Assessment Of Maternal Challenges Of Exclusive Breastfeeding And Complementary Feeding Among Mothers Attending Infant Welfare Clinic Attending State Hospital Asubiasro Osun-State

Assessment Of Maternal Challenges Of Exclusive Breastfeeding And Complementary Feeding Among Mothers Attending Infant Welfare Clinic Attending State Hospital Asubiasro Osun-State (Daniel)
Abstract
This study focused on the assessment of maternal challenges of exclusive breastfeeding and complementary feeding among mothers attending infant welfare clinic attending state hospital asubiasro osun-state. The study is was specifically focused on determining the demographic and socio-economic characteristics of mothers attending infant welfare clinic attending state hospital asubiasro osun-state, determining the knowledge on complementary feeding of mothers attending infant welfare clinic attending state hospital asubiasro osun-state, determining complementary feeding practices of mothers attending infant welfare clinic attending state hospital asubiasro osun-state, establishing the relationship between maternal challenge on complementary feeding practices and exclusive breastfeeding of their children in infant welfare clinic attending state hospital asubiasro osun-state and to establish the relationship complementary feeding practices and nutritional status of children in infant welfare clinic attending state hospital asubiasro osun-state. The study adopted the survey research design and randomly enrolled participants in the study. A total of 141 responses were validated from the enrolled participants where all respondent are mothers attending infant welfare clinic attending state hospital asubiasro osun-state.
Table of Content
- Title Page
- Certification
- Dedication
- Acknowledgement
- Table of Content
- List of Tables
- Abstract
Chapter One:
Introduction
- 1.1 Background of the Study
- 1.2 Statement of the Problem
- 1.3 Objective of the Study
- 1.4 Research Questions
- 1.5 Research Hypothesis
- 1.6 Significance of the Study
- 1.7 Scope of the Study
- 1.8 Limitation of the Study
- 1.9 Definition of Terms
- 1.10 Organisations of the Study
Chapter Two:
Review of Literature
- 2.1 Conceptual Framework
- 2.2 Theoretical Framework
- 2.3 Empirical Review
Chapter Three:
Research Methodology
- 3.1 Research Design
- 3.2 Population of the Study
- 3.3 Sample Size Determination
- 3.4 Sample Size Selection Technique and Procedure
- 3.5 Research Instrument and Administration
- 3.6 Method of Data Collection
- 3.7 Method of Data Analysis
- 3.8 Validity of the Study
- 3.9 Reliability of the Study
- 3.10 Ethical Consideration
Chapter Four:
Data Presentation and Analysis
- 4.1 Data Presentation
- 4.2 Analysis of Data
- 4.3 Answering Research Questions
- 4.4 Test of Hypotheses
Chapter Five:
Summary, Conclusion and Recommendation
- 5.1 Summary
- 5.2 Conclusion
- 5.3 Recommendation
- References
- APPENDIX
- QUESTIONNAIRE
Chapter One
Introduction
1.1 Background to the Study
The period from birth to 2 years of age is a “critical window” for the promotion of optimal growth, health and cognitive development (Srivatsava and Sandhu, 2007). Early years have been recognized as time for developing good dietary habits and important time for taking in nutrients for optimal growth and development (Engle et. al, 2000). Poor breastfeeding patterns, low nutrient density and poor quality of complementary feeds accounts for nutrient deficiency, illness and infections in children leading to malnutrition at an early age (Savatsava and Sandhu, 2007). Malnutrition has a profound effect on a child‟s growth and development, as it can lead to permanent stunting, impaired brain and mortar development or excess weight gain, predisposing the child to obesity later in life (Shrimpton, 2001). Infant and young child feeding practices directly affect the nutritional status of children under two years, impacting on child survival (Black et. al, 2008).
WHO recommends exclusive breastfeeding for the first 6 months, introduction of complementary feeding with continued breastfeeding for at least 2 years (WHO, 2006b). The recommended infant and young child feeding practices for children aged 6-23 months include: continued breastfeeding; feeding semi-solid/solid food according to the age of the child; and feeding a variety of foods such as cereals, fruits, vegetables (WHO 2005).
Breastfeeding of up to 2 years of age and beyond is an important source of nutrients, fluids and immunological protection, while appropriate complementary food promotes good health, nutritional status and growth of young children (WHO, 2006b). In many developing countries, complementary feeding is introduced too early and the quality and quantity of the foods are insufficient, thus children are at the risk of nutritional deficiency (Pelto et al, 2003). Most of the complementary foods are cereal-based gruels low in energy and nutrient density and more so inadequate in iron, zinc, pyridoxine, riboflavin, niacin, calcium, thiamine, foliate, ascorbic acid and vitamin A (Lutter and Rivera, 2003).
Malnutrition has been responsible directly or indirectly for 60% of the 10.9 million deaths annually among children under 5 years in the whole world, where two thirds of these deaths are associated with inappropriate feeding practices in the first year of life (WHO, 2003). In developing countries, malnutrition accounts for 50% deaths of the children under five years (ACC/SCN, 2000). In Africa, malnutrition contributes to half of the 9.7 million annual under five deaths and is a leading cause of diseases and disabilities in children (WHO, 2000 and UNICEF, 2007). In Kenya, inappropriate complementary feeding practices contribute to more than 10000 annual deaths for children under five years (MOPHS, 2007-2010). Malnutrition rates for the under fives in 2008 were, 7% wasted, 35% stunted and 16% underweight based on the Macro, (2010).
To reduce child mortality and achieve the fourth Millennium Development Goal i.e., to reduce child mortality rates (United Nations Development Group, 2008), there is need to improve the feeding practices of the children, since child feeding is one of the most neglected determinants of young child nutrition in spite of the importance in growth pattern of the child hence the need for this study.
1.2 Statement of the Problem
Exclusive breastfeeding in the first 6 months and introduction of complementary feeds at 6 months with continued breastfeeding for at least 2 years can decrease infant mortality by 19% (WHO, 2002). Complementary feeding bridges the gap that arises in breast milk after 6 months (Sethi et al., 2003). Inappropriate quality, quantity, frequency and consistency of complementary foods can make the child more susceptible to infection, slower in recovery after illness and higher mortality (Sethi et al., 2003).
Interventions to address child malnutrition show that appropriate complementary feeding practices can save up to 6% of all under-five deaths (Jones et al., 2003), and therefore attention should be given to decisions taken by the mother during complementary feeding (Bereng et al., 2007). Many observational studies show that maternal knowledge of optimal child feeding practices like exclusive breastfeeding for six months, continued breastfeeding and the timely transition to adequate complementary food is basic to keep health of a child (WHO, 2010). Knowledge does not necessarily translate to practice as supported by Sellen (2001), who observed that a combination of mothers‟ self- perception, assessment of infant‟s well being, culture; food availability and financial status influence the actual complementary feeding, hence child nutritional status. In Nigeria, mothers‟ knowledge on complementary feeding has been identified as a major gap in complementary feeding which needs to be addressed hence the need for this study.
In Nigeria, complementary foods are introduced as early as the first month and by 6 months 84% of the infants are already receiving complementary feeds, where some of these foods are low in energy and micronutrients (MOPHS, 2007-2010). Only 39% of the children aged 6-23 months are fed in accordance with the WHO recommended IYCF guidelines (KNBS and ICF Macro, 2010). This coupled with unhygienic preparation and storage conditions predisposes many infants to diarrhoea and inadequate diet causing a negative impact on growth and development, which is very characteristic in this age group (MOPHS, 2007-2010).
It has been known for long time that malnutrition has been a significant and enduring public health problem in the country; it continues to trap Nigerian children in a vicious circle, affecting their survival, growth and development. The general nutritional status of children under five years for the period 2000 to 2008-09 shows that since 2003, the proportion of stunted children has remained unchanged, in fact stunting levels in the age group 6-11 has increased from 15.3% to 21.6%. In Osun state, stunting rates have increased by 4 points (18.7-22.7%), underweight children although lowest in the state has since almost doubled 6.3% to 10% (Osun health service, 2019).
According to the national strategy on infant and young child feeding, one of the key issues or constrains that need to be addressed to improve complementary feeding in Nigeria is mothers‟ inadequate knowledge on complementary feeding. Mothers‟ knowledge on: hygiene during complementary feeding; timely introduction of complementary feeding; dietary diversity; and feeding frequency (MOPHS), 2007-2010). In view of this, it was mandatory for all mothers with children underfive years of age attending infant welfare clinic attending state hospital asubiasro osun-state to also attend nutrition education sessions offered every morning to fill this gap in knowledge (Personal Communication, Sister- in –Charge, Kahawa West Public Health Centre, 16th august, 2012).
Knowledge on feeding practices of infants and young children is crucial for undertaking or improving health and nutrition programmes in a country (Sethi, et al., 2003). So, it is presumed that it is worthy to conduct a study to assess mother‟s knowledge regarding complementary feeding for evidence based programme planning and intervention. It is also envisaged that it will provide information about existing knowledge and practices of the mothers so that the appropriate steps could be taken to fulfill the goals of the appropriate complementary feeding practices.
1.3 Objectives of the Study
The purpose of the study was an assessment of maternal challenges of exclusive breastfeeding and complementary feeding among mothers attending infant welfare clinic attending state hospital asubiasro osun-state. specifically, the study aims;
- To determine the demographic and socio-economic characteristics of mothers attending infant welfare clinic attending state hospital asubiasro osun-state.
- To determine the knowledge on complementary feeding of mothers attending infant welfare clinic attending state hospital asubiasro osun-state.
- To determine complementary feeding practices of mothers attending infant welfare clinic attending state hospital asubiasro osun-state.
- To establish the relationship between maternal challenge on complementary feeding practices and exclusive breastfeeding of their children in infant welfare clinic attending state hospital asubiasro osun-state.
- To establish the relationship complementary feeding practices and nutritional status of children in infant welfare clinic attending state hospital asubiasro osun-state.
1.4 Research Question
The study will provide answers to the following research questions;
- What is the demographic and socio-economic characteristics of mothers attending infant welfare clinic attending state hospital asubiasro osun-state?
- What is the level of knowledge on complementary feeding of mothers attending infant welfare clinic attending state hospital asubiasro osun-state?
- What is complementary feeding practices of mothers attending infant welfare clinic attending state hospital asubiasro osun-state?
- What is the relationship between maternal challenge on complementary feeding practices and exclusive breastfeeding of their children in infant welfare clinic attending state hospital asubiasro osun-state?
- Is there a relationship between complementary feeding practices and nutritional status of children in infant welfare clinic attending state hospital asubiasro osun-state?
1.5 Hypotheses of the Study
- H01: There is no significant relationship between maternal challenges on complementary feeding and exclusive breastfeeding of their children.
- H02: There is no significant relationship between mothers‟ knowledge on complementary feeding and her practices in complementary feeding for children.
1.6 Significance of the Study
The findings from this study may be useful to the Ministry of Health, Non Governmental Organizations, Community-Based Organizations (CBOs) in improving complementary feeding practices and therefore child health and survival. The findings will contribute to the field of knowledge on infant and young child nutrition and act as a basis for future research on complementary feeding.
1.7 Scope of the Study
This study was carried out in an urban public health centre and the findings can only be generalized to mothers attending infant welfare clinic attending state hospital asubiasro osun-state and mothers living in similar circumstances.
1.8 Limitations of the Study
The sample was recruited from a health centre and not from the households and therefore not be representative of the entire mothers attending infant welfare clinic attending state hospital asubiasro osun-state population since not all mothers in urban areas attend public health centers for child welfare clinics especially those from middle and higher socio-economic classes.
In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.
1.9 Definition of Terms
Complementary Feeding Practices:
In this study it will include; consumption of vitamin A rich fruits and vegetables and iron rich foods, minimum dietary diversity, minimum meal frequency, introduction of solids, semi-solids and soft foods at 6-8 months and minimum acceptable diet.
Maternal Knowledge:
Mothers‟ understanding, information, perception and familiarity about complementary feeding based on the guiding principles of complementary feeding for a breastfed child.
Breastfeeding:
Is the practice of feeding an infant, or sometimes a toddler or a young child, with milk produced from her mammary glands, usually directly from the nipples.
Exclusive Breastfeeding:
Is generally feeding a baby with nothing but breast milk.
1.10 Organization of the Study
This research work is organized in five chapters, for easy understanding, as follows.
- Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
- Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
- Chapter three deals on the research design and methodology adopted in the study.
- Chapter four concentrate on the data collection and analysis and presentation of finding.
- Chapter five gives summary, conclusion, and recommendations made of the study.
Chapter Five
Summary, Conclusions and Recommendations:
5.1 Introduction
This chapter summarizes the findings on the assessment of maternal challenges of exclusive breastfeeding and complementary feeding among mothers attending infant welfare clinic attending state hospital asubiasro osun-state. The chapter consists of summary of the study, conclusions, and recommendations.
5.2 Summary of the Study
In this study, our focus was on the assessment of maternal challenges of exclusive breastfeeding and complementary feeding among mothers attending infant welfare clinic attending state hospital asubiasro osun-state. The study is was specifically focused on determining the demographic and socio-economic characteristics of mothers attending infant welfare clinic attending state hospital asubiasro osun-state, determining the knowledge on complementary feeding of mothers attending infant welfare clinic attending state hospital asubiasro osun-state, determining complementary feeding practices of mothers attending infant welfare clinic attending state hospital asubiasro osun-state, establishing the relationship between maternal challenge on complementary feeding practices and exclusive breastfeeding of their children in infant welfare clinic attending state hospital asubiasro osun-state and to establish the relationship complementary feeding practices and nutritional status of children in infant welfare clinic attending state hospital asubiasro osun-state.
The study adopted the survey research design and randomly enrolled participants in the study. A total of 141 responses were validated from the enrolled participants where all respondent are mothers attending infant welfare clinic attending state hospital asubiasro osun-state.
5.3 Conclusions
With respect to the analysis and the findings of this study, the following conclusions emerged;
Maternal knowledge on complementary feeding was on the whole appropriate; gaps were identified in appropriate feeding of the sick children and the appropriate use of mixed flours for making children‟s porridge
Complementary feeding practices were on the whole appropriate; in terms of introduction of solids, semi-solids and soft foods to children 6-8 months and minimum meal frequency especially for the breastfed children. Dietary diversity was low because of the limited socio-economic capability of the respondents to purchase a variety of foods. The prevalence of under-nutrition was high among the children and was influenced by maternal knowledge on complementary feeding practices and also the complementary feeding practices.
5.4 Recommendation
Based on the findings the researcher recommends that;
- Rural women should be taught on the benefits of exclusive breastfeeding
- Advertisement of baby formulas should be followed with disclaimers that exclusive breast feeding is the best option for both mothers and infants.
- Implementation of national health education campaigns that encourage women to breastfeed, especially during pregnancy by all primary health care nurses.
- Enhancement and development of policies, rules, regulations, legislation and lows that appropriately promote as well supports breastfeeding in and outside work locations.
- Emphasis on legislation and policies that mandate employers to facilitate lactation in the workplace, including breaks for breastfeeding women and access to a private area for breastfeeding or milk expression that is not a bathroom.
- Expansion the maternity leave duration for at least pied six months for all working mothers.
- Multinational companies in the state should lay more emphasis on labour intensive rather than capital intensive. This would help for the employment of manual labourers.

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