“A Study To Correlate Feeding Practices Of Mothers And Nutritional Status Of

Their Children In A Selected Area, Bangalore”

By

ROSAMMA K. J.

Dissertation submitted to the

Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore

In partial fulfillment

of the requirements for the degree of

Master of Science

In

Paediatric Nursing

Under the guidance of

PROF. J. LOVERA GRACE LILLY RANI

Department of Paediatric Nursing

Sarvodaya College of Nursing

Agrahara Dasarahalli,

Bangalore – 560 079

November 2007

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE, KARNATAKA

DECLARATION BY THE CANDIDATE

I, Rosamma K.J. hereby declare that this dissertation / thesis entitled

“A Study To Correlate Feeding Practices Of Mothers And Nutritional Status Of

Their Children In A Selected Area, Bangalore” is a bonafide and genuine research

work carried out by me under the guidance of Mrs. J. Lovera Grace Lilly Rani,

Professor, Department of Pediatric Nursing, Sarvodaya College of Nursing.

Signature of the Candidate Date : Place : Bangalore ROSAMMA K.J.

ii

CERTIFICATE BY THE GUIDE

This is to certify that this dissertation entitled “A Study To Correlate

Feeding Practices Of Mothers And Nutritional Status Of Their Children In A

Selected Area, Bangalore” is a bonafide research work done by Rosamma K.J in

partial fulfillment of the requirements for the award of degree of Master of Science

in Pediatric Nursing.

Signature of the Guide MRS. J. LOVERA GRACE LILLY RANI

Professor

Date: Department of Paediatric Nursing

Place : Bangalore Sarvodaya College of Nursing

Bangalore

iii

ENDORSEMENT BY THE HOD, PRINCIPAL/HEAD OF THE INSTITUTION

This is to certify that this dissertation / thesis entitled “A Study To Correlate

Feeding Practices Of Mothers And Nutritional Status Of Their Children In A

Selected Area, Bangalore” is a bonafide research work done by Rosamma K. J in

partial fulfillment of the requirements for the award degree of Master of Science in

Pediatric Nursing.

Seal & Signature of HOD Seal & Signature of Principal PROF. J. LOVERA GRACE LILLY RANI PROF.T. BHEEMAPPA Date: Date: Place: Bangalore Place: Bangalore

iv

COPY RIGHT

DECLARATION BY THE CANDIDATE

I hereby declare that the Rajiv Gandhi University of Health Sciences,

Karnataka, Bangalore, shall have the rights to preserve, use and disseminate this

dissertation in print or electronic format for academic / research purpose.

Signature of the Candidate Date: Place : Bangalore ROSAMMA K.J

© Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore

v

ACKNOWLEDGEMENT

“Praise the Lord for He is good;

Sing to our God for He is loving;

To Him our praise is due.” (Ps.146:1)

“Gratitude is the attitude of mind and heart.” I raise my heart in gratitude to

God Almighty, who has been my inspiration and guiding force behind all my efforts.

I wish to express my sincere thanks to all who have helped me in

accomplishing this task successfully.

I express my thanks to Mr. V. Narayan Swamy, Chairman, Sarvodaya

Group Of Institutions, Bangalore for his encouragement, support and deep

inspiration to conduct this PG programme in his esteemed institution.

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

Department, Paediatric Nursing, Sarvodaya College Of Nursing I express my

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

to complete this study under her supervision.

I express my heartfelt gratitude to Prof. T. Bheemappa, Principal and HOD

of Psychiatric Nursing, Sarvodaya College of Nursing for his valuable advice and

timely support during the study period.

I owe deep gratitude to my Prof. Victorial Selva Kumari M.Sc. (N), Vice

Principal, Sarvodaya College of Nursing, for her encouragement, suggestions,

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

Nursing in the initial stages of this study.

I express my sincere gratitude to Mrs. Satya Lawrence M.Sc. (N)

Asst. Professor, Dept of Child Health Nursing for her guidance, support and

encouragement during the course of this study.

I acknowledge my gratitude to Mrs. Maria Gladys M. Sc. (N), Lecturer,

Dept of Child Health Nursing, Sarvodaya College of Nursing for her cooperation,

guidance and support during the study.

I wish to place my sincere thanks to all the members of Dissertation

committee of Sarvodaya College of Nursing for their suitable suggestions, genuine

interest and timely encouragement which contributed towards the completion of the

study.

I would like to extend my thanks to Dr. Gangaboraiah, Bio-Statistician,

KIMS for his timely assistance and valuable suggestions and directions in the

statistical analysis and presentation of data.

I extend my thanks to Librarians of Sarvodaya College of Nursing for 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

its final shape.

My thanks goes to Mrs. Nirmala Sridhar, M.A. Psychology, M.A. English

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

translating my tool in Kannada.

I extend my thanks to all my friends especially Mrs. Ceeba Francis,

Mrs. Geeta Das, Miss. Lavanya, Miss. Rajini and Mrs. Rosmin for their

supportive and positive interaction during the study.

My special thanks to all the participants who helped me to complete my

study.

I am immensely thankful to my Provincial Sr. Damian and all my

community sisters for their constant prayers, encouragement and moral support

which sustained me throughout the study.

I am grateful to my beloved parents, brothers and sisters for their valuable

support and encouragement.

My sincere gratitude to all those names have not mentioned but who have

directly or indirectly helped me for the successful completion of the study.

Signature of the candidate

Date:

Place : Bangalore ROSAMMA K.J

viii

LIST OF ABBREVIATIONS USED

1. BF : Breast Feed

2. CF : Complimentary Feeding

3 . χ2 : Chi – Square

4. DHS : Demographic and Health Survey

5. df : degree of freedom

6. HAZ : Height for age Z-scores

7. IAP : Indian Association of Paediatrics

8. NNMB : National Nutrition Monitoring Bureau

9. NCAER : National Council for Applied Economics Research

10. NM : Nutritional marasmus

11. PEM : Protein energy malnutrition

12 SD : Standard Deviation

13. Σ : Summation

14. TCFP : Traditional Complimentary Feeding Practice

15. UNICEF : United Nations International Children’s Emergency Fund

ix

TABLE OF CONTENTS

SL.NO. CONTENTS PAGE NO

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

10. Annexure 83 – 110

x

LIST OF TABLES

Sl. No. Title of the Table Page No.

1 Area wise analysis of mean and standard deviation of feeding

practices of mothers

59

2 Area wise classification of respondents on feeding practices 60

3 Correlation between feeding practice of mothers and selected

nutritional parameters of their children

61

4 Association between feeding practices and demographic

variables of mothers

62

5 Association between feeding practices and selected variables of

children

64

xi

LIST OF FIGURES

Sl.No. Title of the Figure Page No

1 Conceptual frame work 15

2 Schematic representation of research design 38

3 Frequency and percentage distribution of mothers by age 47

4 Frequency and percentage distribution of mothers by religion 48

5 Frequency and percentage distribution of respondents by type of

family 49

6 Frequency and percentage distribution of mothers according to

their educational status 50

7 Frequency and percentage distribution of mothers by occupation 51

8 Frequency and percentage distribution of mothers by family

income 52

9 Frequency and percentage distribution of mothers by duration of

married life 53

10 Frequency and percentage distribution of no of under five

children 54

11 Frequency and percentage distribution of respondents by source

of information 55

12 Frequency and percentage distribution of birth order of children 56

13 Frequency and percentage distribution of children by age 57

14 Frequency and percentage distribution of children by gender 58

xii

ABSTRACT

Statement Of The Problem

“A Study To Correlate Feeding Practices Of Mothers And Nutritional

Status Of Their Children In A Selected Area, Bangalore.”

Background

Malnutrition is an important health problem in many developing countries

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

stunting and underweight in most of the children in India.

The objectives of the study were

1. To assess the feeding practices of mothers.

2. To assess the nutritional status of children.

3. To find out the correlation between the feeding practices of mothers and the

nutritional status of their children.

4. To find out the association between feeding practices of mothers and their children

with selected variables.

Hypothesis

H1: There is a correlation between feeding practices of mothers and nutritional status

of their children.

xiii

Method

The study was conducted in Chikkabasti and Doddabasti after obtaining

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

and inferential statistics and interpreted in terms of objectives of the study.

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

nuclear families. 73 percent of them had income below Rs.5000. 60 percent of

mothers had only one child and 50 percent of them had duration of 5 – 9 years of

married life. Most of them had TV / radio as source of information.

With regard to children 48 percent were between 2 – 3 years of age among

which females were 55 percent and male 45 percent. 48 percent of them belonged to

second in birth order.

Among the total respondents, 5 percent of the respondents practiced not

satisfactory feeding practices, 81 percent of them practiced moderately satisfactory

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 education, occupation and

religion of mothers. Whereas there was no-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,

gender and sources of information.

However, there was positive correlation between feeding practices and

selected nutritional parameters like present weight, height, mid arm circumference

and chest circumference.

Key Words

Feeding practices, Nutritional status, mothers, children.

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

blessing money can’t buy”.

- 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

globally acknowledged that investment in human resources development is a pre-

requisite for economic development of any nation. Early childhood constitutes the

most crucial period in life, when the foundations are laid for cognitive, social,

emotional, physical, motor development and cumulative life-long learning.1

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

these things in an effective manner.

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

mortality. Malnutrition is largely by product of poverty, ignorance, insufficient

education and large family size. These factors influence most directly the quality of

life and are the true determinants of malnutrition in society.

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

mental development as well.3 It is very important that parents provide regular

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

accounts for much of the nutrient deficiency.

Mother’s knowledge related to feeding of babies also reflects the nutritional

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

they do not get enough nutritious foods.

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

whole host of diseases.5

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

introduction of water and liquids and delay in complementary feeding result in a

period of perpetual hunger for the child.6

Many researchers agree that socio-economic and environmental conditions,

together with feeding practices, are important determinants of nutritional status in

developing countries. Inadequate quantity and poor quality of food result in growth

faltering, which is exacerbated by the high prevalence of fever and diarrhoeal

diseases. Inappropriate feeding patterns may also contribute to child malnutrition. The

World Health Organization recommends that children under the age of four months

should be exclusively breastfed.7 Appropriate complementary feeding promotes

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

throughout life. Stunting is seldom reversed in later childhood and adolescence.

Weaning is not a sudden withdrawal of child from the Breast. It is a gradual

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)

decreases the frequency of breast feeding leading to malnutrition.10 Weaning food

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

It is well established that nutritional status is major determinant of the health

and well being among children and there is no doubt regarding the importance of the

study of child’s nutritional status according to spatial and temporal dimension.

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

an individual or population, anthropometry is widely recognized as one of the useful

techniques, because it is highly sensitive to detect undernutrition.12

Reliable community based data generated by the National Nutrition

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

kwashiorkor were observed.13

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

development. These conditions includes poverty, poor environmental sanitation,

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

of mothers and the nutritional status of their children in a selected community.

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

population lives in villages. It is imperative to preserve this wealth and to promote

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

forte of mothers’ irrespective of education, income and social class differences.14

Malnutrition is increasingly recognized as a prevalent and important health

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

normal growth and development. Undernourished children do grow to their full

potential of physical and mental abilities. Malnutrition makes the child more

susceptible to infection and recovery is slower and mortality is higher.8

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

reduction in the prevalence nutritional deficiency disorders. It is therefore important

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

the nutritional status of women and children in India shows no signs of

improvement.13

“Children’s health is tomorrow’s wealth”. The professional who work with

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

of children, should share her skill and knowledge to prevent malnutrition.

According to the National Family Health Survey, malnutrition affects children

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

Appropriate complementary feeding involves a combination of practices to maintain

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

intake can be increased by increasing breastfeeding frequency, increasing food

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.

Knowledge of weaning foods and practice is an important aspect of preventive

and social pediatrics. Programs to improve complementary feeding must conduct

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

A study of Dietary Pattern, Household food Security and Nutritional Profile of

Under-five Children of a Community of West Bengal conducted by Sandip Kumar

Ray, Akshil Bandhu Biswas, Sathi Kumar, concluded that : the overall prevalence

of malnutrition based on IAP classification, among the under-five, was found to be

80.90 percentage and that of severe grades of malnutrition (grades III and IV) was

9.26 percentage Prevalence of both overall malnutrition as well as severe grades of

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

amongst the infants.

The prevalence of malnutrition including its severe grades was observed to be

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

were working as compared to those who were not.16

8

Breast milk is the ideal food for the infant. But after six months production of

breast milk which is the source of nourishment is reduced. So complementary feeds

should be in children’s diet.

Kumar D and Goel conducted a study on “Influence on infant feeding

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

cent stunting and 10.6 per cent wasting.

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,

nutritional deficiency was observed inspite of higher intake of energy. Therefore, to

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

of village and households, an appropriate sampling methodology was used.

Information was collected on households characteristics, demographic profile,

anthropometry etc. Children under five years of age were categorized using Gomez

classification as severe, moderate, mild and normal.

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

children. Malnutrition in children is a complex problem and must be viewed within a

broad frame work of child care including feeding practices. A good understanding of

the nutritious situation of an area is necessary for improved planning of development

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

their children in a selected area, Bangalore.

Statement of the problem

“A Study To Correlate Feeding Practices of Mothers And Nutritional

Status Of Their Children In A Selected Area, Bangalore.”

Operational Definitions

1. Feeding practices: Refers to the pattern of feeding that are commonly

practiced by mothers include breastfeed, type of food stuffs, quality and

quantity, feeding techniques, number of feeds per day that mothers use for

their children.

2. Nutritional status: It refers to assessment of selected nutritional parameters

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.

4. Mothers: Refers to women between the age of 15 to 45 years and having

children in the age group of 6 months to 3 years.

Hypothesis

H1: There is positive correlation between feeding practices of mothers and

nutritional status of their children.

Inclusion criteria

1. Mothers of children who were willing to participate in the study.

2. Both male and female children.

Exclusion criteria

1. Mothers who have physically and mentally challenged children.

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.

They may be based on factual information or misinformation. The health behaviour

usually results from health beliefs.

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

care therapies. Use of the model is based on a persons perceptions of susceptibility to

an illness and the seriousness of the illness.19

This model helps, nurse to understand various behaviours including mothers

perception, beliefs and various behaviour in order to plan the most effective care.

The investigator felt that Becker’s model is suitable as conceptual framework

for this study. Mothers feeding practices regarding breast feeding, weaning and family

diet can be modified by health education and information by health personnel.

Mothers can apply this knowledge in taking care of their children.

The model describes about 3 variables

1. Mothers Perception

Mothers perceived knowledge regarding breast feeding, weaning and family

diet. Foods according to the age, feeding technique and problems during each

stage.

2. Modifying Factors

Mother’s perception is influenced and modified by demographic variables like

mothers age, religion, type of family, child’s age and sex, socio economic

variables like education occupation and family income and structural variables

13

14

like feeding practices. The mother’s perception is also influenced by cues to

action like mass media, information from elders and neighbours and information

getting from health personnel.

3. Likelihood of Taking Action

This part indicates that mothers may try to take action to assess nutritional need of

their children and initiating proper feeding practices to prevent malnutrition,

underweight and feeding problems. Thus to improve the nutritional status of their

children. Perceived barriers like illiteracy, poor socio economic status and lack of

knowledge of mothers may lead to unhealthy practices.

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

towards correct feeding practices.

15

Cues to Action

Fig 1:Adapted from Rosenstochoch’s (1974) Becker’s (1975) Health Belief Model

Demographic variables: Mothers Child Age Age Religion Sex Type of family Place of birth

Socio economic variables: Education Occupation Family income

Structural variables Practices of breast feeding weaning and family diet

Mother’s prescribed threat of under weight, malnutrition, feeding problems of children

Perceived benefits - of proper breast feeding, - weaning, - prevention of malnutrition, perceived barrier - illiteracy - cost of food, cultural

practices, level of education.

Not included in the study

Likelihood of taking action by

nursing personnel to improve the

feeding practices of mothers to improve the

nutritional status of their children

• Mass media • Information from elders and neighbours • Individual health education by health personnel • Newspapers or magazine articles

Perceived susceptibility,

perceived seriousness

Feeding

practices and nutritional status of children

Likelihood of taking action Modifying Factors Individual Perception

CONCEPTUAL FRAMEWORK

2. OBJECTIVES

Statement of the problem

“A Study To Correlate Feeding Practices of Mothers And Nutritional

Status Of Their Children In A Selected Area Bangalore.”

Objectives of the study

1. To assess the feeding practices of mothers.

2. To assess the nutritional status of children.

3. To find out the correlation between the feeding practices of mothers and the

nutritional status of their children.

4. To find out the association between feeding practices of mothers and their

children with selected variables.

16

3. REVIEW OF LITERATURE

Review of literature is a key step in research process. Review of literature

refers to an extensive, exhaustive and systematic examination of publications relevant

to the research project.9 The review of related literature is valuable guide to define the

problem, recognising its significance, suggesting promoting data gathering devices,

appropriate study design and source of data.

Review of literature for the present study has been organised under the

following headings

1. Literature related to the prevalence of malnutrition and its relation with

feeding practices.

2. Literature related to the feeding practices of mothers and nutritional status of

their children.

3. Literature related to the influence of weaning practices on nutritional status of

children

4. Literature related to the maternal nutritional knowledge and child nutritional

status.

1. Literature related to the Prevalence of malnutrition and its relation to feeding

practices

Chirumulay D, Nisal R has done a study on prevalence of malnutrition and

its relation with feeding practices in 605 tribal under five children. There was a

significant relation of nutritional status of preschool children to feeding practices.

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

stress on importance of timely weaning with introduction of solid foods by 6 to 9

months of age; to address the widespread problem of malnutrition in under five

children.24

Abdul Sayed ZT has done the study on the determinants of nutritional

marasmus (NM) and kwashiorkor (K) using Sudanese children aged 6-36 months.

Subjects consisted of 55 children with NM and 55 with K, admitted to the children’s

Emergency Hospital in Khartoum. Mothers were interviewed in hospital, and

information on duration of breastfeeding, age at introduction of supplementary foods,

and weaning foods was obtained. Observations were made in 20 percent of homes of

study children. The results suggest a positive association between prolonged

breastfeeding without introduction of supplementary feeding between the ages of 6

and 24 months, and NM. Using multivariate analysis the data show that late

introduction of supplementary foods produces an increase of 1.4 fold odds of

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

kwashiorkor children breastfeeding for fewer months. Results suggest strategies to

reduce the prevalence of NM and moderate PEM.25

Srivastava N, Sandhu A did a study on Index for measuring child feeding

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

studied separately. More research is needed in the direction of consulting of

composite index which can then be used for research, monitoring, evaluation and

much needed advocacy for complimentary feeding.2

Hossain I M, Yasmin R, Kabir I did a study on Nutritional and

immunisation status, weaning practices and socio-economic conditions of under five

children in three villages of Bangladesh. A total of 479 children aged 6-60 months

were studied during 1991 to 1992. According to Gomez classification, 96 percent of

children had varying degrees of protein energy malnutrition. According to Waterlow

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,

education and promotion of essential vaccination may reduce childhood malnutrition

especially severe PEM.26

19

Excler JL, Nicolas E, Mojon M conducted a study on Protein-energy

malnutrition in an urban African milieu, etiologic factors in kwashiorkor and

marasmus-kwashiorkor. The etiologic factors of protein-energy malnutrition have

been studied in 59 children with kwashiorkor (KWK) or marasmus-kwashiorkor

(MKWK) and living in an African urban area. The decline of breast feeding leads to

an earlier PEM, mainly MKWK. This decline is linked to urbanization, mother's

activities, dislocation of traditional structures and use of artificial formulas.

Essentially based on cereals, the diet is responsible of the post-weaning P.E.M.

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

of KWK and of some MKWK, after 2 years of age. Diarrhoea, measles,

bronchopulmonary and parasitic diseases are the most prevalent infections. Among

socio-cultural factors, conjugal disorders are predominating with child-mother break-

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

2. Literature related to Feeding practices of mothers and nutritional status of

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,

deprivation from colostrum and improper complementary feeding were found

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

protection of optimal infant feeding practices for improving nutritional status of

children.17

Hannan A, Hassan M, Fazlur Rahman AKM, Rahman A conducted a

study on Infant feeding practices from birth to two years of age and nutritional status

of children and mothers in Bangladesh. Six nationwide cross-sectional surveys on

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.

Anthropometric measurements of children included measurement of weight and

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,

complementary feeding and anthropometric measurements were collected using two

sets of pre-tested questionnaire. The prevalence of continuation of breast feeding at

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

Nyaruhucha CNM, Msuya JM, Mamiro PS and Kerengi AJ conducted a

study on Nutritional status and feeding practices of under-five children in Simanjiro

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

more likely to be undernourished. Small size of a household was in favour of nutrition

status. There is a great need to undertake interventions through community education

to rescue the situation in Simanjiro district. Efforts should also be undertaken to

mobilize the community members to adopt practices that favour good nutrition of

children.15

Kamau-Thuita F, Omwega AM, Muita JW conducted a study on Child care

practices and nutritional status of children aged 0 to 2 years in Thika, Kenya. Cross

sectional descriptive survey using a structured questionnaire and taking of

anthropometric measurements to determine the nutritional status of children aged 0 to

2 years. In addition, two day observations were conducted in a subsample of

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

large extent by the mother and caregivers knowledge.21

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

were as follows: current breast-feeding, use of complementary foods and liquids in

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,

especially after 12 mo of age. Differences in HAZ between child feeding practices

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

targeted by nutrition education and behaviour change interventions.22

Alvarado BE, Tabares RE, Delisle H, Zunzunegui MV conducted a study

on Maternal beliefs, feeding practices and nutritional status in Afro-Colombian

infants. They combined ethnographic and epidemiological data. They collected

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

showed a prevalence of wasting of 2.6 percent and prevalence of stunting of 9.8

percent. These practices are characterized by a universal onset of breast feeding, that

lasted 10 months in average, and an early introduction of complementary food.

Breastfeeding is a cultural norm. Weaning is related to new pregnancy, to low milk

production and to negative effects of breast process on mothers’ health. Early

complementary feeding and bottle-feeding are highly valued due to their positive

effect on nutritional status and adaptation of children to adult-type diets. The

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

percent of the mothers having inadequate feeding practices.23

3.Literature related to the influence of weaning practices on nutritional status of

children

Hasan J, Ray J, Khan Z conducted a study on influences of weaning practices on

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

of age. Most of them used the family- food as weaning food.28

Osuhor PC had prepared a standardized questionnaire and administered to 65

mothers attending the Nutrition Clinic of the Ahmadu Bellow University Teaching

Hospital, Kaduna, Northern Nigeria, over the October-December 1978 period to

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

malnutrition, had failed to thrive, or had severe infections, e.g., measles,

gastroenteritis, or respiratory diseases. 58 of the families were of low socioeconomic

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

protein because of socioeconomic factors. The use of carbohydrate gruels among

these low socioeconomic facilities coupled with sociocultural factors compounded the

feeding problem, and, consequently, protein energy malnutrition was common during

the weaning period.29

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

Jansen AA had done a study to assess Mild protein- calorie malnutrition in

Western Samoa. Severe protein-caloric malnutrition is also an important cause of

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

mothers in Sava appeared to give their children monotonous diet. A number of

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

many parts of the country including Kathmandu valley. Complementary feeding

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-

24 months. A set of questionnaire was used to interview mothers of 150 households.

Finding of the study indicated that about 92 percent households were found practicing

Traditional Complementary Feeding Practices and 8 percent households were found

practicing Commercial Complementary Feeding Practices. Traditional

complementary foods given to the children were found lacking in macronutrient

carbohydrate and protein severely, therefore, not fulfilling the nutritional requirement

of the children. Among traditional complementary food fed children, 63 percent of

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

malnutrition, parents were employed. Nutritional status of children from Kathmandu

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

children were found more severely malnourished compared to commercial

complementary food fed.32

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

life in a group of white infants in Dunedin, New Zealand. Statistical analyses

Regression analyses were performed to determine factors associated with successful

breastfeeding initiation and duration. Among mothers, 88 percent initiated breast

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.

Tertiary education and exclusively breastfeeding at 1 month were associated with a

longer duration of breastfeeding. Perception of breastfeeding in public as

embarrassing was associated with a shorter duration of breastfeeding. Among infants,

45 percent were given non milk foods before 4 months of age, and 69 percent were

given unmodified cow's milk as a beverage before 12 months.33

Hussain AM, Rariquzzaman M had undertaken a study to determine the

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

appropriate weaning. Bi-variate controlled analysis showed that a mismatch between

mothers' responses and actual weaning behaviour toward infants 4-6 months old could

be attributed to family poverty.34

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

obstacles to increase energy and-nutrient density of weaning foods of cereals and

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

the processed weaning foods were chemically and biologically evaluated.

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,

germination of ingredients of weaning foods of vegetable origin seems to be a good

option of the simple home processing technique.35

4. Literature related to maternal nutritional knowledge and child nutritional status

Sharma S, Nagar S did a study to determine the impact of educational intervention

on knowledge of mothers regarding childcare and nutrition in Himachal Pradesh. The

study aimed at providing educational interventions to mothers regarding knowledge

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

aspects. Intervention consisted of educating mothers in the experimental group for a

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

between experimental and control group mothers during post-testing.14

Appoh LY, Krekling S undertook a study on Maternal nutritional knowledge

and child nutritional status in the Volta region of Ghana. The data was collected in

Ghana on 55 well nourished and 55 malnourished mother-child pairs. Data on

mother's demographic and socio-economic characteristics as well as child

anthropometric data were also collected. Bi-variate analysis gave significant

associations between child nutritional status and the following variables: time of

initiating of breastfeeding, mother's knowledge of importance of colostrum and

whether colostrum was given to child, age of introduction of supplementary food, and

mother's knowledge about causes of kwashiorkor. Maternal formal education, 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

important than formal maternal education for child nutrition outcome.36

Tada Y, Keiwkarnka B, Pancharuniti N, Chamroonsawasdi K had

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

232 children; socioeconomic background information was obtained by interviewing

their mothers using a structured questionnaire. The prevalence of malnutrition among

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

Thailand and in the Bangkok metropolitan area by weight-for-age was reported to be

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

malnutrition is no longer considered to be a major health problem in Thailand, it

remains a threat to the health of the urban poor in Bangkok. This finding should not

be overlooked and countermeasures are indicated.37

Waihenya EW, Kogi-Makau W, Muita JW conducted a study on Maternal

nutritional knowledge and the nutritional status of preschool children in a Nairobi

slum. Nutritional status of 363 children aged six to 24 months was measured and

nutritional knowledge of their mothers assessed. Makina village was randomly

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

between the nutritional status of children and overall nutritional knowledge.

31

Unexpectedly, a negative relationship was found between nutritional status and

mothers' ability to recognize clinical signs of malnutrition, knowledge in the weaning

process and dietary management during sickness. Knowledge on frequency of feeding

was, however, positively related to nutritional states. In conclusion, nutritional

knowledge alone is inadequate in ensuring young children's nutrition security and,

hence, for nutritional education programmes to have a positive impact, facilitation

strategies must be incorporated.38

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

explore the importance of growth monitoring activity in preventing Protein Energy

Malnutrition. Trained interviewers from the respective State/Division nutrition team

interviewed ninety mothers from different areas and Divisions. Mothers were

categorized into three groups of thirty; those with a well-nourished child, a

malnourished child or a child who had died of infectious disease. 90 percent of

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.

Regarding attitude towards feeding during illness, most mothers of a well-nourished

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

role of basic health staff in these activity is also acknowledged.39

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

forty two mothers in 7 villages of Narayanganj district, Bangladesh were interviewed

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

how to prepare proper weaning foods.40

Pant I, Chothia K had undertaken a study to assess maternal knowledge

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

Sciences in Srinagar to determine whether maternal knowledge and practice were

33

associated with the nutritional status of the infants. 28 children were considered to be

well nourished, while the remaining 95 children were determined to be in various

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

severely malnourished. None of the mothers of malnourished infants had an excellent

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

decreasing trend between awareness and practice of breast feeding/infant weaning;

suggesting that further improvement of health education is needed to reduce the lag

between breast feeding awareness and practice.42

Bekle A, Berhane Y conducted a study on weaning in Butajira, South Ethopia

regarding mothers’ knowledge and practices. A descriptive cross sectional study on

mothers' knowledge and practice related to weaning was conducted in Butajira in

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

mentioned as important feeding methods. The study demonstrated the presence of

inappropriate weaning practice in the area which needs appropriate intervention.43

35

4. METHODOLOGY

Research methodology is a way to solve systematically the research problem.

The methodology enables the researcher to project a blue print of the details, data,

approach, analysis and findings of research undertaken. The methodology of research

indicates the general pattern of an organized procedure for gathering valid and reliable

data for the purpose of investigations.

This chapter includes the description of research approach, research design,

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

selected area Bangalore.

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

A research design is a blueprint for conducting a study that maximizes control

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

analysis to interpret the data.

The investigative design selected for this study is descriptive correlative

design. The purpose of a descriptive co-relational design is to describe variables and

examine relationships among these variables.

37

SELECTED AREA - RURAL

PURPOSE

• To find out the correlation between the feeding practices of mother and nutritional status of their children.

• To find out the association between feeding practices of mothers and selected demographic variables.

RESEARCH DESIGN

Descriptive correlative design

SAMPLES Mothers between 15 – 45 years of

age and children between 6 months to 3 years of age

SAMPLING TECHNIQUE :

Simple Random sampling

DATA COLLECTION INSTRUMENT Interview and anthropometric assessment after validation

DATA ANALYSIS • Descriptive analysis • Inferential analysis • Interpretation of results

FINDINGS AND CONCLUSION

Fig 2:SCHEMATIC REPRESENTATION OF THE RESEARCH DESIGN

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

conducted at Doddabasthi and Chikkabasthi villages under K. Gollahalli PHC.

Variables

Burns and Grove explained that research variables or concepts are the

qualities, properties or characteristics identified in the research purpose and objectives

or questions that are observed or measured in a study.

In the present study research variables are:

• Feeding practices – breast feeding, weaning and family diet.

• Nutritional status – Anthropometry measurements

Demographic variables of mothers include

• Age

• Education

• No of under five children

• Occupation,

• Duration of married life

• Family income and type of family.

Demographic variables of children

• Age

• Gender

• Birth weight

39

Population

The term population refers to the target population which represents the entire

set of individuals who meet the sampling criteria.

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

age and the same children residing at Chikkabasthi, Doddabasti Villages.

Sample

Sample refers to the subject of a population that is selected to participate in a

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

an opportunity to be selected for the sample. One method of providing this

opportunity is referred to as random sampling. Hence, simple random sampling

technique was found to be apt for the study.

Sampling Criteria

Inclusion criteria

1. Mothers of children who were willing to participate in the study.

2. Both male and female children.

40

Exclusion Criteria

1. Mothers who have physically and mentally challenged children.

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

instrument used for the present study is structured interview schedule.

Development of the Instrument

Instrument was developed based on

1. Review of literature

2. Consultation with guides

3. Subject experts in paediatrics and investigators

4. Consultation with statistician for data analysis

5. Spearman Brown’s formula was used for reliability.

Preparation of the blue print

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

the content areas. (Annexure H)

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

mothers background such as age, number of children, religion, education, occupation,

duration of married life, family income, type of family, source of information

regarding feeding practices and next five items are related to child’s age, gender, birth

weight, birth order and presence of other problem.

Section II

Check list consist of 30 items to assess the feeding practices of mothers i.e. breast

feeding, weaning and family diet. Total score is 30.

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

Validity refer to the degree to which an instrument measures what it is

supposed to measure. Content validity refers to the degree to which the items in an

instrument adequately represent the universe of content.

42

The prepared instrument along with the objectives, operational definitions,

blueprint, scoring key and criteria checklist for validation were submitted to 7 experts

which included 5 nurse educators, 1 paediatrician and 1 statistician to establish

content validity.

Reliability of the tool

Reliability of an instrument is the degree of consistency with which it

measures the attributes that it is supposed to measure. It refers to the extent to which

the same results are obtained on repeated administration of the instrument.

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

Spearman Brown’s prophecy formula.

Reliability of the tool was 0.9340 so the tool was found to be highly reliable

for data collection.

Pilot Study

Pilot study is a trial run study conducted before the actual study in a different

population with similar characteristics. Pilot study was conducted on 10 subjects in

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

analysis was done by using descriptive and inferential statistics.

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

anthropometric measurements of their children were taken and recorded.

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

get the 100 samples.

Plan for data analysis

Data was collected from 100 mothers and their children (100) from

Chikkabasthi – Doddabasthi, K.Gollahalli. The collected data was conveniently

summarized and tabulated by applying descriptive statistics such as mean, percentage,

and standard deviation.

Diagrams were used for depicting the authentic nature of at the data collected

on demographic variables and the practice aspects. Association between the selected

demographic variables and feeding practices will be analyzed by using χ2 and

presented through diagrams and tables. Correlation for the present study was

computed by using Spearman’s Rank Correlation.

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.

Ordinarily the amount of data collected in a study is too extensive to be

reliably described by mere pursuit. In order to answer meaningfully the research

questions, the data must be processed and analyzed systematically and testing of

research hypothesis using those data.46

Objectives

1. To assess the feeding practices of mothers.

2. To assess the nutritional status of children.

3. To find out the correlation between the feeding practices of mothers and

the nutritional status of their children.

4. To find out the association between feeding practices and selected

variables of mothers and their children.

Organization and presentation of data

The obtained data were organized and presented under the following sections.

Section I

Describes the frequency distribution and percentage of demographic variables of

mothers and their children.

Section II

In this section mean and standard deviation of feeding practices are described.

45

Section III

Area wise classification of respondents on feeding practices is analyzed.

Section IV

Correlation between feeding practices of mothers and selected nutritional

parameters of their children.

Section V

Association between feeding practices and demographic variables of mothers

Section VI

Association between feeding practices and selected variables of children.

46

SECTION- I

Frequency distribution and percentage of demographic variables of mothers and

their children.

17%11%

72%

0

10

20

30

40

50

60

70

80

<20 21-30 31-40 Age in years

No o

f res

pond

ents

Fig.3 : Frequency and percentage distribution of the mothers by age

Among 100 mothers 17 percent were below 20 years of age, 72 percent were

between 21 to 30 years, and 11 percent were between 31 to 40 years of age. (Fig.3)

47

33%

62%

5%

0

10

20

30

40

50

60

70

Num

ber o

f Res

pond

ents

Hindu Muslim ChristianReligion

Fig.4 Frequency and percentage distribution of mothers by religion Among 100 mothers 33 percent were Hindus, 62 percent were Muslims and 5

percent were Christians. (Fig.4)

48

Type of Family

Extended7%

Nuclear57%

Joint36%

Fig.5: Frequency and percentage distribution of respondents according to type of

family

Out of hundred mothers 57 percent had nuclear families, 36 percent had joint

families and 7 percent had extended families (Fig.5.)

49

5%

13%

24%

40%

8% 10%

0

5

10

15

20

25

30

35

40

Num

ber o

f Res

pond

ents

Illiterate Primary Middleschool

Secondary PUC Graduate

Educational Level

Fig.6: Frequency and percentage distribution of mothers according to their

educational status.

Among 100 mothers 5 percent were illiterate, 13 percent had primary

education, 24 percent had middle school education, 40 percent had high school

education, 8 percent had P.U.C and 10 percent were graduates (Fig.6.)

50

82%

7%

11%

Govt. employeePrivate employeeHouse wife

Fig.7: Frequency and percentage distribution of mothers by occupation.

Among 100 mothers 82 percent were housewives, 11 percent were private

employees and 7 percent were government employees. (Fig.7.)

51

79%

12% 9%

0

10

20

30

40

50

60

70

80

90

<5000 5001-10,000 >10,000

Family Income

Num

ber o

f Res

pond

ents

Fig.8: Frequency and percentage distribution of mothers by 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

36%

50%

14%

05

10

152025

3035

404550

Num

ber o

f Res

pond

ents

1-4 5-9 10-13Duration of Married life in Years

Fig 9 : Frequency and percentage distribution of mothers by duration of

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

10-13 years. (Fig.9)

53

60%

40%

0

10

20

30

40

50

60

Num

ber o

f Res

pond

ents

1 2

No. of under five children

Fig 10 : Frequency and percentage distribution of no of under five children

Among 100 mothers 60 percent had only one childe below five years and 40

percent had 2 children below 5 years of age. (Fig 10)

54

43% 44%

13%

0

5

10

15

20

25

30

35

40

45

Num

ber o

f Res

pond

ents

Familymembers/relatives/friends

Radio/TV Books/Journals

Sources of Information

Fig.11 : Frequency and percentage distribution of respondents by source of

information

Among 100 mothers 43 percent had family members / relatives / friends as

source of information, 44 percent had radio / T.V and 13 percent had books / journals

as source of information (Fig.9)

55

34%

48%

18%

05

101520253035404550

Num

ber o

f chi

ldre

n

1 2 >2

Birth order of children

Fig.12: Frequency and percentage distribution of 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

15%

37%

46%

2%

05

101520253035404550

Num

ber o

f Res

pond

ents

<1 1-2 2-3 >3Age of Children

Fig.13: Frequency and percentage distribution of children by age.

Among 100 children 15 percent were below 1 year, 37 percent were between 1

to two years and 48 percent were between 2 to 3 years of age. (Fig.13)

57

Gender of Children

Male 48% Female

52%

Fig.14: Frequency and percentage distribution of children by gender.

Among 100 children 52 percent were females and 48 percent were males.

58

SECTION II

TABLE 1

Area wise analysis of mean and standard deviation of feeding practices of

mothers

n =100

Sl. No Area wise analysis Max. score Range Mean SD Mean

% 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

Total 30 13-15 19.37 2.51 64.57

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

Area wise classification of respondents on feeding practices

n = 100

Not satisfactory (<50%)

Moderately Satisfactory

(51-75%)

Satisfactory (>75%) Sl.

No Area wise No. of

subjects Percent No. of subjects Percent No. of

subjects Percent

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

not satisfactory, 22 percent had moderately satisfactory feeding practices and 78

percent had satisfactory feeding practices with regard to weaning, 5 percent had not

satisfactory feeding practices, 59 percent had moderately satisfactory feeding

practices and 36 percent had satisfactory feeding practices. As per family diet; 66

percent had not satisfactory feeding practices, 26 percent had moderately satisfactory

and 8 percent had satisfactory feeding practices. (Table 2)

60

SECTION IV

TABLE 3

Correlation between feeding practice of mothers and selected nutritional

parameters of their children

n = 100

Sl. No

Spearman's correlation between the scores of

feeding practices and selected nutritional parameters of children

Spearman's correlation value

1 Present weight (kgs) 0.161 2 Height 0.122 3 Mid arm circumference 0.074 4 Chest Circumference 0.086

Spearman’s correlation between scores of feeding practices and selected

nutritional 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. (Table 3).

61

SECTION V

TABLE 4

Association between feeding practices and selected variables of children n = 100

Feeding practices score Variable Category

≤Median >Median

Chi-square df Table

value

≤Mean 40 20 Age (yrs) ▪

>Mean 24 16 0.463 1 3.841

Muslim 46 16 Religion▪

Hindu and Christian 18 20 7.358* 1 3.841

Nuclear 34 23 Type of Family▪ Joint/Extended 30 13

1.089 1 3.841

Below middle school 33 9 Secondary school 24 16 Education▪

Above PUC 7 11 9.075* 2 5.99

House wife 58 24 Occupation▪

Govt./Private employee 6 12 8.96* 1 3.841

≤ Mean 54 25 Income▪

>Mode 10 11 3.096 1 3.841

1-4 25 11 5-9 31 19 Duration of

Married life 10-13 8 6

0.836 2 5.99

1 34 26 No. of Under Five

Children 2 30 10 3.501 1 3.841

1 22 12 2 30 18 Birth Order

>2 12 6 0.11 2 5.99

Family member/relatives/friends 28 15 Source of

information▪ Radio/TV/Media 36 21 0.041 1 3.841

▪ 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. * Significance at p<0.05 level.

Chi-square established at 0.05 level of significance denotes that the

association between feeding practices and demographic variables such as religion,

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

Association between feeding practices and selected variables of children

n = 100

Total feeding practices score Anthropometric

variables Category≤Median >Median

Chi-square value

df Table value

≤Mean 28 20 Birth Weight (kgs) >Mean 36 16

1.287 1 3.841

≤Mean 34 16 Present weight (kgs) >Mean 30 20

0.694 1 3.841

≤Mean 52 26 Height (cms)

>Mean 12 10 1.094 1 3.841

≤Mean 31 12 Mid arm circumference

(cms) >Mean 33 24 2.145 1 3.841

≤Mean 40 18 Chest Circumference

(cms) >Mean 24 18 1.487 1 3.841

≤Mean 32 14 Age of Child (months) >Mean 32 22

1.145 1 3.841

Male 34 14 Gender

Female 30 22 1.871 1 3.841

No significant association was found between feeding practices and

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

between feeding practices and parameters.

The study was conducted in Chikkabasthi and Doddhabasthi among

reproductive age group of mothers who have children between the age of 6 months

and 3 years.

A structured interview schedule was used to assess the feeding practices

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

between the age group of 6 months to 3 years from rural communities.

Main findings of the study were discussed under the following sections.

Section – 1

Findings related to the demographic characteristics of respondents

Among 100 mothers, 17 percent of them were below 20 years of age, 72

percent of them were between 21 – 30 years and 11 percent were between 31 – 40

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.

Occupation wise, 82 percent of them were housewives, 11 percent of them were

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

14 percent had a duration of 10 – 13 years of married life.

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

family members/ relatives/ friends as the source of information on feeding practices, 4

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

were females and 48 percent of them were males.

The first objective was to assess the feeding practices of mothers

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

not satisfactory, 22 percent had moderately satisfactory feeding practices and 78

percent had satisfactory feeding practices with regard to weaning, 5 percent had not

satisfactory feeding practices, 59 percent had moderately satisfactory feeding

practices and 36 percent had satisfactory feeding practices. As per family diet; 66

percent had not satisfactory feeding practices, 26 percent had moderately satisfactory

and 8 percent had satisfactory feeding practices.

The third objective was to find out correlation between the feeding practices of

mothers and the nutritional status of their children.

Spearman’s correlation between scores of feeding practices and selected nutritional

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

mothers and their children with selected variables.

Chi-square established at 0.05 level of significance denotes that there is

statistically significant association between feeding practices and demographic

variables of mothers such as religion, education and occupation. The remaining

variables are found non-significant.

67

No significant association was found between feeding practices and

anthropometric variables of children like age, gender, birth weight, present weight,

height, mid arm circumference and chest circumference at p<0.05 level.

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

the hypothesis is accepted.

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

between feeding practices and parameters.

The study was conducted in Chikkabasthi and Doddhabasthi among

reproductive age group of mothers who have children between the age of 6 months

and 3 years.

A structured interview schedule was used to assess the feeding practices

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

between the age group of 6 months to 3 years from rural communities.

The following conclusions are made from the study

• 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.

• As per educators 5 percent illiterate, 8 percent PUC, 10 percent graduates and 13

percent primary school, 24 percent middleclass school and 40 percent high school.

• There was significant association between education and feeding practice.

• 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

employees and 11 percent private employees respectively.

• There was significant association between occupation and feeding practices.

• As per family income, most of them had below Rs.5000, 12 percent had between

5,001 to 10,000 and 9 percent had above Rs.10,000 as family income.

• With regard to duration of married life – up to 1 to 4 years 36 percent, 5-9 years

50 percent above 10 years 13 years 14 percent were there. But there was no

association between duration of married life and feeding practice of mothers.

• As per source of information TV / radio was used by 44 percent, family members /

relatives 43 percent and book/journal was used by 13 percent.

• Correlation between feeding practices and nutrition parameter; present weight r =

0.161, height r = 0.122, mid arm circumference r = 0.074 and chest circumference

r = 0.086 were positively correlated.

So findings of the study reveal that there is a positive correlation between

feeding practices of mothers and nutritional status of their children’s parameters.

Implications of the study

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

Nursing education emphasizes on preparing dedicated nurse to impart health

education both in community settings and clinical areas by using various methods of

educational technology to improve the feeding practices.

Nursing Practice

“When love and skill work together expect a master piece”.

– John Ruskin

Nurse plays an important role in the feeding of children. It starts even before a

mother is pregnant. Through health education demonstration of preparation of feed

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

clinical setting as well as in community setting is mandatory.

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

consideration for the improvement of children’s nutritional status.

Nursing Research

We can bring about a tremendous improvement in the health status of children

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

practices of mothers to establish a better nutritional status for their children.

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

• Study can be replicated in different community setting

• Structured teaching program can be arranged for mother as part of experimental

study to improve their feeding techniques.

• A comparative study can be conducted between rural and urban settings.

72

8. SUMMARY

The main purpose of the study was to correlate the feeding practice of mothers

and nutritional status of their children.

Objectives of the study were

1. To assess the feeding practices of mothers

2. To assess the nutritional status of children

3. To find out the correlation between the feeding practices of mother and the

nutritional status of their children.

4. To find out the association between feeding practices of mothers and their

children with selected variables.

The conceptual frame work adopted for this study was based on Rosenstoch’s

and Becker’s health belief model.

The review of related literature and non research literature helped the

investigator to develop the conceptual frame work, structured interview schedule and

plan for data analysis.

The study was conducted in Doddabasthi and Chikkabasthi from 3rd

September to 3rd October 2007. The study adopted descriptive survey approach with

random sampling technique.

Sample of the study consisted of 100 rural mothers and their children. The tool

used for data collection was structured interview schedule.

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

income, type of family, source of information regarding feeding practices.

Also children’s demographic variables such as age, gender, birth weight, birth

order and presence of other problems.

Section II

It consists of 30 items with regard to practices of mothers concerning breast

feeding, weaning and family diet. Total score was 30.

The steps involved in the development of instruments were preparation of blue

print, construction of items, content validity and preparation of the final copy of the

tool.

After obtaining formal permission from Medical officer of K. Gollahalli, PHC,

the tool was used for data collection. Then the collected data were analyzed using

descriptive and inferential statistics and interpreted in terms of objectives.

Section III

Deals with the anthropometry of the children

74

Major findings of the study

1. Findings regarding the demographic characteristics of the respondents

Participants included in the study were mothers between 18 to 40 years of age.

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 were housewives. 11 percent private employees and only 7 percent

Government employees. As per family income 79 percent had below Rs.5,000, 12

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

between 1 to 4 years and only 14 percent between 10 to 13 years. Among them 60

percent had only 1 child below five years and 40 percent had 2 children below five

years.

As source of information 44 percent had TV/Radio, 43 percent had family

members/relatives/friends and only 30 percent used mass media.

With regard to children 48 percent were between 2 to 3 years of age, 37

percent between 1 to 2 years and only 15 percent below 1 year. Among them 52

percent females and 48 percent males were there.

75

2. Findings pertaining to area wise classification of feeding practices

Breast feeding: 78 percent adequate, 22 percent satisfactory and none of them had

not satisfactory feeding practices.

Weaning : 5 percent not satisfactory, 59 percent satisfactory and 36 percent had

adequate feeding practices.

Family diet: 66 percent not satisfactory, 26 percent satisfactory and 8 percent had

adequate feeding practices. Overall 5 percent not satisfactory, 81 percent satisfactory

and 14 percent had adequate feeding practices.

3. Correlation between feeding practices and selected nutritional parameters.

Finally, it is found that there is a positive correlation between mothers feeding

practices and nutritional status of their children. Spearman’s Rank Correlation value

to correlate the feeding practices of mothers and selected nutritional parameters of

children is found to be r = +0.161 for the present weight (kgs), r = +0.122 for height,

r = +0.074 for mid arm circumference and r =+ 0.086.

4. Association between demographic variables and feeding practices.

There were significant association between demographic variables like

religion, education and occupation of mothers and feeding practices. However there

was no significant association between demographic variables such as age, type of

family, income, duration of married life, number of under 5 children, birth order, age

of the child, gender and source of information.

76

9. BIBLIOGRAPHY

1. Child development – An Introduction available from:

http://wcd.nic.in/cdintro.html [cited 2007 Sep 22].

2. Srivatsava N, Sandhu A. Index for Measuring Child Feeding Practices. Indian

J. Pediatr. 2007 April; vol. 74(4): 363-8.

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82

10. LIST OF ANNEXURE

Sl.No. Annexure Page No

A Letter seeking permission to conduct pilot study 84

B Letter granting permission to conduct pilot study 85

C Letter seeking permission to conduct main study 86

D Letter granting permission to conduct main study 87

E Letter seeking expert opinion on content validity of the tool 88 – 89

F Criteria checklist for validating the tool 90 – 91

G Certificate of content validity 92

H Blue Print 93

I Tool used for the study (English) 94 – 98

J Tool used for the study (Kannada) 99 – 103

K Scoring Key 104

L Letter seeking consent of the participant (English) 105

M Letter seeking consent of the participant (Kannada) 106

N Certificate of analysis of data 107

O Certificate of Editing 108

P List of experts 109 - 110

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,

Date: Yours faithfully,

Place: ROSAMMA K.J

84

ANNEXURE – B

LETTER GRANTING PERMISSION TO CONDUCT THE PILOT STUDY

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,

As per your request forward through the Principal, Sarvodaya College of

Nursing you are permitted to do the pilot study in K. Gollahalli, Bangalore as

mentioned in your letter.

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,

Date: Yours faithfully,

Place: ROSAMMA K.J

86

ANNEXURE – D

LETTER GRANTING PERMISSION TO CONDUCT THE MAIN STUDY

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,

As per your request forward through the principal Sarvodaya College of

Nursing you are permitted to do the main study in K. Gollahalli PHC in Bangalore as

mentioned in your letter.

Date:

Place:

87

ANNEXURE – E

LETTER SEEKING EXPERTS OPINION AND SUGGESTIONS FOR THE

CONTENT VALIDITY OF THE TOOL.

From,

Rosamma K.J,

II Year M.Sc. Nursing,

Sarvodaya College of Nursing,

Bangalore.

To,

Through,

The Principal,

Sarvodaya College of Nursing,

Bangalore.

Dear Madam / Sir,

Sub.: Request for opinion and suggestions of experts for establishing

content validity of research tool.

I, Rosamma K.J II Year Student of Master of Science in Nursing

(Pediatric Nursing), student of Sarvodaya College of Nursing, Bangalore, have

selected the following topic for my research project, to be submitted to Rajiv Gandhi

University of Health Sciences, Karnataka, Bangalore, in partial fulfillment university

requirement for the award of Master of Nursing degree.

TITLE OF THE TOPIC

“A Study To Correlate Feeding Practices Of Mothers And Nutritional

Status Of Their Children In A Selected Area Bangalore”.

88

The objectives of the study are

1. To assess feeding practices of mothers.

2. To assess the nutritional status of children.

3. To find out the correlation between the feeding practices of mothers and the

nutritional status of their children.

4. To find out the association between feeding practices of mothers and the

selected demographic variables.

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

opinion and suggestions wherever required.

Herewith I am enclosing a copy of

a) Questionnaire

b) Correct response and scoring key

c) Evaluation criteria

d) Content validity certificate

Thanking you,

Date: Yours faithfully,

Place: Bangalore ROSAMMA K.J.

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

Areas Item No.

Relevant Relevant to

Certain Extent

Not Relevant

Suggestions

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

Section I Demographic data

14. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Section II Checklist

13.

90

Areas Item No.

Relevant Relevant to

Certain Extent

Not Relevant

Suggestions

14. 15. 16. 17. 18. 19. 20.

21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

91

ANNEXURE – G

CERTIFICATE OF CONTENT VALIDITY

This is to certify that the tool developed by Rosamma K.J., M.Sc. Nursing

Student of Sarvodaya College of Nursing, Bangalore (Affiliated to Rajiv Gandhi

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

To Correlate Feeding Practices Of Mothers And Nutritional Status Of Their

Children In A Selected Area, Bangalore”.

Signature :

Name :

Designation :

Date :

Seal :

92

ANNEXURE - H

BLUE PRINT OF STRUCTURED INTERVIEW SCHEDULE

Sl No.

Components Comprehension Application Total No. of

Questions

Percentage

Knowledge

regarding

1. Breast feed.

3, 4 , 9 1, 2, 5, 6, 7,

8

9 30%

2. Weaning.

10, 11, 14, 15 12, 13, 16,

17, 18, 19

10 33.3%

3. Family Diet

20, 22, 24, 28 21, 23, 25,

26, 27, 29,

30

11 36.7%

TOTAL 36.7% 63.3% 30 100%

93

ANNEXURE – I

STRUCTURED INTERVIEW SCHEDULE SECTION – I

DEMOGRAPHIC DATA Code No.

Mother 1. Age (years) _________

2. Number of under five children ________

3. Religion ________

Hindu

Muslim

Christian

4. Education of the mother ________

Illiterate

Primary School

Middle School

High School

PUC

Graduate

5. Occupation of the mother ________

Housewife

Government

Private

Business

Agriculture

6. Duration of married life (years) ________

7. Family income (per month) Rs.________

8. Type of family

9.1. Nuclear

9.2. Joint

9.3 Extended

9. Source of information regarding feeding practices.

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

Sl.No. Feeding practices Yes No

1. Did you initiate breast feeding within one hour of child birth?

2. Have you breast fed the baby exclusively for 6 months?

3. Did you prepare yourself during antenatal period for breast

feeding?

4. Did your baby sleep well after breast feed?

5. Did you practice demand feeding?

6. Did you feed your baby with expressed breast milk?

7. If yes, did you warm the milk by placing it in a bowl of hot

water?

8. Did you burp your child after every feed?

9. Do you consider regurgitation of small amount of feed as

normal?

10. Did you use liquid diet as first weaning food?

11. Did you observe any psychological problem for your baby while

weaning?

12. Did you give weaning food immediately after bath?

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

food item for a week and restarted in small quantities?

17. Have you given weaning food before the breast feed?

18. Do you wash your hands with soap and water before cooking,

serving and feeding your child?

19. Is there any cultural taboos or family tradition to be followed

before starting the weaning food?

20. Does your child get nutritional food from Anganawadi?

21. When your child was one year old, did you give family diet for

him/her?

22. Was your child been given vitamin A solution?

23. Do you check the weight of your child as per age?

24. Did you get any health education regarding feeding practices

from health personnel?

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

year and maintain a record?

28. Do you consider half amount of mothers diet as daily

requirement of 12 to 18 months old child?

29. Did you use spoon or pallada while giving complementary feed?

30. Did you take your child to pediatrician in regular intervals?

SECTION – III

Anthropometry

1. Present weight (kg) of the child ___________

2. Height (cm) of the child ___________

3. Mid arm circumference (cm) ___________

4. Chest circumference (cm) ___________

98

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DºÁgÀªÀ£ÀÄß ¤ÃqÀÄwÛÃgÁ?

13. JgÀqÀÄ «zsÀzÀ ¥ÀÇgÀPÀ

DºÁgÀªÀ£ÀÄß ¤ÃqÀĪÁUÀ £ÀqÀÄªÉ 5–

7 ¢£ÀUÀ¼À CAvÀgÀzÀ°è

ªÀiÁqÀÄwÛÃgÁ?

14. 8 – 12 wAUÀ¼À°è ªÀÄUÀÄ«UÉ ¤ÃqÀĪÀ DºÁgÀzÀ°è ºÀtÄÚUÀ¼ÀÄ, §qsÀ¬Ä¹zÀ ªÀÄvÀÄÛ ZÉ£ÁßV QªÀÅazÀ vÀgÀPÁjUÀ¼À£ÀÄß ¤ÃqÀÄ«gÁ?

15. ¥ÀÇgÀPÀ DºÁgÀ ¤ÃqÀĪÀ

¸ÀªÀÄAiÀÄzÀ°è DºÀgÀ¢AzÀ SÁ¬Ä¯É

§j¸À§ºÀÄzÁzÀ AiÀiÁªÀÅzÀPÀÆÌ

¸ÀÆPÀëöä ¸ÀAªÉâAiÀiÁVgÀĪÀ

¥ÀgÀ¸ÀÜwAiÀÄ£ÀÄß JzÀÄj¹¢ÃgÀ?

16. ºÁUÁVzÀÝ°è CAvÀºÀ DºÁgÀªÀ£ÀÄß

MAzÀÄ ªÁgÀ ¤°è¹ £ÀAvÀgÀ C®à

¥ÀæªÀiÁtzÀ°è ¥ÀÅ£ÀB ¤ÃqÀÄ«gÁ?

17. JzÉ ºÁ®£ÀÄß ¤ÃqÀĪÀ ªÀÄÄ£Àß

¥ÀÇgÀPÀ DºÁgÀªÀ£ÀÄß ¤ÃqÀÄ«gÁ?

18. CqÀÄUÉ ªÀiÁqÀĪÀ ªÀÄÄ£Àß §r¸ÀĪÀ

ªÀÄvÀÄÛ G¤¸ÀĪÀ ªÀÄÄ£Àß ¤ªÀÄä

PÉÊUÀ¼À£ÀÄß ¸Á§Æ£ÀÄ ªÀÄvÀÄÛ

102

¤Ãj¤AzÀ vÉƼÉzÀÄPÉƼÀÄî«gÁ?

19 ¥ÀÇgÀPÀ DºÁgÀªÀ£ÀÄß

¥ÁægÀA©ü¸ÀĪÀ ªÀÄÄ£Àß

¸ÁA¥ÀæzÁAiÀÄPÀ ¤µÉÃzÀ CxÀªÁ

PÀÄlÄA§zÀ°è DZÀgÀuÉ EzÉAiÉÄÃ?

20. CAUÀ£ÀªÁr PÁAiÀÄðPÀvÀðjAzÀ ¤ªÀÄä

ªÀÄUÀÄ«UÉ ¥ËµÀ×PÀ DºÁgÀ

¹UÀÄwÛzÉAiÉÄÃ?

21. ¤ªÀÄä ªÀÄUÀÄ«UÉ MAzÀÄ

ªÀµÀðªÁzÁUÀ PÀÄlÄA§zÀªÀgÀÄ

¸Éë¸ÀĪÀ DºÁgÀªÀ£ÀÄß ¤ÃrgÀÄ«gÁ ?

22. ¤ªÀÄä ªÀÄUÀÄ«UÉ fêÀ¸ÀvÀé “J”

¤ÃqÀÄ«gÁ ?

23. ªÀAiÀĹìUÀ£ÀÄUÀtªÁV ªÀÄUÀÄ«UÉ

vÀÆPÀªÀ£ÀÄß £ÉÆÃqÀÄ«gÁ?

24. DgÉÆÃUÀå ¹§ãA¢UÀ½AzÀ DºÁgÀ

¸ÉêÀ£ÉAiÀÄ C¨sÁå¸ÀUÀ¼À£ÀÄß

DgÉÆÃUÀå ²PÀëtzÀ ªÀÄÆ®PÀ

¥ÀqÉ¢¢ÝÃgÁ?

25. ªÉÄvÀÛUÉ ¨ÉìĹzÁ C£Àß ªÀÄvÀÄÛ

¨ÉüÉAiÀÄ£ÀÄß ¥ÀÇwðPÀgÀ

DºÁgÀªÁV ªÀÄUÀÄ«UÉ ¤ÃqÀÄwÛÃgÁ?

26 ªÀÄUÀÄ«UÉ Cw¸ÁgÀ ¨ÉâAiÀiÁzÁUÀ

JzÉAiÀÄ ºÁ®£À eÉÆvÉ N.Dgï.J¸ï.

PÀÆqÀ ¤ÃqÀÄwÛ¢ÝÃgÁ?

27. ªÀÄUÀÄ«£À JgÀqÀ£Éà ªÀµÀzÀ°è

C£ÀÄPÀæªÀĪÁV ªÀÄUÀÄ«£À

vÀÆPÀªÀ£ÀÄß £ÉÆÃr

103

zÁR°¸ÀÄwÛ¢ÝÃgÁ?

28. vÁ¬ÄAiÀÄÄ ¢£Á®Ä ¸Éë¸ÀĪÀ DºÁgÀ

¥ÀæªÀiÁtzÀ CzsÀðzÀµÀÄÖ 12 – 18

wAUÀ¼À ªÀÄUÀÄ«£À

DºÁgÀªÁVgÀÄvÀÛzÉ JAzÀÄ

£ÀA§ÄwÛÃgÁ?

29. M¼À®qÀ CxÀªÁ ZÀªÀÄZÉAiÀÄ£ÀÄß

¥ÀÇwðPÀgÀ DºÁgÀ ¤ÃqÀĪÁUÀ

G¥ÀAiÉÆÃV¹¢ÝÃgÁ?

30. PÀæªÀħzÀÞªÁV ²±ÀÄvÀdÕjAzÀ

ªÀÄUÀĪÀ£ÀÄß vÀ¥Á¸ÀuÉUÉ

M¼À¥Àr¸ÀÄwÛ¢ÝÃgÁ?

¨sÁUÀ – 3 ªÀÄ£ÀĵÀå£À zÉúÀ ªÀiÁ¥sÀ£ÀPÉÌ ¸ÀA§A¢ü¹zÀ «ªÀgÀUÀ¼ÀÄ :

1. ªÀÄUÀÄ«£À

FV£À vÀÆPÀ

(Q.UÁæA.

UÀ¼À°è)

: ………………………………………………

2. ªÀÄUÀÄ«£À

JvÀÛgÀ (¸ÉA.

«ÄÃlgï UÀ¼À°è)

: ………………………………………………

3. ªÉÄïÁãUÀzÀ

PÉÊAiÀÄ

ªÀÄzsÀåzÀ°è£À

¸ÀÄvÀÛ¼ÀvÉÀ

¥Àj¢ü

(¸ÉA. «ÄÃlgï

: ………………………………………………

104

UÀ¼À°è)

4. JzÉAiÀÄ

¸ÀÄvÀÛ¼ÀvÉ

(¸ÉA. «ÄÃlgï

UÀ¼À°è)

: ………………………………………………

105

ANNEXURE – K

SCORING KEY

Q. No. Correct Option Score

1. Yes 1

2. Yes 1

3. Yes 1

4. Yes 1

5. Yes 1

6. Yes 1

7. Yes 1

8. Yes 1

9. Yes 1

10. Yes 1

11. Yes 1

12. Yes 1

13. Yes 1

14. Yes 1

15. Yes 1

16. Yes 1

17. Yes 1

18. Yes 1

19. Yes 1

20. Yes 1

21. Yes 1

22. Yes 1

23. Yes 1

24. Yes 1

25. Yes 1

26. Yes 1

27. Yes 1

28. Yes 1

29. Yes 1

30. Yes 1

106

ANNEXURE – L

CONSENT FORM FOR THE RESPONDENTS

Dear Participant,

I, Rosamma K.J., 2nd year Nursing student of Sarvodaya College of Nursing

as part of the partial fulfilment of the course, have to conduct a study and the problem

selected is “A Study To Correlate Feeding Practices Of Mothers And Nutritional

Status Of Their Children In A Selected Area, Bangalore”.

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

Signature of the investigator

(Rosamma K.J)

I am willing to participate in the study and aware that the information provided by me

will be kept confidential and used for the study purpose.

Place: Bangalore

Date: Signature of the Participant

107

ANNEXURE – M

GvÀÛgÀ PÉüÀĪÀªÀgÀ ¸ÀªÀÄäw £ÀªÀÄÆ£É

F PÁAiÀÄðPÀæªÀÄzÀ°è ¨sÁUÀªÀ»¸ÀĪÀªÀgÉÃ,

¸ÀªÉÇÃðzÀAiÀÄ PÁ¯ÉÃeï D¥sï £À¹ðAUï£À JA. J¸ï. ¹.

¢éwÃAiÀÄ ªÀµÀðzÀ «zÁåy𤠹¸ÀÖgï. gÉÆøÀªÀÄä eÉÆøÀ¥sï

DzÀ £Á£ÀÄ vÀªÀÄä°è «£ÀAw¹PÉƼÀÄîªÀÅzÉãÉAzÀgÉ £À£Àß

CzsÀåAiÀÄ£ÀzÀ CAUÀªÁV ¤ªÀÄä°è PÉ®ªÀÅ ªÀiÁ»wUÀ¼À£ÀÄß

¸ÀAUÀ滸À®Ä EaÒ¸ÀÄvÉÛãÉ. £À£Àß CzsÀåAiÀÄ£ÀzÀ

«µÀAiÀĪÉãÉAzÀgÉ ‘¨ÉAUÀ¼ÀÆj£À ¤UÀ¢vÀ ¥ÀæzÉñÀzÀ°è

vÁAiÀÄA¢gÀÄ vÀªÀÄä ªÀÄPÀ̽UÉ ºÁ®Ær¸ÀĪÀ PÀæªÀÄ

ªÀÄvÀÄÛ ªÀÄPÀ̼À ¥ËµÀ×PÁA±ÀzÀ ¨É¼ÀªÀtÂUÉUÉ EgÀĪÀ

¸ÀA¨sÀAzsÀ’ ªÀ£ÀÄß PÀÄjvÀÄ.

DzÀÝjAzÀ vÁªÀÅ zÀAiÀÄ«lÄÖ £Á£ÀÄ PÀ¼ÀĪÀ

¥Àæ±ÉßUÀ½UÉ GvÀÛj¸À¨ÉÃPÉAzÀÄ ºÁH F

PÁAiÀÄðPÀæªÀÄzÀ°è ¸ÀQæAiÀĪÁV ¥Á¯ÉÆμÀî¨ÉÃPÉAzÀÄ

«£ÀAw¸ÀÄvÉÛãÉ. ¤ÃªÀÅ MzÀV¸ÀĪÀ ªÀiÁ»wAiÀÄÄ PÉêÀ®

«zÁå¨sÁå¸ÀzÀ zÀȵÀ׬ÄAzÀ ªÀiÁvÀæ §¼À¸À®UÀĪÀÅzÀÄ

ºÁUÀÆ CzÀ£ÀÄß UÉÆÃ¥ÀåªÁV EqÀ¯ÁUÀĪÀÅzÀÄ.

ªÀAzÀ£ÉUÀ¼ÉÆA¢UÉ, vÀªÀÄä «±Áé¹,

«ZÁj¸ÀĪÀªÀgÀ ¸À»

108

£Á£ÀÄ MzÀV¸ÀĪÀ F ªÀiÁ»wAiÀÄÄ CzsÀåAiÀÄ£ÀPÁÌV

§¼À¸À¯ÁUÀÄvÀÛzÉ ºÀUÀÆ CzÀ£ÀÄß UÉÆÃ¥ÀåªÁV

EqÀ¯ÁUÀÄvÀÛzÉ JA§ÄzÀ£ÀÄß w½zÀÄ £Á£ÀÄ F

PÁAiÀÄðPÀæªÀÄzÀ°è ¸ÀQæAiÀĪÁV ¨sÁUÀªÀ»¸À®Ä

EaÒ¸ÀÄvÉÛãÉ.

¸ÀܼÀ : ¨ÉAUÀ¼ÀÆgÀÄ ¢£ÁAPÀ : ¨sÁUÀªÀ»¸ÀĪÀªÀgÀ ¸À»

109

ANNEXURE – N

CERTIFICATE OF ANALYSIS OF DATA

This is to certify that data analysis done by Rosamma K.J., Second Year

M.Sc. Nursing, Sarvodaya College of Nursing, Bangalore, in her study titled “A

Study To Correlate Feeding Practices Of Mothers And Nutritional Status Of

Their Children In A Selected Area, Bangalore” has been verified by me.

Date : Signature

Place : Bangalore Seal

110

ANNEXURE – O

CERTIFICATE OF EDITING

This is to certify that data analysis done by Rosamma K.J., Second Year

M.Sc. Nursing, Sarvodaya College of Nursing, Bangalore, in her study titled “A

Study To Correlate Feeding Practices Of Mothers And Nutritional Status Of

Their Children In A Selected Area, Bangalore” has been edited by me.

Date : Signature of the Editor

Place : Bangalore Mrs. Nirmala Sridhar,

M.A English, M.A Psychology,

PG Diploma in Guidance &

Counselling

111

ANNEXURE - P

LIST OF EXPERTS

1. Dr. G. Kasthuri, Ph.D Prof. and HOD, Dept. of Pediatric Nursing Oxford College of Nursing Bangalore

2. Mrs. Hemalatha Ravi, M.Sc. (N)

Prof. and HOD, Dept. of Pediatric Nursing Maruthi College of Nursing Bangalore

3. Mrs. J. Lovera Grace Lilly Rani, M.Sc. (N)

Prof. and HOD, Dept. of Pediatric Nursing Sarvodaya College of Nursing Bangalore

4. Mrs. Satya Lawrence, M.Sc. (N)

Asso. Professor, Dept. of Pediatric Nursing Sarvodaya College of Nursing Bangalore

5. Mrs. Renuka N, M.Sc. (N)

Lecturer Dept. of Pediatric Nursing, Govt. of College of Nursing Fort, Bangalore

6. Mr. G.R. Chamnalkar, M.Sc. (N)

Prof. Pediatric Nursing, Dept. of Pediatric Nursing Oriental College of Nursing Bangalore

7. Dr. Jayaprakash Rai, MD

Pediatrician, Sarvodaya Hospital Bangalore

112

8. Dr. H.S. Surendra, Asso. Professor in Bio-Statistics, GKVK Agriculture College, Yellahanka, Bangalore

9. Miss. Jesly, M.Sc.

Dietitian Dept. of Nutrition St. John’s Medical College, Bangalore.

113