VALIDATION AND ASSESSMENT OF STANYA KSHAYA WITH SPECIAL REFERENCE TO BREAST-MILK DEPLETION AMONG BREASTFEEDING WOMEN OF BIJNOR DISTRICT: A CROSS-SECTIONAL SURVEY-BASED STUDY

Abstract

Background Breast milk provides appropriate nutrition and important immunological protection during early infancy. In Ayurveda, breast milk is described as Stanya and is closely related to the nutritional status of maternal Rasa Dhatu. Reduction in the quantity or production of breast milk is explained as Stanya Kshaya. Maternal undernutrition, inadequate fluid intake, fasting, fatigue, emotional stress, disturbed sleep, illness and ineffective breastfeeding may contribute to reduced lactation. However, a validated assessment tool integrating classical features of Rasa Kshaya and Stanya Kshaya with modern indicators of inadequate milk production is not commonly available for community-based use. Materials and Methods A cross-sectional, observational and assessment-based survey was designed at Vivek College of Ayurvedic Sciences and Hospital, Bijnor, Uttar Pradesh, 246701. A total of 1,078 breastfeeding women aged 21–40 years, reporting decreased lactation and fulfilling the eligibility criteria, were included. Sample size was calculated by Cochran’s formula using 95% confidence, 50% expected proportion and 3% absolute precision, followed by a 1% adjustment for non-response. The survey included demographic, dietary, reproductive, behavioural and health-related questions; a ten-item Rasa Kshaya scale with a maximum score of 30; and an eleven-point Stanya Kshaya assessment scale. Content validity, face validity, internal consistency and test-retest reliability were assessed. Descriptive statistics, chi-square test, Spearman correlation and ordinal logistic regression were proposed for analysis. Results In the illustrative model analysis, 286 participants, 26.53%, had mild Stanya Kshaya, 518, 48.05%, had moderate Stanya Kshaya, and 274, 25.42%, had severe Stanya Kshaya. Moderate or severe Rasa Kshaya was observed in 69.94% of participants. A statistically significant positive association was found between increasing Rasa Kshaya severity and increasing Stanya Kshaya severity, χ² = 634.65, df = 4, p < 0.001. Spearman analysis showed a positive correlation, rₛ = 0.658, p < 0.001. Mental stress, sleep of less than six hours, inadequate water intake, frequent fasting and higher Rasa Kshaya score were associated with greater Stanya Kshaya severity. The model instrument demonstrated satisfactory content validity and internal consistency. Conclusion The structured instrument showed potential usefulness for identifying and grading Rasa Kshaya and Stanya Kshaya among breastfeeding women. The model results showed a positive and statistically significant relationship between maternal Rasa Kshaya and the severity of breast-milk depletion. The null hypothesis was therefore rejected and the alternative hypothesis was accepted in the model analysis. Actual conclusions must be based on analysis of the completed survey records.