Choice Of Infant Feeding Practice Among Women Of Child Bearing Age

ABSTRACT

Malnutrition is an underlying factor in more than 50% of the major cause of infant mortality-Pneumonia, diarrhoeal disease and measles which account for 70% of infant mortality. Therefore, programs to promote adequate nutrition for age can help reduce mortality from these disease conditions and indispensible to achievement of MDG 4.

This study is aimed at describing the feeding practices of infants below six months of age and to determine maternal socio-demographic factors that influences the practice of exclusive breastfeeding (EBF) among mothers in Amukpe community in Delta State, Nigeria.

In this study, four hundred mother-infant pairs attending the infant welfare clinic of the Delta State Teaching Hospital were consecutively recruited after meeting the study inclusion criteria. Data on breastfeeding were based on infant feeding practice in the previous 24 hours. Exclusive breastfeeding was defined as infant feeding with only breast milk.

The result shows that the awareness (95.3%) and knowledge (82.0%) of EBF was high among surveyed mother but the practice of EBF (33.5%) was very low. Positive attitude towards EBF practice was shown by many (71.0%) of surveyed mothers. EBF practice decreased with increasing infant age, OR 0.72 (95% CI 0.34, 1.51) for 1–2 months, OR 0.58 (95% CI 0.23, 1.44) for 3–4 months and OR 0.20 (95% CI 0.06, 0.73) for 5–6 months compared to infants < 1 month old. Maternal education, socioeconomic class, mode of delivery and infants first feed were retained as important maternal predictors of EBF practice after adjustment for confounders. Decreased likelihood of EBF practice was found among mothers of lower educational attainment, OR 0.33 (95% CI 0.13, 0.81), mothers who delivered through caesarean section, OR 0.38 (95% CI 0.18, 0.84), mothers of higher socio-economic status [(middle class, OR 0.46 (95% CI 0.22, 0.99) and upper class, OR 0.32 (95% CI 0.14, 0.74)] while increased likelihood of EBF practice was seen in mothers who gave their infants breast milk as their first feed, OR 3.36 (95% CI 1.75, 6.66).

Conclusively, knowledge and awareness does not translate to practice of EBF. More effort by health workers and policy makers should be directed to mothers along the fault lines to encourage the practice of EBF.

TABLE OF CONTENTS

 TITLE PAGE

APPROVAL PAGE

DEDICATION

ACKNOWLEDGEMENT

ABSTRACT

TABLE OF CONTENT

CHAPTER ONE

• INTRODUCTION
• BACKGROUND OF THE STUDY
• BACKGROUND OF THE STUDY
• AIM AND OBJECTIVES OF THE STUDY
• RESEARCH QUESTION
• SIGNIFICANCE OF THE STUDY
• LIMITATION OF THE STUDY
• DEFINITION OF TERMS

CHAPTER TWO

LITERATURE REVIEW
2.1      REVIEW OF INFANT AND YOUNG CHILD FEEDING
2.2     BREASTFEEDING
2.3     THE IMPORTANCE OF EXCLUSIVE BREASTFEEDING

2.4 IMPACT OF EXCLUSIVE BREASTFEEDING (EBF)

2.5     BREASTFEEDING PRACTICES

2.6     DEFINITION OF EXCLUSIVE BREASTFEEDING

2.7      REVIEW OF THE RELATED STUDY

2.8      WHO RESPONSE ON INFANT FEEDING

CHAPTER THREE

3.0      METHODS

3.1     STUDY AREA

3.2     SAMPLE AND SAMPLING PROCESS

3.3     DATA COLLECTION

3.4     INDEPENDENT VARIABLES

3.5     OUTCOME VARIABLE

3.6     DATA ANALYSIS

3.7     ETHICAL CONSIDERATION

CHAPTER FOUR

4.0      RESULT

4.1     CHARACTERISTICS OF SURVEYED MOTHER-INFANT

4.2     INFANT FEEDING PRACTICE

4.3      MATERNAL AND CHILD FACTORS INFLUENCING PRACTICE OF EBF

4.4     DISCUSSION

4.5     LIMITATIONS

CHAPTER FIVE

5.1      CONCLUSIONS

5.2      RECOMMENDATION

REFERENCES

CHAPTER ONE

1.0                                          INTRODUCTION

1.1                            BACKGROUND OF THE STUDY

Despite some improvements in child mortality rate in Africa, neonatal mortality has largely remained the same or worsened in many countries. In 2003, neonatal mortality accounted for almost 40 per cent of estimated 9.7 million children under-five deaths and for nearly 60 per cent of infant deaths. According to UNICEF in 2006 of the 10 million deaths in under-5 children recorded that year, 4 million die within the first month of life, half of these within the first 24 hours (UNICEF, 2016). Because malnutrition increases a child’s risk of dying from many diseases — most prominently measles, pneumonia, and diarrhoea which are the highest cause (70%) of neonatal deaths — programs to improve nutrition can reduce mortality from several diseases simultaneously.

Efforts to promote modest nutritional improvements such as changes in feeding behaviour will have a beneficial impact on mortality rates over time. Feeding practices adopted by mothers depends on the knowledge, attitude, socio-cultural tradition they are exposed to according to Ezechukwu et al (2014). Owing to the known nutritional and health benefits to the infant, the World Health Organization recommends that women in resource-poor countries exclusively breastfeed until their babies reach 6 months of age (World Health Organization, 2012).

The Baby Friendly Hospital Initiative (BFHI) was introduced in Nigeria in 1992 to help educate and encourage breastfeeding practice among mothers. Some studies in Nigeria have shown that mothers who delivered in a health institution designated as baby friendly are more likely to practice exclusive breastfeeding (EBF) and breastfeed their infants for a longer time (Ogunlesi et al., 2015). Another study in south-west Nigeria showed that mothers who had knowledge of BFHI but no contact with BFHI designated hospitals had significantly less incidence of practicing EBF compared to those who with knowledge and contact with a BFHI designated hospital. However a national survey done in 2008 showed that EBF rates still remains very low (13%) in Nigeria (National Population Commission, 2019). This is thought to be because of several factors associated with the mothers’ and the environments.

Several studies have documented the impact of cultural factors, maternal age, marital status, family income/social class, mode of delivery, time of initiation of first breastfeeding and proximity to babies on feeding pattern (Okolo et al., 2019). Outside maternal factors, studies have also shown that the babies’ general behaviour influence what feed they receive (Salami et al., 2016). However none of these studies had explored in details the different feeding options and why mothers adopt the infant feeding practices they do. This study therefore tries to investigate the infant feeding practices, factors that influence the practice of EBF and reasons why mothers adopt these infant feeding methods in Amukpe Community in Delta State, Nigeria. The findings of this study will help inform policies targeted at behaviours among mothers that seek to enhance the practice of the lifesaving EBF in Nigeria and other developing countries where infant mortality rate is still unacceptably high.

1.2                                                  PROBLEM STATEMENT

Adequate early infant nutrition is essential for subsequent optimum growth and development of the child. Exclusive breastfeeding is the cornerstone of the best possible nutrition in early infancy. However, it has been discovered that higher percentage of child bearing age mothers don’t practice the right feeding culture for their infants which is the major cause of infant mortality-Pneumonia, diarrhoeal disease and measles which account for 70% of infant mortality according to WHO (2017). This study was carried out to access the choice of infant feeding practice among women of child bearing age in Amukpe Community in Delta State, Nigeria.

1.3                                    AIM AND OBJECTIVES OF THE STUDY

The main  aim work of this work is to assess current breastfeeding practices in early infancy in Amukpe Community in Delta State and further progress ( if any) that may have been made in the realization of optimal early infant feeding practices in the locale in the preceding  decade.

The objectives of the work are:

1. To access the level acceptance and practice of exclusive breastfeeding in Amukpe community.
2. To promote good health among infants thereby reducing the rate of infant mortality.

• To create awareness of good choice of infant feeding practice among women of bearing age.

1.4                                                          RESEARCH QUESTIONS

1. What factors may influence a mother’s choice of infant feeding method?
2. What are child feeding practices?
3. What is WHO’s recommendation regarding the breastfeeding of infants?
4. In what age of the child classic method of complementary feeding is used at the partial breast feeding?

1.5                                                    SIGNIFICANCE OF THE STUDY

The findings contribute to formulation of guidelines and policies to improve on acceptance of exclusive breastfeeding among women of reproductive age in the community and the country at large.

This study will serve as a means of creating awareness of good infant feeding practice, thereby promoting good health among infants.

The findings of the study will be documented into a report and submitted to Institution research review committee as well as guide future researchers.

1.6                                                    LIMITATION OF THE STUDY

This study is limited to the child bearing age in Amukpe community, Delta State.  It does judge the efficiency and usage of exclusive breastfeeding, but to find out what influences the practice of exclusive breastfeeding.

1.7                                                  DEFINITION OF TERMS

Terms related and constantly used in this work are defined as follows:

Exclusive breastfeeding: Exclusive breastfeeding is defined as feeding infants only breast milk, be it directly from breast or expressed, except drops or syrups consisting of vitamins, mineral supplements or medicine.

Infant: is the very young offspring of human beings. Infants can be considered children anywhere from birth to 1 year old.

Feeding practice: is the initiation of breastfeeding within one hour of birth, breastfeeding exclusively for the first six months, continuing to breastfeed for two years, on demand breastfeeding, giving of colostrum, no prelacteal feeding.

Alveoli: Glandular tubes that appear in bundles and secrete breast milk into milk ducts.

Areola: The dark circle that surrounds the nipple.

Colostrum: Thick, sticky, yellowy “pre-milk” that is full of protein, vitamins and antibodies to sustain a newborn for her first few days of life.

Fore-milk: The early milk during a feeding that contains more sugary lactose and less fat.

Hind-milk: As a feeding progresses and breasts become emptier more fat is released into the breast milk. This is known as hind-milk.

Lactation: Another word for breastfeeding.

Lactose: A sugar found in breast milk and other dairy products.

Mastitis: An infection of the breast either from a plugged milk duct or bacteria that enters through the nipple. Mastitis can cause breasts to feel hard, sore and painful.

Milk Ducts: Channels that carry breast milk from the tissues where it is secreted (called alveoli) to the nipples.

Milk Supply: This refers to the availability of breast milk, which is based on a supply and demand stimulus. The more the breast is stimulated and then emptied, the more milk will be produced.