Factors associated with maternal knowledge of newborn care among hospital-delivered mothers in Sri Lanka

The aim of this study was to assess mothers' knowledge on newborn care as well as factors associated with poor knowledge. A cross-sectional study sampled 446 mother-newborn pairs from five hospitals in the Puttalam district of Sri Lanka by stratified random sampling. Maternal knowledge on newborn care was assessed using a questionnaire with 50 statements via exit interview. A knowledge score was created by allocating 1 point for each correct response, which was dichotomised as 'satisfactory' or 'poor' by the median score. Only 21.7% correctly answered that 'surgical spirit' (70% isopropyl alcohol) should not be applied on the umbilical stump. More than 90% of mothers knew about breastfeeding on demand, the advantages of colostrum and the duration of exclusive breastfeeding. Except for a few conditions, mothers demonstrated a satisfactory knowledge in recognising danger signs of the newborn. According to multivariate analysis, primiparae (odds ratio (OR)=2.31; 95% CI 1.53-3.50), unemployed women (OR=3.31; 95% CI 1.89-5.80) and those with delayed antenatal booking visits (OR=2.02; 95% CI 1.26-2.23) were more likely to have poor knowledge. In conclusion, mothers had a satisfactory level of knowledge about breastfeeding and recognition of danger signs, but knowledge about care of the umbilical cord was poor. Maternal education programmes should place more emphasis on first-time mothers, unemployed women and those with delayed booking visits.