Factors Affecting The Nutritional Intake Of Newborn Babies

Factors Affecting The Nutritional Intake Of Newborn Babies

Abstract

The main aim of this study was to assess the factors affecting the nutritional intake of new-born babies in Nigeria. Analytical cross-sectional study design was used in a comparative analysis conducted in communities in Kaduna state. These results show that, in spite of improved food supplement from WFP, the nutrition of children in the intervention area continues to be affected and has not shown any improvement. Feeding practices that are in conflict with traditional beliefs must be changed in favour of modern feeding towards the health of the children. Harmful taboos are adversely affecting children’s nutritional status. The study shows that socio –economically the ignorance of mothers about good nutrition is affecting the prevalence of infection and under nutrition. In a community with a high prevalence of undernutrition (26% wasted, 65% underweight and 60% stunted), it is very important to educate mothers to take appropriate measures to prevent its occurrence. This will require strengthening the package of preventive education in the targeted nutrition programme. The areas which need to be stressed are exclusive breastfeeding for six months and appropriate (both in quantity and quality) and timely introduction of complementary feeding. It was recommended that there should be channels for nutrition education of mothers and community at all contact points through Child Welfare and feeding Centers, and the use of mass media to educate the community on; Exclusive Breastfeeding for 6 months and to avoid early supplements.; Introduction of nutritious foods (high caloric, micronutrient and protein); and Protecting children from infections, by measures such as immunization against common childhood diseases.

Table Of Content

Preliminary Page(s)

• Title Page
• Declaration
• Approval
• Dedication
• Acknowledgement
• Abstract
• Table of Content

Chapter One

1.0 Introduction

• 1.1 Background To The Study
• 1.2 Statement Of Problem
• 1.3 Research Objectives
• 1.4 Research Questions
• 1.5 Research Hypothesis
• 1.6 Significance Of The Study

Chapter Two

2.0 Literature Review

• 2.1 Infant Feeding Practices
• 2.2 Factors Influencing Infant Feeding Behavior
• 2.3 Factors That Influence Child Growth
• 2.4 Socio-Economic Status
• 2.5 Diseases And Infections
• 2.6 Mother’s Knowledge In Child Nutrition
• 2.7 Theoretical Framework

Chapter Three

3.0 Research Methodology

• 3.1 Research Design
• 3.2 Study Population
• 3.3 Sampling Technique
• 3.4 Data Collection Method
• 3.5 Data Analysis

Chapter Four

4.0 Results And Discussion

• 4.1 Result

Chapter Five

5.0 Conclusions And Recommendations

• 5.1 Conclusions
• 5.2 Recommendations
• References
• Appendix

Chapter One

1.0 Introduction

1.1 Background Of The Study

Nutrition is the sum total of the processes involved in the intake and utilization of food substances by living organisms, including ingestion, digestion, absorption, transport and metabolism of nutrients found in food(Melvin, 2005).Adequate nutrition during early childhood is fundamental to the development of each child’s potential. It is established that the period from birth to two years of age is a “critical window” for the promotion of optimal growth, health and overall survival of children (Ali, et al 2006).

Good food is important for good health. Children who are well fed during the first two years of life are more likely to stay healthy for the rest of their childhood. During the first six months of a child’s life, breast milk alone is the ideal food. It contains all the nutrients needed for healthy growth as well as immune factors that protect against common childhood infections (Ashworth, 2002).

Good nutrition is the cornerstone for survival, health and development for current and succeeding generations. Well-nourished children perform better in school, grow into healthy adults and in turn give their children a better start in life (UNICEF, 2006). The United Nations Children’s Fund (UNICEF) and the Ministry of Health (MoH), Nigeria recommend exclusive breastfeeding for the first six months of the infant’s life. Children between the ages of six months and four years who do not get enough of the right types of food to eat easily become malnourished
According to UNICEF (2006), each year under-nutrition contributes to the deaths of about 5.6 million children under- 5 in the developing world and 146 million children younger than 5 are underweight and at increased risk of early death, illness, disability, and underachievement. UNICEF reports that, in the least developed countries, 42% of children are stunted and 36% are underweight as a result of poor nutrition or under nutrition.

The World Health Organization (WHO) refers to malnutrition as “Failure of cells to perform their physical functions due to inability to receive and use the energy and nutrients needed in terms of amount, mix and timeliness. Waterlow and Insel (1995) described malnutrition as “Failing Health that results from long standing faulty nutrition that either fails to meet or greatly exceeds nutritional needs. This description could mean inappropriateness of the food taken. Again, Harrison and Waterlow (1990) defined malnutrition as “The effects of any nutrient deficiency including energy, protein and micronutrients.”

Malnutrition can be operationally defined as a lack of essential nutrients or failure to use available foods to best advantage (Barasi, 1997). Malnutrition affects physical growth, morbidity, mortality, cognitive development, reproduction and physical work capacity and it consequently impacts on human performance, health and survival. A well- nourished child is one whose weight and height measurements compare very well with the standard normal distribution of heights and weighs of healthy children of the same age and sex (Salah, 2006).

In this perspective, malnutrition is not less food or food without the needed nutrients present. It is rather the failure of cells to perform their physiological functions due to inability to receive and use the nutrients in the right proportion.

Malnutrition especially among young children is a widespread problem in most developing countries. Over one hundred million children less than five years of age suffer from protein-energy malnutrition and more than ten million of them suffer from severe protein energy malnutrition, which is usually fatal if untreated (WHO, 1981).
Malnutrition refers to disorder resulting from an inadequate diet or failure to absorb or assimilate dietary elements (Jackson, 1975).

Malnutrition may involve undernutrition and include the symptoms of deficiency diseases or it may be due to overnutrition arising from excessive intake of nutrients (Barasi, 1997). In the case of children under two years they suffer mostly from undernutrition specifically, protein-energy malnutrition. The African Region has the highest estimated prevalence of stunting (48.1%) and has the lowest rate of improvement (20%) (Vlok, 1991). Under-nutrition and under-nourishment also refer to a condition where there is insufficient intake of food to cover energy and nutrient needs. Insufficient intake of food that results in malnutrition could be attributed to varied reasons (Morley and Woodland 1992).

Under-nourished children have lowered resistance to infection; they are more likely to die from common childhood ailments like diarrhoeal diseases and respiratory infections, and for those who survive, frequent illness saps their nutritional status, locking them into a vicious cycle of recurring sickness and faltering growth. Their plight is largely invisible; three quarters of the children who die from causes related to malnutrition were only mildly or moderately undernourished, showing no outward sign of their vulnerability (UNICEF, 2006).

In Asia, the prevalence of stunting (32.8-43.7%) is high, particularly in south and central Asia, although rates of stunting continue to improve throughout this region. In a review of mortality and morbidity trends in Bangladesh between 1970 and 1975 by Hussain (1987) it was found that the crude mortality rate, the infant mortality and the childhood malnutrition rate fell and rose with improvement and deteriorations in food supply that were largely determined by political, economic, climate and social factors.

The importance of addressing childhood malnutrition is a prerequisite for achieving internationally agreed goals to reduce malnutrition and child mortality. Child growth is therefore internationally recognized as an important public health indicator hence growth monitory centers are established in all communities.

In Nigeria malnutrition rate among children under-two years recorded 2.7% in 2003, 5.4% in 2004, and 7.5% in 2005 (GHS, 2005). The Nigeria Health Service Nutrition unit collaborates with the WFP in executing a food supplementation programme in five regions of the country where malnutrition rates are considered especially acute. Under this programme food rations are distributed to pregnant and lactating women as well as children 1-3 years of age at the feeding centres in selected communities during periods of the year when food is particularly scarce. Centre attendants who have been trained to conduct growth monitoring also educate mothers on basic nutrition and hygiene.

The Millennium Development Goal 4 (MDG 4) is aimed at ensuring child survival and a reduction in malnutrition among children under five by at least one third and to reduce mortality by 2/3 by the year 2015 with special attention to children less than two years of age. (UNICEF, 2006)

Children who are malnourished are much more susceptible to life-threatening diseases such as malaria, pneumonia and diarrhoea infections. Complications from malnutrition are; Anemia in children, Convulsions, Poor mental or cognitive development, and Stunting.

1.2 Statement Of Problem

Malnutrition situation in Nigeria is a serious public health problem among pre-school children. About 3 out of every 10 young children are undernourished. Nearly 2 out of every 10 babies born die before their 5th birth day. Undernutrition is an important cause of death (MoH 1995). According to the Reproductive and Child Health (RCH) annual report, (2005) among children registered at Child Welfare Clinics, malnutrition rates have been increasing over the years. In children 0-11months, about 4.1% of children were found to be malnourished. This shows an increase when compared with 2.6% in 2004.Among children 12-23 months, 7.5% were malnourished as compared to 5.4 in 2004.

The 1998 Nigeria Demographic and Health Survey (NDHS) shows that under-nutrition is significant in Nigeria with one in four Nigerian children less than five years of age being stunted (short for their age) 10 % wasted and 25% underweight. The Survey revealed that, in general children residing in the northern regions of Nigeria and children of uneducated mothers are more likely to be malnourished.

1.3 Research Objectives

The main aim of this study is to assess the factors affecting the nutritional intake of new-born babies in Nigeria.

The specific objectives are outlined as follows;

1. To determine the cultural factors which influence nutritional intake of new-born babies in Nigeria
2. To determine the influence of socio-economic status of parents on nutritional intake of new-born babies in Nigeria
3. To compare the level of knowledge of mothers in child nutrition
4. To measure using anthropometric indicators the nutritional status of new-born babies in Nigeria
5. To make recommendations to programme implementers with the view to improve the programme implementation

1.4 Research Questions

1. What are the cultural factors which influence nutritional intake of new-born babies in Nigeria?
2. What is the influence of socio-economic status of parents on nutritional intake of new-born babies in Nigeria?
3. What is the level of knowledge of mothers in child nutrition?
4. What is the nutritional status of new-born babies in Nigeriausing anthropometric indicators?
5. What are the recommendations to programme implementers with the view to improve the programme implementation?

1.5 Research Hypothesis

• HO1: There is no significant influence of cultural factors on nutritional intake of new-born babies in Nigeria
• HO2: There is no significant influence of level of knowledge of mothers on nutritional intake of new-born babies in Nigeria

1.6 Significance Of The Study

Undernutrition is a major public health problem and the World Food Programme (WFP) has initiated food supplementation to help address the problem in rural communities in developing countries. What is unknown is whether the intervention resulted in significant changes in nutritional status when compared with other communities that received the routine services. This study therefore was intended to assess the factors influencing nutritional status of newborn babies in Nigeria. The results of the study would be of immense help to the Health Administration at local, state and national levels. It would also influence health partners including UNICEF and WFP in adopting further strategies for intervention to improve nutrition of children in the country.

Chapter Five

5.0 Conclusions And Recommendations

5.1 Conclusions

These results show that, in spite of improved food supplement from WFP, the nutrition of children in the intervention area continues to be affected and has not shown any improvement. Feeding practices that are in conflict with traditional beliefs must be changed in favour of modern feeding towards the health of the children. Harmful taboos are adversely affecting children’s nutritional status. The study shows that socio –economically the ignorance of mothers about good nutrition is affecting the prevalence of infection and under nutrition. The null hypothesis that there is no significant difference in childhood illness in both communities cannot be rejected (p-value is 0.05). The level of childhood illness is very high 61% and 88% in the communities and they all mentioned fever (malaria) as disease affecting children. The Ministry of Health has put in place many strategies to control malaria and its complications. The roll back malaria programme-chemoprophylasis, alternative preventive treatment and treatment of malaria are included in this package.

The (Chi square 0.2; df=1; p-value=0.6) difference in relation to introduction of complementary feeds in the communities, does not suggest there is a food supplementation in the intervention community. In fact, the communities did not meet the recommendation of WHO on the initiation of complementary feeding at 6 months since all of them introduced foods at the age of 4 and 12 weeks respectively. Porridge is the predominant complementary food in the communities, 31% and77% mothers rarely add protein to it. There should be an increase in complementary food which is well nourishing for children above 6 months of age. It would be advisable to teach mothers on how to prepare nutritious weaning mixes from the various ingredients of their farm output and add vegetables and fruit in whatever amount these are available.

In a community with a high prevalence of undernutrition (26% wasted, 65% underweight and 60% stunted), it is very important to educate mothers to take appropriate measures to prevent its occurrence. This will require strengthening the package of preventive education in the targeted nutrition programme. The areas which need to be stressed are exclusive breastfeeding for six months and appropriate (both in quantity and quality) and timely introduction of complementary feeding.

5.2 Recommendations

1. The local assembly should empower women by giving them micro credit that will make them engage in economic activities to earn income to feed their children better.
2. Local Administration should provide safe water and good sanitation to prevent communicable diseases in the communities that affect the children.
3. Health representatives should talk to mothers in their communities about the importance of nutrition and report on nutritional status of children in their areas.
4. There should be channels for nutrition education of mothers and community at all contact points through Child Welfare and feeding Centers, and the use of mass media to educate the community on;
   • Exclusive Breastfeeding for 6 months and to avoid early supplements.
   • Introduction of nutritious foods (high caloric, micronutrient and protein).
   • Protecting children from infections, by measures such as immunization against common childhood diseases.

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