The Impact Of Exclusive Breastfeeding On Infants 0-6 Month On Infants

Project and Seminar Material for Nursing (Science)

The Impact Of Exclusive Breastfeeding On Infants 0-6 Month On Infants (Daniel)

Abstract

The purpose of this study was to examine the impact of exclusive breastfeeding on infants 0-6 month on infants in Benue State, Nigeria. To achieve this purpose, 10 hospitals were randomly selected using multi-stage sampling technique (simple random, stratified, and purposive sampling techniques). The data was collected using close-ended questionnaire. 500 questionnaires were distributed to nursing mothers who visited antenatal clinics in the randomly selected hospitals, from which 455 were duly completed and returned. Frequencies of percentages and cross tabulation statistics were used to answer research questions. Associations between demographic determinants and breastfeeding practices were analyzed using Chi-square statistics at alpha level of 0.05 to test the formulated hypotheses. The findings of the study, indicated high (99.8%) prevalence of breastfeeding among nursing mothers, out of which 83.5% exclusively breastfed for up to 4-6 months. Only 16.5% however supplemented breastfeeding. The findings of the study revealed that; mother’s age significantly influenced the practice of exclusive and non-exclusive breastfeeding of babies, indicating high exclusive breastfeeding among mothers of 25years and above, and low exclusive breastfeeding among younger mothers of 19 years and below. The results further showed that, mother’s level of education significantly influenced the practice of exclusive and non-exclusive breastfeeding of babies, indicating high exclusive breastfeeding practice among literate mothers with at least secondary education. Those with low educational attainment had poor or low practice of exclusive breastfeeding. Based on the results of this study, the following conclusions are drawn: Mother’s age influence the practice of exclusive and non-exclusive breastfeeding of babies in Benue State. Mother’s level of education influenced the practice of exclusive and non-exclusive breastfeeding of babies in Benue State. Based on the conclusions, the following recommendations are made: Special interventions should be made for young mothers with poor breastfeeding practices usually (15-19years) by health care workers to encourage them endure the herculean task of breastfeeding, through education, and nursing support to enable them breastfeed exclusively. Since education remains the most viable means of reaching mothers on the benefits of exclusive breastfeeding, health care workers should intensify education to provide mothers with complete and current information on the methods of exclusive breastfeeding in order to increase mother’s knowledge of benefits of child development derived from exclusive breastfeeding.

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 of Study

Infant feeding methods are a major determinant of infant nutritional status, which in turn, affects infant morbidity and mortality. Among feeding methods, breastfeeding is of particular importance because this practice is fundamental for growth, development, health and survival of infants. Diallo, Bell, Moutquine, &Garrant (2005) stated that about 5.6 million infants die annually because they do not receive adequate nutrition. Breastfeeding therefore has been classified by scientists and health workers as the best natural food for babies and breast milk contains all the necessary nutrients for the healthy growth of the child. The benefits of breastfeeding are numerous ranging from providing the infant with antibodies, to helping ward off risks of illnesses and providing the baby with all his/her nutritional needs (Mundi, 2008). According to the World Health Organization (WHO) (2004), breast milk provides all the energy and nutrients that the infant needs for the first six months of life, and it provides about half or more of a child’s nutritional needs during the second half of the first year, up to one third during the second year of life. Furthermore, breast milk not only protects the infant against infectious and chronic diseases, but also promotes sensory and cognitive development in addition to contributing to the health and well-being of mothers, helping in birth spacing, reducing the risks of ovarian and breast cancers as well as increasing family and national resources (WHO, 2004).

Generally, breastfeeding is practiced all over the world, though with variation in duration. Considering that the introduction of other food supplements at an early age often increase the risks of infections to the infant which may at times lead to life-threatening conditions such as diarrhoea, the WHO and United Nations Children’s Emergency Fund (UNICEF)(2004), recommended that infants be exclusively breastfed for six months and, thereafter, up to 24 months, introducing other supplements to support the infants growth and development.

In view of the many benefits afforded by mothers and infants in breastfeeding, governments have also set goals and rates for breastfeeding practices. The Nigerian government has earmarked six University Teaching Hospitals as Baby Friendly Hospital Initiative (BFHI) centres, in Benin, Enugu, Maiduguri, Lagos, Jos, and Port-Harcourt, with the objective of reducing infant malnutrition, morbidity and mortality, as well as promoting the health of mothers. Since the inception of BFHI in 1991, a series of programmes, seminars, workshops and conferences aimed at promoting breastfeeding practices have been organized. The BFHI itself has proved to be an effective method of improving breastfeeding practices worldwide (Salami, 2006). To further strengthen the practice of exclusive breastfeeding, government also approved a breastfeeding policy in 1998. The code on the marketing of substitutes of breast milk was reviewed and amended in May, 1999, to further introduce stiffer fines and a clearer definition of breast milk substitutes. These measures are aimed at increasing the rate of exclusive breastfeeding as well as the early initiation of breastfeeding so as to achieve the World Summit on Children 1990 goal of universal exclusive breastfeeding for infants up to six months of age (Mundi, 2008).

These measures notwithstanding, evidence showed that the practice of exclusive breastfeeding (though fast improving) is still low in many parts of the world. In Nigeria, the rate increased from 2% to 20% in infants 0-3 months and from 1% to 8% in infants 4-6 months between 1990 and 1999 (National Planning Commission (NPC)/UNICEF, 2001). The Nigeria Demographic and Health Survey (NDHS) (2008), however, revealed that 97% of Nigerian children under age five were breastfed at some point in their life. A small proportion of infant (13%) were exclusively breastfed throughout the first six months of life. More than seven in ten (76%) children of ages 6-9 months received complementary foods. 16% of infants less than six months of age were fed with a bottle with nipple, and the proportion bottle fed peaked at 17% among infant in the age ranges of 2-3 and 4-5 months. However, less than half of infants (38%) were put to the breast within one hour of birth and only 68% started breastfeeding within the first day. Relatively, among children born in the five year preceding the survey in Benue State, showed that 97.8% of children ever breastfed. 64.1% started breastfeeding within one hour of birth. 90.2% began breastfeeding within 1 day and 38.7% introduce pre-lacteal feed. Only 0.5% children were exclusively breastfed. These proportions indicate a marginal level of decline from the 1990, 1991, 1999, 2003 and the 2008 surveys (NDHS, 2008).

These dwindling attitudes regarding the practice of exclusive and non-exclusive breastfeeding have been attributed to several socio-economic, cultural and socio-demographic factors as it affects the development of children. Thus, this research project purposed to examine the impact of exclusive breastfeeding on infants 0-6 month on infants in Benue State, Nigeria.

1.2 Statement of Problem

Breastfeeding practices have undergone tremendous medical, cultural and sometimes religious challenges and debate. In an attempt to achieve successful breastfeeding globally by the year 2000, the World Health Organization and United Nations Children’s Fund (1993), launched the Baby Friendly Hospital Initiative (BFHI) in 1991. The BFHI is a global effort involving 160 countries, of which 95 of them are in the developing world where Nigeria is inclusive (Salami, 2006). This project is to support, protect, and promote the practice of exclusive breastfeeding for six months and thereafter until 24 months of age. Several medical literature have also established the superiority of breast milk over the other types of milk for the nourishment of the human infants, offering better health benefits.

Although breastfeeding is universal in the country, the trend is towards giving other feeds in addition to breast milk. Generally, the practices are more diversified and are characterized by late initiation of breastfeeding, the administration of substances other than maternal milk, and the introduction of weaning foods within one month following the infant’s birth. The Nigerian Integrated Child Health Cluster Survey (ICHCS, 2003), indicated that a major area of need in infant breastfeeding was early initiation. The survey indicated a decline from 56% in 2000 to 34% in 2002. The Nigeria Demographic and Health Survey (NDHS, 2008) reports also revealed a 13% exclusive breastfeeding rate which is a decline from 17% indicated in 2003 report. The 2008 report further revealed that 34% of infants aged 0-5 months were given plain water in addition to breast milk, while 10% were given milk other than breast milk. Only 32% of infants’ under-24 months of age were still on breast milk.

Considering the percentage of mothers practicing breastfeeding, it should not be surprising that Nigeria is still saddled with high incidence of malnutrition and its associated infant mortality. Many factors have been adduced to influence these practices. The decisions are very often influenced more by other factors than by health considerations alone. According to Sika-Bright (2010), the factors which influence the decision to exclusively or non-exclusively breastfeed include; mother’s marital status, employment status, friends method of feeding their babies, social support and baby’s age. Several other demographic studies conducted over the years (i.e National Demographic Sample Survey (NDSS), 1966; Nigeria Fertility Survey (NFS), 1982; National Population Policy (NPP), 1988; Integrated Child Health Cluster Survey (ICHCS) 2003; Nigeria Demographic and Health Survey (NDHS), 1990, 1999, 2003, & 2008; have also identified similar factors to include; mother’s level of education, occupation, and income level to influence mother’s choice of exclusive breastfeeding. While significantly expanded in content, the primary objective of the previous surveys has been on emerging issues such as awareness and behaviour regarding HIV/AIDS and other sexually transmitted infection, poverty, gender inequality, fertility, mortality, nuptiality, awareness and use of family planning methods, sexual activity, nutritional status of mothers and infants, early childhood mortality and maternal mortality, maternal and child health and of course breastfeeding practices. However, these factors are apparent in the studies conducted over the years. The existence of a large scale of mothers practicing exclusive and non-exclusive breastfeeding, and its associated causes remained elusive in the studies. It is not definite or clear whether demographic factors significantly or insignificantly influence the practice of exclusive and non-exclusive breastfeeding. It is worthy of note that up till recently, the principal foci of attention has been demographic factors and the practice of exclusive breastfeeding. None of the studies conducted over the years concern itself much with demographic factors and the effectiveness of exclusive breastfeeding in the development of under-fives in Benue State. Therefore, the study purposed to examine the impact of exclusive breastfeeding on infants 0-6 month on infants in Benue State.

1.3 Objective of the Study

The main purpose of this research project was to examine the impact of exclusive breastfeeding on infants 0-6 month on infants in Benue State, Nigeria.

The specific purposes of the study are:

To assess whether mother’s age, level of education and occupation has influence on the practice of exclusive breastfeeding.
To assess how effective exclusive breastfeeding is for 0-6 month on infants.
To assess whether mothers have knowledge of the benefits and role that exclusive breastfeeding plays in child development (under-fives).
To determine if family views regarding breastfeeding influence mother’s decision to exclusively breastfeed.

1.4 Research Questions

This study sought to provide answers to the following specific research questions:

Does mother’s age, level of education and occupation influence the practice of exclusive breastfeeding?
How effective is exclusive breastfeeding for 0-6 month on infants?
Do mothers have knowledge of the benefits and role that exclusive breastfeeding plays in child development (under-fives)?
Do family views regarding breastfeeding influence mother’s decision to exclusively breastfeed?

1.5 Research Hypotheses

H01: Mother’s age does not influence the practice of exclusive and non-exclusive breastfeeding of babies in Benue State.
H02: Mother’s level of education does not influence the practice of exclusive and non-exclusive breastfeeding of babies in Benue State.

1.6 Significance of Study

The findings of this study would give an insight into areas where health education campaigns are required to influence and promote the adoption of exclusive breastfeeding. Specifically:

It would also make progress towards obtaining demographic data on exclusive breastfeeding among nursing mothers attending antenatal clinics in Benue State. This, in addition, will benefit nutritionists, health planners in Benue State to formulate policies and strategies that are geared towards the promotion of exclusive breastfeeding on specific group of women and locations in which it is poorly practiced.

The findings of the study would benefit health workers to develop special intervention measures on specific age ranges of mothers who poorly practice exclusive breastfeeding.

The findings of this study would help health educators, nurses, nutritionists and curriculum planners to develop informed programmes for nursing mothers on the benefits of breastfeeding. This in addition, would update the curriculum to educate students in higher institutions of learning in preparing for future parenthood to adopt an effective method of breastfeeding the baby.

1.7 Scope of Study

This research project is focused on examining the effectiveness of exclusive breastfeeding in the development of under-five children in Benue State. The study is limited to some selected mothers in the area. Hence, the respondents for this study will be obtained from and among lacitating in the study area.

1.8 Limitations of the Study

The researcher experienced the following limitations. First, the relationship between types of breastfeeding and the infant mortality and morbidity were probably underestimated by some mothers as they did not attend post-natal care for further assessment and possible advice by the health care providers. Such nursing mothers were not included in the sample of the study. The study considered only nursing mothers that attended postnatal clinics.

The study did not take into account the differences between the infants who were raised by their biological mothers and those raised by significant others and this could involve some bias in the decision to exclusively or non-exclusively breastfeed the infant. Based on this, the researcher convinced the nursing mothers to provide accurate information on the method they feed their babies, as this was not to “witch hunt” them but was merely for academic purpose. Time and finances were limiting constraints to the work, notwithstanding the researcher was able to successfully complete the work.

1.9 Operational Definition of Terms

Exclusive Breastfeeding:

Exclusive breastfeeding means that the infant receives only breast milk. No other liquids or solids are given – not even water – with the exception of oral rehydration solution or drops/syrups of vitamins, minerals or medicines.

Under-Fives:

Children who are less than five years old, especially those who are not in full-time education.

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 impact of exclusive breastfeeding on infants 0-6 month on infants in Benue State as case study. 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 impact of exclusive breastfeeding on infants 0-6 month on infants in Benue State as case study. The study is was specifically carried out to assess whether mother’s age, level of education and occupation has influence on the practice of exclusive breastfeeding, assess how effective exclusive breastfeeding is for 0-6 month on infants, assess whether mothers have knowledge of the benefits and role that exclusive breastfeeding plays in child development (under-fives), and determine if family views regarding breastfeeding influence mother’s decision to exclusively breastfeed.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 455 responses were validated from the enrolled participants where all respondent are nursing mothers who visited antenatal clinics in the selected hospitals in Benue State.

5.3 Conclusions

Based on the findings of this study, the researcher concluded that;

Mothers have knowledge of the benefits and role that exclusive breastfeeding plays in child development (under-fives).
Family views regarding breastfeeding influences mother’s decision to exclusively breastfeed.
Mother’s age significantly influenced the practice of exclusive and non-exclusive breastfeeding of babies, indicating high exclusive breastfeeding among mothers of 25years and above, and low exclusive breastfeeding among younger mothers of 19 years and below. Hence mother’s age influence the practice of exclusive and non-exclusive breastfeeding of babies in Benue State.
Mother’s level of education significantly influenced the practice of exclusive and non-exclusive breastfeeding of babies, indicating high exclusive breastfeeding practice among literate mothers with at least secondary education. Those with low educational attainment had poor or low practice of exclusive breastfeeding. Thus, mother’s level of education influenced the practice of exclusive and non-exclusive breastfeeding of babies in Benue State.

5.4 Recommendations

Based on the findings of the study, the following recommendations are proffered.

Government and non government organizations involve in the promotion of exclusive breastfeeding should organize more training programme for health workers in the ante-natal and post-natal.
Promotion of exclusive breastfeeding should involve programmes that will capture not only nursing mothers and health workers, but other members in the communities most especially husbands and older women who are involved in child care.
Younger generations such as adolescents need to have a reasonable knowledge of exclusive breastfeeding and its many benefits even before child bearing age.
Facilities such as crèche should be provided by various governments and private organization at work place and in higher institution of learning, to enable nursing mothers who are working or studying continue breastfeeding without jeopardizing their work or study. Employers should also be encouraged to give nursing mothers extra break time to be able to perform this very important act of breastfeeding.
Special interventions should be made for young mothers with poor breastfeeding practices usually (15-19years) by health care workers to encourage them endure the herculean task of breastfeeding, through education, and nursing support to enable them breastfeed exclusively.
Since education remains the most viable means of reaching mothers on the benefits of exclusive breastfeeding, health care workers should intensify education to provide mothers with complete and current information on the methods of exclusive breastfeeding in order to increase mother’s knowledge of benefits of child development derived from exclusive breastfeeding.