Knowledge and attitudes of Anganwadi workers about infant feeding in Delhi.

In North Delhi, India, 83 community workers (anganwadi workers) in the ICDS project Alipur participated in a survey designed to assess their knowledge and attitude about breast feeding and to identify gaps in their knowledge of breast feeding. 98.7% knew that breast feeding should be begun immediately after birth. 92.7% knew that the newborn should receive the colostrum. Only 56.6% knew that top milk should not be diluted. 93.9% correctly knew that unhygienic bottle feeds are a leading source of diarrhea and that breast feeding should be continued during a diarrheal episode. Yet 48.2% did not know that mothers with tuberculosis should continue breast feeding and that infants with a fever should continue to receive breast milk. 25.4-48% of the anganwadi workers had incorrect perceptions on breast feeding and social considerations (e.g., 31.4% considered breast feeding to be embarrassing outside the house). Only 57.8% considered breast feeding to benefit maternal health. Only 50.5% knew that mothers should totally avoid bottle feeding. 75.9% incorrectly thought that almonds and dry fruits increase breast milk secretion. These overall encouraging findings about breast feeding may be due to the increased focus on the importance of teaching breast feeding during preplacement training and possibly due to repeated health education messages on breast feeding through the mass media. The findings indicate a need for educating anganwadi workers about continuation of breast feeding during diseases, however.