five years and 40
54
43% 44%
45
40
Number of Respondents
35
30
13%
25
20
15
10
5
0
Family Radio/TV Books/Journals
members/relatives/friends
Sources of Information
source of information, 44 percent had radio / T.V and 13 percent had books / journals
55
48%
50
45
34%
40
Number of children
35
30
18%
25
20
15
10
5
0
1 2 >2
Birth order of children
Among 100 children 34 percent were first born, 48 percent were second in
birth order and 18 percent were above two in birth order. (Fig.12)
56
46%
50
45 37%
Number of Respondents
40
35
30
25
15%
20
15
10 2%
5
0
<1 1-2 2-3 >3
Age of Children
Among 100 children 15 percent were below 1 year, 37 percent were between 1
57
Male 48%
Female
52%
Gender of Children
Among 100 children 52 percent were females and 48 percent were males.
58
SECTION II
TABLE 1
mothers
n =100
Sl. Mean
Area wise analysis Max. score Range Mean SD
No %
1 Breast feed 9 5-9 6.98 0.84 77.56
2 Weaning 10 4-10 7.11 1.08 71.10
3 Family diet 11 1-11 5.28 1.96 48.00
The total score 30. The total mean feeding practices was 19.37 with a standard
deviation of 2.51 while total mean percentage was 64.57. (Table 1).
59
SECTION III
TABLE 2
n = 100
Moderately
Not satisfactory Satisfactory
Satisfactory
Sl. (<50%) (>75%)
Area wise (51-75%)
No
No. of No. of No. of
Percent Percent Percent
subjects subjects subjects
1 Breast feed - - 22 22 78 78
2 Weaning 5 5 59 59 36 36
3 Family diet 66 66 26 26 8 8
Total 5 5 81 81 14 14
As per breast feeding practices, none of them were under the classification of
percent had satisfactory feeding practices with regard to weaning, 5 percent had not
practices and 36 percent had satisfactory feeding practices. As per family diet; 66
percent had not satisfactory feeding practices, 26 percent had moderately satisfactory
60
SECTION IV
TABLE 3
n = 100
Spearman's correlation
Sl. between the scores of Spearman's
No feeding practices and selected nutritional correlation value
parameters of children
1 Present weight (kgs) 0.161
2 Height 0.122
3 Mid arm circumference 0.074
4 Chest Circumference 0.086
nutritional parameters of their children revealed that higher the knowledge level of
is, there exist a positive relationship between feeding practices and present weight
61
SECTION V
TABLE 4
Association between feeding practices and selected variables of children
n = 100
Feeding practices
score Chi- Table
Variable Category df
square value
≤Median >Median
≤Mean 40 20
Age (yrs) ▪ 0.463 1 3.841
>Mean 24 16
Muslim 46 16
Religion▪ 7.358* 1 3.841
Hindu and Christian 18 20
Type of Nuclear 34 23
1.089 1 3.841
Family▪ Joint/Extended 30 13
Below middle school 33 9
Education▪ Secondary school 24 16 9.075* 2 5.99
Above PUC 7 11
House wife 58 24
Occupation▪ 8.96* 1 3.841
Govt./Private employee 6 12
≤ Mean 54 25
Income▪ 3.096 1 3.841
>Mode 10 11
1-4 25 11
Duration of
5-9 31 19 0.836 2 5.99
Married life
10-13 8 6
No. of 1 34 26
Under Five 3.501 1 3.841
Children 2 30 10
1 22 12
Birth Order 2 30 18 0.11 2 5.99
>2 12 6
Family
Source of member/relatives/friends 28 15
0.041 1 3.841
information▪
Radio/TV/Media 36 21
▪ The expected frequencies in these variables were < 5, and hence, the some of the
categories were merged and accordingly the degrees of freedom are adjusted.
62
education and occupation were statistically significant. However the Chi-square value
established at 0.05 level of significance denotes that the association between feeding
practices and demographic variables like age, type of family, income, duration of
married life, number of under five children, birth order and source of information
were not statistically significant. (Table 4).
63
TABLE 5
n = 100
Total feeding
Chi-
practices score
Anthropometric Table
Category square df
variables value
≤Median >Median value
anthropometric variables of children like birth weight, present weight, height, mid
arm circumference, chest circumference, age of the child and gender at P<0.05 level.
(Table.5)
64
6. DISCUSSION
The present study was aimed to correlate the feeding practices of mothers and
nutritional status of their children. The correlation was done by making association
between the demographic variables and feeding practices and correlation coefficient
reproductive age group of mothers who have children between the age of 6 months
and 3 years.
among mothers. The research design adopted for the study was descriptive correlative
design. Random sampling technique was used to select 100 mothers and their children
Main findings of the study were discussed under the following sections.
Section – 1
years of age. 3 percent among the total respondents were Hindus, 62 percent of them
were Muslims and 5 percent of them were Christians. 57 percent of them belonged to
nuclear families, 36 percent of them lived in joint families and 7 percent of them lived
in extended families. Education wise, only 5 of them were illiterate, 13 percent had
primary education, 24 had middle school education, 40 percent had high school
65
education, 8 percent were educated upto PUC and 10 percent of them were graduates.
private employees and 7 percent were government employees. Family income wise,
79 percent of them had an income of below Rs. 5000, 12 percent of them had an
income between Rs.5001 and Rs.10000 and 9 percent of them had a family income of
above Rs. 10000. Among the total mother respondents 36 percent had a duration of
1 – 4 years of married life, 50 percent had a duration of 5 – 9 years of married life and
Among the 100 subjects, 60 percent had only 1 child below 5 years and 40 percent
of them had 2 children below 5 years of age.43 percent of the respondents attributed
percent attributed the same to radios/ television and 13 percent of them attributed it to
books and journals. Among 100 children 34 percent were first born, 48 percent were
2 nd in birth order and 18 percent of them held an ordinal position of >2. 15 percent
of the children were below 1 year, 37 percent were between 1 – 2 years of age and 48
percent were 2 to 3 years of age. Among the total children subjects 52 percent of them
Breast feeding aspect maximum score was 9 and response on feeding practice
mean 6.98, mean percentage 77.56 and SD 0.84. Weaning aspect maximum score 10
and response on feeding practice mean 7.11, mean percentage 71.10 and SD 1.08.
Family diet – maximum score 11, mean 5.28, mean percentage 48.00 and SD 1.96.
66
The second objective was to assess the nutritional status of children
As per breast feeding practices, none of them were under the classification of
percent had satisfactory feeding practices with regard to weaning, 5 percent had not
practices and 36 percent had satisfactory feeding practices. As per family diet; 66
percent had not satisfactory feeding practices, 26 percent had moderately satisfactory
The third objective was to find out correlation between the feeding practices of
parameters of their children revealed that higher the knowledge level of respondents on
feeding practices, better is the outcome of nutritional parameters. That is, there exist a
positive relationship between feeding practices and present weight (r=0.161), height
(r=0.122), mid arm circumference (r=0.074) and chest circumference (r=0.086) of the sample
study group.
The fourth objective was to find out the association between feeding practices of
67
No significant association was found between feeding practices and
anthropometric variables of children like age, gender, birth weight, present weight,
Testing of hypothesis
H1: There is correlation between feeding practices of mothers and nutritional status of
their children.
Since there exist a positive relationship between feeding practices and present weight
(r=0.161), height (r=0.122), mid arm circumference (r=0.074) and chest circumference
(r=0.086), the researcher concluded that there is positive correlation between feeding
practices of mothers and nutritional parameters of their children. Hence the score is positive
68
7. CONCULSION
The present study was aimed to correlate the feeding practices of mothers and
nutritional status of their children. The correlation was done by making association
between the demographic variables and feeding practices and correlation coefficient
reproductive age group of mothers who have children between the age of 6 months
and 3 years.
among mothers. The research design adopted for the study was descriptive correlative
design. Random sampling technique was used to select 100 mothers and their children
• The participants included in the study were between the age group of 18 – 40
years.
• There is non significant association between age of the mothers and feeding
practices.
percent primary school, 24 percent middleclass school and 40 percent high school.
• With regard to under five children most of them had only one child and others 2.
• But there was not significant association between no of under five children and
feeding practices.
69
• Occupation wise most of them were housewives 82 percent, 7 percent government
• As per family income, most of them had below Rs.5000, 12 percent had between
50 percent above 10 years 13 years 14 percent were there. But there was no
0.161, height r = 0.122, mid arm circumference r = 0.074 and chest circumference
The findings of the study have implications in various fields of nursing. They
are:
• Nursing education
• Nursing practices
• Nursing administration
• Nursing research
70
Nursing Education
education both in community settings and clinical areas by using various methods of
Nursing Practice
– John Ruskin
Nurse plays an important role in the feeding of children. It starts even before a
and feeding, nurse can help to improve the feeding practices of mothers wherever it is
needed. Not only during infancy, but also till adolescence this teaching has to be
continued. Planned health teaching programme can be made ongoing process both in
Nursing Administration
Nursing administration should have proper vision and mission while making
and implementing the policy with regard to health care of the children. Since children
are the dependable and vulnerable population, mothers should be taken into
Nursing Research
through research. Though the present correlative study is like a drop in an ocean, can
prepare the path for future quantitative and qualitative research to improve the feeding
71
Limitations
• Only certain parameters were used to assess the nutritional status of children.
• Interview technique does not collect the accurate data regard to feeding practices.
• The tool used by the investigator needs a broad and comprehensive validation.
Recommendations
72
8. SUMMARY
The main purpose of the study was to correlate the feeding practice of mothers
3. To find out the correlation between the feeding practices of mother and the
4. To find out the association between feeding practices of mothers and their
The conceptual frame work adopted for this study was based on Rosenstoch’s
The review of related literature and non research literature helped the
investigator to develop the conceptual frame work, structured interview schedule and
September to 3rd October 2007. The study adopted descriptive survey approach with
Sample of the study consisted of 100 rural mothers and their children. The tool
73
It consists of the following sections
Section I
Deals with demographic variables which include age of the mothers. Number
of under five children, religion, education, occupation duration of married life, family
Also children’s demographic variables such as age, gender, birth weight, birth
Section II
print, construction of items, content validity and preparation of the final copy of the
tool.
the tool was used for data collection. Then the collected data were analyzed using
Section III
74
Major findings of the study
Majority of them (72 percent) were between 21 to 30 years. Most of them (62 percent)
were Muslims. There were 33 percent Hindus and only 5 percent Christians. Majority
(57 percent) had nuclear families, 36 percent had joint families and only 7 percent had
extended families.
With regard to education ; majority (40 percent) had high school education,
only 5 percent illiterates and 10 percent graduates were there as per occupation 82
percent had between 5,001 to 10,000 and only 9 percent had above Rs.10,000 as their
income. Half (50 percent) of them had married life between 5 to 9 years, 36 percent
percent had only 1 child below five years and 40 percent had 2 children below five
years.
percent between 1 to 2 years and only 15 percent below 1 year. Among them 52
75
2. Findings pertaining to area wise classification of feeding practices
Breast feeding: 78 percent adequate, 22 percent satisfactory and none of them had
Family diet: 66 percent not satisfactory, 26 percent satisfactory and 8 percent had
practices and nutritional status of their children. Spearman’s Rank Correlation value
children is found to be r = +0.161 for the present weight (kgs), r = +0.122 for height,
religion, education and occupation of mothers and feeding practices. However there
family, income, duration of married life, number of under 5 children, birth order, age
76
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nutritional status of under two year old children in urban area of the
Vol.2. No.1.
33. Heath AL, Tuttle CR, Simons MS, Cleghorn CL. A longitudinal study of
breast feeding and weaning practices during the first year of life in Dunedin,
New Zealand. J Am Diet Assoc. 2002 Jul; 102(7): 937-43. Available PMID:
12146555.
PMID 7973842.
35. Moussa WA, Tadros MD, Mekhael KA. Some simple methods of home
processing and their implications with weaning foods. Nahrung. 1992; 36(1):
36. Appah LY, Krehling S. Meternal Nutritional Knowledge and Child Nutritional
Status in Volta region of Ghana. Matern Child Nutr. 2005 April. [cited on
2007 June 1]; 1(2): 100-10. Available PMID: 16881885 [pubmed-indexed for
medline]
Status of preschool children of the Klong Toey slum Bangkok. Southern Asian
J Trop Med Public Health. 2002 Sept, 628-37. Available PMID: 12693602
and the nutritional status of preschool children in a Nairobi Slum. East Afr
81
39. Chit TM, Kyi H, Thuwin A. Mother’s beliefs and attitudes towards child
weight, child feeding and related practices in Myanmar. Nutr Health. 2003;
40. Das DK, Ahmed S. Knowledge of the Bangladeshi rural mothers regarding
breast feeding and weaning. Indian J Pediatr. 1995 Mar – Apr; 62(2) 213-7.
41. Pant I, Cholthia K. Maternal knowledge regarding breast feeding and weaning
practices. Indian J Pediatr. 1990 May – Jun; 57(3): 395-400. Available PMID
2228093.
42. Bhat IA, Shah GN, Dhar GM, Mehnaz S. A study on the impact of maternal
mother’s knowledge and practices. Ethiop Med J. 1998 Jan; 36(1): 37-45.
44. Burns N, Grove S.K. Understanding Nursing Research. 2nd ed. New Delhi:
45. Treece EW, Treece JW. Element of Research in Nursing. St. Louis: Mosby;
1977 p349.
46. Polit FT, Beck JC. Nursing Research. Principles and Methods. 2nd ed.
82
10. LIST OF ANNEXURE
H Blue Print 93
83
ANNEXURE – A
LETTER SEEKING PERMISSION TO CONDUCT THE PILOT STUDY
From,
Rosamma K.J,
II Year M.Sc. Nursing,
Sarvodaya College of Nursing
Bangalore
To,
The Medical Officer
Primary Health Centre
K. Gollahalli
Bangalore South
Through,
The Principal
Sarvodaya College of Nursing
Bangalore
Respected sir,
Sub.: Seeking permission to conduct pilot study
I, Rosamma K.J am a bonafide PG Student of Sarvodaya College of Nursing
affiliated to Rajiv Gandhi University of Health Sciences, Bangalore with a
specialization in Pediatric Nursing.
I have to conduct a pilot study as a part of my main research for the purpose of
partial fulfillment of my course. My problem statement is “A Study To Correlate
Feeding Practices Of Mothers And Nutritional Status Of Their Children In A
Selected Area Bangalore”.
In this regard, I kindly request you to grant me permission for conducting pilot
study.
Thanking you,
84
ANNEXURE – B
From,
The Medical Officer,
Primary Health Centre,
K. Gollahalli,
Bangalore South.
To,
Rosamma K.J,
2nd Year M.Sc. Nursing,
Sarvodaya College of Nursing,
Bangalore.
Dear Student,
Date:
Place :
85
ANNEXURE – C
LETTER SEEKING PERMISSION FOR CONDUCTING THE MAIN STUDY
From,
Rosamma K.J.
2nd Year M.Sc. Nursing,
Sarvodaya College of Nursing
Bangalore
To,
The Medical Officer of Health,
PHC K. Gollahalli,
Bangalore South,
Bangalore
Through,
The Principal
Sarvodaya College of Nursing
Bangalore
Sub: Seeking permission to conduct main study
Respected sir,
I, Rosamma K.J is a bonafide PG Student of Sarvodaya College of Nursing
affiliated to Rajiv Gandhi University of Health Sciences, Bangalore with a
specialization in Pediatric Nursing.
I have to conduct a main study as a part of my main research for the purpose
of partial fulfillment of my course. My problem statement is “A Study To Correlate
Feeding Practices Of Mothers And Nutritional Status Of Their Children In A
Selected Area, Bangalore”.
In this regard, I kindly request you to grant me permission for conducting
main study.
Thanking you,
86
ANNEXURE – D
From,
The Medical Officer of Health,
PHC K. Gollahalli,
Bangalore South,
Bangalore.
To,
Rosamma K.J,
2nd Year M.Sc. Nursing,
Sarvodaya College of Nursing
Bangalore
Dear Student,
Date:
Place:
87
ANNEXURE – E
From,
Rosamma K.J,
II Year M.Sc. Nursing,
Sarvodaya College of Nursing,
Bangalore.
To,
Through,
The Principal,
Sarvodaya College of Nursing,
Bangalore.
88
The objectives of the study are
3. To find out the correlation between the feeding practices of mothers and the
4. To find out the association between feeding practices of mothers and the
With regard to this may I request you to validate my tool (Structured Interview
Schedule) for its appropriateness and relevancy. I would be highly obliged and remain
thankful for your great help if you could validate the tool and give your valuable
a) Questionnaire
c) Evaluation criteria
Thanking you,
89
ANNEXURE – F
Evaluation Criteria for validation of tool
Instruction
A tool has been constructed for data collection. It consist of four parts.
Section : I Deals with demographic data.
Section : II Deals with practices of mothers regarding breast feeding, weaning and
family diet.
Section : III Deals with Anthropometry
90
Areas Item Relevant Relevant Not Suggestions
No. to Relevant
Certain
Extent
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
91
ANNEXURE – G
This is to certify that the tool developed by Rosamma K.J., M.Sc. Nursing
University of Health Sciences), has been validated by the undersigned and can
proceed with this tool and conduct the main study for dissertation entitled “A Study
Signature :
Name :
Designation :
Date :
Seal :
92
ANNEXURE - H
BLUE PRINT OF STRUCTURED INTERVIEW SCHEDULE
93
ANNEXURE – I
STRUCTURED INTERVIEW SCHEDULE
SECTION – I
DEMOGRAPHIC DATA
Code No.
Mother
94
10.1. Health Personnel
10.2. TV / Radio
10.3. Magazines / Journals / Books.
10.4. Family members / relatives
10.5. Friends / Neighbours
Child Details
10. Age of the child (months / year) ___________
11. Gender of the child ___________
12. Birth weight of the child (kg.)___________
13. Birth order First / Second / Third ___________
14. Presence of other problem
14.1.Handicap
14.2.Mentally challenged
14.3.Others
14.4.None
95
SECTION - II
1. Did you initiate breast feeding within one hour of child birth?
feeding?
water?
normal?
11. Did you observe any psychological problem for your baby while
weaning?
13. Did you keep 5 – 7 days interval between two different types of
weaning food?
14. Did you include fruits and boiled mashed vegetables in your
96
Sl.No. Feeding practices Yes No
babies diet between 8 – 12 months
15. Have you observed any food allergies while weaning your
baby?
16. If you have observed allergies have you stopped that particular
17. Have you given weaning food before the breast feed?
18. Do you wash your hands with soap and water before cooking,
21. When your child was one year old, did you give family diet for
him/her?
24. Did you get any health education regarding feeding practices
25. Did you give soft mixture of rice and dhal as complementary
food?
26. Did you give breast feed along with ORS when the child had
diarrhoea?
97
Sl.No. Feeding practices Yes No
27. Did you regularly check the weight of your child during second
29. Did you use spoon or pallada while giving complementary feed?
SECTION – III
Anthropometry
98
ANNEXURE - J
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JzÉAiÀÄ ºÁ®£À eÉÆvÉ N.Dgï.J¸ï.
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27. ªÀÄUÀÄ«£À JgÀqÀ£Éà ªÀµÀzÀ°è
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zÁR°¸ÀÄwÛ¢ÝÃgÁ?
28. vÁ¬ÄAiÀÄÄ ¢£Á®Ä ¸Éë¸ÀĪÀ DºÁgÀ
¥ÀæªÀiÁtzÀ CzsÀðzÀµÀÄÖ 12 – 18
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1. ªÀÄUÀÄ«£À : ………………………………………………
FV£À vÀÆPÀ
(Q.UÁæA.
UÀ¼À°è)
2. ªÀÄUÀÄ«£À : ………………………………………………
JvÀÛgÀ (¸ÉA.
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3. ªÉÄïÁãUÀzÀ : ………………………………………………
PÉÊAiÀÄ
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104
UÀ¼À°è)
4. JzÉAiÀÄ : ………………………………………………
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105
ANNEXURE – K
SCORING KEY
106
ANNEXURE – L
Dear Participant,
as part of the partial fulfilment of the course, have to conduct a study and the problem
I request you to participate in the study and respond to the questions asked.
The information provided by you will be strictly confidential and will be used
only for the study purpose. This is for your information and kind participation.
Thanking you,
Yours sincerely
(Rosamma K.J)
I am willing to participate in the study and aware that the information provided by me
Place: Bangalore
107
ANNEXURE – M
ªÀAzÀ£ÉUÀ¼ÉÆA¢UÉ,
vÀªÀÄä «±Áé¹,
«ZÁj¸ÀĪÀªÀgÀ
¸À»
108
£Á£ÀÄ MzÀV¸ÀĪÀ F ªÀiÁ»wAiÀÄÄ CzsÀåAiÀÄ£ÀPÁÌV
EaÒ¸ÀÄvÉÛãÉ.
¸ÀܼÀ : ¨ÉAUÀ¼ÀÆgÀÄ
¢£ÁAPÀ :
¨sÁUÀªÀ»¸ÀĪÀªÀgÀ ¸À»
109
ANNEXURE – N
This is to certify that data analysis done by Rosamma K.J., Second Year
Date : Signature
110
ANNEXURE – O
CERTIFICATE OF EDITING
This is to certify that data analysis done by Rosamma K.J., Second Year
111
ANNEXURE - P
LIST OF EXPERTS
112
8. Dr. H.S. Surendra,
Asso. Professor in Bio-Statistics,
GKVK Agriculture College,
Yellahanka, Bangalore
113