ABSTRACT
Inadequate child feeding practices among children aged 6-24months is a major cause of malnutrition in developing countries. The health outcomes of a child are directly proportional to their feeding practices, which are, in turn, dependent on the knowledge and practices of the mother. The first one years of a child’s life are crucial to ensure appropriate growth and development. Poor feeding practices during the first one year of life have both immediate and long-term consequences. It is estimated that improper feeding of children leads to about one-third of the cases of malnutrition worldwide. Ensuring health, growth and development of children requires adequate nutrition during infancy and early childhood. This study assessed the anthropometry and child feeding practices of children 6- 24 months in Umuahia North LGA in Abia State . A multi-stage sampling technique was used to select the study sample. Four wards and their health centers out of all the 12 wards and health centers that make up the LGA was used. Breastfeeding mothers were the respondents randomly selected in each health center which makes the total of 340. Structured and validated questionnaires were used in data collection. Data collection included social demographics characteristics of mothers and infants, nutritional knowledge of mothers, knowledge of mothers on infant feeding practices, breastfeeding practices of mothers, complementary feeding practices of mothers and nutritional status of the children. Data obtained from this study were analyzed using descriptive statistics - frequency, percentages and pearlson’s correlation. The statistical software SPSS version 22 was used for analysis, cross tabulation and chi square analysis were used to examine the relationship between the variables. Significance was accepted at P < 0.05. This study revealed that 44.1% of the respondents had knowledge that foods apart from breastfeeding should be introduced at 6 months while others thinks that it should be introduced above 6 months. Most of the respondents in this study 57.1% were aware of exclusive breastfeeding and half 50.1% heard about exclusive breastfeeding from health workers. The nutritional status reveals that 160 were male while 180 were female.12.2% of females were severely stunted ,underweight and wasted compare to 8.8%males. There was a positive and strong relationship between average nutritional knowledge of mothers and nutritional status of the children. Recommendation includes that there should be awareness on exclusive breastfeeding and more on complementary feeding through televisions, radio, and other mass media.
TABLE
OF CONTENTS
TITLE PAGE I
CERTIFICATION
II
DEDICATION III
ACKNOWLEDGEMENT IV
TABLE OF CONTENTS V
LIST OF TABLES
IX
ABSTRACT X
CHAPTE1
INTRODUCTION
1.1 Background of study 1
1.2 Statement of problems 6
1.3 Objectives 10
1.4 Significance of the study 10
CHAPTER
2
LITERAUREREVIEW
2.1 Overview
of Breastfeeding 12
2.1.1 Infant
Feeding Practices 16
2.1.2 Disadvantages
of early or late complementary feeding
19
2.1.3 Characteristics
of Proper Complementary Feeding 21
2.1.4 Protein
content 24
2.1.5 Fat
content 24
2.1.6 Mineral
content 25
2.1.7 Iron 25
2.1.8 Vitamin
content 27
2.2 Breastfeeding 28
2.2.1 The
advantages of Breastfeeding, and its Duration
28
2.2.2 Breastfeeding Practices 30
2.2.3 Exclusive Breastfeeding 31
2.2.4 Benefits
of Breastfeeding 31
2.3 Composition of Breast Milk 36
2.3.1 Characteristics of Breast Milk 37
2.4 Types
of Infant Formula 40
2.5 Early
and Late Introduction of Complementary Foods
42
2.5.1 Types
of Weaning 42
2.5.2 Complementary
Foods 43
2.5.3 Common
Feeding Difficulties in Infants 43
2.6 Food items used to Prepare
Complementary Foods 44
2.6.1 Homemade
Complementary Foods 45
2.6.2 Energy and Nutrient
Composition of Complementary Foods 49
2.7 Food
Preferences and Eating Behaviors 51
CHAPTER
3
MATERIALS AND
METHODS
3.1 Study design 53
3.2 Area of study 53
3.3 Population of study 54
3.5 Preliminary
activities 56
3.6 Data
collection 57
3.7 Data
analysis 59
3.8 Statistical analysis 59
CHAPTER
4
RESULTS AND DISCUSSION
Table 4.1 Characteristics
of Infants 61
Table 4.2 Socio-demographic
Characteristics of the Mothers 63
Table 4.3 Mother’s Nutritional Knowledge 66
Table4.4 Knowledge
of Mothers on Infant Feeding Practices 69
Table4.5 Breastfeeding
Practices of Mothers 73
Table 4.6 Complementary
Feeding Practices of Mothers 79
Table4.7 Nutritional
Status of the Children 87
Table4.8 Relationship
Between Mothers’ Nutritional Knowledge 90
and Nutritional Status of their Children
CHAPTER 5
CONCLUSION AND RECOMMENDATIONS
5.1 Conclusion 92
5.2 Recommendations 92
REFRENCE 95
APPENDIX
LIST OF TABLES
Table 4.1 Characteristics of
Infants 61
Table 4.2 Socio-demographic Characteristics of the
Mothers 63
Table 4.3 mother’s
Nutritional Knowledge 66
Table4.4 knowledge of Mothers
on Infant Feeding Practices 69
Table4.5 Breastfeeding
Practices of Mothers 73
Table 4.6 Complementary Feeding
Practices of Mothers 79
Table4.7 Nutritional Status of
the Children 87
Table4.8 Relationship Between
Mothers’ Nutritional Knowledge
and
Nutritional Status of their Children
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND OF STUDY
The
health outcomes of a child are directly proportional to their feeding
practices, which are, in turn, dependent on the knowledge and practices of the
mother (World Health Organization, 2009). The first one years of a child’s life
are crucial to ensure appropriate growth and development. According
to Anoshirike et al. (2014) poor
feeding practices during the first one year of life have both immediate and
long-term consequences. It is estimated that improper feeding of children leads
to about one-third of the cases of malnutrition worldwide. Ensuring health,
growth and development of children requires adequate nutrition during infancy
and early childhood. Therefore, optimal feeding during the first one year of
life provides opportunity for prevention of growth faltering and
under-nutrition (Demilew et al., 2017). Improper feeding practices have also been
linked to reduced reproductive capacity, complicated deliveries, and increased
incidence of low-birth-weight infants in women who were malnourished as children
(Martin et al., 2004). WHO. (2009),
reported that malnutrition during this period results in a series of problems,
beginning with reduced weight for age and stunting, progressing to the
inability to achieve potential height in adulthood, and reduced capacity for
physical work, which ultimately has implications for national development
Improving child feeding practices in children aged 6 to 24 months is crucial to
improved nutritional status, and growth and development.
According
to Victora et al. (2016) the World Health Organization (WHO) has
defined certain indicators to effectively assess infant and young child feeding
practices. They are: early initiation of breastfeeding, exclusive breastfeeding
under six months of age, continued breastfeeding at one year and at two years.
Lamberti et al. (2013) demonstrated
the long-term effects of breastfeeding, with its impact on intelligence
quotient (IQ) and prevention of diseases such as hypertension, type two
diabetes mellitus, and even problems related to obesity. It has also been shown
to reduce the risk of pneumonia mortality and morbidity in young children
(Horta et al., 2007).
Child
feeding is a key area to improve child survival and promote healthy growth and
development. The period from birth to the first year of life is a critical
window period for the promotion of optimal growth, health and behavioural
development (World Health Organization, 2017). Optimal child feeding practices
include initiation of breastfeeding within one hour of birth; exclusive
breastfeeding for the first six months of life; and addition of timely,
appropriate, and adequate family foods for complementary feeding after six
months along with continued breastfeeding (Demilew et
al., 2017). The strategy
recommends early initiation of breastfeeding within one hour of birth,
exclusive breastfeeding for the first six months, and introduction of
appropriate, adequate, and safe complementary foods along with continuing
breastfeeding up to two years and beyond. Improving child feeding practices is
important to reduce under-nutrition and its consequences (Cesar et
al., 2010).
In
order to provide infants with additional nutrients, complementary foods (foods
other than breast milk or infant formula) should consequently be introduced to
the child (United States Department of Agriculture (USDA, 2009). The target age
range for complementary feeding is between the age of 6 and 23 months (with
continued breastfeeding), where most infants reach a general and neurological
stage of development (chewing, swallowing, digestion, and excretion) that
enables them to be fed other foods rather than breast milk (World Health
Organization/United Nation Children’s Fund, 2003). Complementary foods could be
especially designed transitional foods (to meet particular nutritional or
physiological needs of infants) or general family foods and are expected to
address the gaps between the daily energy and nutrient requirement of the young
child and the amount obtained from breastfeeding (WHO, 2009). The World Health Organization (WHO, 2009) has
defined certain indicators to effectively assess child feeding practices. They
are: early initiation of breastfeeding, exclusive breastfeeding under six
months of age, continued breastfeeding at one year and at two years (Martin, et al., 2004)
Poor
child feeding practices coupled with high rates of infectious diseases are the
major causes of malnutrition during the first one years of life. Appropriate
breast feeding and complementary feeding practices and access to adequate amounts
of appropriate foods are essential for optimal child nutrition (Faber and
Bernade, 2007). Breast feeding provides children with superior nutritional
content that is capable of improving infant immunity and possible reduction in
future health care spending (World Health Organization, 2010).
The
nutrition education given to mothers should emphasize the importance of breast
milk only for the first six months of life and promote appropriate and timely
complementary foods at six months with increased feeding frequency and change
in food consistency, quality and diversity as the child ages. However,
inadequate knowledge of appropriate foods and feeding practices is often a
greater determinant of malnutrition than lack of foods (WHO, 2003).
The
WHO and UNICEF have recommended that children should be exclusively breast fed
for the first six months of life, after which nutritionally adequate and safe
complementary foods are commenced while continuing breastfeeding up to two
years and beyond. After the age of six months, breast milk alone may not
adequately supply some of the micronutrients such as zinc and iron to the
infant. It is recommended that complementary foods be commenced at six months
while continuing breastfeeding for two years and beyond (WHO, 2017).
Optimal
child feeding is having exclusive breastfeeding for six months and
nutritionally sufficient and safe Complementary feeding starting from the age
of six months with continued breastfeeding up to two years of age or beyond
(Marquis et al., 2013). In considering
child feeding practices on improving the nutritional status of children under
one year of age, WHO developed a set of core indicators to assess child feeding
practices (USAID and IFPRI, 2008). Various indicators have been used to assess
child feeding practices, the major ones being early initiation of
breastfeeding, exclusive breast feeding under six months, continued breast
feeding, introduction of complementary foods, minimum dietary diversity,
minimum meal frequency, minimum acceptable diet and consumption of iron-rich or
iron-fortified foods (Sanghvi et al., 2013). Optimal complementary
feeding considers the quantity and quality of food, frequency and timeliness of
feeding, food hygiene and feeding during or after illness (Jones et al.,
2014). Poor breastfeeding and complementary feeding practices, together with
high rates of morbidity from infectious diseases are the prime proximate causes
of malnutrition in the first two years of life (Grantham-McGregor et al., 2007). Breastfeeding confers
both short-term and long-term benefits to the child. It reduces infections and
mortality among infants, improves mental and motor development, and protects
against obesity and metabolic diseases later in the life course (Oddy et al., 2003). Poor breastfeeding and
complementary feeding practices have been widely documented in the developing
countries. Only about 39% of infants in the developing countries, 25% in Africa
are exclusively breastfed for the first six months. Additionally, 6% of infants
in developing countries are never breastfed (Lauer et al., 2004). Various factors associated with sub-optimal
breastfeeding and complementary feeding practices have been identified in
various settings. These include maternal characteristics such as age, marital
status, occupation, and education level; antenatal and maternity health care;
health education and media exposure; socio-economic status and area of
residence; and the child’s characteristics including birth weight, method of
delivery, birth order, and the use of pacifiers (Patel et al., 2006).
1.2 STATEMENT OF PROBLEM
Adequate
nutrition is essential for growth and development of children, and malnutrition
reflects poor social and economic development. Growth faltering results in
adverse effects including poor physical and cognitive development, the impact
of which may last a lifetime (Onis and Branca, 2016). Short-term consequences
include increased morbidity and mortality, developmental delay, and economic
burden for sick children, while long-term consequences are stunted brains and
stunted lives, hindering the development of entire societies. Hence, the period
from conception to age 24 months is considered the “critical window” for the
advancement of good growth, health, and behavioural and cognitive development
(UNICEF and WHO, 2017).
In
the world 60% of the infant and young child deaths occur due to malnutrition
where two-thirds of these deaths attributed to sub-optimal child feeding
practices and infectious disease.1‒5 Forty-one percent of these deaths occur in
sub-Saharan Africa and 34% in South Asia. Apart from contributing to childhood
disease burden, early under nutrition has long lasting effects on physical as
well as cognitive growth into adulthood.
Increasing
evidence shows that metabolic events occurring during limited and sensitive
times
of
prenatal and postnatal development have important modulating effects on health
in later life, which is a concept often referred to as “programming”, or “metabolic
programming” (Koletzko, 2005).
One of the hypotheses behind this effect is the rapid postnatal catch-up
growth, which is influenced by the early nutrition pattern adopted (Singhal and
Lucas, 2004). Thus, diet in
early infancy has an important role on growth pattern and development, but it
has also a key role in setting up flavor preferences and behaviors, which may
in turn lead to the development of being overweight or obesity.
The
first one and two years of life are critical stages for a child’s growth and
development. Any damage caused by nutritional deficiencies during this period
could lead to impaired cognitive development, obesity, stunting, overweight,
compromised educational achievement and low economic productivity (Cesar et al., 2008). Poor breastfeeding and
complementary feeding practices, together with high rates of morbidity from
infectious diseases are the prime proximate causes of malnutrition in the first
two years of life (Grantham-McGregor et
al., 2007). Breastfeeding confers both short-term and long-term benefits to
the child. It reduces infections and mortality among infants, improves mental
and motor development, and protects against obesity and metabolic diseases
later in the life course (Oddy et al.,
2003). Poor breastfeeding and complementary feeding practices have been widely
documented in the developing countries. Only about 39% of infants in the
developing countries, 25% in Africa are exclusively breastfed for the first six
months. Additionally, 6% of infants in developing countries are never breastfed
(Lauer et al., 2004). Various factors
associated with sub-optimal breastfeeding and complementary feeding practices
have been identified in various settings. These include maternal
characteristics such as age, marital status, occupation, and education level;
antenatal and maternity health care; health education and media exposure;
socio-economic status and area of residence; and the child’s characteristics
including birth weight, method of delivery, birth order, and the use of pacifiers
(Patel et al., 2006). However, there
are conflicting findings with regards to the consistency of the associations
and the magnitude of the effects (Patel et
al., 2006).
Consequently,
the first two years of life are an important period in which to begin healthy
infant feeding practices in order to promote healthy growth. Complementary
feeding (CF) is a critical window, not only for the rapid changes in
nutritional requirements and the consequent impact on infant growth and
development, but also for the generation of lifelong flavor preferences and
dietary habits, that can influence longer-term health (D’Auria et al., 2018).
The
term CF describes a period of time in which there is a gradual reduction of
frequency and volume of breast milk or formula together with the introduction
of complementary foods (CFs).
According
to the WHO definition, the introduction of CFs is needed to ensure optimal
energy and nutrient intake when “breast milk alone is no longer sufficient to
meet the nutritional requirements in terms of energy and nutrients of infants”
(WHO/UNICEF, 2002); therefore, exclusive breastfeeding is recommended for the
first six months of age and complementary breastfeeding up to two years of age.
The
nutrition education given to mothers should emphasize the importance of breast
milk only for the first six months of life and promote appropriate and timely
complementary foods at six months with increased feeding frequency and change
in food consistency, quality and diversity as the child ages. However,
inadequate knowledge of appropriate foods and feeding practices is often a
greater determinant of malnutrition than lack of foods (Okolo et al.,
2019). It has been observed that mothers who are nutritionally educated bring
up their children in a healthier way than those who lack nutrition knowledge.
1.3 OBJECTIVES OF THE STUDY
1.3.1 General Objective of the study
The
main objective of the study is to determine the anthropometry and child feeding
practices of children aged 6 to 24 months in Umuahia North Local government
area of Abia State.
1.3.2 The specific objectives of the
study
i.
Determine the socio-demographic
characteristics of the parents
ii.
Determine the mother’s nutritional
knowledge in the study area
iii.
Determine breastfeeding practices of the mothers
in the study area
iv.
Determine the complementary feeding
practices of mothers in the study area
v.
Determine the Anthropometric status of the
children
vi.
Assess the relationship between mothers’
nutritional knowledge and nutritional status of their children
1.4 SIGNIFICANCE OF THE STUDY
The
study association anthropometry and child feeding practices of children aged 6
to 24 months in Umuahia North Local government area of Abia State will provide
an information on the child feeding practices and it anthropometric effect in
the study area. The
findings of this study will aid nutritional policy makers in designing
appropriate policies and interventions that can effectively alleviate child
feeding practices.
The result obtained from this study will extensively provide information on the
extent of child feeding practiced and its anthropometric indices
in the study area. The information
will indicate health and nutritional related problems that are associated with
suboptimal child feeding and finding possible solution to households that does not
practice appropriate child feeding practices if found necessary.
Findings
from this study will help to identify the influence of child feeding practices
on the anthropometric status of the children in Umuahia North Local government
area of Abia State. This will help health policy makers, nutrition educators,
health professionals, caregiver’s parents on health danger of poor child
feeding practices on the children and households alike. It will also help human
nutrition and dietetics students who are researching in the related topic and
it will also add to the existing literature.
Click “DOWNLOAD NOW” below to get the complete Projects
FOR QUICK HELP CHAT WITH US NOW!
+(234) 0814 780 1594
Login To Comment