Improving exclusive breastfeeding through effective interventional counselling in an immunisation clinic in a tertiary hospital

The study will be conducted in the Department of Neonatology and Pediatrics, Kasturba Hospital, Manipal, India. All mother-infant pairs who visit the immunization clinic at 6-8 weeks of age will be screened for eligibility. After obtaining written informed consent, those who fulfil the inclusion criteria will be included in the study. Demographic details like antenatal, birth history, feeding history, type of feeding (direct breastfeeding, expressed breastmilk, formula, or combined), and problems faced with feeding (maternal and infant related) will be noted. Breastfeeding habits will be assessed with a standard questionnaire. The mother-infant pair fulfilling the inclusion criteria will be counselled with standard counselling (Cohort 1) for the first three months of the study. In the next three months, they will be counselled using educational interventional counselling (Cohort 2). Infants in cohort 1 will receive regular standard verbal counselling per hospital protocol. Infants in cohort 2 will receive a standard educational interventional counselling session, including breastfeeding videos, brochures, pamphlets, etc. (all resources attached in a separate document titled- RESOURCES). Infants in both cohorts will be followed up in the immunization clinic at six months of age. Those who could not visit at six months of age will be contacted over the telephone. Data on breastfeeding practices, infections ( diagnosis and treatment/ recurrence of any diarrhoea, cough, Acute Respiratory Infections, pneumonia, meningitis, etc., at a clinic or hospital),  noncompliance, and problems mothers face in feeding or discontinuing exclusive breastfeeding before six months of age will be documented via a proforma. After validation, a standard breastfeeding assessment questionnaire will be prepared from pre-existing formats and applied to all Mother-Infant pairs. This questionnaire will assess feeding habits, barriers to feeding, and well-being of mother-infant pairs.