Abstract
Dear Editor:
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With urbanization and increased literacy rates among females, female employment is increasing. Working women find it even more difficult to practice these guidelines. Various factors like paid maternity leave, nursing breaks, family support, and availability of daycare facilities at the workplace help reinforce these practices.
Thus, we planned this study to assess the level of awareness and practices followed by working women and the factors influencing practice of these guidelines. The study was carried out in the Department of Pediatrics, University College of Medical Sciences and Guru Tegh Bahadur Hospital, and nearby private hospitals of Delhi, India, after obtaining clearance from the Institutional Ethical Committee. A semistructured questionnaire was used to interview 200 mothers with children under 2 years of age, after the investigator obtained written informed consent. The questionnaire had demographic details, including educational, employment, and economic status, questions on the awareness of the NGIYCF, practices they followed, and reasons for the gaps, if any. Mothers having children with severe neurological disorders, congenital heart diseases, chronic liver disease, or chronic kidney disease or receiving prolonged treatment for any other illness were excluded. The number of participants who followed optimal feeding practices were presented as proportions. The χ2 test, χ linearity test (for trends), and Fisher's exact test were used to find association of feeding with various factors by using SPSS version 17.0 software (SPSS, Inc., Chicago, IL).
A gap existed between awareness and practice of initiation of breastfeeding (62% vs. 54%), optimal duration of exclusive breastfeeding (67% vs. 38%), initiation of complementary feeding (68% vs. 39%), and optimal duration of breastfeeding along with complementary feeding (72% vs. 60%). Awareness regarding optimal initiation of breastfeeding and exclusive breastfeeding duration showed a significant correlation with increasing parity (p=0.000) but was not reflected in practice. The practice of these two factors improved with increasing maternal age (p=0.000). It is interesting that no significant difference between awareness and practice was seen in relation to type of employment sector, type of delivery, or type of family. The major reasons for this gap were misconceptions prevailing with elders in the family that were imposed on the respondent, short duration of maternity leave, lack of time due to work responsibilities, increased dependency on maids, daycare facilities, and other facilities, and other factors like sociocultural barriers, economic status, ignorance, etc. Ninety-nine percent of respondents felt the need for counseling services; 63% of the respondents considered the last trimester the optimal stage of counseling, whereas 37% thought it to be immediately after delivery.
The alarming rate of dying infants calls for looking into the lacunae and working up a solution for them, with poor feeding being one of them. The problems faced by working women in our country are not different from other parts of the world. Gatrell 4 and Barber-Madden et al. 5 reported similar factors in their studies. Mandatory maternity leave for a duration of 6 months, frequent nursing breaks, daycare facilities, and a better support system at the workplace in both the public and private sectors are musts to ensure optimal feeding practices. Group counseling sessions with not only mothers, but also husbands and elders in the family, starting from the last trimester and continuing in the postpartum period, are extremely important. The aim should be to fill the existing gaps, so that a healthy and better start to infants can be provided.