ABSTRACT
Breastfeeding
rates have increased in recent times in countries that have enacted measures to
protect the rights of infants and mothers. The main objectives are to determine
factors that could enhance the practice of exclusive breast feeding and to
establish factors that could enhance exclusive breastfeeding among mothers
attending PHC, Irrua. The research design used is a descriptive survey
research, instrument used was questionnaire. From the result gotten, it was
found that finance constitutes 89% workload 97%, nature of work 87%, age of
child 93%, poor knowledge 93%, Health of mother 87%, Congenital abnormalities
97% of the factors affecting exclusive breastfeeding. Conclusively, it was
found out that majority of the mothers are now aware of exclusive breastfeeding
and are trying to make effort to practice it. The researcher put up the following
recommendations: Government should try to increase maternity leave, all
establishments should have a crèche to promote breast feeding, health workers
should intensify their health education, home visit and communication to
promote exclusive breastfeeding.
CHAPTER
ONE
INTRODUCTION
Background
of the Study
Breast feeding is a physiological process
through which all mammals feed their babies. Hor nby (2000) defines breast
feeding as an act of feeding from the breast. According to Makanjuola (2006)
breast feeding is the best type of feeding for infants particularly during the
first six months of the child’s life; because it provides the baby with the
essential nutritional requirements when exclusively fed with the breast milk.
While health according to WHO (2002) is defined as the state of complete
physical, mental and social well-being.
Exclusive breastfeeding refers to feeding an
infant with breast milk from his or her mother or a wet nurse, or expressed
breast milk without any additional solid or liquid foods, except for oral rehydration
salt, syrups of vitamins, minerals and medicines (World Health Organization,
2008). Infants should be given exclusive breastfeeding from birth until six
months and continues up to two years, with introduction of complementary food
at the age of six months (World Health Organization, 2003; National
Coordinating Committee on Food and Nutrition, 2010).
Research showed that babies who are
breastfed exclusively for 6 months experience less illnesses because breast
milk contains nutrients and substances that protect the baby from several
infections, some chronic disease and it leads to improved cognitive development
(Hafizan, . 2014). Gastroenteritis, or the family of digestive diseases whose
primary symptom is diarrhea, occurs less often among exclusively breastfed
children and is less severe when it does occur (Clark and Bungum, 2003; Alemayehu
. 2009).
WHO recommends that infants should be
exclusively breastfed for the first six months and up to two years or beyond.
Despite appropriate feeding practice is the most cost effective intervention to
reduce child morbidity and mortality, only 38% of children less than 6 months
of age are exclusively breastfed in the developing countries (Sefene, .
2013,Kemi and Olurotimi, 2011 ; Tengku, . 2013, UNICEF, 2006; Yadavannavar and
Patil, 2011). In a systematic review and meta-analysis of four observational
studies from the UK and US in 2004, Martin and colleagues showed there was no
association between breastfeeding and mortality from cardiovascular disease
(Robinson and Fall, 2012). One and half million infants’ deaths can be avoided
each year by exclusive breastfeeding. Children who are exclusively breastfed
have protection from several acute and chronic diseases such as, otitis media,
respiratory tract infections, atopic dermatitis, gastroenteritis, type 2
diabetes, sudden infant death syndrome, and obesity and asthma during childhood
(Al-Akour, 2014).
Several studies have shown that mothers find it difficult to meet personal
goals and to adhere to the expert recommendations for continued and exclusive
breastfeeding despite increased rate of initiation (Whalen and Cramton, 2010).
Some of the major factors that affect exclusivity and duration of breastfeeding
include breast problems such as sore nipples or mother’s perceptions that she
is producing inadequate milk (Nkala and Msuya, 2011; Cherop, Keverenge-Ettyang,
and Mbagaya, 2009; Thurman and Allen, 2008); societal barriers such as
employment and length of maternity leave (Thurman and Allen, 2008); inadequate
breastfeeding knowledge (Cherop, Keverenge-Ettyang, and Mbagaya, 2009); lack of
familial and societal support; lack of guidance and encouragement from health
care professionals (Ku and Chow, 2010; Thurman and Allen, 2008). These factors
in turn promote the early use of breast milk substitute.
Predictors of breastfeeding and weaning practices vary between and within
countries. Urban or rural difference, age, breast problems, societal barriers,
insufficient support from family, knowledge about good breastfeeding practices,
mode of delivery, health system practices, and community beliefs have all been
found to influence breastfeeding in different areas of developing countries (Nkala
and Msuya, 2011; Cherop, Keverenge-Ettyang, and Mbagaya, 2009; Thurman and
Allen, 2008). Information on the prevalence and factors influencing infant
feeding practices is limited in Mauritius and dates back to 2006 (Grummer-Strawn,
Kalasopatan, Sungkur, and Friedman, 2001). The breastfeeding at work is influenced by
several social and cultural factors that influence the frequency, duration and
initiation of breastfeeding practices among mothers (19-21). Economic factors
compelling mothers to work during breastfeeding (19,21). Socioeconomic status,
race, ethnicity, employer’s attitude and other factors have been found to
affect the working mother's choice whether or not to breastfeed, and how long
she breastfeeds her child. The cultural support for breastfeeding differs,
still some societies identify the mother as either work oriented or family
oriented (mother or worker) and to combine breastfeeding with work seems quiet struggling
for working mothers. Most female employees maintain both social roles (mother
and worker) simultaneously and reported to negotiate the boundaries on daily
basis. Cultural variations in breastfeeding can bring visible change on the
effect of the usual demographic variables on breastfeeding prevalence.
Statement
of the Problem
Several factors affect mother’s infant feeding choices and options,
including their social roles, availability of artificial baby milks, cultural
norms and hospital birth practices. A woman’s return to work has frequently
been found to be a main contributor to the early termination of breastfeeding. There
are many issues that disrupt mother’s breastfeeding plan at work. Commonly cited
issues are lack of workplace breastfeeding facilities, lack of family support, mother’s
inadequate knowledge about breastfeeding and feeling of embarrassment.
Working mothers often face inflexibility in the working hours, unable to
find facility for childcare at or near the workplace, lack privacy for
breastfeeding, place to store breast milk (refrigerator), limited paid
maternity leave and fear over job insecurity. Almost all mothers can
breastfeed, as long as they have correct information and support from their
family, employer, health care system and society. Often healthcare providers
have limited knowledge and training on breastfeeding and breastfeeding support
at work. A study described that significant number of primary healthcare
providers were unable to provide mothers with the necessary information on
breastfeeding.
As a result of
the increase rate of diarrhea among breastfeeding mothers, global campaign urges mothers to be baby
friendly, however, in most developing countries of the world like Nigeria,
malnutrition is still a life threatening issue particularly among the poor and
low income earners. The most affected are babies and children under five years
of age. High mortality rates are still persisting among the babies who are not
breastfed4 In Nigeria, despite increasing level of campaign on exclusive
breastfeeding, there is still a wide gap between knowledge and practice of
breast feeding since most mothers do not appreciate practicing it
appropriately.
Objectives
of the Study
The broad
objective of this study is the Factors affecting the practice of exclusive
breastfeeding among mothers attending model PHC Esan Central LGA of Edo State.
The following specific objectives were formulated;
1. To
establish the Practice of breast feeding among mothers attending model PHC Esan
Central LGA of Edo State.
2. To
determine whether exclusive breast feeding is practiced among mothers attending
model PHC Esan Central LGA of Edo State
3. To
determine factors that could hinder the practice of exclusive breast feeding
among mothers attending model PHC Esan Central LGA of Edo State.
4. To
establish factors that could enhance exclusive breastfeeding among mothers
attending model PHC Esan Central LGA of Edo State.
Research
Question
1.
Do women of Esan Central LGA of Edo State breastfeed their babies
2. Is
exclusive breast feeding being practiced among mothers attending model PHC Esan
Central LGA of Edo State?
3. What
are the possible factors that could hinder the practice of exclusive breast
feeding among mothers attending model PHC Esan Central LGA of Edo State?
4. What
are the factors that could enhance exclusive breastfeeding among mothers
attending model PHC Esan Central LGA of Edo State?
Significance
of the Study
It is expected
that the finding from this research will be of benefit to student, teachers,
nursing mothers, medical practitioners, and the Ministry of Health and the
government at all levels among others. The study will be of help to them in the
following areas:
Scope
of the Study
This study
investigates Factors affecting the practice of exclusive breastfeeding among
mothers attending model PHC Esan Central LGA of Edo State. The study is limited
to all mothers who’s babies are within 6 months who are breastfeeding attending
model PHC Irrua living in the metropolis of Irrua.
Operational
Definition of Term
The following
terms are operationally defined for the study:
Exclusive:
The
state of being in a relationship with someone where you are officially
boyfriend and girlfriend, and there is no-one else involved. Usually attained
after going on a couple of good dates with someone.
Breastfeeding:
is the milk from the mother, or another lactating mother (in case of unwilling
mothers and royalty), has nourished, protected and helped raise babies since
time immemorial. Like all mammals humans possess mammary glands for the purpose
of feeding their infants before they are ready for food from other sources.
Mothers:
is
the female
parent of a child.
Mothers are women
who inhabit or perform the role of bearing some relation to their children,
who may or may not be their biological offspring.
Exclusive
breastfeeding: Exclusive breastfeeding is the practice
of feeding the infant for the first six months of life on breast milk only;
without any other type of food, not even water.
Nutritional
Immunology: It centers on studying the mechanisms
underlying the modulation of immune responses by nutritional, naturally
occurring and orally active compounds.
Passive
Immunity: Refers to the short term immunity which results from
the introduction of antibodies from another person or animal.
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