19 Annals of Community Health • Apr-Jun 2020 • Vol 8 • Issue 2 The First Steps toward Sustaining Breastfeeding Together: Understanding the Perceptions of Breastfeeding among Male and Female Youth in India Avita Rose Johnson, Bhavapriya Mani, N. Deepika, Christy Maria Manuel, K. Rajitha, Farah Naaz Fathima Department of Community Health, St. John’s Medical College, Bengaluru, India INTRODUCTION B reastfeeding can save 800,000 lives and 30000 crore dollars every year. [1] Breastfeeding has clear health advantages for infants including reduced risk of infections, better long-term outcomes, and reduced childhood obesity. [2-5] Positive maternal health outcomes include reduced risk of type 2 diabetes, breast and ovarian cancers, and postpartum depression. [3,6] Following the Innocenti Declaration of 1990, there has been a global effort to implement practices that protect, promote, and support breastfeeding. [7] In India, the government has proposed RMNCH-A strategies to improve exclusive breast feeding rates at an annual rate of 9.6% from the baseline of 36%. [8] Despite initiatives, breastfeeding practices remain inadequate. Recent NFHS-4 data show that exclusive breastfeeding among infants below 6 months of age was practiced for only 54.9% and early initiation of breastfeeding (within an hour of birth) was done for only 41.6% of newborns. [9] Mother’s prenatal attitude is an important predictor of optimal breastfeeding practice [10,11] and knowledge regarding breastfeeding is directly proportional to intent to breastfeed. [12,13,17] Since NFHS-4 data show that 26.8% of women are married before the age of 18 years and 7.9% of women aged 15–19 years are already mothers or pregnant, [9] this indicates that young women are an important group for targeted interventions for promoting breastfeeding. Those mothers who receive support from their spouses usually opt for exclusive and optimum breastfeeding for their infants. [14,15] Social influences among youth, guide breastfeeding beliefs, and future feeding practices. [16] This study was therefore conducted to assess the perceptions toward breastfeeding among both male and female college-going students in peri-urban Brngaluru and to identify knowledge gaps and misconceptions which need to be addressed during health education to promote optimal breastfeeding practices. [18] Correspondence: Bhavapriya Mani, Department of Community Health, St. John’s Medical College, Sarjapur Road, John Nagar - 560 034, Bengaluru, India. Phone: +91-7259189801. E-mail: bhavupaveen@gmail.com ORIGINAL ARTICLE ABSTRACT Background: NFHS-4 data indicate that breastfeeding practices in India remain inadequate. Mother’s prenatal knowledge and attitude regarding breastfeeding, spousal support, and perception of breastfeeding are predictors of optimal breastfeeding practices. Social influences among youth can impact future breastfeeding practices. Objective: The objective of the study was to assess the perceptions toward breastfeeding among both male and female college-going students in peri-urban Bengaluru and to identify knowledge gaps and misconceptions which need to be addressed during health education to promote optimal breastfeeding practices. Methods: A cross-sectional study was conducted among 1111 students in a degree college in peri- urban Bengaluru, India. A pre-tested, face-validated questionnaire was administered to both male and female students, consisting of socio-demographic details as well as questions to assess knowledge of the benefits of breastfeeding (27 questions), attitudes toward breastfeeding and bottle-feeding as well as myths and misconceptions related to breastfeeding (11 questions). Results: A total of 1111 students were included as a part of our study, 1026 undergraduates and 85 postgraduates. Overall, the students had poor knowledge about breastfeeding with a significant number being unaware of correct breastfeeding practices as well as benefits of breastfeeding. Females and students who had received formal education about breastfeeding fared better than their male and other counterparts who had not received an official education about breastfeeding. Conclusion: Students had poor awareness and attitudes regarding breastfeeding. The study revealed many misconceptions as well as gaps in awareness that need to be addressed when planning targeted interventions to sensitize youth regarding breastfeeding. Key words: Perceptions, breastfeeding, youth