Mothers’ Knowledge, Practice of Exclusive Breast Feeding and Anthropometric Indices of their Infants in Aba South Local Government Area, Abia State, Nigeria

Mothers’ Knowledge, Practice of Exclusive Breast Feeding and Anthropometric Indices of their Infants in Aba South Local Government Area, Abia State, Nigeria.

ABSTRACT

This study assessed mothers’ knowledge, practice of exclusive breastfeeding and the anthropometric indices of their infants in Aba south local government area, Abia state, Nigeria.

Five hundred (500) lactating mother-child pair randomly selected during their postnatal care visit in six out of seventeen health centers in the LGA participated in the study. Ethical clearance was obtained from the chief medical officer in the LGA and mothers’ consent was sought through the clinic head.

Interviewer administered questionnaire was used to obtain information on the mothers’ socio-economic characteristics, knowledge and practices of exclusive breastfeeding (EBF).

The anthropometric measurements of the children were taken using standard techniques and indices such as weight-for-age, weight-for length and length-for-age derived. The data obtained from the questionnaire were analysed using Statistical Package for Social Sciences, version16.

The anthropometric indices of the children were compared with reference standards and the children subsequently classified as normal, underweight, stunted, wasted, and overweight. The results obtained showed that 68% of the urban and 53.6% of the rural respondents had adequate knowledge of EBF.

About 24.7% of the urban and 20.1% of the rural respondents who had adequate knowledge of EBF practiced it. Adequate knowledge was significant to EBF practice (p<0.05).

The rate of EBF varied from 20% to 28% from birth to three months in rural and urban areas to 10.8% and16.8% from birth to six months, respectively. Only 16.4 % in the urban and 8% in the rural areas initiated breastfeeding within 30minutes of delivery.

Over 90% of the respondents in both areas fed their children colostrum. A total of 34.8% of the urban and 55.6% of the rural respondents practiced prelacteal feeding. The main reason given by 35.6% of the urban and 35.3% of the rural respondents for prelacteal feeding practices was to stop stomach ache.

Only 8.8% and 6% in urban and rural areas respectively expressed breast milk (EBM) and 45.5% in urban and 33.3% in the rural area preserved the EBM by refrigeration.

The major problems encountered during lactation were job commitment (16%) in the urban area and insufficient breast milk (20.8%) in the rural area.

Socio-economic factors that influenced compliance to EBF were mother’s age between 30-39 years (12.8 and7.6)%, higher maternal education (15.6 and10.4)%, places of delivery (16.4 and 10.8)% and mode of delivery (16.8and10.8)% in urban and rural areas, respectively.

More than half of the urban (50.8%) and rural (72%) respondents introduced complementary foods within the 3rd month of the child’s birth. The major reason for early introduction of complementary food was that breast milk alone was not adequate for the baby (38.5% and 39.5 % in urban and rural areas, respectively).

Exclusively breastfed males and females aged 0-6 months in the urban area had mean weight of 9.40kg ±0.1 and 8.56kg±0.1 respectively relative to 8.01kg ±1.3 and 7.84 kg ±1.5  kg,  respectively  weighed  by  the  non-exclusively  breastfed(Non-EBF)  counterparts.

Similarly, the exclusively breastfed males and female children from 0-6 months in the rural area had mean weight of 9.21 kg ±0.9 and 8.35 kg ±0.6, respectively relative  to 7.74 kg ±1.1 and 7.36 kg ±1.4 respectively weighed by the non-EBF breastfed counterparts.

Based on the new WHO child growth standards, none of the EBF was malnourished. A few (11.1%) of non-EBF females aged 19-24 months in urban area and 16.7% of non-EBF male children aged of the same age in the rural area had low length-for-age.

Low weight-for-age (underweight) was highest (26.7%) among non-EBF males aged 7-12 months in the rural area. The prevalence of wasting was 18.8% among non-EBF female children aged 7-12 months in the rural area.

Based on the finding of the study, integrated effort on protection, promotion and support for EBF is recommended among others to enhance the full benefit of EBF in Abia state in particular and Nigeria in general.

TABLE OF CONTENTS

Title page- – – – – – – – – – i
Approval page – – – – – – – – ii
Certification page – – – – – – – – iii
Dedication – – – – – – – – – iv
Acknowledgements – – – – – – – – v
Table of contents – – – – – – – – vi
List of Table – – – – – – – – – vii
List of Figures – – – – – – – – viii
ABSTRACT – – – – – – – – – ix

CHAPTER ONE: INTRODUCTION

1.0 Background of the study – – – – – 1
1.1 Statement of Problem – – – – – – – 3
1.2 Objective of the Study – – – – – – 4
1.3 Specific Objectives – – – – – – – 4
1.4 Significance of the Study – – – – – – 4

CHAPTER TWO: LITERATURE REVIEW

2.0 Concept of Breastfeeding – – – – – – 6
2.1 Physiology of Breastfeeding (BF) – – – – – 6
2.2 Science of Prevalence – – – – – – – 7
2.3 Global prevalence of Exclusive Breastfeeding (EBF) – – – 8
2.4 Composition of breast milk – – – – – – 11
2.5 Maternal nutrition – – – – – – – 14
2.6 Complementary foods. – – – – – – – 14
2.7 Baby Friendly Hospital Initiatives (BFHI) and EBF in Nigeria – – 16
2.8 Ten Steps to successful breastfeeding advocated in the Baby Friendly Hospital Initiatives  – 17
2.9 Breastfeeding techniques (How to Breast Successfully) – – 18
2.10 Expressed Breast Milk (EBM) – – – – – 20
2.11 Exclusive Breastfeeding And HIV/AIDS Infection – – – 21
2.12 Factors Affecting Exclusive Breastfeeding in Nigeria – – 22
2.13 Infant Anthropometry and Breastfeeding – – – – 23
2.14 WHO Growth Reference – – – – – – 25

CHAPTER THREE: MATERIALS AND METHODS

3.1 Area of Study – – – – – – – 28
3.2 Design of the Study – – – – – – – 28
3.3 Population of the Study – – – – – –
3.4. Sample size and Sampling Techniques – – – – 28
3.5 Ethical clearance Sample Method – – – – – 28
3.6 Sampling Techniques – – – – – – – 29
3.7 Instrument for Data Collection – – – – – 30
3.8 Method of data Collection – – – – – – 30
3.9 Method of Data Analysis – – – – – – 31

CHAPTER FOUR: RESULTS 

CHAPTER FIVE: DISCUSSION

5.1 Mothers’ knowledge and practice of EBF – – – – 68
5.2 Socioeconomic characteristics of the respondents – – – 68
5.3 Complementary feeding – – – – – – 70
5.4 Anthropometric indices of the children – – – – 70
5.5 Stunting – – – – – – – – 71
5.6 Underweight – – – – – – – – 72
5.7 Wasting – – – – – – – – 72
Conclusion – – – – – – – – 73
Recommendations – – – – – – – 73
REFERENCES – – – – – – – 75
APPENDICES – – – – – – – – 84

INTRODUCTION

1.1 Background of the Study

Over the years, experts have found that breast milk provides the best possible start to life in all areas of infant’s development.

Evidences have confirmed that early initiation of infants to breast feeding and optimal breastfeeding of children for two years and beyond have the potential to prevent 6 million deaths in the developing countries (UNICEF, 2008 & 2009).

In addition, breast milk carries anti-bodies from the mother that help combat diseases, protects babies from diarrhoea and acute respiratory tract infections.

Breastfeeding stimulate infants’ immune system and response to vaccination and according to some studies confers cognitive benefits as well.

Feeding at breast is emotionally satisfying, reduces the risk of post partum bleeding in mothers and thus a healthy practice for both the mother and the child.

Continued breast feeding after six months accompanied by sufficient quantities of nutritionally adequate, safe and appropriate complementary foods also helps to ensure good nutritional status and protects the infants against illnesses (UNICEF, 2009).

Exclusive breastfeeding (EBF) means giving breast milk in response to all the child’s need for food, drink, suckling and perhaps comfort or soothing.

REFERENCES

ACC/SCN (1997). Breast milk’s protective qualities. United Nations publication, 7, 14.
Adetugbo, D. A. & Irinoye, O. O. (1994). Perception of breastfeeding and diarrhea in rural communities of Osun States, Nigeria. Journal of Pediatrics, 21, 39 – 47.
Adetugbo A.A. (1997). Socio-cultural factors and promotion of EBF in rural Yoruba community of Osun State, Nigeria. Social Science and Medicine, 45 (1): 113-125
Amed, J. D., Roa, M. R., Sack. D. A., Khan, M. R., & Haque, E. (1992). Community based evaluation of the effect of Breastfeeding on the risk of microbiologically confirmed Shigellosis in Bangladeshi children. Journal of Pediatrics, 90, 406 – 411.
Bailey, K. V. (1965). Quantity and composition of breast milk in some New Guinea population. Journal of Pediatrics, 11, 35.
Baker, R. (2003). Human milk substitute. America Journal of Pediatrics, 55(3): 195 – 207. Baridam, D.M. (2001). Research methods in administrative science. Press Chuba, Port Harcourt: University of Port Harcourt: p60

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