PREVALENCE OF UNDER NUTRITION AND FEEDING PRACTICE AMONG CHILDREN OF 0 -24 MONTH OF AGE ATTENDING DUTSE GENERAL HOSPITAL

ABSTRACT

Good infant feeding and healthcare are critical for growth and development of children in the first few years of life. Optimal infant feeding practice recommended by World Health Organization (WHO) and United Nations Children's Fund involves exclusive breastfeeding for the first 6 months of life, followed by adequate complementary feeding, and breastfeeding until the child is at least 2 years old.  And the aims of the study is to determine the feeding practices and nutritional status of children 0-24 months attending Dutse General Hospital. To determine the nutritional status of children 0-24 months using anthropometrics measurements. To determine the breastfeeding practices among mothers with children 0-24 months at the postnatal Ward. The scope of the study constituted the geographical and content scope. The study would be conducted at postnatal Ward, Dutse general hospital, Dutse metropolis, Jigawa State and the data was collected from mothers of children 0-4 months attending the Ward. In conclusion, the rate of undernutrition among children (0-23 months old) in Dutse General hospital Government was as follow; wasting 18%, Stunting 40% while underweight 28% . This shows that stunting is more of a problem than wasting and underweight in the metropolitan; Further studies are needed to identify the barriers to optimize IYCF practices of caregivers; Nutrition Education programs should be strengthened and implemented to promote exclusive breastfeeding and enhance sensitization on IYCF practices, and the effect of “Hidden hunger”; Numerous developmental initiatives should be established by the government at the local levels, focusing on women empowerment in the state, aimed at creating sustainable employment, which in return, improve the household income of the families in the research area.

TABLE OF CONTENTS

Title Page___________________________________________________________ i

Declaration ________________________________________________________ii

Dedication________________________________________________________ iii

Acknowledgement_________________________________________________ iiii

Approval Page_____________________________________________________ v

Table of content ___________________________________________________vii

Abstract____________________________________________________________xi

CHAPTER ONE

1.0 INTRODUCTION

1.1 Background of the study  -           -           -                       -           -           --          -1

1.2 Statement of the Problems            -           -           -           -           --          -           -2

1.3 Aim and Objectives -        -           -           -           -           -           -           -           -3

1.4 Significance of the Study-            -           -           -           -           -           -           -           4         

1.5 Research Questions-         -           -           -           -           -           -                       -4

1.6 Justification           -           -           -           -           -           -           -           -           -4

1.7 Scope of the Study-          -           -           -           -                       -           -           -5

1.8 Limitations of the Study - -           -           -           -           -           -           -           -5        

1.9 Definition of Terms-         -           -           -           -           -           -           -           -6

CHAPTER TWO

2.0 LITERATURE REVIEW

2.1 Preamble to Feeding Practices -    -           -           -           -           -           -           -8        

2.2 Feeding Practices -            -           -           -           -           -           -           -           -10

2.3 Relationship between Feeding Practices And Nutritional Status -           -           -14

2.5 Infant and Young Child Feeding Practice (IYCF)          -           -           -           -16

CHAPTER THREE

3.0 METHODOLOGY

3.1 General Description of The Study Area-  -           -           -           -           -           --17

3.2 Research Design-  -           -           -           -           -           -           -           -           -17

3.3 Study Population -            -           -           -           -           -           -           -           -17

3.4 Sample Method And Procedure-  -           -           -           -           -           --          -17

3.5 Sample Size -        -           -           -           -           -           -           -           --          -18

3.6 Method Of Data Collection -       -           -           -           -           -           -           -18

3.7 Research Instruments        -           -           -           -           -           -           -           -18

3.8 Method Of Data Analysis -           -           -           -           -           -           -           -19

CHAPTER FOUR

RESULTS AND DISCUSSION

4.1 Respondent’s demographic data  -           -           -           -           -           -           -20

4.2 Discussion of the Findings           -           -           -           -           -           -           24

CHAPTER FIVE

5.0 CONCLUSION AND RECOMMENDATION

5.1 Conclusion -          -           -           -           -           -           -           -           -           -28

5.2 Recommendations-           -           -           -           -           -           -           -           -28

References

Appendix

CHAPTER ONE

1.0 INTRODUCTION

1.1 Background of the study

Good infant feeding and healthcare are critical for growth and development of children in the first few years of life. Optimal infant feeding practice recommended by World Health Organization (WHO) and United Nations Children's Fund involves exclusive breastfeeding for the first 6 months of life, followed by adequate complementary feeding, and breastfeeding until the child is at least 2 years old. This feeding pattern is expected to supply the macro and micronutrients in adequate amounts required for optimal growth and development of the child. Globally, an estimated 1.3 million lives are lost each year as a result of the lack of exclusive breastfeeding and another 600,000 from not continuing breastfeeding with proper complementary feeding. Breastfeeding remains a pivotal factor between life and death for the vast majority of children in developing countries such as Nigeria, but the current data reveals that 55% of Nigerian mothers are ignorant of the importance of exclusive breastfeeding. Also, the underlying factor of more than 50% of all childhood deaths in Nigeria is under-nutrition (Grummer, 2010).

Appropriate complementary feeding requires not only introducing foods too early or too late to infants, but also feeding infants and young children between 6 and 24 months foods considered safe and nutritionally adequate without discontinuing breastfeeding. However, despite the unparalleled benefits of optimal infant feeding, less than 35% of infants worldwide are exclusively breastfed during first 6 months of life. A study from Kano, Nigeria revealed that the proportion of mothers who exclusively breastfed their babies for 1 month, 3 months and 6 months after their last delivery were 26.0% 24.8% and 22.0% respectively. A similar study from southern Nigeria also reported that more than 90% of mothers had adequate knowledge of exclusive breastfeeding, 21.2% practiced exclusive breastfeeding for all their children, 51.6% had never practiced exclusive breastfeeding with any child.

 Several changes have occurred in the traditional breastfeeding and weaning practices in sub-Saharan Africa over the years. These changes emanated from the introduction of alien cultures and values; and urbanization with the consequent changes in lifestyle. Furthermore, many mothers in sub-Saharan Africa do not know the appropriate time to initiate breastfeeding, have little knowledge of the proper positioning and attachment of infants to the breast for breastfeeding; or have little knowledge of when and what to introduce as complementary feeds. These deviations from what is appropriate during infancy and early childhood may result in irreversible faltering in linear growth and cognitive deficit. Growth during 1^st year of life is greater than at any other time after birth and good nutrition during this period of rapid growth is vital to ensure that the infant develops both physically and mentally to the fullest potential.

1.2 STATEMENT OF THE PROBLEMS

Poor  infant  feeding  practices  coupled  with  high  rates  of  infectious  diseases  are  the  major causes  of  malnutrition  during  the  first  two  years  of  life.  Appropriate breast  feeding  and complementary feeding practices and access to adequate amounts of appropriate foods are essential  for  optimal  infant  nutrition. Breast feeding  provides  infants  with  superior nutritional  content  that  is  capable  of  improving  infant  immunity  and  possible  reduction  in future  health  care  spending.  Child mortality  remains  high  in  low  and  middle  income countries. It  has  been  reported  that  17%  of  Nigerian  children  were  exclusively breastfed  for  less  than  4  months,  while  13%  were  exclusively  breastfed  for  less  than  6 months.  All  these  figures  are  still  far  below  average  levels.  Children  need  complementary foods  in  addition  to  breast  milk  from  the  age  of  six  months.  Infancy  period  is  a  critical nutritional  period  for  children,  in  which  they  should  be  transitioning  from  exclusive  breast feeding to receiving complementary foods in addition to continued intake of breast milk.  The  nutrition  education  given  to  mothers  mainly  emphasizes  the  importance  of  breast  milk only for the first six months of life but rarely promote the use of appropriate and timely complementary foods at six months with increased feeding frequency and change in food consistency, quality and diversity  as  the  child  ages.  This lack of adequate  knowledge  of  appropriate  foods  and feeding  practices  is  often  a  greater  determinant  of  malnutrition  than  lack  of  foods.

1.3 AIM AND OBJECTIVES

1.3.1 Aim       

To determine   the feeding practices and nutritional status of children 0-24 months attending Dutse General Hospital.

1.3.2 Objectives         

1. To determine the nutritional status of children 0-24 months using anthropometrics measurements.        

2. To determine the breastfeeding practices among mothers with children 0-24 months at the postnatal Ward.

3. To identify  the complementary feeding patterns/practices among mothers with children 0-24 months at the postnatal Ward           

1.4 SIGNIFICANCE OF THE STUDY

Appropriate feeding practice is an early investment towards the making of a healthy generation. This study is, therefore, to investigate feeding practices and nutritional status of mothers and their children (0-24 month) attending Post-natal Ward in Dutse general hospital. It is envisaged that the information would be useful to policy makers and programme managers especially for the achievement of millennium development goals (MDG) 4 that is the reduction of child mortal as well as educate the general public on the importance of appropriate infant feeding practices and dangers of malnutrition.

1.5 RESEARCH QUESTIONS

1. What is the prevalence of wasting, underweight and stunting among the children 0-24 months attending Dutse General Hospital?

2. What are the breastfeeding practices among mothers of children 0-24 attending the Postnatal Ward?

3. What are the complementary feeding practices among mothers of children 0-24 attending the postnatal Ward?

1.6 JUSTIFICATION

Under nutrition in children can result from suboptimal infant and child feeding practices, among other factors. Several studies have confirmed that feeding practice is associated with stunting and nutritional status of children under five as one of the directly related factors. Optimal feeding practice also plays an important role in determining the growth and development of children under five. Toddlers with poor growth have high rates of morbidity and mortality and can experience motor and mental development delays. Adequate complementary feeding entails feeding children aged between 6 and 23 months with foods from four or more food groups at least twice a day. Wasting and stunting typically accelerate between the ages of 6 and 23 months, the phase when complementary feeding is needed, partly because the child becomes increasingly independent and mobile and are thus exposed to environmental contaminants6. If malnutrition in children under the age of five continues to occur, it can affect one’s intellectual performance, work capacity and health conditions at a later age. Stunting in toddlers may become a risk factor for obesity and metabolic diseases such as diabetes and hypertension during adulthood. Identifying risk factors by looking at feeding practice as the cause of malnutrition is expected to provide information on the appropriate intervention or prevention actions. There is strong evidence that the promotion of appropriate complementary feeding practices reduces the incidence of stunting and leads to better health and growth outcomes.

1.7 SCOPE OF THE STUDY

The scope of the study constituted the geographical and content scope. The study would be conducted at postnatal Ward, Dutse general hospital, Dutse metropolis, Jigawa State and the data will be collected from mothers of children 0-4 months attending the Ward. The study will be based mainly on assessment of breastfeeding practices and complementary feeding practices from the mothers of children 0-24 months attending the postnatal Ward Dutse general hospital and assessment of prevalence of Wasting, Stunting and underweight in the children.

1.8 LIMITATIONS OF THE STUDY

The information gathering will be the hardest part of this study. Problem of false information during data collection may be encountered. These challenges will be countered by the confidentiality clause in the questionnaires to treat all information provided with utmost confidentiality. The researcher will also use persuasion and explain to the respondents that the purpose of the data collection will be for academic use only. The respondents will be enlightened on the importance of the study as well

1.9 DEFINITION OF TERMS

This section provides a definition of relevant key terms. 

Complementary feeding practices: They cover the time of introduction of solid and semi-solid foods or soft foods, frequency of feeding, dietary diversity, consumption of iron-rich foods and continued breastfeeding among children 6-23 months old (PAHO/WHO, 2003).

Nutritional Status: Refers to the current body status of an individual or a population group related to their state of nourishment (the consumption and utilization of nutrients). Nutritional status will be assessed by anthropometry which is the measurement of body height/length, weight and proportions (WHO Growth Standards, 2006).

Exclusive Breastfeeding: It is the feeding process by which a child below six months is fed breast milk only, with no addition of any liquid or solids, apart from drops or syrups consisting of vitamins, mineral supplements or medicine, and nothing else (WHO/UNICEF, 2010). In the present study, mothers with babies below 6 months of age who fed their babies on only breastmilk a day before the study were considered those currently practicing exclusive breastfeeding. 

Inappropriate feeding practices:  Include not exclusively breastfeeding infants the first six months of life and starting complementary feeding before 6 months of age. They also include not feeding children on a variety of foods (feeding from < 4 food groups) and not feeding children daily the recommended number of times based on their ages. Children 6-8 months, 9-11 months and 12 -23 months should be fed 2-3 times, 3-4 times and >4 times respectively. 

Infant:  An infant is a child below one year or 12 months of age (WHO, 2013)  

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