A survey of knowledge and concepts of Public Health Midwives on exclusive breast feeding, in three districts of Sri Lanka

Baby Friendly Hospital Initiative which was introduced by WHO introduced to Sri Lanka in 1992. Main mission of this program was to promote exclusive breast feeding (XBF) under which all health care staff had multiple training sessions. Public Health Midwives (PHM) are pivotal in this mission both in fields as well as in hospitals. And their knowledge on breast feeding is crucial since they are directly involved in health education and management of lactating mothers. Despite measures undertaken to disseminate and update knowledge on XBF, mis-concepts and ill practices still prevail and is a major hindrance to achieve above goal. This descriptive cross-sectional study was planned to assess knowledge and concepts of XBF among a cohort of PHMs in the government sector. 234 midwives attending CME sessions in 3 districts were assessed based on a questionnaire regarding exclusive breast feeding (XBF). Despite the satisfactory overall performance, results revealed gaps in basic knowledge and concepts of breast-feeding practices among midwives. PHMs showed satisfactory knowledge on important properties of colostrum and breast milk, management of common breast conditions during lactation and indications for EBM. However, participants knowledge on practical aspects of XBF such as frequency of breast feeding was unsatisfactory and the 45.7% did not appreciate the concept of demand feeding. This study revealed that important aspects of mis-concepts still prevail among PHMs which needs to be addressed in order to promote XBF among mothers.