Factors Influencing the Choice of Infant Feeding Practice Among Women of Child-Bearing Age
Chapter One
General Objectives
To assess the factors influencing the choice of infant feeding practice among women of child bearing age in Lagos, attending Lagos State Primary Health Centre.
Specific Objectives
- To determine the choice of infant feeding practice among women of child bearing age in Lagos attending Lagos State Primary Health Centre.
- To establish the relationship between social-demographic factors and choice of infant feeding practice among women of child bearing age in Lagos attending Lagos State Primary Health Centre.
- To establish the effect of culture on choice of infant feeding practice among women of child bearing age in Lagos attending Lagos State Primary Health Centre.
- To establish the infant factors influencing choice of infant feeding practice among women of child bearing age in Lagos attending Lagos State Primary Health Centre.
CHAPTER TWO
LITERATURE REVIEW
Breastfeeding of human infants has been a common feature of all cultures and all times because our very survival depends on it. In contrast, other modes of infant feeding: what is fed, when, how and by who have differed according to both time and place (WHO, 2020).
The world health organisation recommends exclusive breastfeeding of infants for the first six months using on demand feeding and with initiation within the first hour of birth. Nutritionally adequate, safe and appropriate complementary foods should be introduced after six months. Breastfeeding should be encouraged for up to two years (Ulak et al., 2021). Exclusive breastfeeding for six months of age is recommended for HIV positive mothers with abrupt cessation of breastfeeding and introduction of safe and appropriate weaning and other foods. When implemented in both developed and resource poor developing countries, these recommendations have been shown to reduce both morbidity and mortality and also provide more pronounced benefits to the mother (Kruger and Gericke, 2011; Ulak et al, 2021).
Breastfeeding is accepted as the natural and optimal means of nourishing an infant and of preventing morbidity and mortality. The superiority of breast milk has been confirmed: it is the best (Kruger and Gericke, 2011). Colostrum, the yellowish, sticky breast milk produced at the end of pregnancy, is recommended by WHO as the perfect food for the newborn, and feeding should be initiated within the first hour after birth (WHO, 2021).
Globally, an average of about 35% of infants between ages of child bearing age are breastfed exclusively. The nutritional, immunologic, and economic advantages of breastfeeding are well recognized. In the 2019 Paediatric Nutrition Surveillance System (PedNSS), 61.7% of infants were ever breastfed, 27.0% were breastfed for at least 6 months, and 18.5% were breastfed for at least 12 months (CDC, 2011). Poor breastfeeding and complementary feeding practices have been widely documented in developing countries with only about 39% of infants exclusively breastfed for the first six months.
In the USA breastfeeding report card 2020, exclusive breastfeeding rates were 33% at 3 months and 13.3% at 6 months. A similar report in 2011 indicated exclusive breastfeeding rates at 35% at 3 months and 14.8% at 6 months.
In India, according to 2015-2016 report, 58% of infants under four months were exclusively breastfed while 46% of those under 6 months were breastfed exclusively (WHO, 2021).
In Ghana, only 8% of children under four months of age are breastfed and 45% are given some form of supplementary feeding by age three months (Awumbila, 2013).
In Nigeria, according to Nigeria Demographic and Health Survey (KDHS) 2018-2019, 32% of children under the age of six months are exclusively breastfed an improvement from 13% in 2013 (Kimani-Murage et al, 2011).
Urban poor settlements or slums provide distinct challenges with regards to child health and survival. Slums in sub-Saharan Africa expand at a fast rate with majority of urban dwellers living in slum settlements. They are characterized by poor environmental sanitation and livelihood conditions and as such urban slum dwellers tend to have very poor health indicators contrary to the long-held belief that urban residents are advantaged with regards to health outcomes (Kimani-Murage et al, 2011). In Nigeria, slum children are reported to be sicker and to have higher mortality rates than any other sub-group in Nigeria including the rural areas. Therefore, infants born to mothers that reside in the urban slums may be exposed to sub-optimal breastfeeding and complementary feeding practices.
Despite efforts by Health Service Providers (HSPs) to increase the percentage of breastfed babies, not much success has been achieved because feeding practices are directly related to varied economic, socio-cultural and religious factors in the community and to various dynamics prevailing at the household level (Awumbila, 2013). Sub-optimal breastfeeding and complementary feeding practices are associated with various factors including maternal age, marital status, education level and occupation; antenatal and maternity health care; health education and media exposure; culture, socio-economic status and area of residence; and the infant’s birth weight, birth order and use of pacifiers (Kimani-Murage et al, 2011).
CHAPTER THREE
Methodology
Study design
A descriptive cross-sectional study design will be used to collect data through a quantitative approach. The design will be chosen as it focuses on collecting data concerning factors influencing mothers or caregiver knowledge, attitudes and practices on optimal infant feeding practices at one point in time.
Study population
The target population will comprise all breastfeeding mothers or caregivers with infants between ages of child bearing age in Lagos State. The accessible population consisted of breastfeeding mothers or caregivers of infants of child bearing age in Lagos attending Lagos State Primary Health Centre.
Sample size calculation
The sample size selection will be calculated using the kish and leslie formula.
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