Rajiv Gandhi University of Health Sciences, Karnataka

Curriculum Development Cell

CONFIRMATION FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

Registration No. :

Name of the Candidate : D.SAMUEL KAVITHA

Address : D.No.30-79/B, Melupatla, Punganur PIN: 517 247 CHittoor

D.T. A.P.

Name of the Institution : Gold Finch College of Nursing,Bangalore

Course of Study and Subject : M.Sc.Nursing in OBG

Date of Admission to Course : 15-06-2009

Title of the Topic : A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE

AND ATTITUDE RELATED TO BREAST FEEDING AMONG
PRIMIGRAVIDA MOTHER S IN GENERAL HOSPITAL OF
BANGALORE,KARNATAKA.

Brief resume of the intended work : Attached

Signature of the Student :

Guide Name : JULIE JESTIN. A

Remarks of the guide : BREASTFEEDING OFFERS MANY BENEFITS IT HELPS

BABY TO GET PROPER NUTRITION INTIME AND HELPS
MOTHERS IN GOOD INVOULTION AND ESPECIALLY
PROMOTE GOOD BONDING BETWEEN MOTHER AND
BABY. STUDIES LIKE THIS TO AMONG PRIMIGRAVIDA
MOTHERS WILL HELP TO OVER COME FEW
BREASTFEEDING COMPLICATIONS IN THE POSTNATAL
PERIOD

Co-Guide Name :

Signature of the Co-Guide :

HOD Name : JULIE JESTIN. A

Signature of the HOD :

Principal Name :

Principal Mobile No :

Principal E-mail ID :

Remarks of the Principal : THIS STUDY WILL HELP THE PRIMI GRAVIDA MOTHER’S
TO IMPROVE THEIR KNOWLEDGE REGARDING BREAST
FEEDING

Principal Signature :

1
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
PROFORMA SYNOPSIS REGISTRATION OF SUBJECT
FOR DISSERTATION TITLE

TOPIC : A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE AND

ATTITUDE RELATED TO BREASTFEEDING AMONG PRIMIGRAVIDA
MOTHERS IN GENERAL HOSPITAL IN BANGALORE, KARNATAKA.

SUBMITTED BY:

MRS.D.SAMUEL KAVITHA,
M.Sc.(N) 1ST YEAR
GOLD FINCH COLLEGE OF
NURSING,
BANGALORE.- 92

2
 GOLD FINCH COLLEGE OF NURSING – BANGALORE
RESEARCH PROPOSAL

TO ASSES THE KNOWLEDGE AND PRACTICE REGARDING BREAST

FEEDING AMONG
PRIMIGRAVIDA MOTHERS AT GENERAL HOSPITAL, BANGALORE.

RESEARCHER
D.SAMUEL KAVITHA
M.Sc(N) FIRST YEAR
GOLD FINCH COLLEGE OF NURSING
BANGALORE

GUIDER
PROF: Mrs.JULIE JESTIN
M.sc.(N)
PROFESSOR,
GOLD FINCH COLLEGE OFNURSING

BANGALORE

3
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE,
KARNATAKA.

PROFORMA SYNOPSIS REGISTRATION OF SUBJECT FOR

DISSERTATION TITLE
1 NAME OF THE CANDIDATE D. SAMUEL KAVITHA

GOLD FINCH COLLEGE OF NURSING

NO. 150/24, KODIGEHALLI ROAD

MARUTHI NAGAR

BANGALORE-92

KARNATAKA.

2 NAME OF THE INSTITUTION GOLD FINCH COLLEGE OF NURSING

BANGALORE.

3 COURSE OF STUDY AND SUBJECT 1ST YEAR M.Sc NURSING

OBSTETRIC & GYNECOLOGICAL NURSING

4 DATE OF ADMISSION TO COURSE 15TH JUNE 2009.

5 TITLE OF THE TOPIC ADESCRIPTIVE STUDY TO ASSESS THE

KNOWLEDGE AND ATTITUDE RELATED TO BREAST
FEEDING AMONG PRIMIGRAVIDA MOTHERS IN
GENERAL HOSPITAL OF BANGALORE,KARNATAKA.

4
6.BRIEF INTRODUCTION OF THE INTENDED WORK

INTRODUCTION

The world health organizations definitions of midwife includes the skilled supervision care
and advise to be given to the mother during the postpartum period and care to be given the new born
baby and the young infant responsibility for the imitation of infant feeding and lactation therefore
lies with the midwifery profession. The International confederation of mid wives adopted a policy
about breast feeding in 1984 which clearly defines the midwives’ responsibility in this field and
describes unique and vital role of the midwife in the promotion of breast feeding.

Many hours of the mother’s time, day and night for many months, will be spent feeding the
baby she should be supported in the feeding method of her choice and enabled to accomplish it with
skill, knowledge, confidence and pleasure. A firm mother baby attachment can be forged during
these frequent encounters, provided that day they proceed without anxiety. When breastfeeding goes
well, there is the added advantage of the mother’s sense of achievement and satisfaction. Breast
feeding must be the ideal way to feed a baby.

Breast feeding one of the oldest practices recommended by all religions and it is the
universally endorsed solution in the prevention of early malnutrition (Dana, 1979). In light of the
extensively studied benefits of Breast feeding to the society, mother and infant (Heining and
Dewey.1996; Moreland and Coombs, 2000), it is been estimated that the lives of 1 million infants a
year can be saved in the developing world y promoting Breast feeding. Different factors affecting
such promotion need further studies including mother awareness, socio-economical factors and more
importantly the health professional’s training and attitude (A1-Nassaj et al .,2004)

In the 1960’s and 1970’s, maternity was not a prime feminist issue in the west. Women were
more concerned with feeding themselves from child bearing and rearing than with the releasing the
potential of these roles as female resource. The tendency to bottle feed gained momentum over the
last 100 years , especially here in the united states. Only in the last couple of decades as there been a
return to Breast feeding – a campaign largely initiated by the La Leche League which provided
person to person support for women who wished to breast feed. Baby formula was a disaster in the
developing countries. Powder added to water in developing countries were mother’s had no access
to clean water or refrigeration led to the death of great numbers of babies. In Urban areas of the
Philippines and Tanzania bottle feeding did help to raise well babies – but with the benefit of piped
water, proper sanitation, adequate medical care, good housing, and higher than average medical
education.

The assumption that Breast feeding is a merely nutritional, or at most psychological matter,
lies behind both medical approaches and women’s failure to take a position to these approaches. The
notion of ‘successful’ Breast feeding varies cross –culturally, and often includes timely weaning here
is an example. Some Breast feeding societies deliberately deny the infant the colostrums the first
Breast milk which is rich in nutrients and antibodies. This may affect the infant’s chances for
survival. Breast feeding like female sexuality and child birth, is the subject on considerable cultural
elaboration in most societies. Stated differently, ‘the nutritional uses’ of breast feeding are culturally

5
determined. It is not only conditioned by cultural patterns, but exerts a definite influence on them.
Breast feeding may, in an indirect way, confirm the Universalist ethos; the milk of human kindness.

6.1 NEED FOR THE STUDY

Breast feeding is a personal decision a mother needs to make carefully, taking full in to
account the benefits and burdens it will bring to both mother and baby. Breast feeding offers many
benefits. It helps babies get the proper nutrition and can help mothers recover from pregnancy and
delivery. Importantly, breast feeding can promote a “bond” between mother and baby. It is
estimated that approximately 62% of mothers breast-feed their children. Expecting mothers planning
to nurse should discuss breast-feeding with a physician, nurse, or certified lactation consultant before
giving birth. A healthy baby can benefit from breast milk or a combination of the two.

Physical Breast Changes During Pregnancy and Nursing

Benefits and Risks to Breast-Feeding

Breast Engorgement (swelling)

Breast Mastitis (infection)

Common Breast-Feeding Problems

Additional Resources on Breast-Feeding

During pregnancy, the breast increase in size and become more tender, especially in the first
half of pregnancy. The most rapid period of breast growth is during the first eight weeks of
pregnancy.

As the pregnancy progresses, the breast become firmer and more nodular to prepare for
lactation. The Montgomery’s gland surrounding the areola (the pigmented region around the nipple)
becomes darker and more prominent, and the areola itself darkens. The nipples also become larger
and more erect as they prepare for milk production. The blood vessels within the breast enlarge as
surges of estrogen stimulate the growth the ducts and surges of progesterone cause the glandular
tissue to expand. Prolactin, a hormone produced by the pituitary gland, starts the growth of the
mammary glands and triggers production of milk (lactation).

After childbirth, estrogen and progesterone and progesterone levels decrease and the
production of prolactin declines. The breast will usually being to produce milk three to five days
after a woman has give birth. During these few days before milk is produced, the body produces
colostrums, a liquid substance that contains antibodies to help protect the infant against infections.
Some physicians believe that colostrums also decreases an infant’s chances of developing asthma
and other allergies. Within a few days, the infant’s own immune system will develop and he or she
will not need colostrums.

The other hormone responsible for milk production, oxytocin, triggers the delivery of milk
that prolactin has produced. When an infant suckles at the mother’s breast, it brings milk out of the
nipple. This suction signals the body to make more milk (using prolactin) and deliver more milk
(using oxytocin). The body also produces a variety of other hormones (insulin, thyroid, cortisol) that

6
are useful to the infant. A woman’s body will continue to produce milk until she stops breast-
feeding, and even then, it may take several months for milk production to completely stop.

The American Academy of Pediatricians and the National Association of Pediatric Nurses
Associates and Practitioners recommend breast-feeding as much as possible during the baby’s first
year. Breast milk is extremely nutritious and contains carbohydrates, proteins, and fats essential for
a baby’s health. Breast milk also contains antibodies that help prevent infections and allergies

Studies have shown that breast-feeding may help protect against infant ear infections,
allergies, diarrhea, eczema, bacterial meningitis, and other serious illnesses. Research has also
shown that breast-feeding reduces infant anemia (iron deficiency in the blood) and stomach or
intestinal infections.

Breast-feeding also offers benefits to nursing mothers. Breast –feeding releases hormones which
cause the uterus to shrink after delivery and also decreases bleeding. Mothers who breast-feed
typically have an easier time losing weight after pregnancy. According to the American Academy
of Pediatrics, breast-feeding also helps build a woman’s bone mineral density and helps prevent
osteoporosis after menopause.

While most mothers are able to breast-feed, in some cases, breast-feeding is not possible.
Infant problems that may complicate or prevent breast-feeding include:

Premature birth or small size at birth

Birth defects such as a cleft lip or cleft lip or cleft plate

Digestive problems such as breast milk jaundice (a liver disease caused by a mother’s breast
milk)or galactosemia (milk intolerance)

Problems with sucking

Frail or weak physical condition

Certain conditions or diseases may also prevent a woman from breast-feeding. Breast- cancer.
Certain breast infections, or another type of cancer may prevent a woman from breast-feeding her
baby. Women who are HIV positive, have AIDS, heart disease, are malnutritioned, or have untreated
tuberculosis may be recommended not to breast-feed. Sometimes, previous radiation therapy or
surgery may complicate breast-feeding. In rare cases, women do not have enough milk to breast-
feed.

If a mother does decide to breast-feed her children, she should understand that breast-feeding
is a major responsibility that requires her to maintain excellent nutrition and health. Women who
breast-feed should eat well-balanced, nutritious meals. Generous portions of whole grain breads and
cereals, fruits and vegetables, and dairy products with an abundance of calcium are recommended.
Most physicians agree that it is safe for breast-feeding mothers to consume small amounts of

7
caffeine (equivalent to one to two cups of coffee per day),though larger amounts of caffeine may
interfere with a baby’s sleep or cause him or her to become fussy.

Alcohol should be avoided by breast-feeding mothers because it can be passed through the
breast milk to the baby. An occasional drink (no more than two ounces of alcohol) is probably safe
but women should ask their physicians before consuming any alcohol or over the counter
medication, including Tylenol.

6.2 REVIEW OF LITERATURE

This chapter deals with a review of literature relevant to the study. Review refers to an
extensive, through and systematic examination of publications related to the research project.
Critical review refers to the examination of the strength and weakness of appropriate publications.
Review of literature gives an insight to various aspects of the problem under study. It helps the
investigator in developing the methodology and tools for data collection and planning the analysis of
data.
The review of literature is grouped under the following headings:
Section I : Reviews related to Antenatal counseling on breast feeding.
Section II : Reviews related to Breast feeding practices and weaning habits.
Section III : Reviews related to predicting behavioral intention of Breast feeding amond
Primigravida.
Section IV : Reviews related to examine the current trend in infant feeding.
Section V : Reviews related to the perceptions of Vietnamese mothers
Section VI : Reviews related to factors affecting Breast feeding in perinatal period.

SECTION I : Reviews related to Antenatal counseling on breast feeding.

GUNASEKHARAN DHANDAPANY,ADHISIVAM BETHOU (2008) Antenatal
counseling on breast feeding and postnatal lactation support are likely to improve rates of exclusive
breast feeding. This descriptive study was undertaken to assess whether antenatal visits were
utilized for promotion of exclusive breastfeeding in addition to the routine obstetric services. This
descriptive study was conducted at a tertiary hospital in Pondicherry, India. Every third
primigravida mother admitted in the maternity ward from June to December 2005 was recruited.
Among these 144 primigravida mothers, 108 who had minimum of three antenatal visits (“booked”)
were included in the study. These 108 mothers were administered a pre-tested semi-structured
questionnaire on breastfeeding in the local language, Tamil, within 24 hours of giving birth.
Appropriate flash cards with pictures were also used while administering the questionnaire. The
awareness among mothers (both “counseled” and “not counseled”) regarding health information
pertaining to breastfeeding was assessed. Of the booked mothers, 21%(n=23) had received some
antenatal counseling about breast feeding while 79%(n=85)had not received any such counseling.
Four percent had undergone breast examination during antenatal visits. Awareness related to
breastfeeding among mothers in the “counseled” group was better than those in the “not counseled”
group. Even in the “counseled” group awareness among mothers with regard to correct
breastfeeding technique and concept of continuing breastfeeding during illness in the baby was no
different from those in the :not counseled” group. Existing antenatal counseling on breastfeeding is
8
inadequate in the population studied and needs to be strengthened. Informing all pregnant women
about the benefits and management of breastfeeding should be a priority during antenatal visits.

SECTION II : Reviews related to Breast feeding practices and weaning

habits.Ahmed A. Al-Shoshan Mothers whom been admitted for delivery at maternity
hospitals in Riyadh. Pre-lactic feeding was practiced by 10.5% of mothers, 74.4% of mothers
performed exclusive Breast Feeding 42% of them initiate it within the first hour of delivery. Even
though not significant, percentage of mothers who breast-fed was higher among older, child-bearing,
nonworking of lower family income and less educated mother than their contrast. Retrospectively
Breast feeding duration mean was 11.10+8.37 months and weaning was 40.8% at the first month and
before the six month of the infant life respectively. Of mothers, 62% said they are influenced by
health providers in their decision for feeding their babies and in selecting specific brand of milk or
supplementary foods products. However, only 34.7% say they discuss the feeding practices with
health providers and only 21.2% say they think the role of health providers in supporting mother
decision is adequate.
Insufficient breast milk was the main reason for diverting to mixed feeding while advices by
others and mothers own experience were the most source of information. Further studies of factors
affection mother’s determination and practice of Breast feeding are recommended. Polices and
educational efforts to promote exclusive Breast feeding and prevent further changes also needed. A
real change in health provider’s attitudes and practices is also emphasized.

SECTION III : Reviews related to predicting behavioral intention of Breast

feeding amond Primigravida.
Jie-Eun KimDong – Yean Park This study was conducted to examine the predicting factors
for the intention of breastfeeding with The Theory of Planned Behavior. The questionnaires were
distributed to 131 primi gravidas who were in their third trimester of pregnancy in Seoul Kyonggido,
Kyongsangbukdo, and Kyongsangnamdo. Descriptive statistics, Pearson’s Correlation and Multiple
Regression were used to analyze the data. The subject showed significant correlation with the belief
that their breastfeeding. The subject showed favorable attitudes towards breastfeeding. This fact
showed significant correlation with the belief that their breastfeeding intention was due to the
advantage of breast milk for the infant with regard to allergy prevention, disease protection,
contribution to intellectual development psychological closeness between mother and infant,
convenience, cost, and the reduction of breast cancer risk and weight of the mother. No item of
outcome evaluation did showed significant correlation with behavioral intention. The subject were
influenced about breast feeding by there reference such as siblings and friends with breast feeding
experience, their mothers and husbands, mothers- in-law. Most items of the control believes had a
significant influence on the intention of breast feeding. The subject felt they could not control the
situation ie,. ‘when I have to breast feed in public’. However they felt they could control the
situation ie,. ’when I suffer from mastitis ‘, ‘when I have cut down on coffee, alcohol, and
smoking’.’ when I have caesarean section ‘, when I need to maintain breast condition , and ‘ when
the infant hates to suck my nipple’. Regressior analysis revealed that control believes and attitudes
to ward breast feeding could predict the behavioral intention of breast feeding control beliefs were
the most important factor in predicting behavioral intention. There fore, nutrition education is
needed to enhance to ability to cope with difficult situation while breast feeding and increase
favorable attitudes toward breast feeding.

SECTION IV : Reviews related to examine the current trend in infant feeding.

9
Chye jk, Zain Z, Lim WL, Lim CT Despite the numerous changes made in accordance with
the baby friendly hospital initiative at the University Hospital Kuala Lumpur, the low rates of breast
feeding have persisted. The study aims to examine the current trend in infant feeding. And the
influences of some perinatal and socio demographic factors on breast feeding. Five hundred
mothers with singleton pregnancies and healthy infants were interviewed at 6 weeks post – partum.
Only 124 (25%) mothers were practicing exclusive breastfeeding (EBF) and 132 (26%) mothers
were using exclusive infant formula (EIF). On logistic regression analysis , mothers who followed
EBF were more likely to have had antenatal plans to breastfeed(Odds ratio 2.44,95% confidence
interval 1.75 – 3.45),not in paid employment post neatly(OR 1.76, 95% CI1.31-2.36) of older age
group(>27 years )(OR 1.48, 95% CI 1.13-1.93) had female infants (OR 1.38, 95% CI 1.05-1.80) and
of Indian ethnicity ( compared to Chinese)(OR 3.87, 95% CI 2.16-6.89)breast feeding difficulties
were associated with decreased odds of EBF (OR 0.21, 95% CI 0.13-0.34). parental education ,
fathers ages and incomes , primi gravida status , caesarean section ,present of episiotomy , late first
breastfeeding ,photo therapy and length of hospital stay were not significant predictors of failure of
EBF. In comparison , predictive factors for increased use of EBF were mothers who have had
breastfeeding difficulties <or=9 years of schooling , and of Chinese descent. In conclusions, the
overall rate of EBF 6 weeks of age in infants born in urban hospital had remained poor. The adverse
factors for EBF identified in this study warrant further in depth studies to determine effective ways
of improving EBF rates.
SECTION V : Reviews related to the perceptions of Vietnamese mothers
Joh Chin Rossiter SRN SCm MRCN PhD BSc ADNEd
A review of the literature indicated that the majority of Vietnamese mothers bottle fed their infants
after migration to western countries. Those who breast fed weaned their infants very early. . This
study aimed to explore, from the Vietnamese mothers' perspective, their experiences of infant
feeding and the attributes of nurses, midwives, other health professionals and the health care system
that were considered to be important in encouraging the immigrant Vietnamese women to breast feed
in Sydney, Australia. A convenience sample of 124 postnatal Vietnamese women were recruited from
the western and south-western suburbs of Sydney of New South Wales, Australia. In-depth
interviews were conducted in the privacy of the respondents' homes. An ethnographic approach
guided the concurrent data collection and content analysis. Through constant comparison of
categories, nine concepts emerged from the findings to describe the women's process of decision
making, experiences and perceptions of breast feeding: believing, complying, rewarding, facing the
unexpected, experiencing pleasure and pain, fulfilling, communicating, counselling and supporting.
These findings highlighted the significance of social, cultural and economic factors which influenced
the women's decisions and maintenance of breast feeding. Implications for nursing practice and
further research are discussed

10
6.3 PROBLEM STATEMENT
A descriptive study to access the knowledge and attitude to breast feeding among primigravida
mothers in General Hospital of Bangalore Karnataka with a view to develop health education
pamphlet

6.4 OBJECTIVES
1. Determine the pre exiting knowledge of Primi Gravida mothers regarding Breast feeding
problems and its management using a closed ended structured knowledge questionnaire.

2. Identify Breast-Feeding practice using an observational checklist.

3. To determine the relationship between knowledge and attitudes of women about breast
feeding.

6.5 HYPOTHESES
There will be a significant relationship between knowledge and attitudes of Primy Gravida
mother about Breast-Feeding.

6.6 OPERATIONAL DEFINITIONS

1) Descriptive: Description of the state if affairs as it exists at present

2) Study : Effort to learn by reading and writing

3) Assess : The critical analysis and valuation or judgment of the states or quality of
operational condition, situation or other subject of appraise

4) Knowledge : it refers to women’s awareness regarding cervical cancer, risk factors and pap
smear testing as measured by scores obtained according to the response to the items on the
structured questionnaire.

5) Attitudes : Refers to scores obtained by women as measured by their response to items on

a likerts scale in which they expressed their views about cervical cancer.

6) Breast feeding :Feeding a baby with human milk from the breast of the mother or milk
donner. This natural milk cannot be equal with any other known formula of artificial milk.
Hence breast milk is the best milk.

7) Primigravida: A women experiencing her first pregnancy

6.7 ASSUMPTION:

women possess some knowledge regarding Breast-Feeding in Primi

11
 Gravida.

6.8 DELIMITATION:
The study results would be generalized to women who are attending Govt., Maternity
Hospital in Bangalore

6.9 PROJECTED OUTCOME:

Pretest assessment will be done for primigravida mothers attending to hospital. Post test will

be done one week after the preliminary assessment after providing informational booklet.

7.MATERIALS AND METHODS:

7.1 SOURSE OF DATA: Primigravida mothers attending selected hospital at Bangalore.

7.1.1 RESEARCH DESIGN AND APPROACH:

RESEARCH DESIGN: Group pretest and post test (Quasi experimental

Design).

RESEARCH APPROACH: An evaluative research approach is used to The

study.

7.1.2 SETTING: The study will be conducted at a selected hospital, in Bangalore, which is
located 25 kms away from Gold Finch College of nursing

7.1.3 POPULATION: PrimiGravida mothers

7.2 METHOD OF DATA COLLECTION:

12
7.2.1 SAMPLING PROCEDURE: Purposive sampling technique

7.2.2 VARIABLES UNDER STUDY:

DEPENDENT VARIABLE: Knowledge among PrimiGravida

INDEPENDENT VARIABLE: Effects of traveling during pregnancy

7.2.3 SAMPLE SIZE: 100

7.2.4 DURATION OF STUDY: 4 WEEKS

7.2.5 INCLUSIVE CRITERIA FOR SAMPLING:

 PrimiGravida mothers who are present at the time of study.

 PrimiGravida mothers who are willing to participate in this study.

7.2.6 EXCLUSIVE CRITERIA FOR SAMPLING:

 PrimiGravida mothers who are not present at the time of study.

 PrimiGravida mothers who are not willing to participate in the study.

7.2.7 INSTRUMENT INTENDED TO BE USED:

Planned questionnaire will be used to assess the knowledge of

breast feeding among PrimiGravida mothers .

It has two sections: - Demographic data

- Questionnaire.

7.2.8 METHOD OF DATA COLLECTION: Questionnaire

13
7.2.9 LIMITATIONS:
The study is limited to:

- PrimiGravida mothers attending to hospital

- PrimiGravida mothers those who are available at the time of data collection.

- Those who are willing to participate.

- Those who are able to understand English,kannada and Hindi.

- Consented to participate in the study.

7.2.10 PILOT STUDY:

Pilot study will be conducted at a selected hospital in Bangalore for assessing

the knowledge of attitude related to breast feeding among primigravida mothers. Ten primigravida

mothers who come regularly will be taken under convenient sampling procedure for the study.

7.2.11 PLAN FOR ANALYSIS: The data will be analysed using descriptive statistics and

inferential statistics.

7.2.12 DESCRIPTIVE STATISTICS: Frequency and percentage distribution of socio

demographic variables.

7.2.13 INFERENTIAL STATISTICS:

- Paired ‘t’ test to compare pretest.

- Post test findings

- Student ‘t’ test to compare post test assessment.

14
 - Chi- square test to find association between findings of study and selected socio economic

variables.

7.2.14 DOES STUDY REQYIRE ANY INVESTIGATION TO BE CONDUCTED

ON
YES: Assessment of effects of breast feeding will be done for PrilmiGravida mothers

by providing informational booklet.

7.15 HAS ETHICAL CLEARANCE OBTAINED

YES:

 Confidentiality and anonymity of the subjects will be maintained.

 Consent will be obtained from the PrimiGravida mothers before conducting the study.

 A written permission from the institutional authority will be obtained.

8. LIST OF REFERENCES:

BOOKS:
1. Myles. Textbook for midwives: 14th edition. New Delhi, India: Churchill Livingstone, 2003,

Page no. 755-768.

2. Dutta D.C. Textbook of Obstetrics: including perinatology and

contraception. 6th edition. Calcutta, India: New central book agency (P)

LTD, 2004. Page no. 483.

3. USHA Krishna, Tank D.K. Pregnancy at risk: current concepts. 4th edition. New

Delhi, India: Jaypee brother’s medical publishers (P) LTD, 2004.

15
 Page no. 68-70.

4. Annamma Jacob. A comprehensive textbook of midwifery. 2nd edition. New

Delhi, India: Jaypee brother’s medical publishers (P) LTD; 2008.

Page no. 328-351.

5. Sabaratnam Arulkumaran, Sivasaratnam V. Essentials of obstetrics. 1st edition.

New Delhi, India: Jaypee brother’s medical publishers (P) LTD, 2004.

Page no. 333-364.

6. Text Book of Midwifery, Premalatha Dwivedi, Anant Prakashan,124,Reshimbag,

Nagpur-9,page no 323-327.

7.Pakistan Journal of Nutrition 6(4):318-322.

WEB REFERENCES:

11. www. Google.com

12. www.yahoo.com

16
13. www.pubmed.com

14. www.cdc.gov/vaccines.

9. SIGNATURE OF THE
CANDIDATE

10. REMARKS OF THE GUIDE BREASTFEEDING OFFERS MANY

BENEFITS IT HELPS BABY TO GET
PROPER NUTRITION INTIME AND
HELPS MOTHERS IN GOOD
INVOULTION AND ESPECIALLY
PROMOTE GOOD BONDING BETWEEN
MOTHER AND BABY. STUDIES LIKE
THIS AMONG PRIMIGRAVIDA
MOTHERS WILL HELP TO OVERCOME
FEW BREASTFEEDING
COMPLICATIONS IN THE POSTNATAL
PERIOD

11. NAME & DESIGNATION OF Mrs. JULIE JESTIN. A , ASSOCIATE

PROFESSOR.
GUIDE

12. SIGNATURE

13. CO-GUIDE

14. SIGNATURE

15. HEAD OF THE DEPARTMENT Mrs. JULIE JESTIN. A , ASSOCIATE

PROFESSOR.

16. SIGNATURE

17. REMARKS OF THE PRINCIPAL THIS STUDY WILL HELP THE PRIMI
GRAVIDA MOTHER’S TO IMPROVE
THEIR KNOWLEDGE REGARDING
BREAST FEEDING. 17

18. SIGNATURE
18
19