• Muhammad Owais Ahmad
  • Ume Sughra
  • Umay Kalsoom
  • Muhammad Imran
  • Usman Hadi


Background: The promotion and support of breastfeeding is a global priority. However, in realitymost of the mothers are unable to practice exclusive breastfeeding. Most mothers discontinuebreastfeeding because of lack of confidence in their ability to breastfeed, problem with infantsuckling, breast pain, perception of insufficient milk, in addition to other unspecified difficulties.Some these problems can be solved if the women are counselled antenataly about the benefits ofbreastfeeding and prepared mentally for exclusive breastfeeding. The aim of the study was todetermine whether the mothers with antenatal counselling on breastfeeding would improve theirexclusive breast feeding and compare this with that of the mothers without antenatal counselling. Itwas a cross-sectional comparative study which took place at the Maternity ward of Fauji FoundationHospital, Rawalpindi. Methods: Hundred mothers selected by consecutive non probability samplingdivided in two groups. Group A: 50 mothers who were counselled on breastfeeding and Group B: 50mothers who were not counselled on breastfeeding. Fifty mothers practicing breast feeding afterantenatal counselling in the maternity ward of Fauji Foundation Hospital, Rawalpindi were recruitedin the study. Another fifty mothers practicing breastfeeding without antenatal counselling were askedto take part in the study as a control group. Performa was completed and an informed consent wasobtained. Results: As compared to the not counselled group, the mothers who initiated breastfeedingimmediately after birth were statistically significantly higher (p<0.046) in the counselled group (84%and 96% respectively). Similarly the number of counselled mothers who practiced exclusivebreastfeeding was statistically very highly significantly more (p<0.001) than the not counselledgroup (68% and 16% respectively). Conclusion: Antenatal counselling helps in motivating themothers for initiation of breastfeeding immediately after birth and practicing exclusive breastfeedingfor first six months of infant’s life. Existing antenatal counselling on breastfeeding is inadequate inthe population studied and needs to be strengthened.Keywords: Breastfeeding, Antenatal counselling, Exclusive breastfeeding


Tripathy AK, Mishra L, Bakhshi S, Arya LS. Breast feeding and

childhood hematological malignancy. Indian J Pediatr


Kramer MS, Kakuma R. Optimal duration of exclusive

reastfeeding. Cochrane Database Syst Rev 2004;(3):CD003517

American Academy of Pediatrics, Work Group on Breastfeeding.

Breastfeeding and the use of human milk. Pediatrics


US Department of Health and Human Services. Developing

Objectives for Healthy People 2010. Washington, DC: US

Department of Health and Human Services, Office of Disease

Prevention and Health Promotion; 1997.

Cunha AJ, Leite AM, Machado MM. Breastfeeding and pacifier

use in Brazil. Indian J Pediatr 2005;72:209–12.

Ertem IO, Votto N, Leventhal JM. The timing and predictors of the

early termination of breastfeeding. Pediatrics 2001;107:543–8.

Taveras EM, Capra AM, Braveman PA, Jensvold NG, Escobar

GJ, Lieu TA. Clinician support and psychosocial risk factors

associated with breastfeeding discontinuation. Pediatrics


Kuan LW, Britto M, Decolongon J, Schoettker PJ, Atherton HD,

Kotagal UR. Health system factors contributing to breastfeeding

success. Pediatrics 1999;104(3). Available at:


Philipp BL, Merewood A, Miller LW, Chawla N, Murphy-Smith

MM, Gomes JS, et al. Baby-friendly hospital initiative improves

breastfeeding initiation rates in a US hospital setting. Pediatrics


Su LL, Chong YS, Chan YH, Chan YS, Fok D, Tun KT, et al.

Antenatal education and postnatal support strategies for

improving rates of exclusive breast feeding: randomised

controlled trial. Br Med J 2007;335:596–612.

Sikorski J, Renfrew MJ. Support for breastfeeding mothers.

Cochrane Database Syst Rev 2004;(4):CD001141.

Gagnon AJ, Dougherty G, Jimenez V, Leduc N. Randomized

trial of postpartum care after hospital discharge. Pediatrics


Escobar GJ, Braveman PA, Ackerson L, Odouli R, ColemanPhox K, Capra AM, et al. A randomized comparison of home

J Ayub Med Coll Abbottabad 2012;24(2)

http://www.ayubmed.edu.pk/JAMC/24-2/Owais.pdf 119

visits and hospital-based group follow-up visits after early

postpartum discharge. Pediatrics 2001;108:719–27.

Graffy J, Taylor J, Williams A, Eldridge S. Randomised

controlled trial of support from volunteer counsellors for mothers

considering breast feeding. BMJ 2004;328:26.

IYCF Policy and Programme: Information support


Alexander JM, Grant AM, Campbell MJ: Randomized controlled

trial of breast shells and Hoffman’s exercises for inverted and

non-protractile nipples. Br Med J 1992;304:1030–2.

Singh D, Kumar A, Ravichander B. Breastfeeding and antenatal

preparation: (Letter). Medical Journal Armed Forces India


Bhandari N, Bahl R, Mazumdar S, Martines J, Black RE, Bhan

MK. Effect of community-based promotion of exclusive

breastfeeding on diarrhoeal illness and growth: a cluster

randomized controlled trial. Lancet 2003;361:1418–23.

Fein SB, Roe B. The effect of work status on initiation and

duration of breastfeeding. Am J Public Health 1998;88:1042–6.

Chopra M, Piwoz E, Sengwana J, Schaay N, Dunnett L, Sanders

D. Effect of a mother-to-child HIV prevention programme on

infant feeding and caring practices in South Africa. S Afr Med J


Shankar AV, Sastry J, Erande A, Joshi A, Suryawanshi N,

Phadke MA, et al. Making the choice: The translation of global

HIV and infant feeding policy to local practice among mothers in

Pine, India. J Nutr 2005;135:960–5.

Dhandapany G, Bethou A, Arunagirinathan A, Ananthakrishnan

S. Antenatal counseling on breastfeeding —is it adequate? A

descriptive study from Pondicherry, India. International

Breastfeeding Journal 2008;3:3–5.

Labarere J, Gelbert-Baudino, Ayral A, Duc C, Berchotteau M,

Bouchon N, et al. Efficacy of Breastfeeding Support by Trained

Clinicians during an Early, Routine, Preventive Visit: A

Prospective, Randomized, Open Trial 0f 226 Mother-Infant

Pairs. Pediatrics 2005;115:139–46.

Taveras EM, Li R, Grummer-Strawn L. Opinions and practices

of clinicians associated with continuation of exclusive

breastfeeding. Pediatrics 2004;113(4). Available at:


Taveras EM, Li R, Grummer-Strawn L. Mothers’ and clinicians’

perspectives on breastfeeding counseling during routine

preventive visits. Pediatrics 2004;113(5). Available at:




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