RESEARCH PROPOSAL

PRESENTATION
. LINCOLN UNIVERSITY

K.Nirushanah
AGF.Hinaya
A.Lutharshini
S.Aaruthra
 KNOWLEDGE AND PRACTICE ON BREAST FEEDING AMONG PRIMI
MOTHERS IN POST NATAL WARD AT BASE HOSPITAL AKKARAIPATTU
SRILANKA.
ACKNOWLEDGEMENT
We would like to thank our supervisor Dr.Nisha Nambiyar for her ongoing
guidance, tireless assistance & encouragements are very supportive to us
on our path of the study and spent her valuable time with us inorder to
achieve our goal.Our since thanks also go to our supervisors Mrs.Fatima
Yahiya and Mr.K.Jude nimal for their dedicated effort and supervision that
enable the production of this thesis.

We would like to thank our Dean faculty of Nursing Lincoln University

Malasia for giving us the permission to conduct this study.
Many thanks also go to Medical Superintendent of Base Hospital,
Akkaraipattu to allow to proceed this study.

We would wish to share our gratitude to health care workers who are
working at Base Hospital Akkaraipattu for their support.
We wish to convey our special thanks to primi post natal mothers who are
participated in this study.
 DECLARATION

We declare that the thesis entitled “Knowledge and practice on breast

feeding among primi mothers in post natal ward at Base Hospital
Akkaraipattu Srilanka is submitted by us in Lincoln university college,
Malaysia for Bachelor of Science (hons) in Nursing (post registration)is our
original work and that has not been presented to any other university for
similar or any other bachelor award.

Mrs.A.G.F Hinaya ………………

Mrs.K.Nirusanah ………………
Mrs.A.Lutharsini ………………
Mrs.S.Aaruthra ………………

Signature of supervisor. ………………..

Signature of supervisor. ………………..

Chapter 1 Chapter 2 Chapter 3 Chapter 4
INTRODUCTION LITERATURE REVIEW METHODOLOGY PLANE OF DATA
ANALYSIS

• Introduction
• Background of
the study
• Problem
statement
• Purpose of the
study
• Significance of
the study
• Research
objectives
• Research
questions
• Hypothesis
• Variables
• Independent
variables
• Dependent
variables
• Scope and
Limitations
• Conseptual
and
INTRODUCTION
This chapter presents the Background of the study ,Problem
statement ,Purpose of the study ,Significance of the study, Research
objectives, Research questions, Hypothesis, Variables, Independent
variable ,Dependent variable ,Scope and limitations , Conceptual and
operational definitions of the variables, and Summary.
BACKGROUND OF THE STUDY
The World Health Organization (WHO) recommends at least 2 years
of breastfeeding for all infants.(WHO,2002). 98% of women in the
world are capable of full lactation, however, only 35% of infants in the
world get exclusive breastfeeding for the first 6 months after birth.
(WHO,2002).

INorder to achieve the Millennium Development Goal of reduction of

infant mortality, EBF has been identified as one of the major
intervention approaches, both globally and nationally (Dwinanda N
and SyarifBh,2018).According to United Nations Children's Fund
(UNICEF) India Statistics 2015, India's infant and under-five mortality
rates are 48 and 38 per 1,000 live births, respectively, and nearly
50% of these deaths are caused by malnutrition. (Victora CG, Bahl R
and Barros AJ, et al. Lancet, 2016).
Primigravidas are regarded as Vulnerable group In which insufficient messages
may lead to Decreased Chances to achieve breastfeeding (Mannel R,2012). Primi
mothers are more accepting of non -scientific health promotion messages
received through various sources. (Sloans sneddon H,2006).

from Ghana found that 22% of deaths newborns would have been prevented of
new borns started breast feeding, within one hour of b irth, irrespective of
whether they were exclusively breast feed later or not. Extrapolating the data to
other countries, the same researches estimated that if 99% of infants started
breast feeding on the first day of Life a total of 867,000 lives could be saved
worldwide and if they started breastfeeding within one hour of birth, then 31%
of all neonatal death could the prevented, which amounts to 1,117,000. India can
save its 2, 50,000 babies annually by just one action. (GrossmanLK,2005)
Problem statement

According to 2016 Demographic and Health Survey (DHS) data in Sri Lanka, the
prevalence of EBF of infants at 4–5 months was 64% (SL,DHS,2016).
Furthermore, studies conducted in different districts in Sri Lanka reported
different rates of exclusive breastfeeding. A study in a rural area in Srilanka
found that 32% of the babies less than 3months of age were on formula milk and
that difficulty in breast feeding was a significant factor in starting formula
feeding(Shamini,2017).
Primi breast feeding mothers, compared to multipara breast feeding
mothers,have been observed to have more challenges in practising,
breastfeeding being their first experience. They may face difficulties in adjusting
to the new role and they may have less knowledge and breastfeeding practise
by their first experience(Afiyanti Y,2010).
According to statistics of Neonatal Intensive Care Unit(NICU) and Lactational
Management Centre of Base hospital Akkaraipattu, there is a huge number of
babies admitted and referred for breast feeding related problems. When we
discussed with Medical superintendent of Base Hospital Akkaraipattu he instructed
us to proceed a study about knowledge and practice of breast feeding primi
mothers.
 Number of babies treated under phototherapy in NICU at Base
Hospital Akkaraipattu
200
180 188
160
140 157
120 136
124
100 110
80
60
40
20
0
2017 2018 2019 2020 2021

source: Statistical Unit,Base Hospital-Akkaraipattu

 Number of babies referred to lactational man-
agement centre related to feeding problems at
Base Hospital Akkaraipattu in year of 2020
120

100

80

60

40

20

0
January February March April May

Source:Quality Management Unit,Base

Hospital-Akkaraipattu
Breast feeding assessment check list.
Source- Lactational Management Centre
Base Hospital /Akkaraipattu.
Significance of the study

Since evidence shows that poor breast feeding rate in Srilanka. Fnding of this
study would helps to identify the knowledge and practice of primi mothers
regarding breast feeding.It supports to Nurses to find out the barriers and
problems towards the breast feeding. These informations help to promote
breast feeding rate and reduce complications among primi mothers with
antenatal and early post partum health education and supportive care by Nurses
and other health care workers. This study would a great way to do more breast
feeding awareness programmes.

instrumental in delving into the deep rooted beliefs at individual, family and
community level, which if addressed appropriately may help promote the culture
of breast feeding could be counselled during antenatal period and all the
misconceptions regarding breast feeding would be appropriately addressed.
This study reiterates the need for strengthening public health information,
education and communication campaigns to promote breast-feeding. This
preliminary and baseline information can be shared with the all the relevant
stakeholders and health professionals especially those who are working at
primary level and so that they can devise targeted breastfeeding interventions
on issues pertinent at each stage of pregnancy and lactation.(Tenghk
Alina,2016).It is hoped that this review will serve as baseline information for any
upcoming longitudinal studies on breastfeeding in Srilanka.
OBJECTIVE OF THE STUDY
General Objective
• To identify the knowledge and practice on breast feeding among
primi mothers in postnatal ward at Base Hospital Akkaraipattu.

Specific Objective
• To determine the level of knowledge on breast feeding among
primi mothers in postnatal ward at Base Hospital Akkaraipattu.
• To assess the level of practice on breast feeding among primi
mothers in postnatal ward at Base Hospital Akkaraipattu.
• To find the significant relationship between knowledge and practice
on breast feeding among primi mothers in postnatal at Base
Hospital Akkaraipattu.
 RESEARCH QUESTIONS

• What is the level of knowledge on breast feeding among primi mothers in postnatal
ward at Base Hospital Akkaraipattu.
• What is the level of practice on breast feeding among primi mothers in postnatal ward
at Base Hospital Akkaraipattu.
• What is the significant relationship between knowledge and practice on breast feeding
among primi mothers in postnatal ward at Base Hospital Akkaraipattu.
RESEARCH HYPOTHESIS

There is no significant relationship between Knowledge and Practice

on breast feeding among primi mothers in post natal ward at Base
Hospital Akkaraipattu.
Variables

1.9.1.Dependent Variable

Knowledge among primi mothers on breast feeding

1.9.2. Independent Variable

Practice among primi mothers on breast feeding

Scope and Limitations

This study is mainly focused only post natal breastfeeding primi mothers
in one hospital, however it is unable to include all primi post natal
breast feeding mothers because some of them go to Neonatal Intensive
Care Unit and Lactational Management Center to feed their babies.

Research questionnaire is in English language,and this research is done

among primi mothers so questionnaire has to translate to mother's own
language.

Primi post natal mothers show poor response to questions due to pain
and have to pay their attention towards their babies.
 Conseptual and Operational definition

Variables Conseptual definition Operational definition

Knowledge of breast feeding
Knowledge is a form of familiarity, awareness, understanding, There are 20 questions about knowledge of breast feeding in this
acquaintance. It often involves the possession of information learned study which mainly focused on the importance of breast feeding
through experience (Harper collins,2022),(Merrian wepster,2023). and breast milk, duration of feeding, early initiation, breastfed on-
Some breast feeding mothers have insufficient knowledge of demand, colostrum, the right time to start the complimentary foods,
breastfeeding, so they reject breastfeeding and fail to continue definition, benefits to mothers and babies, the danger of bottle
breastfeeding. Therefore, changing the feeding intention of feeding, and general knowledge about exclusive breastfeeding.
primiparas and urging them to continue breastfeeding are important
measures to encourage breastfeeding ( St John AM, Kao K and (Jean prince Dukuumuremyi,Kwabena Acheampong,Julius Abesig and
Liederman,2017). Jiayou Luo et al.International Breast feeding journal,2020).
Practice of breast feeding Practice is an empirical phenomenon there are five questions about
from the perceptive of knowing as a practices of breast feeding in this study
knowledgeable activity (Silvia which is focused on initiation, breast
Gherardhi,2018).The way of caring the feeding on-demand, exclusive
infant by the primi para mothers by breastfeeding only, colostrum, and
providing breast feeding, warmth, , prelacteal food. (Jean prince
basic hygiene and identifications of Dukuumuremyi,Kwabena
danger sign and seeking help from Acheampong,Julius Abesig and Jiayou
health personals Luo et al.International Breast feeding
(C, Aldrovandi GM,2013). journal,2020).
Demographic data Demographics are statistics that demographic characteristics which
describe populations and their consists five questions including age
characteristics. Demographic analysis is group,race,type of delivery, type of
the study of a population-based on living place and educational
factors(Adam Hayes,2024). qualifications.
Exclusive breast feeding According to WHO,EBF is the situation in Exclusive breast feeding is operationally
which an infant receives only breast milk defined as whether the primi mother has
from idea about Exclusive breast feeding (Yes or
mother(Elysl,MekashA,2017).Adequate No) .
nutrition during early childhood decides
growth and development of babies and
breast milk is better than any other
products given to a child.(Abadiasis
Jama,2020).
 LITERATURE REVIEW
The literature review consists of related literature about knowledge and
practice of breast feeding among primi mothers. International and Srilankan
literatures were reviewed from various sources such as journals, articles, text
books, magazines on Google scholar, Pub Med,Cross Ref,Health Affairs,
Government website with relevant field.

It consists review of literature, theoretical frame work, Rationale for choosing

the theoretical frame work, conseptual frame work and summary.

The literature review mainly focused on exploring the breast feeding abilities of
primi mothers. Most of the journals and articles on literature were reviewed the
current ranging period of 2019-2023.
Author Aim Research Sample Instruments Key Country
design findings
Avneet Patiala
Randhawa, To Cross 370 Interview Promotion of city
Neha determine sectional mothers knowledge
chaudhary, the practice studies regarding the
BS Gill, of breast right
Amarjitsing feeding practice of
h, among the breast
Vibbo Gorg lactating feeding &
RS Balgir mothers focus on the
(2019) factors
affecting
them.

MA Hegazi, Exclusive Cross 420 mothers Questionnaire Promote Western

M.Allebdi breast sectional breast Saudi
M. feeding in studies feeding by Arabia
Almohamm relation to targeted
adi knowledge , educational
Abduleaah attitude & programmes.
Alnafe practice of Proper
Lama breast knowledge
(2019) feeding about
mothers benefits of
colostrum &
continue
breast
feeding
Author Aim Research Sample Instruments Key findings Coun
design try
Questionnaire Improving
Thomas Investigatin Cross 334 women breast feeding
senghore, g the sectional rates.
Franc
Tobilonba determinate studies e
H s of breast
Williams, feeding
Omotosho, knowledge
Omar intention /
cessay,Dais practice
y clara H among
Williams ANC ,PNC
mothers

MO Oche, Knowledge Cross 4179 mothers Interview Knowledge & Kuwa

AS umar,H2 & practice of sectional practice of re
Ahmed exclusive descriptive breast feeding Nigeri
breast studies was slow
feeding There is a
a
need to
institute
intervention
aim at early
initiation of
breast feeding
Author Aim Research Sample Instruments Key findings Count
design ry
Breast
M sail sunil feeding Cross 77 mothers Semi structural Brest feeding North
Kishore,Pra knowledge sectional questionnaire counseling India
veenkumar, among studies with emphasis
Arun K mothers in on correct
Aggarwal rural technique can
population improve
breast feeding
rates
THEORETICAL FRAME WORK
In this study knowledge & practice on breast feeding among primi
mothers in post natal ward in Base hospital Akkaraipattu
CONCEPTUAL FRAMEWORK

Lack of knowledge about

breast feeding

Provide knowledge & practice

Level of practice about on breast feeding among
breast feeding prime mothers

Complication on breast
feeding
 RESEARCH METHODOLOGY
1. Type of study
The researchers implement and quantitative knowledge and
practice of breast feeding among the primi mothers at base
hospital Akkaraipattu

2. Study design
Quantitative descriptive cross sectional study design

3. Study setting
the research have been contacted for post natal ward primi
mothers
4. population
There are around 400 post natal ward primi mothers monthly at
BH Akkaraipattu
5.SAMPLE SIZE
RESEARCH METHODOLOGY CONT..

6. Sampling method
Samples for this study were selected by using simple random
sampling.
Simple random sampling was used in this study because of accuracy
o f representation according to Depersio (2018).
No easier method exists to extract a research from large
population then simple random sampling the only requirements are
that random nurse golems the selection process & that each number
of the large population has an equal probability of selection.
7. INCLUSION & EXCLUSION CRITERIA

Inclusion criteria - All the post natal primi mothers

Exclusion criteria - Mothers who have chronic or mental

disorders

8. Research instruments
The data collection instrument will be a questionnaire which is
filled by research team with asking questions and obtaining of Tamil
and Sinhala.
Research team members help the mothers to understand & fill
the questions.
In case of mothers are unable to read/ write an explained
consent should be taken From the mothers.
 9. Ethical considerations
Obtain ethical clearance letter from ethical review community
Lincoln university Malaysia.

getting permission from medical superintendent BH Akkaraipattu.

Explain and written consent from the participants.

 GNAT CHART – YEAR 2023
Activity January February March April May June

Identification √
of problem
Selection of √ √
heading
Literature √ √ √
review
Proposal √
writing
Data
collections
Data
analysis

Writing
report
CONCLUSION
Breast feeding is the first fundamental right of the baby.
It plays an important role in the health, growth, & development
of both baby & mother.
Mother’s positive attitude & knowledge also plays a major role in
the process of breast feeding.
Breast feeding is considered as the pivotal factor between life &
death of a vast majority of children in developing countries like
srilanka.
At the sametime it is neglected and ignored often by most of the
primi mothers
 CONCLUSION CONT.…
The aim of the study is to assess the knowledge & practice
towards breast feeding primi mothers at BH
Akkaraipattu.
Health educational strategies are important to improve & correct
the standard of knowledge, attitudes, beliefs,& socio cultural
norms about breast feeding.
Health care workers should be involved with breast feeding
educational campaigns & programmes and it has to be started
from primi mothers antenatal period and to be continued until
post partum period.
 QUESTIONARE

The questionare has taken from following link.

www.nepjol.info>index.php > HREN > article> viewfile

[PDF] Knowledge & Practice Of mothers regarding breast feeding
Mothers knowledge Mothers Mothers not
having idea having idea
K1. Have to breast feed
K2. Initiation of breast feeding within ½ - 1hrs of
birth
K3. Meaning of prelacteal feed
K4. Exclusive breast feeding
K5. Importance of colostrum feeding
K6. Importance of night time feeding
K7. Feeding one side at a time
K8. Continuing breast feeding for two years
K9. Expressed breast feeding can be used
K10. Dangers of bottle feeding
K11. Complementary feeding to be started at
6month
K12. Advantages of breast breast feeding
 BREAST FEEDING PRACTICE RELATED.
QUESTIONS
1. Time interval between birth and first breast feeding
1. < 1hour
2. 1-6 hours
3. 7-12 hours
4. 13-34 hours
5. >24hours

2. Practice of colostrum feeding

1.Yes
2.No

3. Use of prelactal
feeding
1. Gl
uc
os
4.Exclusive breast feeding
1.Yes

2.No

5 .Feeding pattern

1.One side at a time

2.Both side at a time

6. Practice of night feeding
1.Yes

2.No
7. Attachment and positioning during breast feeding

.
1.Satisfactor
y 2.poor

8. Breast
feeding
advice
during
ANC
1. Yes
2.No
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 THANK
YOU