Knowledge And Practice Of Complimentary Feeding Among Mothers Of Under Five Children In Gadar Maiwa Community Of Ningi Local Government

Project and Seminar Material for Nursing (Science)

Knowledge And Practice Of Complimentary Feeding Among Mothers Of Under Five Children In Gadar Maiwa Community Of Ningi Local Government


Abstract


Worldwide, malnutrition is responsible directly or indirectly for deaths of children under five years. Two thirds of these deaths are associated with inappropriate feeding practices. Interventions that address child malnutrition show that appropriate complementary feeding practices can save up to 6% deaths in under-fives. Attention should therefore be given to decisions taken by the mother during complementary feeding. Thus the purpose of this study was to determine mothers‟ knowledge on complementary feeding practices and relate this to the nutritional status of their children aged 6-23 months. The study adopted a cross-sectional analytical study design and was carried out at In Gadar Maiwa Community Of Ningi Local Government among the randomly sampled 286 mothersand their children. A researcher-administered questionnaire and a focus group discussion were used to collect data. Data was entered and analyzed using (SPSS version 20).The respondents were mostly young (mean age 26.1±4.7 years), married (88.1%), housewives (66.4%) with mainly primary school level of education (47.2%). The main sources of income for most households were business (48.6%) and casual labour (31.8%). Mothers had average knowledge on complementary feeding (14.11±2.33) out of the 20 knowledge questions. All (100%) the children aged 6-8 had been introduced to solids, semi-solids and soft foods. Maternal knowledge on complementary feeding was significantly associated with nutritional status of their children. Mothers‟ knowledge on feeding the sick and recovering children was related to underweight in children (chi-square test; p=0.026). The same was true of mothers who knew that a child‟s main meal should be diversified (chi-square test; p=0.027). There was a significant relationship between mothers‟ knowledge on duration of exclusive breastfeeding (chi-square test; p=0.022) and feeding bottles (chi-square test; p=0.005) and wasting in their children. Children who did not attain the minimum meal frequency were likely to be wasted (chi-square test; 0.001 and underweight (chi-square test; 0.013). Mothers‟ knowledge on complementary feeding practices was not significantly related to her complementary feeding practices (p>0.05). Nutrition messages on Infant and Young Child Feeding Practices should emphasis dietary diversity and frequency of feeding especially for non breastfed children and also on how to feed sick children. Nutrition programmes should pay attention to cultural beliefs on infant and young child feeding. A longitudinal study on factors that may influence complementary practices is also recommended.


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 under five 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 manydeveloping 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 Nigeria, 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 Nigeria Demographic (KNBS and 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 Nigerian children under five are fed in accordance with the WHO recommended IYCF guidelines (MOH 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 Nigeria; 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 Nairobi province, stunting rates have increased by 4 points (18.7-22.7%), underweight children although lowest in Nairobi province has since almost doubled 6.3% to 10% (KNBS and ICF Macro, 2010).

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 (Ministry of Public Health and Sanitation(MOPHS), 2007-2010). In view of this, it was mandatory for all mothers with children underfive years of age in Gadar Maiwa Community Of Ningi Local Government to also attend nutrition education sessions offered every morning to fill this gap inknowledge .

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 Objective of the Study

The purpose of the study was to determine the knowledge and practice of complimentary feeding among mothers of under five children in Gadar Maiwa Community Of Ningi Local Government.specific objectives:

  1. To determine the demographic and socio-economic characteristics of mothers with children under fivein Gadar Maiwa Community Of Ningi Local Government.
  2. To determine the knowledge on complementary feeding of mothers with children under fivein Gadar Maiwa Community Of Ningi Local Government.
  3. To determine complementary feeding practices of mothers with children under fivein Gadar Maiwa Community Of Ningi Local Government.
  4. To assess the nutritional status of children under fivein Gadar Maiwa Community Of Ningi Local Government.
  5. To establish the relationship between maternal knowledge on complementary feeding practices and nutritional status of their children under fivein Gadar Maiwa Community Of Ningi Local Government.
  6. To establish the relationship complementary feeding practices and nutritional status of children under five and in Gadar Maiwa Community Of Ningi Local Government.

1.4 Research Question

  1. What is the demographic and socio-economic characteristics of mothers with children under fivein Gadar Maiwa Community Of Ningi Local Government ?
  2. What is the level of knowledge on complementary feeding of mothers with children under fivein Gadar Maiwa Community Of Ningi Local Government ?
  3. What isthe complementary feeding practices of mothers with children under fivein Gadar Maiwa Community Of Ningi Local Government ?
  4. What is the nutritional status of children under fivein Gadar Maiwa Community Of Ningi Local Government ?

1.5 Hypotheses of the Study

  • H01: There is no significant relationship between mothers‟ knowledge on complementary feeding and the nutritional status of their children under five.
  • H02: There is no significant relationship between mothers‟ knowledge on complementary feeding and her practices in complementary feeding for children under five.

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 in Gadar Maiwa Community Of Ningi Local Government 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 Ningi Local Government population since not all mothers in urban areas attend public health centers for child welfare clinics especially those from middleandhigher socio-economic classes.


1.9 Definition of Terms

Complementary Feeding:

Period during which other foods or liquid are provided along with breast milk (WHO, 2006b).

Complementary Foods:

Any non-breast milk foods or nutritive liquids that are given to young children during the period of complementary feeding (WHO, 2006b).

Introduction of Solid, Semi-Solid or Soft Foods:

Proportion of infants 6–8 months of age who receive solid, semi-solid or soft foods during the previous day (WHO, 2007).

Minimum Dietary Diversity:

Proportion of children 6–23 months of age who receive foods from four or more food groups during the previous day. The seven food groups used for this indicator were: grains, roots and tubers; legumes and nuts; dairy products (milk, yoghurt and cheese); flesh meats (meat, fish, poultry and liver/organ meats); eggs; vitamin A-rich fruits and vegetables; and other fruits and vegetables (WHO, 2007).

Minimum Meal Frequency:

Proportion of breastfed and non-breastfed children 6–23 months of age who receive solid, semi-solid or soft foods the minimum number of times or more (two times for breastfed infants 6–8 months; three times for breastfed children 9– 23 months; and four times for non-breastfed children 6–23 months) in the previous day including a snack (WHO, 2007).

Minimum Acceptable Diet:

The proportion of children 6–23 months of age, who received minimum dietary diversity and attained the minimum meal frequency during the previous day (WHO, 2007).


1.10 Organizations of the Study

The chapter one consist of the introductory part of the study which includes the study background, the statement of the research problem, the study objective and scope of the study.

The second chapter is a critical review of other literatures relevant to the study and its objectives including the theoretical framework for the study. While the third chapter is methods of data collection, sampling and data analysis used in conducting the study. The fourth chapter centres around the research findings including an analysis of how it relates to previous findings. The fifth chapter consists of the summary of findings, conclusion and recommendations base on the study objectives.


Chapter Five


Summary, Conclusion and Recommendations

5.1 Introduction

This was a cross-sectional analytical study whose purpose was to determine the knowledge and practice of complimentary feeding among mothers of under five children in gadar maiwa community of ningi local government.

5.1.2 Summary of the Findings

The respondents were mostly young women (mean age 26.1±4.7 years), married (88.1%), housewives (66.4%) with mainly primary school level of education (47.2%). They were mainly of low socio-economic status with the main sources of income being small-scale business (48.6%) and casual labour (31.8%).

Mothers were fairly knowledgeable on complementary feeding practices with a score of 14.11±2.33 out of a total of 20. Mothers‟ knowledge was high in terms of; correct timing of introduction of complementary foods (90.9%), appropriate hygiene practices in terms of hand washing before preparation of children‟s food (93.4%) and the importance of providing balanced meals to children (93.4%). Knowledge gaps were observed in appropriate feeding of the sick children (23.8%) and the fact that mixed flours are inappropriate for making children‟s porridge (31.1%).
All (100%) the children aged 6-8 months had been introduced to solids, semi-solids and soft foods. Majority of the breast-fed children received the recommended minimum meal frequency, children 6-8 months old (95.9%) and those 9-23 months old (96.4%) unlike the non-breast fed children (6-23 months old) where only 55.0% received the recommended minimum meal frequency. Over three-quarters (79.0%) of the children attained the minimum dietary diversity whereas 75.9% attained the minimum acceptable diet.

Overall, 13.3% of all the children were stunted, 11.9% wasted and 16.8% underweight. Maternal knowledge on complementary feeding was significantly associated with nutritional status of the children. Mothers‟ who did not have the correct knowledge on feeding the sick and children recovering from illness were more likely to have underweight children (chi-square test; p=0.026). While mothers who did not know that a child‟s meal should be balanced were more likely to have underweight children (chi- square test; p=0.027).

Children who did not attain the minimum meal frequency were more likely to be underweight (chi-square test; p=0.013) and wasted (chi-square test; p=0.001) compared to those who consumed minimum meal frequency as per WHO (2007) recommendations.


5.2 Conclusions

The population was comprised of young mothers with low levels of education and low socio-economic status. 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.


5.3 Recommendations

5.3.1 Recommendations for Policy and Practice

Messages on the promotion of appropriate IYCF practices by the Ministry of Health and other organizations dealing with child health should emphasize: appropriate feeding of the sick child and those recovering from illness; the importance of dietary diversity and frequency of feeding especially for non-breastfed children, to improve child‟s growth and health.

The Ministry of Health and Organizations involved in child health issues should explore factors which influence mothers‟ knowledge on complementary feeding hence child nutritional status with a view of taking appropriate action to improve complementary feeding practices. . Positive cultural beliefs on complementary feeding practices should be encouraged and negative ones discouraged.

5.3.2 Recommendations for Further Research

This study was done in an urban poor-resource setting among mothers recruited from a health facility and therefore the findings may not be representative of mothers from such a setting. It is therefore recommended that a similar study in a community setting be conducted to verify the findings of this study.

There is need to conduct a longitudinal study to establish the whole array of factors that influence complementary feeding practices and over a period of time since this study only focused on mothers‟ knowledge and socio-economic factors.


Get Complete Project Material

6,000 Naira

The Complete Material Will Be Sent to You in Just 2 Steps

Quick & Simple…


Step One Purchase

Make Payment (Through Transfer) of ₦6,500 to the Account Below

Zenith BankAcc No: 1225513212
Samphina Academy
Current Account

Or CLICK HERE To Pay With Debit Card


FOR STUDENTS OUTSIDE NIGERIA
CLICK HERE To Purchase Material ($25)

Step Two Purchase

Send the Following Details on WhatsApp ( 08143831497) After Payment

  1. Payment Details

  2. TOPIC: Knowledge And Practice Of Complimentary Feeding Among Mothers Of Under Five Children In Gadar Maiwa Community Of Ningi Local Government

The Complete Material Will Be Sent To You On WhatsApp After Receiving Your Details
T & C Apply


  Contact Our Help Desk


Need a Different Topic? Perform a Quick Search



List of Related Works

Click on Any Topic to Preview the Content


Frequently Asked Questions


What do we know about mothers’ knowledge about breast feeding and complementary feeding?

Assessment of mother’s knowledge about breast feeding and complementary feeding and their practices and study of factors affecting them is of outmost important for health planners and policy makers. Objectives: To study the knowledge and practices of mothers about complementary feeding in infant and young child and factors influencing it.

Is complementary feeding inappropriateness of parents?

Inappropriateness of complementary feeding. The study revealed that most of the being carried out by them were found to be very low. Family type, knowledge about be not associated with the ideal feeding practices.

What percentage of mothers start complementary feeding at the discretion?

In this study human-milk period. Complementary feeding was started at the discretion of the mother in consultation with the child’s pediatrician. According to this study, forty-two per cent

What is the difference between complementary and mentary feeding?

It was found in the study that 66.9% of mothers used the separate container for comple mentary feeding. In the contrary, container to different children in some communities in our country. age. Both practices are not only desirable but also harmful to our children but complementary feeding developed problems of infections and malnutrition.  

samphina.academy

Samphina Academy

Samphina Academy is an Online Educational Resource Center that is aimed at providing students with quality information and materials to aid them in succeeding in their academic pursuit.