ABSTRACT
This study examined the infant feeding
practices of women attending infant welfare clinics in Nsukka Local Government
Area. To achieve the purpose of the study eleven research questions and six
corresponding hypotheses were posed to guide the study. The research questions
and hypotheses sort to identify the relationships and the significance of the
relationship between six independent variables of age, parity, level of
education, occupation, location and marital status. Quantitative data were
collected using a researcher-made questionnaire with twenty three items. The
questionnaire was used to collect data on the mother’s socio-demographic
variables and their infant feeding practices. The questionnaire was distributed
to 630 mothers drawn from the area of study. The descriptive survey research
design was used for the study. The population for the study consist of all the
mothers that brought their children to infant welfare clinics. The sample for
the study was 630 mothers that brought their children to infant welfare clinics
in Nsukka Local Government Area. The collected data were analysed using
percentages, chi-square and Anova. The result showed that there was no
significant relationship between age, parity and feeding practices at .05 level
of significance while there was significant relationship between level of
education, occupation, location, marital status and infant feeding practices
all at .05 level of significance. It was recommended among others that nurses,
doctors, health workers should intensify health education teaching to mothers
to change their negative attitude towards infant feeding and imbibe positive
attitude.
CHAPTER ONE
Introduction
Background to the Study
Human beings are essentially the products of what they eat. This suggests that eating right leads to wellness while malnutrition leads to impaired health, and for children, impaired growth as well. Malnutrition which means taking less nourishing foods and drinks than the body needs (Kibel and Wagstaff, 1995) has been linked with serious health problems across populations worldwide.
Earlier Huffman and Martin, (1994) stated that infants and toddlers have been identified as the most common victims of malnutrition because of their vulnerability during the growth phase. Nel and Lodzani (1993) had also earlier stated that inadequate qualities of breast milk or inappropriate weaning practices leads to malnutrition that could cause stunted growth at a later stage.
Black and Brown (1996) stated that several researchers have found that breast feeding is supplemented from as early age even in the first month with either milk or water, fruit juice, tea, gruel, cereal, fruit and vegetables, and this affect the child’s growth and development. Steyn (1993), earlier stated that infant feeding practices clearly affect a child’s nutritional status, health and growth hence the need arises for an increased focus on feeding practices of infants to help reduce chronic malnutrition and mortality, and this could be achieved if infants are adequately fed.
Adequate nutrition as was defined by Federal Government of Nigeria (FGN, 2005) is the intake and utilization of enough energy and nutrient to maintain well being health and productivity of an individual; in this case the infant, stating that the provision of adequate nutrition during infancy and early childhood is a basic requirement for the development and promotion of optimum growth, health and good behavior of an infant. Federal Government of Nigeria (FGN, 2005) defined infancy period as the period from birth to one year of age, and noted that it is recognized as a critical period for which adequate nutrition should be provided for the infant to achieve optimum development and full potential. Earlier Ene-Obong (2001) had stated that the first months of life outside the womb is crucial. It is a period of intensive growth in the life of an individual. An infant doubles its weight from 3kg to 6kg in four months, then shows down, reaching about 9kg at one year. The length of the infant also increases rapidly within the first three months and by the end of the first year the total length is about 1½ times the birth length. The nutrient requirements of the child are high per unit body weight because of the rapid growth rate during this period, and this stresses the need for an increase focus on the infant feeding practices in order to ensure adequate nutrition for the proper growth and development of an infant.
American Heritage (2009) defined practice as to do something or perform habitually or customarily polish a skill. Kernerman (2010) defined practice as the usual way of doing things, a habit or idea. Based on the definition, infant feeding practice is a way in which mothers feed their infants base on the knowledge acquired because of their custom. It is recommended that children are breastfed for the first six months of life before other foods are introduced. For some mothers, this breastfeeding continues along side other foods for up to eighteen (18) months.
Breastfeeding is the feeding of babies with breast milk and according to WHO/UNICEF (1990), it is a natural way of providing idea food for the healthy growth and development of the infant and has unique biological and emotional influences on the health of both mother and child. Smith (2006) noted that breast milk meet infant nutrient need for the first 6 months of life. He also noted that breastfeeding reduces the infants overall risk of developing infections, this is partially because an infant can use the antibodies in human milk.
Wardlaw, 2006 in supporting the view reported that breastfeeding has a lot of advantages, which includes fewer intestinal infections, respiratory and ear infections and fewer allergies also food intolerances. Breastfeeding is also less expensive and more convenient for the mother. According to Encyclopedia of Health and Education (2006) no laboratory has been able to create a product which has all the nutritional properties of breast milk, stating that breast milk is the natural food for a baby and is the only food which is perfectly adapted to baby’s needs, because it contains protective components which come from the mothers blood, stressing that mothers should breast feed their babies exclusively for 6 months for the healthy growth of the child.
W.H.O (2001) defined exclusive breast feeding as the feeding of an infant on breast milk alone for six months of life, without the addition of water, food or drinks. The baby however receives vitamins, minerals and medicines in the form of drops and syrup as need arises, noting that lack of exclusive breastfeeding is a major cause of infection in early infancy and precipitate malnutrition. Mothers should breast feed babies for the first six months of life to avoid infection which might be introduced while using dirty feeding utensils in feeding babies. Urban dwellers should be encouraged to breast feed for six months irrespective of their nature of work.
A mother is described as a female parent. Data from WHO (2000) showed that mothers in rural areas breastfed for longer periods of time between 18-24 months. Uwaegbute and Nnanyelugo (1987) had earlier reported that while majority of mothers breastfeed for at least six months, there was a great variations in duration of breastfeeding with non-educated mothers breastfeeding for longer periods of time and the duration decreasing with increasing in educational achievement.
Okoli (2009) stated that the influence of western culture through education and mass media led to decline in breastfeeding. She noted other reasons for the decline included mothers going back to work, and inadequate breast milk. This induced the mothers to introduce artificial feeding early in the baby’s life. The artificial feeding is adopted alongside breastfeeding. She defined artificial feeding as the feeding of an infant with infant milk formular.
Kaine (1985) had earlier stated the main artificial milk used all over the world is cow’s milk. She noted that cow’s milk is given where mother’s milk is insufficient for the infant need. Artificial milk could also be given at the death of the mother, or mother was absent and there was no one else to breastfeed the baby, it can also be given when mother work outside the home, noting that all these are to ensure that the baby get enough nutrient for proper growth and development.
WHO (2000) noted that in urban areas, the use of cow’s milk was more common and should be discouraged. They stated that the early introduction of cow’s milk is associated with diarrhea due to use of contaminated feeding utensils and contaminated water. They also noted that the time of introduction of cow’s milk depended on the mother’s education and family income, stating that infants from wealthier families receive cow’s milk significantly earlier than those from low income families.
According to Smith (2006) at six months of age babies need other foods in addition to breast milk or formular feed. These foods termed complimentary food which means the introduction of other food in addition to breast milk are semisolid foods such as cereal, pap, soup among others. Complimentary food should be highly enriched to ensure proper nutrition for growth and development. Although complimentary food is introduced at 6 months WHO (2000) advocates that breast feeding should be continued till the child is up to two years of age before weaning the child.
Okoli (2009) defined weaning as the transition from breast milk as the sole source of nourishment to usual family diet. She noted that it is the process of introducing foods other than breast, to a child and gradually increasing the amount so that eventually the child gets enough energy and nutrients from the family food, noting that the diet varied according to family income. The author also noted that most weaning foods fail to provide adequate nutrients and are often deficient in protein land micronutrients, such as vitamin A, iron and 2inc, noting that the child loses appetite as a result of this quality food, the mothers resort to forcefully feeding the baby.
This forced feeding is described by Jegede (2006) as an infant feeding method where mothers force their babies to eat with the sole aim of emptying the whole content inside the infant’s stomach. He noted that forced feeding leads to diarrhea as mother may not wash their hands properly before they feed their babies. The utensils are not also properly cleaned. He observed that child’s feeding satisfaction is measured by mother’s perception while she observes the child’s stomach, if the child is heavy the child is taken to have been satisfactorily fed. Continuing, he observed that this situation often results in over feeding which leads to abdominal pain, such children he noted express discomfort by crying for a long time after feeding is over. Jegede further stressed that forced feeding can lead to choking. He observed that while forcing the baby to eat, food particles or liquid may escape to the to the trachea and lung of the babies which may result in serious cough and other respiratory tracks infection or sudden death. These problems could be prevented if mothers had a good knowledge in feeding of infants. Such knowledge is given to mothers during child welfare clinics. This makes it mandatory that mothers should attend infant welfare clinic to acquire enough knowledge on child rearing.
Akinsola (1993) defined infant welfare clinic as a place where a child’s health and growth is monitored from 0-12 months of life. He noted that the aims of such clinics are to prevent illness, promote health, and provide treatment for minor ailments.
Nsukka Local Government Area has up to twenty seven health facilities providing infant welfare clinics. Majority of women of child bearing age take their children to these clinics for infant welfare services, this gives the researcher the opportunity of coming in contact with these children, observing their health status, growth rate and feeding pattern. This study focuses on the infant feeding practices of mothers, the different methods of infant feeding such as exclusive breast feeding, complementary feeding, bottle feeding, and infant weaning practices. In other words, the researcher seeks to find out whether proper infant feeding practice in carried out and how mothers carry out these infant feeding practices in Nsukka Local Government Area.
Studies have shown that such practices are often dependent on certain demographic variables for example, such practices have been linked with age and level of education of the mothers. According to Ford and Labbor (1990), older and more educated mothers are the subgroup most likely to choose breastfeeding as their preferred infant feeding method. Such mothers, they added, generally breastfed their children longer than other groups.
Furthermore, mothers’ occupation has been linked to infant breastfeeding practice. Spisak and Gross (1991) observed that mothers on full-time employment usually breastfeed their babies less regularly and for shorter duration.
With regard to parity, Delamora (1999) suggested that those with more pregnancies appear to be more dispose to breastfeed their babies than those with fewer previous pregnancies. This present study intends to examine these demographic variables in relations to infant feeding practices of mothers in Nsukka Local Government Area, and any practice that does not meet the recommended practice as in the definition of exclusive breastfeeding, complementary feeding, weaning diet should be regarded as not acceptable practice, the practices that in line with the definitions are accepted.
Statement of the Problem
Breast milk is regarded as the best method of feeding an infant. It should be started immediately after birth, and the baby is to be fed exclusively on breast milk for six months, there after complementary feed should be introduced. The complementary feed is mainly semi solid food which is to be highly enriched to ensure proper nutrition for growth and development.
Researchers have shown that many nursing mothers do not start breast feeding immediately after birth. The reasons given for this include that breast should be washed and allowed to start producing milk before giving it to the baby. Others opined that the first milk, Colustrum (yellow milk which is rich in nutrient and antibodies) that comes out of the breast should not be fed to the baby as the milk is bad and should be pressed out. Therefore breastfeeding should not commence until this yellow milk has stopped flowing. This notion is supported by Wardlaw (1999) who affirmed that in some communities breastfeeding is not commenced immediately after birth, this may be the case with mothers in Nsukka L.G.A.
Mothers in Nsukka Local Government Area are mostly not gainfully employed, as a result, poverty level is high among the women. This has resulted in many children being malnourished as can be observed from the child welfare clinics. Some of the children have discoloured hair, small weight and are not growing well. It could be that such mothers started complementary feed early and such foods are poor in nutrient, or that the breast milk is not flowing enough to satisfy the child as the mother herself may be malnourished. Meeting the nutritional needs of these children is of primary importance if they must be helped to grow, develop and become responsible adults. This, in the main, has aroused the interest of this investigator to find out the infant feeding practices of mothers in Nsukka Local Government Area. Furthermore, to the best knowledge of the researcher, no such study has been conducted in Nsukka Local Government Area.
