Background: Exclusive breastfeeding is considered a major public health intervention to promote both child and maternal health. Introduction and awareness of infant milk substitutes among mothers appear as a threat to this important practice.Methods: The study is an observational cross-sectional study using a questionnaire containing socio-demographic variables. The study was conducted among 300 mothers who reported to immunization clinic and paediatrics OPD of a BFHI accredited hospital in Delhi. Data collected in the study has been analysed using SPSS version 21.0 and MS-Excel. Student ‘t’ test for quantitative variables and ‘chi square test’ for categorical variable have been used for statistical significance. p-value <0.05 was considered to be significant.Results: In this study 78.7% mothers intended to breastfeed. 71.3% knew that breastfeeding should be continued up to 2 years and 96.3% knew exclusive breastfeed should be given till 6months. Major source of knowledge were doctors and elders of society. However, 49.6% mothers started breastmilk substitutes before 6 months of age. Major causes that appeared as barriers against exclusive breastfeeding were insufficient quantity of milk (23.4%), child refusal (61%) and maternal health problems (15.6%).Conclusions: Despite good knowledge about breastfeeding among upper middle-class mothers, practice of exclusive breastfeeding remains suboptimal. There is a need for more reinforcement upon importance of breastfeeding, its benefits for both mother and baby so as to foster the practice.

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BACKGROUND AND AIM: Critically sick children have increased risk of mortality due to multi-organ failure. Increased oxidative stress may be one of the reasons for extensive cellular damage and death during critical illness. 8-hydroxy-2'deoxyguanosine (8-OHdG) is a DNA(deoxyribonucleic acid) oxidation product and can be used as a marker of severity of illness and mortality. Aim is to study the association of urinary 8-OHdG levels with mortality and severity of illness in critically sick children. METHOD:In this single center cross-sectional study, 88 critically sick children aged between 1 month and 18 years were enrolled. Urinary 8-OHdG levels were measured for each patient within 24 hours of admission in pediatric intensive care unit (PICU). Severity of illness was recorded at PICU admission using the PEdiatric Logistic Organ Dysfunction-2 (PELOD-2) score. Urinary 8-OHdG levels were analyzed in relation to PICU mortality and PELOD-2 score.RESULTS: Urinary 8-OHdG levels were higher in nonsurvivors as compared to survivors. ROC curve analysis for the association between urinary 8-OHdG levels and PICU mortality gave an area under the curve value of 0.626 which has satisfactory discriminatory power. Ideal 8-OHdG level cut off was 21.38, sensitivity was 50% and specificity was 72%. Pearson correlation coefficient between PELOD-2 score and urinary 8-OHdG levels was poor. [r=0.192(p-value=0. 074)]CONCLUSIONS: There is increased DNA oxidative damage in non-survivors. The discriminatory power of urinary 8-OHdG levels is just satisfactory in predicting mortality in critically sick children. There is poor correlation of urinary 8-OHdG levels and severity of illness, which limits its use as a tool for monitoring illness severity.