Influence of Information Sources on Knowledge, Attitude and Practice of Exclusive Breastfeeding Among Nursing Mothers
CHAPTER ONE
Objective of the Study
The main objective of this study was to investigate influence of information sources on knowledge, attitude and practice of exclusive breastfeeding amongst nursing mothers, in Minna, Niger State. The specific objectives are to:
- Identify the sources from which nursing mothers get information about exclusive breastfeeding;
- To assess the level of knowledge and the practice of exclusive breast feeding among nursing mothers.
- To ascertain the attitude of nursing mothers towards the exclusive breastfeeding.
- To find out the factors influencing the practice of exclusive breast feeding among nursing mothers.
CHAPTER TWO
LITERATURE REVIEW AND THEORETICAL FRAMEWORK
The concept of Exclusive Breastfeeding
Several health organizations, such as WHO, UNICEF, American Academy of Paediatrics, recommend exclusive breastfeeding for the first six months. It is considered as the most preferred way of infant feeding based on scientific evidence of the benefits for infant‘s survival, growth, and development. According to WHO (2002), exclusive breastfeeding means the infant receives only breast milk from his or her mother or a wet nurse, or expressed breast milk, and no other liquids or solids with the exception of drops or syrups consisting of vitamins, mineral supplements, or medicine. Gartner, Morton and Lawrence (2005), defined exclusive breastfeeding as an infant’s consumption of human milk with no supplementation of any type (no water, no juice, no non-human milk and no foods) except for vitamins, minerals and medications.
Introduction of solid or liquid foods to infants before the six months of age has been discouraged by many health organizations due to health implications associated with it. According to Naylor and Morrow (2001), if solids or complementary foods are introduced before a baby‘s system is ready to handle them, it is most likely going to be poorly digested and that may cause unpleasant reactions, such as digestive upset, gas, constipation, among others. This is because full term infants are not developmentally ready for the transition from suckling to sucking or for managing semi-solids and solid foods in addition to liquids until around six months of age. To enable mothers to establish and sustain exclusive breastfeeding for 6 months, WHO and UNICEF recommends initiation of breastfeeding within the first hour of life, exclusive breastfeeding, breastfeeding on demand, that is, as often as the child wants, day and night and also no use of bottleteats, or pacifiers (Gartneret al,2005).
Exclusive Breastfeeding Rate
Exclusive breastfeeding for up to six months has been the desired goal of many health organizations, but partial breastfeeding, as well as breastfeeding for shorter periods of time, has been and still remains prevalent in different parts of the world. Although, mothers have the edge to practice breastfeeding, majority of them are unable to exclusively breastfeed their infants for the recommended period as there exists serious obstacles to practicing it until six months from the infant‘s birth.
The rates of exclusive breastfeeding have improved over the recent past, with the global rate put at 37% (UNICEF, 2011). This was achieved through numerous awareness campaigns launched by national governments, multilateral organizations, non-governmental and private sector organizations across the globe to educate mothers and families about the benefits of exclusive breastfeeding and with the aim to encourage the practice (Ogbo et al, 2020). Such initiatives include Baby Friendly Hospital Initiatives (BFHI) and establishment of work place breast feeding facilities. Despite all these initiatives put in place, exclusive breastfeeding rate is particularly low in Africa, where less than one third of infants under six (6) months old are exclusively breastfed (UNICEF, 2009). According to (WHO, 2012), one out of three children has been exclusively breastfed in Africa. In addition, information provided by WHO (2011) on breastfeeding practices in 94 countries estimates that only 35% of the infants between zero and four months are exclusively breastfed.
CHAPTER THREE
RESEARCH METHODOLOGY
Research design
The study employs quantitative descriptive research design to examine knowledge and attitude of nursing mothers toward the practice of exclusive breastfeeding in Nigeria.
Research area
This study was carried out in Minna, Niger state. Niger state is located in the middle belt of Nigeria.
Sources of Data
The data for this study were generated from two main sources; Primary sources and secondary sources. The primary sources include questionnaire, interviews and observation. The secondary sources include journals, bulletins, textbooks and the internet.
Population of the study
A study population is a group of elements or individuals as the case may be, who share similar characteristics. These similar features can include location, gender, age, sex or specific interest. The emphasis on study population is that it constitute of individuals or elements that are homogeneous in description (Prince Udoyen: 2019). In this study the study population constitute of nursing mothers in Minna, Niger state.
Sample size determination
A study sample is simply a systematic selected part of a population that infers its result on the population. In essence, it is that part of a whole that represents the whole and its members share characteristics in like similitude (Prince Udoyen: 2019). In this study, the researcher used 208 nursing mothers from 4 randomly selected local government areas in Minna, Niger state.
CHAPTER FOUR
DATA ANALYSIS AND INTERPRETATION
Socio-Demographic Data
This section presents the socio-demographic characteristics of the respondents using two sets of tables. The first Table presents the Age, Religion and Level of Education, while the second table is on Level of Income of respondents, ethnic group, marital status and mother‘s category (expectant mother, nursing mother and experienced mothers).
Table 4.1.1 is on the socio-demographic data of the respondents. The practice of exclusive breastfeeding varies across different age groups; therefore, women‘s age plays a significant role in projecting disparities on knowledge and practice. Respondent‘s distribution based on age shows that majority 38% are within age bracket of 28-33 years followed by 35% aged 34-39. Women within ages 28-33 and 34- 39 are mostly in their childbearing age. This explains why they are the majority among other age groups.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary of Key Findings
The study discusses essentially, the knowledge attitude and practice of exclusive breastfeeding among women among nursing mothers in Niger state. The objectives of the study were to find out women‘s knowledge of exclusive breastfeeding, examine the attitude of women towards exclusive breastfeeding among nursing mothers in Niger state, identify the behaviour of women towards exclusive breastfeeding in the study area and analyse factors influencing the practice and non-practice of exclusive breastfeeding among women in the study area.
The findings showed that most (38%) of the respondents were within the age bracket of 21-30 years, findings also revealed that respondents who were between the ages of 21-30 practiced mixed feeding more than other age groups. Furthermore, majority (52%) of the respondents are Christians, most of the respondents have (53%) have attained tertiary education and majority (31%) are public servants. Findings also reveal that majority (33%) of the respondents earn below 18,000 naira monthly, most (40%) of the respondents are from other tribes, majority (84%) are married women, and (40%) are experienced mothers.
Findings on knowledge of exclusive breastfeeding show that majority (95%) of respondents were aware of exclusive breast feeding, majority(85%) received their education in a hospital, majority (51%) believe that breastfeeding should be initiated within one hour of birth, most (81%) of the respondents believe it is recommended for 0- 6months and majority (61%) of the respondents believe it is beneficial to both the mother and child. Further findings revealed that respondent‘s knowledge of benefits of exclusive breastfeeding. Result shows that majority (93%) agreed that breastfeeding increases mother and infant bonding, 92% of the respondents agreed that exclusive breastfeeding increases stronger immune system. Also, majority (93%) agreed that exclusively breastfed infants have reduced risk of infectious diseases and majority (66%) agreed that exclusively breastfed infants have reduced rates of diseases.
Findings also reveal that majority, agreed that mothers who breastfeed exclusively have reduced risk of breast and ovarian cancer with83% and 85% respectively. Analysis on higher cognitive development capacity of exclusively breastfed infant shows that majority 75% of the respondents agreed that exclusively breast-fed infants have higher cognitive development and intellectual capacity than their formula fed peers, 83% agreed that exclusive breastfeeding increases intellectual capacity and 81%believe that exclusive breastfeeding reduces health care cost.
Findings further revealed that majority (71%) agreed that mother‘s perception of insufficiency of breast milk discourages the practice of exclusive breastfeeding and most (66%) agreed that lack of maternal education predisposes mothers not breastfeed exclusively. Results also revealed that majority (85%) agreed that nutritional status of mother influences decision to breastfeed exclusively and majority (53%) agreed that mother/child medical condition can hinder the practice of EBF. Finally, majority (16%) of respondents suggested education for everyone as means of motivating the practice
Conclusion
Mixed feeding still seems to be more prevalent among nursing mothers in Niger state. Despite the increased knowledge of exclusive breastfeeding, and the favourable attitude towards it, it consequently reflects in the health of mothers and children. This implies that the knowledge of exclusive breastfeeding does not necessarily translate into practice. Other factors were identified as barriers to the practice. Such factors include: lack of support from spouse and relatives, employment, lack of support from co-workers and management at places of work. Also, findings of the study revealed that social cultural beliefs and practices, lack of maternal education, poor perception about insufficiency of breast milk and poor power supply for the storage of expressed breast milk, hinders the practice of exclusive breastfeeding. Maternal nutritional status, medical condition, and infant‘s medical condition were also identified as possible factors that hinder the practice of exclusive breastfeeding.
Recommendations
Based on the findings of the research, the following recommendations are made:
- Although, knowledge is no longer a challenge like it was before, the ministry of health and other health organization still need to intensify their efforts in educating women of child bearing age by organizing seminars and symposia specifically addressing the concerns of delayed milk production and breastfeeding difficulties. Mothers should be educated on breastfeeding techniques, how to care for the breast and ways to prevent breast feeding problems such as breast pain and engorgement. They also need to be educated on how to maintain good health and proper diet as they contribute to ensuring a successful practice.
- Current public health interventions on exclusive breastfeeding are tailored to the needs of breastfeeding women only. As a result, health organizations and NGO‘s should come up with strategies in educating grandmothers, fathers and traditional birth attendants with the aim at increasing the familiarity of family relations on exclusive breastfeeding, as they play a key role in influencing mothers in infant feeding practices. Husbands should be fully involved throughout the stages of pregnancy and delivery so they can understand what is needed to provide adequate support
- Breastfeeding education should be introduced in school curriculum. That way, young people of both sexes can be educated at an earlier stage as they are future parents.
- Based on the findings of the study, lack of support from management at the work place has been a barrier to the practice of exclusive breastfeeding. Therefore, the ministry of labour and productivity need to address women‘s right to breastfeed in the workplace by ensuring that employers provide breastfeeding and expressing facilities at the work place, such as crèche facilities to be used by employees who are nursing mothers. Also, employers should consider reduced working hours for breastfeeding employees or extension of maternity leave period. This will give nursing mothers time to breastfeed on demand and that will consequently motivate the practice of exclusive breastfeeding.
- Based on the findings of the study, lack of support was identified as one of the major factors that hinder the practice of exclusive breastfeeding. Therefore, government in collaboration with health organizations should come with intervention on behaviour change programmes to support the practice of exclusive breastfeeding.
- Government and health professionals need to especially target low-income women when creating and applying interventions. Women with very low income find it difficult to feed themselves let alone breastfeed exclusively. Early cessation was associated with impoverished living conditions, and the government need to tackle the issue of poverty and improve its citizen‘s standard of living.
- Government and electricity distribution companies should address the problems of power supply so as to ensure a proper storage of expressed milk.
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