Colostrum Feeding: Knowledge, Attitude and Practice in Pregnant Women in a Teaching Hospital in Nepal

Background: The role of colostrum in promoting growth and development of the newborn as well as fighting with the infection is widely acknowledged. In Nepal, there are differences in cultures in the acceptability of colostrum and the prevalence of colostrum feeding. Although, breastfeeding is a common practice in Nepal, importance of colostrum feeding is still poorly understood. Objectives of the study: To assess the awareness of the importance of colostrum feeding in pregnant women. Methods: Data collection was done through semi structured questionnaire regarding colostrum feeding among pregnant women attending Gynaecology and Obstetrics Outpatient Department (OPD) and Antenatal Ward of Kathmandu Medical College Teaching Hospital (KMCTH). The study was conducted during the months of December 2011and January 2012. Results: The study shows that 74% of women had heard about colostrum, 69% knew that it is nutritious milk to be fed to the new born babies. Nine percent (9%) women were aware about its protective effect and 41 % had knowledge that it helps in proper growth of children and fight against infections. There were still many women (26%) who lacked knowledge about colostrum, majority being uneducated and who came from the rural areas. Those women who knew about it, received the information about colostrum via various media (30%), followed by family and friends (16%) and antenatal advice (12%) which contributes the reason of improved practice of colostrum feeding in urban areas. Conclusion: Many women were aware about the importance of colostrum but the data still indicates that further efforts are necessary to improve the Knowledge, Attitude and Practice of colostrum feeding. Introduction 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. Colostrum is very rich in proteins, carbohydrates, vitamin A, and sodium chloride, but contains lower amounts of lipids and potassium than normal milk. Newborns have premature digestive system which suits the low-volume concentrated form of nutrient supply system of colostrums. The laxative effect of colostrum encourages passage of baby’s first stool, meconium. This helps to clear excess bilirubin which is produced in large quantities at birth and helps prevent jaundice. It contains various immunoglobulins like IgA (reactive to Escherichia coli virulence associated proteins), IgG and IgM. Other immune components of colostrum are lactoferrin, lysozyme, lactoperoxidase, complement and proline-rich peptide (PRP). It also contains various cytokines and growth factors. PRP helps fight against various viral infections like herpes viruses and HIV, bacterial and viral infections which are difficult to treat, various cancer, asthma, allergies and autoimmune diseases. It helps to reduce one of the leading causes of death in our country like diarrhoea and ARI. Colostrum feeding Practices: Though colostrum has been proved beneficial to the new born babies, studies have revealed that breast feeding mothers and the other family members do not have adequate knowledge about it, thus, preventing the infants from acquiring this nutritional food. A study in India revealed that mothers were unaware about the time of initiation of breastfeeding and colostrum feeding. Only 92% and 70% women undergoing normal delivery and caesarean section respectively gave correct response about time of initiation of breastfeeding. Though 92% of the mothers knew that breastfeeding should be initiated within one hour after delivery, only 36% of them had actually done so. It also showed that 52% of the mothers did not receive any advice on breastfeeding during antenatal period. A similar study conducted in the eastern part of Nepal on knowledge, attitude and practice of mothers regarding WebmedCentral: International Journal of Medicine and Molecular Medicine > Research articles Page 2 of 14 WMC003601 Downloaded from http://www.webmedcentral.com on 01-Aug-2012, 09:42:10 PM breast feeding showed that though all mothers knew that they had to breastfeed their babies, they did not have knowledge about the appropriate timing for breastfeeding and colostrum feeding. None of the mothers got advice regarding breast feeding and colostrum feeding during ANC visits. Colostrum feeding myths and barrier: The importance of colostrum is known to the limited population. There are still many people who believe that colostrum is a harmful substance which should be discarded. It is thought to be an unwanted substance related with ill health. There are certain barriers perverting the feeding of colostrum to the new born babies. Maternal barriers – Many mothers lack knowledge about the importance of early initiation of breastfeeding and the benefits of colostrum feeding. Some mothers dislike the colour of colostrum. They even discard it themselves and also on the advice of in-laws. There is also misinterpretation that breast milk doesn’t come in the first few days after delivery and it is insufficient for the baby’s needs. Prolonged labour and surgical deliveries are also the hindrance to colostrum feeding. Neonatal barriersNeonatal illness is one of the major barriers to colostrum feeding. Some babies are not able to suck breast milk due to illness, deformities or other reasons. Other barriers: Bathing baby and mother after birth delays initiation of breastfeeding. Lack of family support, discouragement for early initiation of breastfeeding by traditional birth attendants, decision made by family members to give other fluids are some important barriers to colostrums feeding. This study was initiated to assess the knowledge, attitude and practice of colostrum feeding in pregnant women who have visited a teaching hospital. The study was also done with an aim to create awareness regarding importance of colostrums feeding among the pregnant women. The objective of the study was to find awareness of the importance of colostrum feeding in pregnant women.