Infant Weaning Knowledge and Practices Among Mothers in Ikenne Local Government Area, Ogun State
Weaning is the introduction of supplementary food to a child’s diet after the first six months of life. Early introduction of feeds and incorrect weaning practices are commonly found in communities around the world. This research was designed to explore infant weaning knowledge and practices among mothers.
Descriptive research design was adopted. The populations were 260 mothers attending three Primary Healthcare Centres in Ikenne Local Government. Sample size was determined using Leslie Kish formula and simple random sampling was adopted to select 100 mothers for the study. A designed questionnaire was used to collect data from participants. Face and content validity of the questionnaire was ascertained by presenting it to experts in the field. Reliability was tested using split-half method and Cronbach alpha reliability coefficient was 0.85. Data was processed using statistical package for social sciences (SPSS) version 21. Two research questions were answered using descriptive statistics of mean standard deviation. Four hypothesis were tested using inferential statistics of Pearson correlation at 0.05 level of significance.
The study revealed that 8(8%) of mothers had low knowledge level on infant weaning, 50(50%) had moderate knowledge level and 42(42%) had high knowledge level. Also, 3(3%) of mothers had high practice level on infant weaning, 66(66%) had moderate practice level and 31(31%) had low practice level on infant weaning.There is a significant relationship between occupation and weaning practices among mothers (r = 0.035; p = 0.004). There is also a significant relationship between educational level and weaning practices among mothers (r = 0.003; p = 0.000), whereas there is no significant relationship between ethnicity and infant weaning practices among mothers (r = 0.036; p = 0.723) and there is a significant relationship between mothers knowledge level and infant weaning practices among mothers (r = 0.086; p = 0.001).
In conclusion, infant weaning knowledge and practices among mothers is moderate. The study recommended that nurses should regularly train mothers on infant weaning to improve their knowledge and practice regarding infant weaning.
Keywords: Weaning, Mother, Knowledge, Practice, Infants
1.1 Background to the study
The World Health Organization (WHO) and United Nations International Children‟s Emergency Fund (UNICEF) recommended that after delivery, optimal early
breastfeeding practices should be encouraged. These optimal practices include initiating breastfeeding within 30 minutes to an hour of birth, giving colostrum, not giving prelacteals or post-lacteals and exclusive breastfeeding (EBF) of infants. This is because these practices have been proven to provide significant benefits for the overall development and survival of children (WHO & UNICEF, 2009). The international Baby Friendly Hospital Initiative (BFHI), which was launched in 1991 by UNICEF and WHO promotes and protects maternal and child health. This is achieved by ensuring that mothers are supported and helped with breastfeeding in maternity care facilities. It has been proved that the Baby Friendly Hospital Initiative (BFHI) affects the early initiation and EBF breastfeeding rates directly at the hospital level (Abrahams & Labbok, 2009).
Timely initiation of breastfeeding is when a baby is put to the breast within an hour of birth according to WHO (2008), and within half an hour in Nigeria (MOH, 2013). According to UNICEF (2014), the prevalence of timely initiation of children breastfeeding (within 1 hour) is 43% globally, 48% in Sub-Saharan Africa, and 58% in Eastern and Southern Africa. In Nigeria the rate of breastfeeding is reported to be 97%. It is also reported that 86% of Nigerian mothers initiated breastfeeding within one day of birth while 62% initiated breastfeeding within 1 hour of birth. In the Rift Valley region, the rate of timely initiation has been reported to be 69.4% (Nigeria National Bureau of Statistics ICF Macro, 2014). Studies report that early initiation of breastfeeding is a strategy that can be used to reduce neonatal morbidity and mortality (Shwetal, Pooja, Neha, Amit, & Rahul, 2012).
Giving colostrum to a baby is another optimal Weaningpractice that should be encouraged after initiating breastfeeding successfully. Colostrum is the first thick, yellow milk that contains antibodies which protect the baby from illness (MOH, 2013). According to recommendations, children should be fed on colostrum within one hour or immediately after birth and should continue to be breastfed exclusively even if regular milk has not yet started to flow (Nigeria National Bureau of Statistics ICF Macro, 2014). In a study in Southern Ethiopia by Adugna, (2014) some women considered colostrum as expired milk and gave pre-lacteal feeds instead and discarded the colostrum.
The term weaning means “to accustom to”. Weaning or complementary feeding is the introduction of semisolid or solid food in infant who is on liquid diet. When breast milk is no longer enough to meet the nutritional needs of the infant, complementary feeding or weaning should be started.
The transition from exclusive breast feeding to semisolid foods is a very vulnerable period because it is the time when malnutrition starts in many infants, contributing significantly to the high prevalence of malnutrition and infection in children under five years of age worldwide.
Timely weaning is an important process in every child which has an impact on future health, growth and development of the child. Weaning also marks the beginning of the child developing some degree of independence. Weaning foods should be adequate in nutrition, appropriate in consistency, given in sufficient quantity and hygienic. According to the WHO guidelines weaning should be started at 6 months of age along with breast feeding up to 2 years or more.
The decision when and how to start weaning is a complex issue among mothers and there are various factors influencing weaning. Understanding the decision making process, beliefs, knowledge, attitude and practices of weaning and factors influencing weaning is an important step prior to designing an intervention strategy to affect change in behavior.
Poor breastfeeding and weaning or complementary feeding practices, coupled with high rates of infectious diseases, are the principal proximate causes of malnutrition during the first two years of life. For this reason, it is essential to ensure that mothers and caregivers are provided with appropriate guidance regarding optimal feeding of infants and young children.
1.2 Problem statement
The Nigeria National Bureau of Statistics ICF Macro (2014), cites the rate of initiating breastfeeding within 1 hour in Nigeria as 62% of children ever breastfed, and the rate of giving pre-lacteals as 15.4%. In Rift Valley province, 69.4% of children ever breastfed are initiated to breastfeeding within 1 hour. This indicates that good Weaningpractices are still sub-optimal in Nigeria, specifically in Ogun State, and this presents a challenge to meeting goal three of the Sustainable Development Goals (SDGs), and the second pillar of Nigeria Vision 2030. According to Shommo, Sohair, and
Shubrumi, (2014); and Garg et al., (2010) there is limited maternal knowledge about early breastfeeding, and an attitude gap with regards to Weaningwhich could impede optimal practice. There is limited literature on the Weaningknowledge, practices, and attitudes of mothers who deliver in a hospital, and no study has been conducted in MTRH or in Ogun State to determine the knowledge, attitudes and practices on early breastfeeding.
This study seeks to establish the knowledge, attitudes, and practices on Weaningamong mothers who deliver at the Moi Teaching and Referral Hospital (MTRH), in Ogun State. The MTRH being a the largest facility in the region serving the entire north rift, Nyanza, western Nigeria and also part of eastern Uganda.
1.3 Objectives of study
1. To assess the knowledge, attitude and practices regarding weaning or complementary feeding among mothers with children 6 months to 24 months of age.
2. To know the source of information and various factors influencing age of weaning like parity, education, occupation, socioeconomic status, sex of the child, religion, residence.
3. Age of weaning started and its effect on growth of the child.
1.6 Significance of the study
The findings of this study will contribute to the knowledge generated in future studies. The findings may also benefit stakeholders such as the Ministries of Health (Division of Nutrition) at national and county levels, institutions such as the MTRH and other health facilities in Uasin Gishu and Nigeria by providing a reference, which may inform policies. Non-governmental organizations (NGOs), community-based organizations (CBOs) and other institutions, which are concerned with infant and young child health can also benefit from this study. The study highlights the gaps in Weaningknowledge, attitude, and practices among mothers delivering at health facilities.
The study sought to assess the Weaning knowledge, attitudes and practices of mother‟s who deliver in a hospital as determined by rooming in, skin to skin contact, giving/not giving pre-lacteals, exclusive breastfeeding, timely initiation of breastfeeding, and giving/not giving post lacteals. The study was conducted at MTRH in Ogun State, and therefore findings can only be generalized to health facilities and populations of similar characteristics.
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