A community based assessment study of positioning, attachment and suckling during breastfeeding among 0-6 months aged infants in rural area of Gandhinagar district, Gujarat, India

Background: Effective breastfeeding is a function of the proper positioning of mother and baby and attachment of child to the mother's breast. Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy recommended systematic assessment of breastfeeding and emphasized counselling of the mother on proper positioning and attachment of infant to the breast. Objective of the study was to assess the correct position, attachment and effective suckling in the breastfeeding of infants as practiced by mothers in rural community . Methods:  An observational, descriptive study was done at field practice area of rural health training centre, Dabhoda, from January 2013 to December 2013. One hundred twenty mothers of 0-6 months of aged infant were interviewed and observed for baby's position, attachment and effective suckling using pre-tested semi-structured questionnaire through random selection. Grading of positioning, attachment and suckling was done according to the score of various characteristics. Data thus collected were analyzed using MS Excel 2007 and also Epi info. Results: There was poorer positioning among primipara (41.7%) than multipara (20.9%) mothers. Poorer attachment was also more evident among primipara (45.8%) compared to multipara (10.9%) mothers. Parity was significantly linked with poor positioning of infant (P value = 0.001) and attachment (P value <0.001). Maternal occupation was also significantly associated with attachment (p value = 0.028) and positioning (p value = 0.009). Preterm delivery was significantly associated with poor attachment (P value = 0.023) and poor effective suckling (P value <0.0001) . Conclusions:  Primipara mothers require help and support for correct breastfeeding techniques as poor positioning and attachment was found among primipara mothers.