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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