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ASSESS THE KNOWLEDGE ATTITUDE AND PRACTICE

REGARDING BREASTFEEDING AMONG PRIMI MOTHERS


S.No. CONTENT
1. INTRODUCTION
 Need for the study
 Statement of the problem
 Objectives
 Operational Definitions
 Hypothesis
 Assumption
 Projected Outcome
II. REVIEW OF LITERATURE
III. RESEARCH METHODDLOGY
 Research Design
 Setting of the Study
 Population
 Sample and Sampling Technique
 Criteria for sample selection
 Instrument
 Validity of the Tool
 Data collection procedure
 Plan for data analysis
IV. DATA ANALYSIS AND INTERPRETATION
V. DISCUSSION
VI. SUMMARY, CONCLUSION, IMPLICATION
RECOMMENDATION AND LIMITATION
VII. BIBLIOGRAPHY
RESEARCH CHAPTER – I
INTRODUCTION
Breastfeeding is the ideal from of feeding in the neonate.Artifical feeding
exposes the infant to infection and results in over a million death annually world
wide due to its illeffects.
World breast feeding week is August first week(1-7days)
The Care for a child needs to begin is the first few hours of life with
exclusive breast feeding and appropriate interventions at 4-6 months in the form of
timely complementary feeding.
Exclusive breast feeding for 6 months means that the infant receives only
breast milk from her mother on expressed breast milk who other foods or drinks
with the exception of drops or medications, during this time and after 6 months
breast feeding should continue for 24 hrs or more along with appropriate
complementary feedings.
Good nutrition is one of the basic components of health and as particulars of
optimal child development survival and maintenance of health through our life.
The nutritional and health status of infants depends mainly on the feeding
practices of the community. Early life is a period of rapid growth with the weight of
infant doubling by 6 months and tripling by one year of age
(Dr.Riten Kumar, 2004)
Infants constitute 3% of India’s population and through their chances of
survival have improved by nearly 50% in the last 20 years the infant mortality
rate(IMR) of India is 74/1000 live births, much higher than the IMR of the
development world which stands at 8/1000 live births. Many low cost measures like
immunization exclusive breast feeding growth monitoring.
All New born who cry soon after birth and do not show any signs of illness
must be kept close to their mother and put to the breast soon after birth. This will
ensure warmth initiation of breast feeding and emotional bonding-Breast feeding
should be initiated within the first hour after birth .
Exclusive breast feeding will saves lives of many babies by preventing malnutrition
infection like diarrhoea
(S.S.PRABHVDEVA)
Breast feeding Promotion Network of India(BPNI) 2002, says, infants
aged (0-5)months who are not breastfed have seven fold and five fold increased risk
of death from diarrhoea compared with infants who are exclusively breastfeed. At
the same age, non exclusive breast feeding results in more than two fold creased risk
of dying from diarrhea .Infants aged 6-11 months who are not breast fed also have
been an increased risk of such deaths.
The 10th five year plan of Government of India (2003-2007) had set a
target to increase exclusive breast feeding rate to 80% during first 6 months from
the current level of around 40.5% and increased rate initiation of breast feeding
within one hour to 50% from the current level of about 15% and increased rate of
complementary feeding from 33.5%to75% to reduce infant and childhood mortality
and improve health and development of infants and young children.
There is a crucial window of opportunity provide the support and information
necessary for breast feeding. One of the more commonly used breast feeding
assessment tool is called the “ LATCH” tool .This tool is utilized to assess the
mother and infant by further identifying areas where assistance is needed. The
components of this tools assess.
L : The infants Latch
A : Available swallowing
T : The mother’s type of nipple
C : Comfort with breastfeeding
H : Infant hold
(Dr.Mrs.S.KAMALA,Dr.Mrs.JEYAGOWRI,
Dr.Mrs.KALAVATHI,Dr.Mrs.GANDHIMATHI ,2008)
They have A to Z about breast feeding
The following will give complete array of information about breast milk and
its benefits to babies
A - Anaemia
B - Bonding
C - Colostrum
D - Dehydration
E - Easiness
F - Feed
G - Growth
H - High risk babies
I - Immunological
J - Jaw development
K - Kids problems
L - Long term benefits
M - Mental development
N - Nutritional advantages
O - Obesity
P - Pain
Q - Quicker brain growth
R - Respiratory infections
S - Sudden death syndrome
T - Type II diabetes
U - Urinary Tract infections
V - Vaccine
W - Warm chain
X - Exactly
Y - Your baby
Z - Zero waste

Ensure exclusive breast feeding during first 6 months of life , additional


water is not necessary even in summer.
Breast feeding should be continued during diarrhea as well as other illnesses
It help’s the baby to get optimal nutrition and recover from the illness faster.
NEED FOR THE STUDY
Currently only 31% of Indian mothers practices demand feeding must be
practised by educating mothers regarding breast feeding inorder to improve the
health of the mother and the baby.
The mother of today has adopted to the recent trends of life style replacing
traditional ones. There are many changes one of which is changes in cultural
diversity and the majority of mothers (68.3%) breast feed on the day of delivery
while 31.6% of mothers rejected colostrums as bad for the child, whereas 81.3%
considered it is good.
Recent study from Ghana found that 22% of deaths new borns would have
been prevented of new borns started breast feeding, with in one hour of birth
,irrespective of whether they were exclusively breast feed later or not. Extrapolating
the data to other countries, the same researches estimated that if 99% of infants
started breast feeding on the first day of Life a total of 867,000 lives could be saved
worldwide and if they started breastfeeding within one hour of birth, then 31% of
all neonatal death could the prevented, which amounts to 1,117,000. India can save
its 2,50,000 babies annually by just one action..
STATEMENT OF PROBLEM :
A Study to assess the knowledge , attitude and practice regarding
breastfeeding among primi mothers in Government Hospital at Dharapuram.
OBJECTIVES :
To assess the demographic variables of primi mothers .
To assess the knowledge regarding breast feeding among primi mothers
To assess the attitude regarding breast feeding among primi mothers.
To assess the practice regarding breast feeding among primi mothers.
To correlate the knowledge attitude regarding breast feeding among
primi mothers.
To find out the association between the knowledge regarding breast feeding
among primi mothers with their demographic variables.
OPERATIONAL DEFINITIONS :
ASSESS :
It means the process of collecting, organizing,validating and recording data.
In the study, the knowledge of primi mothers regarding breast feeding is assessed.
KNOWLEDGE :
Information gained through experience on education. It refers to correct
response of the primi mothers regarding breast feeding which is measured by
structured questionairre.
ATTITUDE :
It means mental stance that is composed of different beliefs, usually
involving a positive or negative judgements towards a person, object or idea . In this
study it refers to the attitude of breastfeeding among primi mothers which is
measured by 3 point likert scale.
PRACTICE:
It means the way of doing something. In this study if refers to the practice of
breast feeding among primi mothers which is measured by observational check list.
BREASTFEEDING:
Breastfeeding is the feeding of an infant or young child with breast milk
directly from human breasts.
PRIMI MOTHERS:
Primi mothers is the one who has given birth for the first time.
ASSUMPTIONS:
 Primi mothers have inadequate knowledge regarding breast feeding
 Primi mothers are not aware of proper techniques of breast feeding.
 Primi mothers will vary in breast feeding practice according to socio cultural
factors.
LIMITATIONS:
 Sample size is limited to 30
 The study is limited to the primi mothers admitted in Government Hospital,
Dharapuram.
PROJECTED OUTCOME:
This study helps to assess the knowledge about breast feeding of the primi
mothers in Government Hospital at Dharapuram.
This study will help the primi mothers to analyse the importance of breast
feeding and it techniques.
It helps to improve the level of knowledge, attitude and practice of breast
feeding among primi mothers in Government Hospital, Dharapuram.
CHAPTER – II
REVIEW OF LITERATURE
This Chapter includes review of literature for this study which is organized
under the following headings.
PART – I
Overview of breast feeding
PART –II
Studies related to breast feeding
PART- I
OVERVIEW OF BREASTFEEDING:
It is the ideal form of infant feeding and is crucial for life long health and
well being. Breast feeding is the birth right of every baby .Nature has so designed
that when a baby is born a readymade food in the form of breast milk flows like
divine nectar. Breast feeding is natural and instinctive every mother want to
breastfeed her baby and she must the provided with necessary guidance every
mother can successfully breastfeed and provide a best start in life to her baby.
DEFINITION OF EXCLUSIVE BREASTFEEDING:
Only breast milk is given no other food or drink not even water is given an
infant should be exclusively breast feed for 6 months of life.
COMPONENTS OF THE BREAST MILK:
FAT:
Provides the baby with more than 50% of his caloric requirements.
LACTOSE:
There is more lactose in human milk than in any other mammalian milk,
PROTEIN:
Human milk contains has than half the amount of protein contained in cow’s
milk., but because of its easy digestibility it provides the baby with the ideal
quantity.
VITAMIN –A
Mature human milk contains 280 international units(IU) of vitamin A if
vitamin A and colostrums contains twice that amount cow’s milk contains only 180
IU
VITAMIN –D
It is now believed that both water soluble and for soluble vitamin D are
present in human milk.
VITAMIN –E
Human colostrument is rich in vitamin E and the levels in mature human
milk are higher than in cow’s milk.
VITAMIN-K
This vitamin is essential for the synthesis of blood clotting factors. It is
present in human milk and absorbed efficiently.
VITAMIN B COMPLEX:
All of the B Vitamins are present at levels which believed to provide the
baby with his necessary daily requirements.
VITAMIN –C
Human milk contains 43mg/100ml is vitamin C compared with 21 mg/100ml
in fresh cow’s milk.
IRON
Normal full term babies are usually born with a high hemoglobin level (16-
22g/dl ) which decreases rapidly after birth.
ZINC
This trace mineral is essential to humans. A deficiency may result in failure
to thrive and typical skin lesions.
OTHER MINERALS
Human milk has significantly lower levels of calcium, phosphorus ,sodium
and potassium than cow’s milk.
OTHER IMPORTANT PROPERTIES
IMMUNOGLOBULINS:
IgA ,IgG, IgM, and IgD are all found in human milk.
LYSOZYME:
LYSOZYME Is present in breast milk in concentrations 5000 times greater
than in cow’s milk.
LACTOFERRIN
LACTOFERRIN Is abundant in human milk but is not present in cow’s
milk
THE BIFIDUS FACTOR:
THE BIFIDUS FACTOR in human milk promotes the growth of gram-
positive bacilli in the gut –flora ,particularly Lactobaccillus bifidus,which
discourages the multiplication of pathogens.
ANTI-ALLERGIC FACTORS:
Allergic problems occur less frequently in breastfeed babies than in bottle
fed babies.
TECHNIQUES OF BREASTFEEDING:
 Mother should take bath daily and wear clean cloths.
 Mother should clean her breast and hands before starting the feed.
 Mother should sit comfortable position .The baby head should be elevated.
 Identify cues for breastfeeding (Rooting, Sucking, hand to mouth
movement).
 Hold the infant close facing the breast with chest.
 Start feeding the baby before becomes hungry.
 Support the breasts in the palm of her hands allowing the nipple to pay
through the index and the middle fingers into the infants mouth.
 The infant should drawn both the nipple and areola in to her mouth.
 The baby’s nose should not be obstructed the breast tissues.
 Change the breast with each feed
 Allow him to suckle at one breast for 10-15 minutest or more.
 End the feed by introducing a finger in between corner of the mouth of infant
breast tissues to break the suction to avoid injury the nipple.
 Do not keep the baby in supine position. Burp the baby immediately after
feeding.
 Burp is keep the baby on the shoulders and gently tap the back to ensure
release of air from the stomach and digestion.
ADVANTAGES OF BREASTFEEDING:
BENEFITS TO THE BABY:
o Breast milk is a complete food and it provides all the nutrients a baby needs
during first 6 months of life.
o Breast milk contains a number of anti-infective substances and antibodies
o Breast fed babies are less likely to suffer from allergic disorder like asthma
and eczema
o Breast feeding provides immunological benefits to the baby for the life time.
o Breast feeding provides emotional security.
BENEFITS TO THE MOTHER:
 During breast feeding there is a release of oxytocin to eject the milk,
oxytocin helps to contract the uterus.
 Breast feeding delays ovulation and onset of menstruation.
 Breast feeding is convenient
 Breast feeding helps to maintain and regain the pre pregnancy body weight.
 Mothers who breast feed their babies have a reduced risk of development of
breast and ovarian cancer.
SORE AND DAMAGED NIPPLES:
It is due to trauma from the baby’s mouth and tongue which results from
incorrect positioning baby’s mouth to the breast
ENGORGEMENT:
The breasts are hard ,painful and sometimes flushed.
MASTITIS:
It means inflammation of the breast
BREAST ABSCESS:
A fluctuant swelling develop in a previously inflammed area.
LONG NIPPLE:
It leads to poor feeding
INVERTED AND FLAT NIPPLE
Initiates lactation by expressing the milk.
PART – II
STUDIES RELATED TO BREAST FEEDING
Okolo S.N(1999) conducted on current breast feeding knowledge , attitude
and practices of mothers in five rural communities in the savannah region of
Nigeria. The knowledge attitude and practice regarding breast feeding among 310
mothers in five rural communities in Toto local Government in Nassarwa state.
‘Nigeria were investigated using a questionnaire.162(52.3%) were illiterate while
148(47.7%) had either primary or secondary school education. Apart from giving
babies colostrums, which was seen amongst with higher levels of educations
(P<0.001) other practices investigated such as exclusive breast feeding, demand
feeding” rooming in” and time of first breast feeding and time of breast feed were
not influenced by the mothers level of education. All mothers attended the antenatal
clinic but only 103(33.3%) received instructions from the health worker on breast
feeding and 46.8% delivered at home. Only 28.6% of babies were breast feed with
in 24 hours of birth.
A mean time after birth for the first breast feeding was 47.7 hours. Although
breastfeeding is widely practiced, none of the babies was exclusively breasted and
prelacteal feeds ranging from water. formula. The practice of discarding colostrums
and replacing if with a wide range of prelacteal feeds and late initiation of breast
feeding has implication for health education programmes and neonatal feeding
strategies.
Nanthine Subbaish (2000) conducted a study to arrears the knowledge
attitudes, practice and problems of post natal mothers regarding breast feeding in a
selected hospital at Madurai, revealed that majority of the samples had sufficient
knowledge of breastfeeding like importance of breast milk, benefits feeding from
both the breasts , diet of lactating mother’s prevention of breast engorgement, etc.,
They have positive attitude towards breast feeding practices.
Bellegio guidelines (2000), summarises that the maximum spacing effect of
breast feeding is achieved when a mother fully breast feeds and these remains
amenorrhic, that is she does not menstruate. Full breast feeding entails providing an
infant with no other food or liquid but breast milk. when these two conditions are
met, breast feeding provides more than 98% protection from pregnancy during the
first 6 months breast feeding not only delays ovulation but also reduces the
likelihood of conception
Worldege brief. A (2002) “Mother’s knowledge and brief on breast feeding.
A cross sectional survey was conducted to assess the knowledge and belief of
mothers towards breast feeding the study was carried out on 317 mothers with new
born. The conventional cluster sampling technique was utilized to select the study
subjects. Almost all mothers 308 (92%) of them considered human milk is best milk
for good child growth compared to cow’s milk.
A higher population proportion 253(80%) mothers considered breast milk
alone sufficient enough to feed a baby up to the age of six months. The majority 310
(97%) suggested not to breast feed when a mother gets pregnant . Three quarters of
mother’s prefer red hot to breast feed when the mother’s get sick. Concluded that
though mother’s value breast milk as the best child fed. Their knowledge and breast
towards breast feeding the child when the baby / mother gets sick and the mothers
gets pregnant is very poor. These are potentially harmful effects, which could lead
to the dangerous practice of abrupt cessation. These harmful should we well
addressed and minimized though continues health education
Rinda John (2003) conducted descriptive study on knowledge, attitudes and
practice of employed mothers about breast feeding. The main objective of the study
to determine knowledge, attitudes and practice of breast feeding. The major results
showed that the level of knowledge shows that 28% of the sample had poor
knowledge ,57% of the mothers had average knowledge and only 15% had good
knowledge regarding breast feeding. The mothers has higher means. percentage
73% knowledge score in the area of benefits of breast feeding. Which is essential
Gulbin G. etal in Turkey (2002) conducted a study aimed at comparing the
first year growth of infants who had received different feeding regimens throughout
the first 4 months. Anthropometric measurements of 332 infant during a well baby
clinic wore analyzed. The infants were divided into 4 groups exclusively
breastfeed, predominantly breastfeed, practically breastfeed and non breast feed.
Exclusively breast feed infant were significantly healthier in the first two months of
life compared to partially breastfeed or non-breastfeed infants. Weight and length
measurement of the predominantly breastfeed infant were almost identical to those
of the exclusively breast fed group at all ages.
Ogbonna C, Daboer, J.C. (2007), conducted cross sectional study on
knowledge and practice of exclusive breast feeding among mother’s in Jos, Nigeria.
The target population of interest was nursing mothers who have infants aged 6-12
months,pretested structured closed ended interviewer questionnaire was used.. Four
hundred and seventy nursing mothers consented were recruited for the study through
a house to house visit. 2 female and 1 male were recruited and trained on the
questionnaire administration. Results showed that out of the 470 nursing mothers
studied 387 were able to define correctly exclusive breast feeding. Targeting
adolescents for exclusive breast feeding education and sensitization is necessary in
preparing them for motherhood
Shilaja. K.G. (2008) conducted study to assess the knowledge and
confidence of prim Para mothers regarding exclusive breast feeding in post natal
units of selected hospitals.
CHAPTER – III
RESEARCH METHODOLOGY
RESEARCH METHODOLOGY:
This chapter deals with methodology adopted for the study. If includes
research approach, research design, setting sample and sampling technique,
instrument, data collection procedure and plan for data analysis
RESEARCH APPROACH:
The research approach adopted for the study was survey approach
RESEARCH DESIGN
The research design for the present study is a descriptive design which is one
of the non-experimental design.
SETTING OF THE STUDY
The study was conducted in Government Hospital. Dharapuram. It is a
Government Hospital. The samples were selected from the maternity ward.
POPULATION
The population of the study is 30 primi mothers.
CRITERIA FOR SAMPLE SELECTION
INCLUSION CRITERIA
1. Primi mothers
2. Mothers who knows tamil language
3. Mothers who are willing to participate in the study
EXCLUSION CRITERIA
1. Multi mothers
2. Mothers who are not willing to participate
SAMPLING TECHNIQUE
Convenient Sampling techniques used to select the samples.
SAMPLE SIZE:
The sample size included for the study consist of 30 primi mothers
INSTRUMENT AND SCORING PROCEDURE
DESCRIPTION OF THE TOOLS
The tool consist of 4 sections;
SECTION – 1
It deals with demographic data such as age, family monthly income, religion,
type of family, educational status, occupation, type of food, media like television,
radio, newspaper, etc.,
SECTION II
This section consist of 20 short answer questions to assess the knowledge of
primi mothers regarding breastfeeding for each correct response score “1”was given
and for the incorrect response ‘0’ score was given. The total score selected was 20.
SECTION III
This section consist of 10 questions to assess the attitude of breasr milk
regarding breastfeeding. for this 3 point likert scale was used to assess the attitudes.
SECTION IV
This section was observed using a check list consist of 10 questions to assess
the practice of primi mothers regarding techniques, each question has ‘yes’ or ‘No’
response. For each correct response score ‘1’ was given and for each incorrect
response score ‘0’ was each total score was 10.
SCORING PROCEDURE
PART – II: structured questionnaire on knowledge
It consist of 20 questions. A score of “1” for each correct response and
‘0’ for each incorrect response. The total score is 20.
VALIDITY OF THE TOOL AND RELIABILITY:
The validity of the tool was established in consultation with the guide the tool
was modified according to the suggestions and recommendations of the guide

DATA ANALYSIS PLAN


S.No. Data Analysis Methods Remarks
1. Descriptive Frequency Percentage To describe the demographic
Statistics variables of primi mothers
Frequency Percentage To assess the attitude
knowledge & Practice
regarding breastfeeding
among primi mothers
Correlation To Correlate the knowledge
and attitude of primi mothers
regarding breastfeeding.
2. Inferential Statistics Chi-Square To find out the association of
demographic variables with
knowledge scores of
breastfeeding among primi
mothers

PROTECTION OF HUMAN SUBJECTS:


The proposed study was conducted after the approval of college dissertation
committee. Consent was obtained from Nursing superintendent and Dean of
Government Hospital, Dharapuram. Verbal consent got obtained from the primi
mothers before the data collection. The information was kept confidential.
Mothers were interviewed by the researcher in the maternity ward those who
met the inclusion criteria were selected by using convenience sampling.
The investigator gave a brief introduction, collected demographic variables.
The knowledge was assessed by using structured interview schedules and data was
collected for 3 to 4 mothers in a day. The same procedure was continued up to 30
samples.
DATA ANALYSIS:
Descriptive and inferential statistics were used for data analysis. The
collected data were tabulated and analyzed using descriptive and inferential
statistical methods. The statistical method used for data analysis frequency,
percentage, correlation and chi square test
CHAPTER –IV

DATA ANALYSIS AND INTERPRETATION

This chapter deals with the description of sample, characteristics, analysis


and interpretation of data collected from primi Para mothers regarding exclusive
breastfeeding in Government hospital, Dharapuram
The present study was designed to assess the knowledge, attitude and
practice of primi Para mothers regarding breastfeeding. The collected data was
organized and interpreted using descriptive and inferential statistics and was coded
and analysed as per objectives of the study under the following headings.
ORGANIZATION OF DATA:
The data has been described and organized as follows:
SECTION - A : Distribution of demographic variables of mother
SECTION – B : Assessing the knowledge, attitude and practice
Regarding breast feeding among primi mothers
SECTION – C : Correlation of knowledge and attitude of primi
mothers regarding breastfeeding
SECTION – D : Association of knowledge scores of primi mothers with
their selected demographic variables.

SECTION – A DISTRIBUTION OF DEMOGRAPHIC VARIABLES OF


PRIMI MOTHERS.
Table 1 : Frequency and percentage of demographic variables of primi mothers
S.No. Demographic Variables Frequency Percentage
1. Age of mothers
a).18 – 25 yrs 23 76.66%
b). 26 – 30 yrs 7 23.34%
c).31 – 35 yrs - -
d) above 36 - -
2. Religion
a) Hindu 24 80%
b).Christian 3 10%
c). Muslim 3 10%
d).others - -
3. Type of family
a).Nuclear family 15 50%
b).Joint family 15 50%
4. Education
a).Higher Education 20 66.67%
b).Primary Education 4 13.33%
c).Secondary Education 3 10%
d).Illiterates 3 10%
5. Occupation
a).House wife 27 90%
b).Private Sector - -
c).Government Sector - -
d).Coolie 3 10%
6 Type of food
a).Vegetarian 7 23.33%
b).Non-vegetarian 23 76.67%

Table 1
showed that distribution of primi mothers by demographic variables
Regarding age among 30 primi mothers 23(76.67%) were belongs to 18-25
years age group 7(23.33%) mothers were belong to age group of 26 – 30yrs

90
80
PERCENTAGE

70
60
50 18-25 YRS
40 26-36 YRS
30
20
10
0
18-25 YRS 26-36 YRS
AGE

Percentage distribution of 30 primi mothers regarding breastfeeding


according to their age.
Regarding religion among 30 mothers 24 (80%) were Hindus 3 (10%) were
Christian ,3 (10%) were Muslim.
90
80
Percentage 70
60
Hindu
50
Christian
40
Muslim
30
20
10
0
Hindu Christian Muslim
Religion

Percentage distribution of 30 primi mother regarding breast feeding according to


their religion .
Regarding type of family among to primi mother 15 (50%) were Nuclear family
and 15 (50%) were joint family.

Joint Family

Nuclear Family

15(50%) 15(50%)
Nuclear family
Joint family

Type of Family

Percentage distribution of 30 primi mother regarding breast feeding according to their type
of family.

Regarding education among 30 primi mother 4 (13.33%) had primary education 20


(66.67%) had higher secondary education 3 (10%) had secondary education 3(10%) were
illiterates.
80

Percentage
70 Higher Education
60
50 Primary Education
40
30 Secondary Education
20
10 Illiterate
0

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P

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Type of Education

Percentage distribution of primi mother recording crest feeding according to their


education.
Regarding Occupation among 30 primi mother 27(90%) were housewives and 3
(10%) were coolie.

100
90
80
70
Percentage

60
House Wife
50
Coolie
40
30
20
10
0
House Wife Coolie
Type of Occupation

Percentage distribution of primi mother recording breastfeeding according to their


occupation
Regarding type of food among primi mother 23 (76.67%) were non-vegetarian
and 7 (23.33%) were vegetarian.
76.67% Non-Vegetarian

Vegetarian
23.33%
Vegetarian

Non-Vegetarian

Type of Food

Percentage distribution of primi mother regarding breastfeeding according to


their food habit.

SECTION –B ASSESSING THE KNOWLEDGE


ATTITUDE, AND PRACTICE REGARDING BREAST FEEDING
AMONG PRIMI MOTHERS
Table : 2 Frequency and percentage distribution mean and S.D of primi mother
knowledge regarding breastfeeding .
N = 30
CATEGORY KNOWLEDGE MEAN S.D
Frequenc percentage
y
Adequate 26 86.67
(67-100%)
Moderately adequate 4 13.33 14.43 5.61
(34 – 66%)
Inadequate
(0 – 33%) - -
100
90 86.67%
80
70
Percentage

Adequate knowledge
60
50
40 Moderately Adequate
30 knowledge
20
10 13.33%
0
Adequate knowledge Moderately
Adequate knowledge
Level of Knowledge

Percentage distribution of primi mother recgarding breastfeeding according to their level of


knowledge.

Table 3 :
Frequency and percentage distribution mean and S.D of attitude regarding
breast feeding among primi mothers .
N= 30
Level of attitude Attitude Mean S.D
Frequency Percentage
Favourable attitude 20 66.67
(68 – 100%)
Moderately Favourable 24.6 1.07
10 33.33
attitude
(34 – 67%)

- -
Un Favourable attitude
(0 – 33%)
80
66.67%
70
60
Percentage

50 Favourable Attitude

40 33.33%
Moderate favourable
30
attitude
20
10
0
Favourable Attitude Moderate favourable
attitude
Level of Attitude

Percentage distribution of primi mother regarding breast feeding according to


their attitude.
Frequency and percentage distribution mean and S.D of practice regarding
breastfeeding among primi mothers.
N= 30
Category Practice Mean S.D
Frequency Percentage
Satisfactory 20 66.67%
(67-100%)
Moderately 10 33.33% 8.5 4.45
Satisfactory
(34-66%)
Unsatisfactory - -
(0-33%)
80
66.67%
70
60
Percentage

50
Satisfactory
40 33.33%
Moderately Satisfactory
30
20
10
0
Satisfactory Moderately
Satisfactory
Level of Practice

Percentage distribution of primi mothers regarding breastfeeding according


to their practice.
SECTION – C CORRELATION OF KNOWLEDGE AND ATTITUDE OF PRIMI
MOTHERS REGARDING BREASTFEEDING
Group Mean Correlation

Knowledge 14.43 0.929


Attitude 24.63

Showed that the knowledge and practice correlation is calculated as 0.929


which is significant.
It shows that there is correlation between knowledge and attitude regarding
breastfeeding among primi mothers.

SECTION – D ASSOCIATION OF KNOWLEDGE SCORES OF PRIMI


MOTHERS WITH THEIR SELECTED DEMOGRAPHIC VARIABLES
Table.5: Association between level of knowledge and demographic variable
N = 30
S.No. Demographic Variables Inadequate Moderate Adequate Chi Table
square Value
F % F % F % x2
1 Age
18-25 yrs - - 8 26 8 26 2.26(NS) 3.841
26-30 yrs - - 5 16 9 30
31-35yrs - - - - - -
above 36 yrs - - - - - -
2. Religion
Hindu - - 6 20 9 30
Christian - - 3 10 6 20 2.76(NS) 3.841
Muslim - - 3 10 3 10
Others - - - - - -

3. Type of family
Nuclear family - - 10 33. 15 50
3
Joint family - - 2 6 3 10 2.45(NS) 3.841
4. Education
Primary Education - - 4 13 4 13
Secondary Education - - - - 2 6
Higher Education - - 6 20 10 33 3.92(S) 3.841
Illiterate - - 2 6 2 6
5. Occupation
House Wife - - 10 33. 5 16
3
Private Sector - - - - - -
Government Sector - - - - - - 2.6(NS) 3.841
Coolie - - 2 6 3 10
6. Type of Food
Vegetarian - - 2 6 3 10
Non-Vegetarian - - 11 37 14 47 2.181(NS) 3.841

S- Significant NS- Not Significant

There was no association found between knowledge score when scored to


age, occupation, type of family, religion and type of food. However significant
association found between knowledge scores of primi mothers with their education
CHAPTER –V
DISCUSSION
This chapter attempts to discuss the findings of the study as per objectives
these findings are discussed under the following headings.
 Demographic characteristics of the primi mothers regarding breast feeding
 Assess the knowledge, attitude and practice regarding breast feeding among
primi mothers.
 To find the correlation between the knowledge and attitude regarding breast
feeding among primi mothers
 To find the association between the knowledge score of primi mothers with
their selected demographic variables.
Demographic characteristics of the primi mothers regarding breast
feeding.
According to age among primi mother 23(76.67%) belongs to 18-25 years of
age group 7(23%) mothers belongs to age group of 26-30 yrs.
According to religion among primi mothers 24(80%) were hindus,3(10%)
were Christians and 3(10%) were Muslims.
According to type of family 15(50%) are nuclear family and 15(50%)
belongs to joint family.
According to education among primi mothers 20(66.67%) are higher
education 4(13.33%) are primary education, 3(10%) had secondary education
3(10%) were Illiterates.
According to occupation 27(90%) were house wives 3(10%) were coolie.
According to type of food 7(23.33%) were Vegetarian 23(76.64%) were non-
Vegetarian.
Assess the knowledge regarding exclusive breastfeeding among primi
mothers.
Data analysis shows that 26(86.67%) primi mothers had adequate
knowledge,4(13.33%) primi mothers had moderately adequate knowledge regarding
breastfeeding.
Assess the attitude regarding exclusive breastfeeding among primi
mothers.
Data analysis showed that 20(66.67%) had favorable attitudes, 10 (33.33%)
had moderately favourable attitude regarding breastfeeding.
Assess the practice regarding breast feeding among primi mothers.
Data analysis showed that 20(66.67%) adequate practice, 10 (33.33%) had
moderately adequate practice regarding exclusive breastfeeding.
To find the correlation between the knowledge and attitude of primi
mothers regarding breast feeding.
There is correlation between knowledge and attitude regarding breastfeeding
among primi mothers and is calculated as 0.929 which is significant.
The find the association between the knowledge scores of primi mothers
with them selected demographic variables.
Data analysis showed that the chi-square values were calculated. The study
shows that there was statistically significantly association between knowledge of
breastfeeding with their education (3.92) and there was no association found
between knowledge score when compared to age, occupation, type of family, type
of food and religion.
CHAPTER – VI
SUMMARY, CONCLUSION, IMPLICATION
RECOMMENDATIONS AND LIMITATIONS
The chapter is divided into five aspects
 Summary of the study
 Conclusion
 Implication for Nursing
 Recommendations
 Limitations
SUMMARY OF THE STUDY:
The study was done to assess the knowledge, attitudes and practice regarding
breast feeding among primi mothers.
The research approach and design used for this study was descriptive
approach and non-experimental design was selected for the study conducted at
Government hospital, Dharapuram. The sample size was 30 primi mothers.The
sample were selected by convenience sampling method and were assessed for
knowledge, attitude regarding breastfeeding observed the practice of breast feeding.
The data of demographic variables were analyzed by using descriptive
statistics ( frequency and percentage) chi square test was used to find out the
association of selected demographic variables with their knowledge. Score
regarding exclusive breast feeding among primi mothers.
The Major findings are summarized as follows
o Higher percentage 23(76.67%) of primi mothers regarding breastfeeding was
in the age group of 18-25 years.
o Majority of primi mothers 20(66.67%) had higher secondary education.
o Most of the primi mother were house wives 27(90%)
o Half of the primi mothers (15(50%) belongs to nuclear family and 15(50%)
belongs to joint family.
o 24(80%) of the mothers belongs to Hindu 3(10%) of the mothers belongs to
Christian and 3(10%) of the mothers belongs to muslim.
o Highest percentage of mothers 23(76.64%) belongs to non-Vegetarian.
o 26(86.67%) of primi mothers had adequate knowledge 4(13.33%)of primi
mothers had moderately adequate knowledge regarding breast feeding.
o 10(33.33%) primi mothers has moderately favourable attitude 20(66.66%)
primi mothers had favourable attitude regarding breast feeding.
o 10(33.33%) primi mothers had moderately adequate practice 20(66.67%)
primi mothers had satisfactory practice regarding breast feeding.
CONCLUSION
The study findings revealed that there was a significant association between
the knowledge attitude and practice with their educational level.
IMPLICATION FOR NURSING
NURSING SERVICE:
 Nursing personnel is in the best position to provide this descriptive study of
primi mothers.
 The findings has enlighten that there has been adequate knowledge, attitude
and practice regarding breastfeeding.

NURSING RESEARCH:
This study findings can be effectively utilized by the emerging researchers
for their reference purposes.
The findings of study helps to expand scientific body of professional
knowledge upon which further researches can be conducted.
RECOMMENDATIONS:
 A Comparative study can be conducted between primi mothers and multi
gravida mothers.
 Similar study can be conducted for mothers who undergo caessarean section.
 A comparative study can be conducted between caessarean mothers and
mothers who delivered normally.
LIMITATIONS:
It was time consuming for the investigator which took 40 -60mts to interview
the sample.
BIBLIOGRAPHY
Books:
Arun Gupta at all (2001) Breast feeding and complementary feeding
Delhi BPNI Publication.
Chandra (2004) Promotion of Breast feeding Delhi Elbs Publication.
Elizabeth (2005) Nutrition and child development Chennai paras
medical publisher.
Marlow R.Dorothy and Barbara(2006) Text Book of Paediatric Nursing
( 6th edition) philadelphia W.B.Saunder’s company.
Park.k (2003) Preventive and social Medicine(19th edition) Jabalpur,
Banarsidis Bhanot publications.
Piyush Gupta(2004) Essential paediatric Nursing (I - Edition) New
Delhi) – A.P. Jainand Co publications.
Suraj Gupta(2005) The short Textbook of paediatrics (7th edition)
New Delhi Jaypee brothers.
Wong L.Donna (2005) Nursing care of Infants and children ( 7th
edition) Missouri Mosby publications)
Tambulwadker (1993) paediatric Nursing ( I edition) Bombay vora
Medical Publications.
JOURNALS:
• Baghorts.P(2007) Breast feeding self efficacy midwifery Dec.23
Pg..382-391
• Chertok J.R. (2006) Breast feeding initiation among post caessarean women
of the Neger Israel British Journal of Nursing Feb-March 2008
Pg 205
• Hoddincott P.et al (2006) “ Effectiveness of breast feeding peer coaching
intervention is rural Scotland Birth 2006 March:33(27-36)
• Spear AJ (2004) Attitude knowledge and beliefs related to the promotion of
breast feeding among women Journal of Paediatric Nursing June 19
Pg 176-183.
PART - I
DEMOGRAPHIC VARIABLES

1. Age of the mother _____________________


a) 18 – 25 Years b)26 – 30 Years
c) 31 – 35 Years d) 36 and above

2. Religion of mother _____________________


a) Hindu b) Christian
c) Muslim d) Other

3. Type of Family __________________


a) Nuclear Family b)Joint Family

4. Education of the mother______________


a) Illiterate b) Primary
c) Secondary d) Higher Secondary

5. Occupation of mother __________________


a) Housewife b) Private Sector
c) Government Sector d) Coolie

6. Type of food _______________________


a) Vegetarian b) Non – vegetarian
QUESTIONNAIRE ON KNOWLEDGE

1. Which food is best for newborn baby?


a) Breast Milk b) cow’s milk
c) Artificial Food d) Home made milk
2. When to start breastfeeding for the baby?
a) After 30 minutes b) After 5-6 hours
c) 2-3 hrs after delivery d) after one day
3. What is colostrum ?
a) first breast milk b) exclusive breast milk
c) secretes after 5 days d) Secretes after 2 weeks
4. Why colostrum is needed for the baby?
a) To maintain immunity b) To promote growth of the baby
c) as a food d) since baby is in demand
5.which is best method of feeding?
a) bottle feed b) Breast feed
c) Spoon feed d) Baladai
6.what is the colour of colostrum ?
a) Lemon yellow b) Red
c) Black d) Green
7. What is the best position for mother while feeding?
a) side lying b) sitting position
c) standing position d) prone position
8. what will you do after feeding the baby ?
a) Do burping b) Give bath
c) Make to sleep d) Cradle the baby
9. How long breast feeding should be continued?
a) Upto 1 year b) 1-1 ½ years
c) 1 ½ -2 year d) >2 years
10. How long the exclusive breast milk can be give?
a) First 6 months b) First 2-3 months
c) First 8 months d) Upto 1 year
11. what is the interval for each breastfeeding ?
a) 5-10 minutes b) 10-15 minutes
c) 20-30 minutes d) 30-50 minutes
12. How many times breast feeding can be given during day time?
a) 4 times b) 6 times
c) 10 times d) 12 times
13. How much is the stomach capacity of the new born?
a) 30 ml b) 40-60 ml
c) 10 ml d) 50 ml
14. What type of nutrition is best for lactating mothers?
a) Protein rich diet b) Iron rich diet
c) caloric rich diet d) calcium rich diet
15. What is the outcome of breast feeding?
a) Malnourished baby b) Healthy baby
c) Unhealthy baby d) Diseased baby
16. What is the nutrition present in breast milk?
a) Vitamins b) Minerals
c) Protein and fat d) Protein, fat and vitamin
17. What are the measures taken before giving breastfeeding?
a) Wash the breast with water
b) Wash with soap & solutions
c) Not to clear
d) Expose the nipples to air on sunrise
18. what is the colour of stool during exclusive breastfeeding?
a) Green coloured b) Shaw coloured
c) Golden yellow coloured d) Brown coloured
19. How many times the baby passes urine during exclusive breastfeeding ?
a) 4-6 times b) 2-3 times
c) 5-7 times d) 6-8 times
20. What are the method to improve secretion of breast milk?
a) 1 cup of milk or juice or any liquid food should be taken before breast
feeding
b) keep the breast clean
c) walking for a long time
d) Taking healthy food
CHECK LIST ON PRACTICE
S.No Question Yes / No
1. During breastfeeding the mother
should sit comfortably
2. After feeding the mother should
take the baby for bathing
3. During breastfeeding the mother
should maintain eye to eye contact
and talk with the baby
4. Breastfeeding should be given
with an interval of 20 minutes in
each breast
5. Burping should be done after each
feeds
6. Taking fruit juices or milk before
feeding the baby
7. Breast milk should be given on
breast engorgement
8. Wash each breast with warm water
before breast feeding
9. Awakening the baby while breast
feeding
10. While feeding the baby the other
breast should be massaged
ATTITUDE SCALE
SELF ADMINISTERED QUESTIONNAIRRE
S.No Statements Agree Uncertain Disagree
1. Do you think breast feeding helps
in mother and child bonding?
2. Breast feeding can prevent
diseases affecting breast
3. Breastfeed affect the beauty of
feeding mothers
4. Mother should not feed the child
when she has diarrhea
5. High calorie diet is taken by all
mothers at the time of lactation.
6. Colostrum is bad for child’s
health
7. Stop breastfeeding when you start
weaning
8. Drinking water while feeding
affects breastfeeding?
9. After feeding the baby the breasts
should be cleansed
10. After feeding the baby the baby
should make to sleep
Levels of Practice Score Percentage
Unsatisfactory 0.3 < 30 %
Moderately satisfactory 4-6 30-60%
Satisfactory 7-10 60-100%

SCORING KEY
Question Number Answer Number
1 a
2 a
3 a
4 a
5 b
6 a
7 b
8 a
9 d
10 a
11 c
12 b
13 a
14 c
15 b
16 d
17 a
18 c
19 c
20 a
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