1.Interview of mothers - mothers of children attending the immunization clinic at N.R.S Medical College and Hospital (dept. of Community Medicine) were interviewed with the schedules. They were asked about their children (name, age, sex, date of birth, place of delivery, etc.), their occupation and their husbands', their knowledge about aspects of breast feeding and weaning, etc.

2Examination of children - the general examination of children were done along with anthropometry-

a)Clinical examination: this was done to detect pallor, oedema, Bitot's spot, glossitis, angular stomatitis, etc. to assess the nutritional and health status.

b)Anthropometry : followings were performed-

1)Length- this was measured for babies who cannot stand up. The child was placed supine on a flat surface, the head was held firmly in a position touching a vertical, rigid head board. Legs were straightened with feet at right angles to the legs keeping the toes upwards. Another rigid vertical board was brought in contact with the heel. The positions of the two boards were marked and the distance between them was measured by a tape to obtain the length of the child. The measurements were taken in centimeters.

2) Height - For children who can stand up, height was measured. Child stands upright without shoes against a vertical wall with head, shoulders, buttocks, and heel touching the wall. He looks directly forwards. A rigid board was placed on the head and its point of contact with the wall was marked. The distance between the point and the floor was measured in centimeters by a tape to give the height.

3) Mid- upper arm circumference - this was measured for children of 12-59 months of age. The left arm is conventionally chosen. It was measured at a point mid-way between the acromian process of scapula and the olecranon process of ulna. A non-elastic measuring tape was used for the purpose. Results were interpreted as follows-

• MUAC >13.5 cm suggests normal nutritional status.

• MUAC between 12.5 and 13.5 cm suggests mild to moderate malnutrition.

• MUAC <12.5 cm suggests severe malnutrition.

4) Weight - weight is measured in kilograms by using a spring balance. For this, the subject must be in minimal clothing. Proper functioning of the spring balance was assessed by weighing a known weight and also by noting if the pointer comes back to zero mark upon withdrawal of the weight.

If the child could stand, he /she was made to stand on the machine and weight was noted. If the child could not stand, he/she was laid down on the balance and weight was noted.

B)Compilation and analysis of Data: data collected by above procedures were compiled and tabulated for analysis and interpretation.

c)Presentation and Final report writing: the results of the project were presented in front of the teachers of the dept. of community medicine and fellow students. This was followed by a thorough discussion and some important suggestions came up. These were incorporated into the final report.

Then final report was prepared and written.

• All the family members, particularly the elderly females should be taught about the disadvantages of prelacteal feeding and importance of colostrum feeding.

• Mothers should be advised to initiate breast feeding within one hour of delivery.

• Importances of exclusive breast feeding for the first 6 months of baby's life and proper weaning thereafter should be properly explained to the mother.

• They should be taught to continue feeding normally during illness of the children.

• Consumption of low cost nutritious foods and green leafy vegetables on part of mother is advocated during the days of pregnancy and lactation.

• Proper and timely immunization of both mother and child is to be ensured by the family.

• There should be arrangements for social programmes like mother's meeting, baby shows etc. by various organizations.

• For spreading awareness, mass communication may be made by utilizing posters, banners, local cable channels, local fairs, puja, festivals etc.

• Afternoon schools or night school should be opened and ran by the community so that mothers and fathers may get proper education.

• Pregnant women and lactating mothers should be encouraged to go to ICDS centers and take supplementary nutrition.

• Government should allot more money in health sector for integrated health packages and should ensure proper functioning of health programmes and health workers.

• Mass communication should be properly utilized for this purpose.

• It should promote integrated literacy programmes and should make provisions for incentives to attract more people.

• The government should organize seminars on this topic frequently and attendance of health workers should be made mandatory.

• The education ministry can introduce a section on infant feeding in the 'Nutrition' Chapter of Biology at Secondary or Higher Secondary level to promote knowledge in this aspect.

• They should arrange and actively participate in more seminars.

• The ten steps of successful breast feeding and other Infant and child welfare programmes should be followed and practiced by health personnel.

• Mothers attending the Immunisation Clinic, antenatal and postnatal wards should be informed about benefits of breast feeding and different aspects of infant feeding.

Name of child:

Sex: M/F Age:

Date of Birth: Birth Weight:

Place of delivery: Hospital/Home/Nursing Home/others

BACKGROUND INFORMATION ABOUT FAMILY :

Name of mother:

Age:

Address:

Rural/Urban:

Religion: Hindu/Muslim/others

Occupation of father:

Occupation of mother:

Literacy status: Father - Illiterate/Literate (class)

Mother-Illiterate/Literate (class)

Type of family: Nuclear/Joint

KNOWLEDGE OF MOTHER ABOUT INFANT FEEDING:

1. What should be the first food for a new-born?

2. When should breast feeding be initiated after normal delivery?

3. What foods are to be given to a baby of 3 months of age?

4. At what age semi-solid foods are started to infant?

5. Name some semi-solid foods that can be offered to infants during period of weaning.

6. During illness feeding should be - discontinued/given much less than normal/continued normally.

NUTRITIONAL STATUS: FEEDING HABIT:

• Colostrum feeding : Yes/No

• Pre-lacteal feeding :Yes/No

• When breast feeding initiated after birth: within 1 hour/1-24 hours/after 1 day.

• Exclusive breast feeding : Yes/No

• Duration of exclusive breast feeding : <6 months/>6 months.

• Weaning started at : <4 months /4-6 months/> 6 months.

• Weaning foods used were :

• Whether feeding continued during illness: as usual/ given more/ given less/ stopped.

• Whether taken iodized salt: Yes/No.

• Pallor : Present/Absent

• Glossitis resent/ Absent

• Oedema : Present/Absent

• Angular stomatitis : Present/Absent

• Bitot's spot : Present/Absent

• Weight : kg

• Height/length : cm

• MUAC: cm.