Who is responsible for artificial feeding? An evaluation.

Indian J Matern Child Health 4(2):55-8 (1993) PMID 12318488

Artificial feeding has been found to be on the increases in India. In this research study, 320 infants who were artificially fed before 6 months of age and attended the child health clinic of the Department of Community Medicine, SKIMS Srinagar, between March and November, 1991, were surveyed. Information was obtained from mothers on personnel who advised artificial feeding by type of medical care unit. The sample of mothers included 59.3% who were illiterate. 52.25% of all mothers were housewives and 43.75% had a middle socioeconomic status, while 31.5% had a low socioeconomic status. 53.75% of the artificially fed babies were born at a hospital, of which 2.5% received intensive care. 46.25% were born at home. 76.87% were first or second births. 3.55% of babies were completely artificially fed from birth; at 3 months, 18.76% were exclusively artificially fed. Mixed feeding of breast and artificial milk was 10.76% at birth and 25.97% by 3 months and 42.10% by 6 months. 51.25% of mothers were advised by pediatricians to use artificial feeding; 24.65% of mothers were advised by general practitioners and 10.31% by paramedical. 40% were advised at private clinics and 26.25% in hospital wards at the time of discharge. 18.12% were advised in outpatient departments, and 15.62% at other health centers, such as immunization clinics, health clinics, or nutrition education centers. 66.25% received recommendations to use tinned milk (Lactogen/Milk-care) and 30%, for cows milk. 45.31% of mothers received advice from pediatricians about tinned milk and 5.93% about cow's milk. 5.93% of infants received advice from general practitioners about tinned milk and 5.31 about cow's milk. Over 80% of mothers were given instructions on the amount of dilution and frequency of feeding. 60.93% of mothers received information on feeding equipment and 56.15% on sterilization of feeding equipment. Only 59.37% and 65.37% were able to understand instructions on equipment and sterilization, respectively. The reasons given by mothers for using artificial feeding were low milk output (49.68%), nonacceptance of breast milk by the baby (22.50%), working mothers (12.18%), and baby illness (8.12%). Mothers attributed infections, colic, and regurgitation to artificial feedings. Clearly, the professional community is not complying with the professional code promoted by the World Health Assembly and Indian legislation in 1986 on not recommending milk formula.