PROFORMA FOR REGISTRATION OF SUBJECT

FOR DISSERTATION

SAVANT BHANUDAS KUNDALIK

I Year M.Sc (Nursing) PEDIATRIC NURSING

2008-2009

THE KARNATAKA COLLEGE OF NURSING.

12-KOGILU MAIN ROAD, YELAHANKA

BANGALORE.

Rajiv Gandhi University of Health Sciences KarnatakaCurriculum Development Cell

PERFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. Name of candidate and address

SAVANT BHANUDAS KUNDALIK12 Kogilu Main Road,

Yelahanka, Bangalore-64.

2. Course of study and subject M.Sc(Nursing) Pediatric Nursing

3. Date of admission to course 29-11-2008

4. Title of the topic

A STUDY TO EXPLORE THE

KNOWLEDGE AND ATTITUDE

REGARDING WEANING AMONG

MOTHERS OF INFANTS IN SELECTED

HOSPITALS AT BANGALORE WITH A

VIEW TO DEVELOP A INFORMATION

BOOKLET ON WEANING.

5. Statement of the problem

A STUDY TO EXPLORE THE

KNOWLEDGE AND ATTITUDE

REGARDING WEANING AMONG

MOTHERS OF INFANTS IN SELECTED

HOSPITALS AT BANGALORE WITH A

VIEW TO DEVELOP A INFORMATION

BOOKLET ON WEANING.

6. BRIEF RESUME OF THE INTENDED WORK

6.1 INTRODUCTION

In the first year of life, infants undergo periods of rapid growth when good

nutrition is crucial. In fact, nutrition in the early years of life is a major determinant of

healthy growth and development throughout childhood and of good health in adulthood.1 

Breastfeeding is an excellent way to feed your baby in the early months and breast

milk continues to be the best food for baby's first year. It is a complete food for the baby

because it contains many immune cells which help the baby fight germs and infections

without first falling ill. It also creates a psychological security and bond between the

mother and child. Babies on mother milk are less likely to be overweight as adults than

the one fed on formula feeds. The incidence of diabetes and intestinal diseases is also

much lesser in a breast fed child.1

Breast milk does provide all the nutrients that a baby needs for healthy

development in the first six months of life. But after the first few months, your baby's

needs are no longer met entirely by breast milk. Around the age of six months, solid food

should be introduced. This is called Weaning the baby. Weaning, as the word indicates, is

the process of transition from a purely milk based intake of the child (i.e. weaning away

from) to a semi solid diet for the child.1

Weaning a baby from the breast is a big change for mothers as well as for babies.

Besides affecting you physically, it may also affect you emotionally. Some mothers feel a

little sad to lose some of the closeness that breast-feeding provides.1

Weaning should be started at a suitable time. Mixed feeding may be introduced

early into an infant's diet (say from 2 months after birth) depending on the infant's growth

pattern. Also, it's easier to get babies accustomed to new foods earlier than when they

grow older. However, weaning should definitely start around 3 months.2

NEED FOR THE STUDY

The most appropriate length of the breastfeeding period has often been a subject

of controversey. “Particularly in third world countries, length of breastfeeding may have

a major influence on child mortality and morbidity. Some authors have found a beneficial

effect of breastfeeding into the second year of life, or even into the third year in special

situations. Others have recommended that children should breastfeed no longer than 18

months due to a negative impact on nutritional status among children who breastfeed for

more than 18 months.3

The relationship between prolonged breastfeeding and nutritional status of young

children in developing countries has been subjected to debate for the last 10 years. Many

cross sectional studies have reported lower weight-for-age, height-for-age and weight-

for-height among breastfed children compared to weaned children between the ages of 12

and 36 months .4

Using data from the Demographic Health Surveys (DHS) carried out in 19

developing countries, it was recently reported that children who were breastfed beyond

the first year of life were shorter and lighter compared with non-breastfed children.8

Most of the studies that have examined this question, including the large and

representative DHS, are limited by their cross-sectional design which does not allow

examination of temporal relationships between full weaning and under nutrition. 5

The infant feeding practices have their roots in ill-defined socio-cultural pattern,

religious beliefs, superstitions and taboos prevalent in every social group. The knowledge

is passed down the generations from mothers to daughters and by observation of ladies in

the neighbourhood. However, mere acquisition of knowledge does not guarantee that it

will be effectively utilized. Attitudes have a very important role to play in determining

whether the knowledge is applied or not. Unfortunately attitudes have remained the

'Cinderella' of health educators. Studies on attitudes regarding infant feeding not assessed

using standard accepted scientific methodology. No wonder that most health education

programmes remain localized to the level of imparting knowledge. No attempt is made to

either assess attitudes or change them, with the result that the beneficiaries fail to

transform the knowledge into actual practice.6

Exclusive breastfeeding is currently recommended in developing countries for the

first 4-6 months. With appropriate complementary food, the continuation of breastfeeding

is recommended for up to 2 years or more. Prolonged breastfeeding has been associated

with improved child survival. However, the value of breastfeeding for nutritional status

beyond 12 months has recently been questioned. No benefit to nutritional status and

poorer nutritional status among breastfed versus fully weaned children aged 12 months or

older.7

6.2 REVIEW OF LITERATURE.

The literature reviewed for the present study is organized and presented under

following headings:

A. Knowledge an attitude of mothers regarding weaning and breast feeding

B. Knowledge and practice of mothers regarding weaning and breast feeding

A. Knowledge and attitude of mothers regarding weaning and breast feeding:

Reliance on full breastfeeding alone for a longer time could have deleterious

nutritional and health implications at later stages of children’s lives. About 47% of

children are weaned at age 6 months and more than 50% of children in India under 4

years are stunted. Study investigated the association between timing of weaning and

stunting of children in India, using the data from National Family Health Survey, 1992–

1993. Logistic analyses were employed on pooled data comprising one state each from

six regions of India (N = 6285) with height status of children aged 2–4 years as the

dependent variable. Timing of weaning was considered as the main control variable in the

regression models. Results showed that Children weaned at age 6 months and after 6

months were more likely to be stunted at later age compared with those weaned before 6

months (P < 0.001). Stunting appeared to be considerably lower for children weaned at

age 3 months and showed an upward trend thereafter. The effect of age at weaning on

stunting attenuated but persisted with statistical significance after controlling for

important demographic, health, social and region variables. The likelihood of stunting

was 77% for children weaned at age >6 months who had not received full immunization

in the first year and had lived in poor conditions. It was concluded that timing of weaning

is significantly associated with stunting among children in India. The underlying causal

associations between weaning behaviour and growth retardation need to be further

examined by using longitudinal data.8

In many developing countries, breastfed children have a lower nutritional status

than those weaned from 12 months of age. Reverse causality, which is, earlier weaning of

healthy and well-nourished children, is a possible explanation. Maternal reasons for early

and late weaning were investigated in a cohort of 485 rural Senegalese children using

structured interviews during two rounds at the ages of 18–28 and 23–33 months,

respectively. Length, weight and height were assessed, and dates of weaning were

monitored. Results showed the mean duration of breastfeeding was 24.1 months. Two-

thirds of mothers of breastfed children under 2 stated that they would wean at the age of

2, while for breastfed children aged 2 years, a ‘tall and strong’ child was the most

prevalent criterion. The main reasons for weaning prior to 2 years (N = 244) were that the

child ate well from the family plate (60%), that the child was ‘tall and strong’ (46%) and

maternal pregnancy (35%). The main reasons for weaning later than the age of 2 were: a

‘little, weak’ child (33%), food shortage (25%), illness of the child (24%) and refusal of

family food (14%, N = 120). Children breastfed above the age of 2 because they were

‘small and weak’ had lower mean height-for-age and a greater prevalence of stunting than

children breastfed late for other reasons (P < 0.0001). Concluded that the habit of

postponing weaning of stunted children very likely explains why breastfed children have

lower height-for-age than weaned children in this setting.9

The primary objective of this report is to use data from a study of infant growth

and weaning practices in Kathmandu, Nepal, to investigate universal recommendations

about exclusive breast-feeding up to 6 months postpartum. A secondary objective is to

demonstrate the complexity of the biocultural nature of infant feeding practices. A

sample of 283 children under 5 years of age and their 228 mothers living in a peri-urban

district of Kathmandu participated in this study. The children’s height/length and weight

were measured three times over 9 months. At each session, a demographic, child health

and infant feeding survey was administered; between sessions, in-depth interviews were

conducted with mothers regarding infant feeding practices. While a few of the infants

under 2 months were receiving non-breast milk foods, at 3 months of age half of the

sample had been introduced to non-breast milk foods and by 7 months all infants were

eating non-breast milk foods. A comparison of growth indices and velocities between

exclusively and partially breast-fed infants from birth to 7 months of age shows no

evidence for a difference in nutritional status between the two groups. Although there are

cultural rules about breast-feeding that vary by ethnic group, all mothers followed a

feeding method that depended on their assessment of whether the child was getting

enough breast milk. The conclusion is that exclusive breast-feeding up to 6 months may

not be appropriate for all infants. In this sample, breast-feeding duration is not shortened

by the early introduction of non-breast milk foods, as the median age of breast-feeding

cessation is 36 months. One of the main reasons for severance was the onset of another

pregnancy. Investigation of infant feeding practices must be contextualized in the local

ecology of the population. While cultural beliefs about breast-feeding are relevant,

mothers’ individual assessments of their children’s nutritional needs and demographic

events in parents’ lives must also be considered.10

Infant feeding and weaning practices were investigated in a survey of 328 mothers

living in 38 villages in the semi-arid Jaipur district (Rajasthan State, India). 81% of

mothers were illiterate and 65% were engaged in agriculture or livestock. Only 23% of

mothers initiated breast feeding within 24 hours of delivery and 77% discarded

colostrum, depriving their infant of important nutrients. More common was the

withholding of breast milk for the first 2-3 days of life. 65.2% of mothers gave jaggery

water as a prelacteal feed; another 33.2% offered tablets containing jaggery, ghee, and

ajawain. 9.1% of mothers introduced supplementary foods before 3 months of age, 15.6%

of mothers introduced these foods at 3-6 months of age, 36.0% began supplementation at

6-12 months, and 24.1% waited until after 12 months of age. The mean age at food

supplementation initiation was 8.7 months--far beyond the recommended time of 4-6

months. The most common supplementary foods were milk, rabadi, rice, and roti. Most

mothers breast fed for at least 2 years (mean age at weaning, 27 months), in part because

of poverty and in part due to inadequate knowledge of child nutritional needs. During

prolonged breast feeding, mothers did not increase their own caloric intake. The feeding

practices identified in this study are presumed responsible for the high rates of

malnutrition among infants and preschool children in the area.11

A study To assess compliance with Department of Health guidelines on weaning

practice in a representative sample of 127 infants from Glasgow, and to identify factors

influencing timing of weaning. Questionnaires on feeding and weaning were completed

during home visits. Ninety eight mothers completed a further questionnaire on attitudes to

weaning. Results showed that Median age at introduction of solid food was 11 weeks

(range 4-35 weeks); only 7% of infants had not been weaned before age 4 months. There

was no difference in timing of weaning between boys and girls. Younger mothers (< 20

years old), those of lower socioeconomic status, and those who formula fed their infants

tended to introduce solids earlier. Infants who were heaviest before weaning were weaned

earlier. Seventy three of 98 mothers reported that they weaned their babies because they

felt that they required more food. Sources of information influencing time of weaning

were previous experience (53/98), books and leaflets (43/98), advice from the health

visitor (31/98), and family and friends (15/98). Sixty five of 98 mothers reported

receiving formal information on weaning, in most cases (54) this was from the health

visitor. Mothers who received formal information tended to wean their infants later. Two

per cent of infants had been given cow's milk as a main drink by age 6 months, 17% by

9 months, and 45% by the end of the first year.12

93 mothers from low socioeconomic status families with at least 2 pre-school

children were selected from villages in Aswan, Assiut, Dakahlia and North Sinai in

Egypt. A structured open-ended questionnaire was used to obtain details of beliefs and

practices regarding introduction of complementary food and weaning. Few mothers

practiced introduction of complementary foods before age 3 months (10.8%). The

majority of children from Aswan and Assuit were introduced to complementary food at

12-18 months. In Dakahlia and North Sinai, the majority were introduced to

complementary food at 6-9 months. There were wide variation in foods given. No mother

stopped breast-feeding before their child was 6 months of age. In Dakhalia and North

Sinai the majority of mothers weaned the child at 18-24 months and most mothers in

Assuit and Aswan weaned at 24-36 months. All the mothers weaned rather abruptly. It

was concluded that to improve health and nutritional status of young children, mothers

should be encouraged to breast-feed for not less than 24 months and to correct and

improve complementary feeding practices.13

B. Knowledge and practice of mothers regarding weaning and breast feeding:

A growing body of literature suggests that prolonged breastfeeding (typically

defined as beyond the first year of life) may be a risk factor for malnutrition. To examine

the extent to which continued breastfeeding is a risk factor for malnutrition, a study used

multiple regression techniques to relate current breastfeeding status to weight and stature

in children <36 months old whose mothers participated in one of 19 Demographic and

Health Surveys (DHS) conducted between 1987 and 1989. Results showed that the data

from 9 of 11 countries outside sub-Saharan Africa (SSA) indicated that among older

children, those still breastfed are shorter and lighter than those no longer breastfed. These

differences, which reached statistical significance in five countries, become apparent at

12–18 months of age. In contrast, in live of eight SSA countries, younger still breastfed

children are significantly shorter and lighter than those no longer breastfed, but the

differences are largely diminished among older children. These basic patterns were not

altered by adjustment for family sociodemographic characteristics, health care utilization,

and recent child illness. Concluded that important differences in nutritional status

associated with continued breastfeeding are observed throughout the developing world,

and are not likely due to confounding by family sociodemographic characteristics, health

care utilization or recent child illness. A unifying interpretation of the observed

relationships is that child size is somehow related to the decision to wean, and that

whereas in SSA, the biggest children are weaned first, in non-SSA countries, the smallest

children are weaned last. 14

A descriptive cross sectional study on mothers' knowledge and practice related to

weaning was conducted in Butajira in 1994. A total of 1543 mother-child pairs were

included in the study, of which 1052 (68%) children were on weaning diet and 491 (32%)

were exclusively breast-feeding. Among children who were already weaned, 40% were

reported to have been started on weaning food at the age of 4-6 months. Of the children

who were reported to be exclusively breast-feeding, 34% were beyond the age of 7

months. The most commonly used weaning food were cow's milk, adult food, sorghum

water and cereal gruel in descending order and the most important reasons for mother to

start weaning were reduction of the amount of breast milk and mothers' belief that the

child is at the right age to start weaning food. The majority of the mothers used "swallow

or suffocate" method in feeding their children, though cups and bottles were also

mentioned as important feeding methods. The study demonstrated the presence of

inappropriate weaning practice in the area, which needs appropriate intervention.15

In India, health workers interviewed 123 mothers of infants attending the child

health clinic of the S.K. Institute of Medical Sciences in Srinagar to determine whether

maternal knowledge and practice were associated with the nutritional status of the

infants. 28 children were considered to be well nourished, while the remaining 95

children were determined to be in various degrees of malnutrition. Mothers whose infants

were well nourished had a higher level of breast feeding knowledge than did those whose

infants were moderate to severely malnourished. None of the mothers of malnourished

infants had an excellent score on breast feeding practices. Differences in the mean score

values for breast feeding practices between all consecutive grades of nutrition were

significant. The only mothers who had an excellent score for infant weaning awareness

were 3 mothers whose infants had an excellent nutritional status. A significant difference

in mean score values for knowledge of infant weaning between mothers of well

nourished infants and grade I malnourished infants as well as between those of grade II

malnourished infants and grade III malnourished infants were significant. Little

difference in infant nutritional status existed between mothers who scored fair and those

who scored poor, but, among mothers of well nourished infants, those who scored well

were more likely to be have infants of good nutritional status than those who did not

score well. These findings show a decreasing trend between awareness and practice of

breast feeding/infant weaning; suggesting that further improvement of health education is

needed to reduce the lag between breast feeding awareness and practice.16

A Cross sectional study to assess the knowledge and weaning practices of mothers

of infants in the Shah Di Khohi, Lahore for a period of 6 months 300 mothers were

identified having infants aged 4 months to 1 year. One hundred mothers were selected by

systematic random sampling that were interviewed and observed for weaning practices in

the area of Shah Di Khohi, Lahore. Their education and socio-economic status was also

recorded. Results showed that a total of 100 mothers of infants aged 4 months to 1 year

were interviewed for weaning practices. Twenty four percent were house wives and 78%

were working women. Those who Commercial formulae were used by 58% and 20%

used home made foods for weaning. Working Women (97%) started weaning at 6 months

and 45% house wives started weaning at 4-6 months. Thirty nine percent of the mothers

gave weaning diet for improving growth while 27% gave it as a tradition. It was

concluded that weaning practices were not adequate due to a number of reasons,

including poverty, poor educational status of mother and lack of knowledge about how,

when and what to give. Breastfeeding practices were also not optimal.17

6.3 STATEMENT OF THE PROBLEM

A study to explore the knowledge and attitude regarding Weaning among mothers

of infants in selected hospitals at Bangalore with a view to develop a information

booklet on Weaning.

6.4 OBJECTIVES OF THE STUDY

1. To assess the knowledge of mothers regarding weaning.

2. To assess the attitude of mothers regarding weaning.

3. To determine the relationship between knowledge and attitude of

mothers regarding weaning.

4. To determine the association of knowledge regarding weaning among

mothers with their selected personal variables viz, mother’s; age,

education, occupation, family income and number of children.

5. To determine the association of attitude regarding weaning among

mothers with their selected personal variables viz, mother’s; age,

education, occupation, family income and number of children.

6. To develop information booklet.

6.5 OPERATIONAL DEFINITIONS

1. Knowledge: It refers to amount of information or awareness of the mothers

about weaning, which is evaluated in terms of correct response to knowledge item

given in structured questionnaire and compared in terms of knowledge scores.

2. Attitude: It refers to the general feeling or a frame of reference around which a

mother organizes knowledge towards weaning which is measured in terms of

expressed responses of weaning to structured questionnaire.

3. Infant: A male/female child aged 1 to 12 months.

4. Weaning: Weaning, which is often referred to as "mixed feeding", proceeds in

stages from liquids to solids, and from one method of feeding to another.

5. Information booklet: It refers to the written information guide regarding the

weaning, its importance and benefits.

6.6 ASSUMPTIONS

Mothers will be having some knowledge regarding Weaning.

Mothers will be less aware regarding the weaning

Well prepared information media can be effective one for mothers to improve

their knowledge and attitude about weaning.

6.7 DELIMITATIONS

Study is limited to

This study is delimited to selected hospitals at Bangalore.

Delimited to only to mother

6.8 PROJECTED OUT COME

HYPOTHESES

H1 There will be significant relationship between the knowledge and attitude of

mothers regarding weaning.

H2 There will be significant association between knowledge regarding weaning

among mothers and their selected personal variables.

H3 There will be significant association between attitude regarding weaning among

mothers and their selected personal variables.

MATERIALS AND METHODS

7.1 SOURCE OF DATA COLLECTION

Setting: Selected Hospitals at Bangalore.

Population Mothers of infants.

7.2.1 SAMPLING CRITERIA

Inclusion Criteria

Mothers of infants at selected hospitals

Mothers who are available during data collection period.

Mothers who can understand and respond in Kannada and/or English and/or

Hindi.

Those mothers who were willing to participate in the study.

Exclusion criteria:

Mothers of infants who are not willing to participate in the study.

Mothers who can not understand and respond in Kannada and/or English

and/or Hindi.

7.2.2 RESEARCH DESIGN

The research design adopted for the study is explorative design.

7.2.3 VARIABLES UNDERSTUDY

The variables of the study were

Knowledge about Weaning

Attitude towards Weaning

These variables are inter dependents that is to say that having knowledge about the

weaning aids in positive attitude.

The other variables included were the selected personal variables viz. mother’s; age,

education, occupation, family income and number of children.

7.2.4 SETTING OF THE STUDY

Selected Hospitals at Bangalore.

7.2.5 SAMPLING TECHNIQUE

Non-probability Convenient sampling will be used

7.2-6 Sample Size

The sample size proposed for the present study is 50

7.2.7 TOOL OF RESEARCH

The data collection tool in the study consisted of three parts:-

(1) Proforma for socio – demographic data.

(2) Structured knowledge questionnaire

(3) Attitude scale.

7.2.8 COLLECTION OF DATA

A formal administrative permission will br obtained from the administrative

heads of selected hospitals in Bangalore city.

An informed consent will be obtained from the respondent indicating their

willingness to participate in the study.

The study samples will administered with structured knowledge questionnaire

and attitude scale along with Proforma for socio-demographic data.

7.2.9 METHOD OF DATA ANALYSIS AND INTERPRETATION

Both descriptive and inferential statistics will be used in this study.

Percentage, mean, median and Standard Deviation will be computed to analyze

the knowledge score and attitude score.

Frequency and percentage distribution will be computed to analyze the selected

personal variables.

Karl Pearson’s correlation (r) will be computed to analyze relationship between

the knowledge and attitude scores.

Chi square will be used to analyze the association between knowledge score and

the selected personal variables.

Chi square will be used to analyze the association between attitude score and the

selected personal variables.

7.3 Does the study require any investigation or intervention to be conducted on

patients or other humans or animals” If so please describe briefly ?

No, intervention is not present in the study.

7.4 Was ethical clearance been obtained from your institution in case of 7.3?

Yes, informed consent will be obtained from the Special schools authorities and

subjects. Privacy confidentiality and anonymity will be guarded.

8. LIST OF REFERENCE

1. Dr. Sharma Shikha. Nutri- health Information Book, New Delhi; page no: 25-31.

2. Marie Stella. Dietician. Weaning- its importance in child care. 2003; pg no: 21-25.

3. Marianne S Jakobsen, Morten Sodemann, Kare Molbak and Peter Aaby. Reason for

Termination of Breastfeeding and the Length of Breastfeeding. International

Journal of Epidemiology. 1996; (25)1; 115-121. Kirsten B

4. Simondon and Francois Simondon. Mothers prolong breastfeeding of

undernourished children in rural Senegal. INTERNATIONAL JOURNAL OF

EPIDEMIOLOGY 1998;(27) 490-494.

5. Wafaie W Fawzi, M Guillermo Herrera, Penelope Nestel, Alawia El Amin and

Kamal A Mohamed. A longitudinal study of prolonged breastfeeding in relation to

child under nutrition. INTERNATIONAL JOURNAL OF EPIDEMIOLOGY

1998:27.255-260

6. Manorama Verma, Vandana Saini, Tejinder Singh. Attitudes of future Mothers

regarding Infant feeding. INDIAN PEDIATRICS. 1995 (32); 429-432.

7. Adelheid Onyango, Kristine G Koski and Katherine L Tucker. Food diversity

versus breastfeeding choice in determining anthropometric status in rural Kenyan

toddlers. INTERNATIONAL JOURNAL OF EPIDEMIOLOGY 1998:27.(4): 484-

489.

8. Sabu S Padmadas, Inge Hutter and Frans Willekens. Weaning initiation patterns and

subsequent linear growth progression among children aged 2–4 years in India.

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY; 2002; 31:855-863.

9. Kirsten B Simondon, Régis Costes, Valérie Delaunay, Aldiouma Diallo and

François Simondon. Children's height, health and appetite influence mothers'

weaning decisions in rural Senegal. INTERNATIONAL JOURNAL OF

EPIDEMIOLOGY. 2001; 30:476-481.

10. Tina  Moffat.  A biocultural investigation of the weanling’s dilemma in Kathmandu,

Nepal: do universal recommendations for weaning practices make sense? Journal of

Biosocial Science. 2001;(33)3:321-338 Cambridge University Press.

11. Singh MB, Haldiya KR, Lakshminarayana J. Infant feeding and weaning

practices in some semi-arid rural areas of Rajasthan. J INDIAN MED

ASSOC. 1997 Nov; 95(11):576-8, 590.

12. Shirley-Anne H Savage, John J Reilly, Christine A Edwards and John V G A

Durnin. Weaning practice in the Glasgow longitudinal infant growth study.

ARCHIVES OF DISEASE IN CHILDHOOD 1998;79:153-156.

13. Hassanyn, S. A. M. Complementary feeding and weaning practices in four

governorates in Egypt. Eastern Mediterranean Health Journal. 2006; 20(3) 122-124.

14. Laura E Caulfield, Margaret E Bentley and Saifuddin Ahmed. Is Prolonged

Breastfeeding Associated with Malnutrition? Evidence from Nineteen Demographic

and Health Surveys. INTERNATIONAL JOURNAL OF EPIDEMIOLOGY. 1996

(25) 4: Pp. 693-703

15. Bekele A and Berhane Y. Weaning in Butajira, south Ethiopia: a study on mothers'

knowledge and practice. ETHIOPIAN MEDICAL JOURNAL. 1998 Jan; 36(1): 37-

45.

16. Bhat IA, Shah GN, Dhar GM and Mehnaz S. A study on the impact of maternal

knowledge and practice on the nutritional status of infants. INDIAN JOURNAL OF

MATERNAL AND CHILD HEALTH, 1992 Jan-Mar;3(1):12-15.

17. Muhammed Khalil (Khalil M), Junaid Rashid, Mallik M Nazir Khan and Ahmed

Zaheer. Assessment of knowledge and practice regarding weaning among mothers

of infants 4-12 months of age in a semi urban population.PAK PAED JOURNAL.

2005; Mar 29(1):9-14.

9. SIGNATURE OF THE CANDIDATE

10 REMARKS OF THE GUIDE RECOMMENDED AND FORWARDED

11. NAME AND DESIGNATION OF (IN BLOCK LETTERS)

11.1 GUIDE MRS. RAJESHWARI

11.2 SIGNATURE

11.3 CO-GUIDE(IF ANY)

11.4 SIGNATURE

11.5 HEAD OF DEPARTMENT MRS. RAJESHWARI

11.6 SIGNATURE

12.1 REMARKS OF THE CHAIRMAN AND PRINCIPAL

RECOMMENDED AND FORWARDED

12.2 SIGNATURE