Download The study was conducted calcium intake nutritional status in

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1
NAME
OF
CANDIDATE
THE Ms SUBY BOSE
AND
ADDRESS
1ST YEAR MSc. NURSING STUDENT
RAJEEV COLLEGE OF
NURSING, HASSAN, KARNATAKA.
2
3
4
NAME
OF
THE RAJEEV
COLLEGE
OF
NURSING
HASSAN,
INSTITUTION
KARNATAKA.
COURSE OF THE STUDY
MASTER OF SCIENCE IN NURSING,
AND SUBJECT
OBSTETRICAL AND GYNECOLOGICAL NURSING
DATE OF ADMISSION TO
26 - 10 -2010
COURSE
5
TITLE OF THE STUDY
“ A DESCRIPTIVE STUDY TO ASSES THE
KNOWLEDGE, ATTITUDE, AND PRACTICE ON
DIET DURING LACTATING PERIOD AMONG
PRIMI LACTATING MOTHERS IN A SELECTED
HOSPITAL AT HASSAN WITH A VIEW TO
DEVELOP AN INFORMATION BOOKLET”
5.1
STATEMENT
PROBLEM
OF
THE “ A STUDY TO ASSESS THE KNOWLEDGE,
ATTITUDE,AND PRACTISE ON DIET DURING
LACTATING PERIOD AMONG PRIMI LACTATING
MOTHERS
IN
A SELECTED
HOSPITAL AT
HASSAN WITH A VIEW TO DEVELOP AN
INFORMATION BOOKLET”
1
6. BRIEF RESUME OF THE INTENDED STUDY:
INTRODUCTION
Nutrition is a key factor in national development. The term maternal nutrition
focuses on woman as mothers on their nutritional status as it relates to the bearing and
nurturing of children1. Lactating women should not stick to any diet eat the food any
specific products. The women should have a balanced and varied menu to stay health2
The diet recommended for lactating mother is essentially the same as for
pregnant women and should include plentiful supplies of milk and alternate calcium
and protein sources .the nursing mother needs a lot of fluids to provide for the water
content of breastmilk.3
A mother’s body has undergone many physiological changes during
pregnancy ,as well as with the birth of her baby. She needs to and recover from
pregnancy and child birth. In addition to rest all mothers to need to maintain a healthy
diet to promote healing and recovery. 4
Diet plays an very important role because diet for lactating mother should help
to produce enough milk, should provide her with enough nutrients and also take care
of the mothers daily dietary requirement. It should be rich in protein, calcium,
phosphorous, iron and vitamin c.5
Eating well during pregnancy and lactation extra requires few adjustments to
general good health dietary guidelines. A woman’s needs extra calories, protein,
vitamins, minerals, and water. Each woman will require different amount of foods
providing key nutrients to achieve the desired pregnancy weight gain. Age, weight,
activity level and metabolism All influence her that how much she need to eat for
optimum weight gain health and fetal development and also breast milk production6
If you eat too little which affects lactating mother breast milk production.
When breast feeding a single baby 300to 500 calories per day should be added to the
diet when feeding for twins an extra 600to1000calories per day should be added to the
diet. Total calories intake while lactating is 2300to2500calories while single baby
and2600to 3000 calories for twins.6
2
Mother who is breastfeeding her child has to eat for two. It is essential that
she take balanced nutrious diet. In this period apart from calories and proteins there is
increased need to calcium and iron. . Optimum Nutrition is of great importance for
women, due to the special nutritional needs associated with psychological changes
such as pregnancy, childbirth, lactation .7
Included in all food groups in daily diet; are These groups are cereals, pulses,
ghee oil ,sugar, jaggery, vegetables, fruits, milk and its products. She has to consume
more nutrients containing as rich in iron like green leafy vegetables, black sesame
seeds ,jaggery ,poha she has to, consume more calcium foods containing milk and
its products white sesame seeds ,ragi guava, bajara, daily consumption of one litre of
milk in any form eg; curd yoghurt paneer, khe., foods that are rich in protein; milk,
dhal, paneer, egg white, foods rich in vitamin c; guava, lemon, orange, amla,
capsicum. In addition to the above it is compulsory for lactating mothers to have at
least 1 and half litre of water every day.
8
The defiency of these foods causes some diseases such as the maternal health
and fetal health., It includes iron deficiency anaemia , vitamin deficiency diseases.
And also calisium defiency diseases, malnutrition. And some allergic diseases affect
to the lactating mother. These diets should be included in the daily diet for the
lactating mothers to prevent the defiency diseases.
Lactation makes considerable nutritional demands on the mother . the success
of lactation as well as the health status of the infants depends on the type of diet
consumed by women during pregnancy and lactation period . the maternal diet is
significantly important during lactation . the quality and quantity of milk secretion
depends upon maternal diet.1
6.1 NEED FOR THE STUDY
All the nursing mothers/lactating mothers take only rice supplemented with little
pulses and
vegetables; milk is used in tea or in coffee. In india it is the custom to
breast feed infants for prolonged period .mothers future health as well as the baby’s
health depend on the large event on the type of diet to protects the women’s own
nutritional health.1
3
Lactation period refers to the duration when the mother breastfeeds her child.
A Nutritious dietary intake is therefore particularly important and has to be different
from a mother who has to feed her child orally. The food intake should be such that it
meets her nutritional requirements besides ensuring adequate milk production for the
baby. Inadequate food intake reduces the milk secreted and may even change the
composition. 9
Nutritional requirement for lactating mothers include extra energy, protein,
calcium, iron, vitamins and water. Energy nearly extra 550kcal for first six months
and 400kcal for during the next six months are required for a lactating mother.
Protein there is an increased requirement during this period due to milk production.
Calcium
is one of the important minerals required both during pregnancy and
lactation. Iron requirement during this period is the same as adult women about 30mg
per day fetus stores enough iron to survive for the initial 6 months after birth. During
lactation the vitamin requirement is also increased. She needs to drink 10to12 glasses
of water every day. Along with all the nutrients since there is a increase requirement
of water during lactation.10
Global studies have unequally demonstrated association between under
nutrition and increased risk of maternal and infant mortality and morbidity. Results of
small scale clinical trials of food supplementation to undernourished group suggest
that reduction in mortality and morbidity rates to improve growth in infancy could be
achieved by food supplementation.11
Certain substances in the mother`s diet could enter the milk and reach the
child`s stomach. Keeping this factor in mind, a lactating mother has to plan her diet
very well. Three glasses of milk daily is essential for the health of both the feeding
mother and the suckling baby. Lactating mothers should well be aware of the fact that
any food that causes indigestion and does not suit the mother`s system will affect the
infant and cause diarrhea, stomach ache, cold another ailments.Adequate consumption
of pulses, vegetables and milk must be ensured for proper lactation. In general sour
foods and cold drinks could be avoided.12
According to the National Institute of Health, lactating mothers need 1,500
ug/day of calcium. It is necessary to pay attention to this fact in the diet. The lactating
4
mother can consume medicine only on medical advice as these could reach the child
and cause irreparable damage.12
The India diets Tailored Diet Plan hereafter referred to as TDP has been
customized for Lactating Mothers. The Plan has been prepared after duly analyzing
the nutritional requirements of a Lactating Mother. It advises you how to keep in
check your eating habits, working on the philosophy that the right food can work
wonders not only for you but for your child as well.13
1992:
WHO consultation reported that, “Where infectious diseases and
malnutrition are the main cause of infant deaths and the infant mortality rate is high,
breastfeeding should be the usual advice given to pregnant women including those
who are HIV infected.”. A few months later, a meta-analysis of studies conducted
around the world over the previous four years was published, which estimated a
breastfeeding transmission rate of 14% from mothers infected before delivery and
29% from mothers infected after delivery.14
Nutritional problems are one of the major cause of morbidity and mortality
among infants. During infancy infant get nutrients through breastfeeding. if The
primi mothers have less knowledge regarding nutrition .They may suffer from so
many diseases while giving education to them they can modify their diet and reduce
the no of nutritional defiency disorders. So the mothers should take adequate balanced
diet to prevent diseases.
6.2 REVIEW OF LITERATURE.
Review of literature is a key step for research process. It refers to an extensive
exhaustive and systematic examination of the publications relevant to the research
project.
1 .Studies related to importance of diet during lactating mother
The study was conducted to vegetarian diets of breast feeding women in the
light of dietary recommendations. The literature review concerning selected
nutritional and health aspects of applying different vegetarian diets by breastfeeding
women was presented. The only two types of vegetarian diets: lactoovo- and semivegetarian, when properly composed, seem to be relatively safe for mother and her
5
child. The most threatening vegetarian diets for lactating women are those including
exclusively products of plant origin. The results of studies performed on mothers
consuming these vegetarian diets showed deficiencies in: vitamin B12 and vitamin D
in mothers and their infants and calcium only in lactating women. It considered that
lactating women on vegetarian diet should have a greater nutritional knowledge in
order to avoid deficiencies which would adversely affect mother's and her child's
health15.
Study was conducted to maternal vitamin A status and its importance in infancy
and early childhood. Adequate maternal vitamin A status is important for newborn
reserves and for sustaining adequate breast-milk concentrations. Vitamin A
supplements are not needed for most pregnant women in Western countries who
consume the recommended dietary allowance during their reproductive years.
Increased consumption of vitamin A-rich foods can meet increased needs during
lactation. Women in developing countries whose habitual intakes are near basal needs
should receive additional 100 micrograms retinol equivalents during pregnancy and
300 micrograms during lactation. Supplements not above 3000 micrograms daily are
safe for fertile women where circumstances preclude obtaining the needed increment
through diet. The first postpartum month is the only safe period during which to
provide deficient lactating women with a single high-dose supplement to benefit the
mother and breast-feeding infant for several months16
The postpartum period is associated with increased risk for weight gain and
weight retention, and is associated with overweight development in women (Rooney
and Schauberger 2002). In a sample of 540 healthy primarily white women, Olson et
al. (2003) found that although the average weight retained at 1 year postpartum was
1.51 ± 5.95 kg, retained weight exceeded 4.55 kg. (10 lbs.) in 25.6% of women. Also,
Rooney and Schauberger (2002) reported that although the mean weight retained at
1year postpartum centered at 1 to 2 kgs (2-5 lbs.), some women gain over 5 kg (10
lbs). Ethnic minorities (Williamson et al. 1994) and persons with low incomes are at
greater risk of excessive postpartum weight retention17
A study was conducted on Food and nutrient adequacy among selected tribal
lactating mothers in Ranchi district of Jharkhand. The socio-economic conditions, diet
and nutrient adequancy of 72 lactating tribal mothers residing in four villages of
6
Ranchi district were assessed. The study revealed that majority of households
belonged to nuclear families with medium family size and farming as their primary
occupation. Except cereal, the diet of tribal mothers were inadequate and far below
the recommended amount. Results of diet survey further showed that the per cent
adequacy of only roots and tuber and other vegetables was 94 and 82 per cent,
respectively. For rest of the food stuffs the percent adequacy was found to be between
13 to 37 per cent. Calories and protein intake was found to be 82 and 69 per cent,
respectively.18
A study was conducted Nutritional composition of traditional supplementary
foods consumed by lactating women in India's Udaipur region. To learn more about
the nutritional content of supplementary foods consumed by mothers during the 1st 3
months of lactation. A food consumption survey revealed that 6 different
supplementary food items--ajwain ka laddu, gond ka laddu, battia ka laddu, haldi
laddu, lidh ka laddu, and soth ka laddu. A nutritional analysis of these supplementary
foods indicated that a 250-gram serving is sufficient for meeting a third of the protein
and carbohydrate requirements of a lactating woman. All foods analyzed were rich
sources of iron, calcium, phosphorus, and magnesium. Of all the forms of laddu,
ajwain contained the maximum amount of protein, calcium, phosphorus, and moisture
while battia provided the most iron. The study was concluded that the diet of lactating
women is given greater attention in the immediate postpartum period than in is in later
stages of lactation.19
The study was conducted calcium intake nutritional status in lactating women.
The aim of this study was to analyze the diets of 39 healthy, lactating women (average
age = 34.3 years; average BMI = 26.2 kg/ m2) by a 24-hour dietary recall. This
investigation was focused on calcium and vitamin D intake. Nutrients were estimated
using the software Dial. These are divided into calcium restrictors, calcium intake <
1200 mg/day, and non-restrictors (> 1200 mg/day). The results showed that 64% of
the study population (restrictors) reported a mean energy intake (2042.7 +/- 458.3
kcal), calcium intake (812.4 +/- 211.2 mg/day) and vitamin D intake (1.71 +/- 1.59
microg/day) below the adequate intake level (AI) and lower than non-restrictors
estimated intakes (p < 0.01). The conclusion of this study is that a high percentage of
the lactating women consume a diet below nutritional recommendations during this
7
stage. It is recommended that health professionals should inform these mothers about
the correct dietary habits during this period.20
2 Studies related to defiency diseases for lactating women
Cross sectional study was conducted to investigate the prevalence of vitamin
A deficiency among lactating women in a poor urban population of Bangladesh.
According to this study there are total of 120 lactating women aged 17–37 years were
randomly selected from women who attended a local maternal and child health clinic
in Dhaka City. Various socio-economic, personal characteristics, dietary intakes of
vitamin A and anthropometric data were collected. Serum retinol (vitamin A)
concentration was determined as a measure of vitamin A status. Results showing that,
37% had low serum vitamin A levels with 13.3% having sub-clinical vitamin A
deficiency. 87% had vitamin A intakes below the recommended dietary allowance.
The lactating women who were received only informal education had lower serum
vitamin A levels compared with those who received formal education. The serum
vitamin A levels of women in lower than those households with good
sanitation/latrine practice. The women with one child had lower serum vitamin A
levels than those with two or more children. Women with a lactation period of 6
months or lower serum vitamin A levels than women with a lactation period of less
than 6 months. The women who consumed less than the median vitamin A intake
(274.8 μg day−1) had lower serum vitamin A levels than those who consumed more
than the median vitamin A intake. By the analysis, education level of the women,
number of living children, duration of lactation and dietary intake of vitamin A were
found to have significant independent relationships with serum vitamin A. and also
appear to be important in influencing the vitaminA status of these women. The study
was concluded that a significant proportion of poor, urban, lactating women in
Bangladesh have vitamin A deficiency21.
The study was conducted to nutritional status, dietary intake, and the
anthropometric measurements height and weight of pregnant women and lactating
mothers to assess the knowledge, attitudes and practices regarding milk use and
consumption of various products were assessed. Results showed that the subjects
surveyed presented poor consumption pictures of not only milk, but also of all other
8
foods (except cereals), which in turn reflect low nutrient intakes and poor nutritional
status. Women in all were found to be suffering from nutritional deficiencies in
vitamin A, B complex and iron. The prevalence of vitamin B complex deficiency and
anaemia was found to be slightly higher in pregnant women than lactating mothers,
On the other hand, vitamin A deficiency, characterized by conjunctival xerosis. The
study concluded that all the women had positive views about milk consumption. So
that milk is a complete food for all, and that it is vital for growing children, old and
sick people.22
A study was conducted at a large private urban hospital in the north central
United States, it is estimated that 33% of American women are high incidence of
anemia in pregnancy.
so anemia is a common complication for lactating mother.
Exploring the relationship between anemia and insufficient milk supply with 630 first
time mothers. Anemic mothers reported a higher level of symptomatology associated
with low milk supply and were more frequently classified as having insufficient milk
syndrome. Anaemic mothers reported that “not enough milk” was the main reason for
weaning. The study result suggests that anemia, an important indicator of maternal
health, is associated with the development of insufficient milk. Insufficient In this
study breastfeeding durations were shorter for anaemic than for non anemic
mothers.23
The study was conducted in a cross sectional survey in rural west java
Indonesia 155 lactating mothers and their healthy infants were assessed. Deficiencies
of vitamin A, iron, and zinc are affecting vulnerable groups such as lactating women
and infants. . The aim was to investigate the deficiencies of vitamin A, iron, and zinc
coexist and the nutritional relation between lactating mothers and their infants. In this
study blood, urine, and breast-milk samples were obtained. Results show that
Marginal vitamin A deficiency was found in 54% of the infants and 18% of the
mothers. More than 50% of the mothers and infants were anemic and 17% of the
infants and 25% of the mothers were zinc deficient. There was a strong interrelation
between the micronutrient status of the mothers and infants. Vitamin A deficiency in
infants led to an increased risk of anemia and zinc deficiency whereas in mothers the
risk of anemia and iron deficiency increased. In infants, the study was concluded that
Micronutrient deficiencies were prevalent in West Java. The micronutrient status of
9
lactating mothers and that of their infants were closely related; breast milk was a key
connecting factor for vitamin A status.24
Nutritional study was conducted to assessed the and medical status of 26
lactating women and their 2to6 months of infants. Analysis of 24-h duplicate diet
composites indicated that the mothers were consuming approximately 2100 kcal
energy/d. The diets contained approximately 62 g protein (11.6% of the calories), 392
g carbohydrate (73.3% of the calories), and 20.9 g fat (8.6% of the calories) Although
anthropometric measurements indicated that the mothers had mild protein
malnutrition and inadequate energy reserves, their infants exhibited low-normal
weight and length for age the result shows that. All the mothers had hepatitis A
antibodies; 92% had tropical eosinophilia, indicating intestinal parasites; 16% had
cheilosis and angular stomatitis, indicating a possible B-vitamin deficiency; and 8%
had elevated urinary nitrite, indicating urinary tract infection. The study concluded
that there are no unusual physical findings on the infants. Although, the mothers
showed evidence of multiple infections and possible nutrient deficiencies.25
3. EDUCATIONAL STUDIES RELATED TO DIET FOR LACTATING
MOTHER
In this descriptive study, was conducted the diet status of 104 lactating
mothers referring to khoramabad health and treatment centers. Food stuffs were
analized by N3 software and for statistic analysis SPSS software used: Results
showed that studied mothers were in good condition from view point of energy
receiving, consumption of Protein, Carbohydrate, fat and fatty acids. But they had no
good condition in consumption of mineral elements such as: Calcium, Iodine,
Magnesium, Phosphorus, Zinc and vitamins C, B9,B2 and D. More attention to the
nutrition of lactating mothers specially mineral elements and vitamins, as well as
increase in milk and dairy products intake, seafoods ,fruit and fresh vegetables or
using food compliments is recommended for them too. Study was concluded that
lactating mothers need to nutrients more than the pregnancy period, and if this
additional requirement to nutrients foodstuff isn’t meet lactation causes malnutrition
in lactating women.26
10
STATEMENT OF THE PROBLEM
“A STUDY TO ASSESS THE KNOWLEDGE ,ATTITUDE AND
PRACTICE ON DIET DURING LACTATING PERIOD AMONG PRIMI
LACTATING MOTHERS
INA SELECTED HOSPITAL AT HASSAN
KARNATAKA, WITH A VIEW TO DEVELOP
AN INFORMATIONAL
BOOKLET .”
6.3
OBJECTIVES OF THE STUDY
1.To assess the knowledge regarding diet during lactating period among primi
lactating mother.
2.To assess the attitude regarding diet during lactating period among primi
lactating mother.
3.To assess the knowledge on practise regarding diet during lactating period
among primi lactating mother.
4.To correlate the knowledge, attitude,and knowledge on practice regarding diet
during lactating period among primi lactating mother.
5. To associate the knowledge, attitude, and practise regarding diet during
lactating period among primi lactating mothers with their selected
demographic variables.
6.To prepare an information booklet regarding diet during lactating period among
primi lactating mothers.
6.3.1 HYPOTHESIS
H1: There will be a significant association between knowledge, attitudes ,and
knowledge on practice of
primi lactating mothers regarding diet during
lactating period.
6.3.2 ASSUMPTION
11
This study assumes that: 1. Primi lactating mothers will have some knowledge regarding diet during
lactating period.
2. Primi lactating mothers may have either positive or negative attitude towards
diet during for lactating period.
3. Primi lactating mothers might be practising diet.
4. The information booklet will help to improve the knowledge, attitude, and
knowledge on practise of diet during lactating period among primi lactating
mothers.
6.3.3
OPERATIONAL DEFINITION
1. Assess- It refers the organize, systematic, process of collecting information
from primi lactating mothers regarding diet during lactating period.
2. Knowledge-It refers to the correct response to knowledge questionnaire
assessed through structured interview schedule and quantified as obtained score
about diet during lactating period among primi lactating mothers .
3. Attitude- it refers to the feelings and thinking of primi lactating mothers
towards diet during lactating period as elicited by five point attitude scale.
4. Practise- it refers to the verbal response to the primi lactating mothers
regarding diet during lactating period assessed through checklist.
5. Diet during lactating period-It is a
food consumed during lactation period
among lactating mothers which includes type of food, calorie requirement, and
nutrients.
6. Primi mothers: who are the one who have given birth for the first time.
7. Information Booklet- It is an instructional material prepared by the investigator
to enhance the knowledge level regarding diet during lactating period for the
primi lactating mothers.
12
7.
7.1
MATERIALS AND METHODS OF STUDY
SOURCE OF DATA
Data will be collected from primi lactating mothers who are attending outpatient
departments in selected hospitals of Hassan. On the basis of the findings an
information booklet will be prepared regarding the diet during lactating period.
7.2
METHODS OF DATA COLLECTION-:
7.2.1 RESEARCH APPROACH: Descriptive survey
7.2.2 RESEARCH DESIGN: -The research design used is Descriptive design.
7.2.3 POPULATION
Population for the study will be primi lactating mothers who are attending
outpatient departments of selected hospitals of Hassan.
7.2.4 SAMPLES
Primi Lactating mothers who are attending outpatient departments of selected
hospitals of Hassan who fulfilled the inclusion criteria.
7.2.5 SAMPLE SIZE
The sample size for this study will be 60
7.2.6 SAMPLING TECHNIQUE
convenient sampling.
7.2.7 SELECTION OF TOOL
A structured interview schedule will be used for gathering self report
information from primi lactating mothers regarding diet during lactating period.
The response of the respondent will be marked immediately by the investigator.
The tool will be organized into 4 sections.
13
Section 1:Socio demographic variables
Section 2: Knowledge questionnaire on diet during lactating period among primi
lactating mothers.
Section 3: 5point attitude scale consisting to assess the attitude of lactating
mothers regarding diet during lactating period.
Section 4: check list to assess the knowledge on practise of lactating mothers
regarding diet during lactating period.
7.2.8
CRITERIA FOR SELECTION OF TOOL
Inclusion Criteria
1.
Primi lactating mothers who are attending outpatient departments of selected
hospitals of Hassan.
2. Primi lactating mothers who are willing to participate in the study.
3. Primi lactating mothers who were able to understand Kannada or English.
Exclusion Criteria
1. Primi lactating mothers are not willing to participate in the study.
2. Primi lactating mothers who are not present during the time of data collection.
3. Primi lactating mothers who are not able to understand Kannada or English.
7.2.9 DELIMITATION
This study is limited to:
1. 100 primi lactating mothers attending outpatient departments of selected
hospitals of Hassan.
2. Those who are willing to participate in the study.
3. 4-6 weeks of duration.
7.2.10 SIGNIFICANCE OF THE STUDY
14
This study signifies the importance of information booklet regarding the diet
during lactating period and it will enhance the knowledge, and positive attitude,
practise .for primi lactating mothers regarding good nutrious diet during lactating
period.
7.2.11
CONCEPTUAL FRAMEWORK
The conceptual framework adopted for this study is modified open system by
Janet, w. Kenny
7.2.12 RESEARCH SETTING
The study will be conducted in outpatient departments of selected hospitals of
Hassan.
7.2.13 PILOT STUDY
Pilot study is planned to conduct with 10% of sample, in selected outpatient
department of hospitals which will be excluded from the main study.
7.2.14 EXTRANEOUS VARIABLES
STUDY VARIABLES
1. Independent variables; information booklet on diet during lactating period
among primi lactating mothers.
2. Dependent variables; knowledge, attitude, and knowledge on practise of primi
lactating mothers regarding diet during lactating period.
3. Extraneous variables; such as age , age at marriage, education, religion,
occupational status, family monthly income, type of family, dietary pattern,
source of information regarding diet during lactation period.
7.2.15 PLAN FOR DATA ANALYSIS
Descriptive statistics: -The descriptive statistical analysis includes frequencies,
percentages, mean and standard deviation.
Inferential statistics: - Chi square test is used to calculate and analyze the
relationship between knowledge attitude practise scores with selected socio
demographic variables.
15
7.3 DOES THE STUDY REQUIRE ANY INTERVENTIONS TO BE CARRIED
OUT ON PATIENTS OR OTHER HUMANS?
No interventions. Data will be collected from primi lactating mothers
regarding diet during lactating period by structured interview schedule.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR
INSTITUTION?
Yes. Permission has been obtained from the research committee of Rajeev
College of nursing. Hospital authority Informed consent will be obtained from
subjects who are selected for the study.
8) LIST OF REFERENCES
1.
Amutha shoba. Diet for lactating mother; Nightingale Nursing Times.
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2.
Hripunowa. Nutrition for mothers during lactation.11 may 2011. Available site
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3.
Dugas, Introduction to patient care, A comprehensive approach, 4th edition,
Elsevier publication.
4.
http://www.drlera.com/healthy-baby/lactation.
5.
Rekha sudarshan, Diet for a lactating mother.
Available
site at
http://www.malli.in/spotlightArchives.asp?acode=A0016&actg=h.
6.
pregnancy and Lactation. Site for http://www.starknet.com/ip/nutritional
health/basic/pregnancy-guideline.html.
7.
http://www.indiadiets.com/diets/normal/diets in pregnancy.htm.
8.
Chapter 7 diet for lactating mother. http://www.drketan.com/breastfeed/
chapter 7.
9.
www. Indiadiets. Com/ shopping/health/prod/diet for lactating mother.htm.
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m.healthcare magic.com/articles/diet for lactating mothers/2008.
16
11.
Sumathi R Mudambi “Fundamentals of food and nutrition” 3rd edition, new
age international pvt. Ltd., New Delhi.
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www. Target women.com articles/healthy mother html.
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www.india diets.com/shopping/health-prod/diet for lactating mother htm.
Copy right 1999.
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www. Avert. Org/hiv-breastfeeding.
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Rocz panstwzaki hig, Zaktad zywienia, Instytutmatki, Warszawa. Vegetarian
diets for breastfeeding women in the light of dietary recommendations. Year
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A.m.j. Clin nutr; maternal vitamin A status and its importance in infancy; Who
nutrition
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Ronney BL , Schaaberger CW, excess pregnancy weight gain and long term
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Sniha R ,Lakra V , Kumari N, Sharma B. Food and nutrient adequacy among
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dairying, food and home sciences, year 2006;volume 25,issue 3&4 print
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Kaushik D , Mathews, Nutritional composition of traditional supplementary
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Sancherz ch, Rodrquez AB, Sanchez j, Gonzalez R , Rivero M, Barriga C,
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Faruk Ahammad, Asfia Azim and Mohammad Akhtaruzzaman. Vitamin A
defiency in poor, urban lactating women in Bangladesh; Camebridge journal
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17
22.
Devi .T.R; Sarojini G. Food and nutrient intake of defiencies and KAP of
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