BARRIERS TO EXCLUSIVE BREASTFEEDING AMONG MOTHERS ATTENDING DUTSE GENERAL HOSPITAL

ABSTRACT

Breastfeeding is a process whereby the infant receives breast milk from the maternal breast. Exclusive breastfeeding has been defined as feeding of an infant with breast milk only without giving any other foods, not even water. The definition allows for prescribed medicines, immunizations, vitamins and mineral supplements. Breastfeeding, aim of the research is to assess the barriers to exclusive breastfeeding and attending Dutse General Hospital. While objectives of the study is to identify factors that hinder exclusive breastfeeding practice; To assess the mothers' level of knowledge of exclusive breastfeeding; To assess the nutritional status of non-exclusively breastfed infants. This study has shown that the women have good knowledge and practice of exclusive breastfeeding as well as good practice of breastfeeding. The most challenging factors of breastfeeding identify in this study were condition of the mother, health condition of the baby, cracked or sore nipples, inadequate production of milk and work schedule, Based on the findings research recommended; The government should formulate policies that will be generally accepted by the public on exclusive breastfeeding; The community and the government should work together to ensure that every girl-child is educated, and guarantee that workplace is free of harassment and discrimination against women who prefer to breastfeed their babies through appropriate mechanisms.

TABLE OF CONTENTS

CHAPTER ONE

1.0 BACKGROUND OF THE STUDY

1.1 INTRODUCTION

1.2 BACKGROUND OF THE STUDY AREA (DUTSE GENERAL HOSPITAL)

1.3 STATEMENT OF THE RESEARCH PROBLEM

1.4 AIM AND OBJECTIVES

1.4.1 AIM

1.4.2 OBJECTIVES

1.5 RESEARCH QUESTIONS

1.6 SCOPE

1.7 JUSTIFICATION

1.8 SIGNIFICANCE OF THE STUDY

1.9 DEFINITION OF TERM

CHAPTER TWO

2.0 LITERATURE REVIEW

2.1 THE HISTORICAL BACKGROUND OF BREASTFEEDING

2.2 EFFECTS OF BELIEFS AND ATTITUDES ON EXCLUSIVE BREASTFEEDING

2.3 THE PHYSIOLOGY OF LACTATION

2.4 THE VALUE OF BREASTFEEDING TO THE BABY

2.5 THE VALUE OF BREASTFEEDING TO THE MOTHER

2.6 FACTORS INFLUENCING MOTHERS' EXCLUSIVE BREASTFEEDING PRACTICE

2.6.1 Level of knowledge on breastfeeding

2.6.2 HIV status

2.6.3 Age

2.6.4 Marital status

2.6.5 Education

2.6.6 Employment

2.6.7 Cultural factors

2.6.8 Husband/Family support

2.6.9 Religion

CHAPTER THREE

3.0 METHODOLOGY

3.1 INTRODUCTION

3.2 RESEARCH DESIGN

3.3 TARGET POPULATION

3.4 SAMPLS SIZE AND SAMPLING TECHNQUE

3.5 INSTRUMENT OF DATA COLLECTION

3.6 VALIDITY AND RELIABILITY OF THE INSTRUMENT

3.7 METHOD OF DATA COLLECTION

3.8 METHOD OF DATA ANALYSIS

3.9 ETHICAL CONSIDERATION

CHAPTER FOUR

4.0 DATA PRESNTATION,INTERPRETATION AND ANALYSIS

4.1 INTRODUCTION

4.2 DATA PRESENTATION

4.2.1:Gender of The Respondent

4.2.2:Age of The Respondent

4.2.3A:Marital Status of the Respondents

4.2.4: Educational Qualification of the Respondent

CHAPTER FIVE

5.1 DISCUSSION

5.2 SUMMARY

5.3 CONCLUSION

5.4 RECOMMENDATIONS

5.6 SUGGESTIONS FOR FURTHER STUDIES

       REFERENCES

CHAPTER ONE

1.0 INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Breastfeeding is a process whereby the infant receives breast milk from the maternal breast (Kong et al. 2004). Exclusive breastfeeding has been defined as feeding of an infant with breast milk only without giving any other foods, not even water (Jolly,2008).The definition allows for prescribed medicines, immunizations, vitamins and mineral supplements. Breastfeeding as a practice was recommended by WHO(2001),for optimal feeding (i.e. exclusive Brest feeding for the first 6 months and continued breastfeeding for up to 2 years, with the introduction of other foods). Breastfeeding has been practiced since mammals existed on earth. Breastfeeding was rarely described even by those few ancient writers interested in infant health. The ancient Greek and Roman medical writings from crates, and Galen included infant health and feeding to some extent in their broader treatises on health (WHO, 2018).

Moreover, there exist several factors influencing mothers' exclusive breastfeeding practice.  Age, level of knowledge on breastfeeding and HIV status are among the major factors facilitating mothers' exclusive breastfeeding practice around the world and in Nigeria to be specific. In addition, et al., (2006) noted that cultural beliefs have a significant influence on breastfeeding practices. Where perceived primarily as sex symbols, the breasts must be decently hidden which makes breastfeeding in public places difficult (Fisher etal.2017).

1.2 BACKGROUND OF THE STUDY AREA (DUTSE GENERAL HOSPITAL)

The Hospital was established in 1972 as Dutse Comprehensive Health Centre. Then in 1991 a hospital was promoted to general hospital under the major General Ibrahim Babangida Regime, which is its current status. The Hospital has 199 beds; has a total catchments population of about 275062 peoples. Dutse General Hospital has ‘a total number of 258 staff which includes 8 Doctors (Permanent and NYSC), 86 Nurses, 32 Chew, 30 JCHEW and 102 Casual Workers. The facility offers the following services: out patients care, accident and emergency, antenatal car postnatal care, physiotherapy services. laboratory services, TB DOTS, ophthalmology, immunization, scanning, X-ray, counseling and testing of HIV RVD management and care, PMTCT services, quality assurance, and blood banking.

1.3 STATEMENT OF THE RESEARCH PROBLEM

Despite the extensive available information on the benefits of exclusive breastfeeding both for the mother and the infant, in Nigeria only 13% of children below six months are exclusively breastfed (UNICEF, .2020). More so UNICEF (2018) reported a prevalence of 2.% of exclusive breastfeeding in Jigawa State. The mean duration in months of EBF was 1.5 in 2018, 1.6 in 2019 and 1.7 in 2020 in Dutse Local Government Area (UNICEF, 2020).

High infant mortality rates associated with diarrhea, acute respiratory infections and poor responses to vaccinations result from lack of exclusive breastfeeding. Acute respiratory infections and diarrheal diseases are two of the major causes of infant mortality in the developing world (UNICEF, 2020). Infant mortality rate in Nigeria was 63 deaths per 1,000 live births and 52 deaths per 1,000 live births in the Jigawa State (UNICEF, 2020).

 While almost all Nigerian mothers initiate breastfeeding, 73% to 85%. Of them offer water and other liquids to their babies in the first month. This increases the babies risk to infection, poor nutrition and diarrhea (, 2015). Based on UNICEF (2020), 46% and 30% of children fiber than 5 years experienced Acute Respiratory Infections (ARI) and diarrhea respectively. Of these, 41% of ARI and 26% of diarrhea cases were from the Jigawa under which Dutse General Hospital is found.

Early introduction of other foods is of public health concern because it exposes infants to increased infection, particularly diarrheal diseases. It may also lead to poorer infant nutrition and adversely affect growth rates. The fifty-ninth World Health Assembly projected that by 2015 the relative contribution to the global prevalence of childhood under nutrition was expected to increase from 16% to 38% for Africa (WHO, 2016).

In this era of HIV/AIDS, exclusive breastfeeding faces a great challenge as mothers who are HIV/AIDS positive are advised to formula feed their infants to minimize transmission of the virus to the infant. Feeds introduced to infants may have too much fat and carbohydrates leading to obesity, poor muscle development and low resistance to infections. For HIV-positive mothers, infants' risk of death from infectious diseases is high in the absence of breastfeeding (WHO, 2000). Poor infant diet hampers cell division (Drone, 2015). The low prevalence and. short duration of exclusive breastfeeding in previous studies have highlighted the need for more investigation into the problem (Kong et al,  2014).

1.4 AIM AND OBJECTIVES

1.4.1 AIM

The aim of the research is to assess the barriers to exclusive breastfeeding and attending Dutse General Hospital.

1.4.2 OBJECTIVES

1.      To identify factors that hinder exclusive breastfeeding practice.

2.      To assess the mothers' level of knowledge of exclusive breastfeeding.

3.      To assess the nutritional status of non-exclusively breastfed infants.

4.      To determine the relationship between mothers socio-demographic characteristics and exclusive breastfeeding practice.

1.5 RESEARCH QUESTIONS

1.      What are the factors that hinder exclusive breastfeeding practice?

2.      What is the mothers' level of knowledge of exclusive breastfeeding?

3.      What is the nutritional status of non-exclusively breastfed infants?

4.      What is the influence of mother's socio-demographic characteristics on exclusive breastfeeding practice?

1.6 SCOPE

This study is limited to assessing the barriers to exclusive breastfeeding and nutritional status to nonexclusive breastfeeding attending Dutse General Hospital.

1.7 JUSTIFICATION

High infant mortality rates associated with diarrhea, acute respiratory infections and poor responses to vaccinations that result from lack of exclusive breastfeeding (UNICEF, 2006)can greatly be reduced if exclusive breastfeeding of infants is encouraged. This is because human milk is the ideal nourishment for infant's survival, growth and development as it contains all the nutrients, antibodies, hormones, immune factors and anti-oxidants an infant needs to thrive (UNIC, 2018). Studies by (Jolly, 2017) estimated that exclusive breastfeeding for the first six months of life could reduce infant mortality by a remarkable 13% and by an additional 2% were it not for the fact that breastfeeding may transmit HIV (Jones et al,, 2013): Exclusive breastfeeding has to be practiced in order to contribute to achieving Millennium Development Goal number 4 which is to reduce child mortality by two thirds by 2015 (UNSD, 2015).

1.8 SIGNIFICANCE OF THE STUDY

1.      This study can be used in designing appropriate and effective breastfeeding intervention programmers aimed at improving infant and young children feeding practices.

2.      The research will also provide insights for exclusive breastfeeding promotion programmers of mothers in Dutse General Hospital.

3.      The study will contribute some extra knowledge in the study area and therefore serve as a basis for implementing child health policies.

4.       The research findings will form a basis for other researches on breastfeeding such as the plight of breastfeeding employed mothers.

1.9 DEFINITION OF TERM

The following are the key terms to be used in this study:

Breast Feeding: is a process whereby the infant receives breast milk from the maternal breast.

Exclusive Breastfeeding: refers to a process of feeding an infant with breast milk only without giving any other foods, not even water.

Infant Mortality: This refers to the number of death of children of one year or less than per 1000 live birth.

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