Nutritional Awareness among Lactating Indian Women

The present study was conducted to determine the consciousness of lactating women (0-6 months) towards betterment of their health. Fifty lactating women participated in this study. A structured interview method was used to collect data on demographic profile, clinical profile and dietary pattern. The data on dietary intake was taken by 24 hour recall method. The demographic profile indicated predominance of lactating women to be in the age group of 22-32 years, belonging to nuclear family and house owned by her husband. The 24 hour recall showed a better consumption pattern of pulses and milk or milk products in the diet. Physical activity was also adopted by lactating women for the betterment of their health. Consciousness among lactating women for the betterment of their health was assessed through a questionnaire. On analysis, it was concluded that they were little conscious about their health. They were consuming diet rich in fat but low in carbohydrates and proteins.


Introduction
Breast milk is produced by mammary glands located in the breast tissue. These glands are present from birth, but become fully functional for milk production only during pregnancy. Several hormones regulate the development of the mammary glands as well as the initiation and maintenance of lactation. The most important of these hormones are prolactin and oxytocin, both of which are produced in the pituitary gland in the brain. Prolactin, together with other hormones (e. g., estrogens and progesterone), regulates the final development of the mammary glands during pregnancy. After birth, the woman hormonal environment changes, and in this setting prolactin can initiate milk secretion from the mammary glands. During pregnancy, hormonal action prepares the female mammary glands to produce milk, which will continue to be produced in the postpartum period in response to the infant suckling at the breast [1].
Interventions aimed at increasing breastfeeding rates do not have to be expensive and complicated to be successful, and a successful program can have a substantial impact on the health of mother and their children [2]. Breastfeeding enhances mother and baby emotional attachment and contributes to optimal short and long term health outcomes for both. Statistically a baby who is not breastfeeding has more health care needs than its breastfed counterparts [3]. Energy or calorie needs during lactation are based upon the women's basal metabolic rate, age, activity, how much breast milk is being produced, and other factor. While calorie is needed for milk production, the mother does not need to eat substantially more than she did in her pre-pregnancy state to sustain milk production [4]. Nutrient is mobilized from maternal stores to produce breast milk and the lactating women are vulnerable to depletion of her nutrient stores. She should be encouraged to consume foods high in calcium, Vitamin A, B1 (thiamine), B2 (riboflavin), Vitamin B6, B12, folate and iodine to minimize losses and to maintain her health and wellbeing [5]. Obese mothers are more likely to have delayed lactogenesis and reduced lactation. Therefore, weight control and breastfeeding promotion should be reinforced before and during pregnancy. In overweight and obese mothers, breastfeeding should be closely monitored after birth [6].

Material and Methods
This study was conducted on 50 lactating women (0-6 months) randomly selected for assessing the common practices followed by lactating women for betterment of their health or nutritional status. The standardized pretested questionnaire consisting of closed-ended questions regarding frequency of intake of junk food, skipping meals, consumption of carbonated drinks, balanced diet and general awareness about health concern was developed and the data was recorded from selected subjects. Lactating women were examined for anthropometric measurement, biochemical parameters, clinical analysis and dietary pattern using 24 hours recall scale. The questionnaire covered demographic characteristics of the subjects. These are namely age, occupation and marital status, economic status, medications used, clinical assessment of eyes, hair, nails, teeth, skin were observed and recorded. Further, the number of symptoms experienced by each individual was compiled and percentage was calculated, involvement in drinking, smoking, restrictions in daily activities due to health problems, information regarding social life, habitual exercise etc. Anthropometric parameters included recording of weight and height. The information was further used for determination of body mass index (BMI). The haemoglobin level in the blood was measured by cyanmethemoglobin method. Clinical assessment is the oldest method and is widely used in all nutritional survey.
In clinical investigation changes in the superficial tissues, especially the skin, eyes, gums, hair, nail and buccal mucosa were seen. Dietary survey was done by 24 hour recall technique in which respondent was asked to name approximate amounts the foods eaten during the previous day at each meal and between meals.

Results
Present study was conducted to find out the consciousness among lactating women (0-6 months) for the betterment of their health (Figure 1-22). The average calorie intake of lactating women was 1986.8 kcal which was below the RDA i.e 2425 kcal because they were not consuming proper food. The intake of carbohydrates among the lactating women was little less the amount required whereas the protein intake of the lactating women was very less. The intake of fats was slightly high due to myth of increased requirement of same for speedy recovery in post-partum period (Table 1-23).             Figure 13: Out of 50 samples 4% were taking 2 meals, 12% were taking 3 meals, 68% were taking 4 meals, 12% were taking 5 meals and 8% were taking 6 or more meals in a day.

Type of family Subjects no. Percentage
Joint 17 34% Nuclear 33 66% Table 5: Total income per month.

Time duration Subject no. Percentage
In every 2 hours 42 84% In every 3 hours 8 16% In every 4 hours 0 0

Lack of time 37 74%
Meal is not tasty 9 18% Meal is not of your choice 4 8%

Summary and Conclusion
It was concluded that majority of lactating women were married and belonged to Hindu religion. Most lactating women were 12 th pass, belonged to nuclear family, with mixed income group, and in overweight category. Most of the lactating women were anaemic, were not following any special diet and skipping their meals. Majority were consuming milk, fruit in their daily life which helped in fulfilment of nutrient requirement during lactation. Most of the lactating women were conscious about their health so that they did many kind of physical activity according to their ease. It was concluded that the nutrient intake of lactating women was not fulfilled according to recommended dietary allowance because they were not taking proper food. The intake of Calorie, protein and carbohydrate was low as per the required daily allowance.