ABSTRACT
The lactation period is a major source of concern in developing countries because of its positive impact on the health and nutrition of mothers and children. Adequate nutrition for the mothers is therefore important for their good health as well as for that of their offspring. This study assessed the dietary practices of breastfeeding mothers attending postnatal clinics at Federal Medical Center, Umuahia Abia State. The study was a cross-sectional study. A multi-stage sampling technique was used to select a total of 120 mothers. Data on socio demographic and socio economic characteristics, feeding habits and anthropometric status of mothers were collected using structured and validated questionnaire. The IBM SPSS version 22.0 computer programme was used to analyze the data. Data obtained were presented using frequency and percentage. Pearson correlation was used to analyze the association between socio demographic/economic characteristics, dietary pattern and nutritional status of the breastfeeding mothers. A p value of <0.05 was considered significant. The result from this study revealed that more than half (58.3%) of the women were between 21-30 years. Majority (80.8%) of them were married and most (61.7%) of them have 1-2 children already. (40.0%) of the lactating mothers usually skip breakfast meals. From the anthropometric status, more than half (53.3%) of the women were overweight while 27.5% were obese. The result findings of the anthropometric indices (hip/wait ratio) of the breastfeeding mothers showed that majority (72.5%) of them were normal while (27.6%) were at risk of cardiovascular diseases. there was significant positive relationship between monthly income and consumption of ultra-processed foods. Result findings on the dietary pattern showed that most (60.0%) of the mothers usually eat from home, 24.2% of them buy junk foods while 9.2% of them eat fast foods, majority (87.5%) of the respondents are able to make effective food choice. However, more than half (56.7%) of the respondents consume food 3 times in a day while 19.2% of them consume food twice a day. There was also a significant relationship between body mass index of mothers, consumption of ultra-processed foods and age of mothers. Intervention programs such as nutrition education and dietary diversity should be emphasized during antenatal and lactation period to improve better health and nutrition outcomes.
TABLE OF CONTENTS
TITLE
PAGE I
CERTIFICATION II
DEDICATION III
ACKNOWLEDGEMENT
IV
TABLE
OF CONTENTS V
LIST
OF TABLES VIII
ABSTRACT IX
CHAPTER ONE:
INTRODUCTION
1.1
Background to the Study 1
1.2
Statement of the Problem 3
1.3
Objectives of the Study 4
1.3.1 General objective of the Study 4
1.4
Significance of the Study 5
CHAPTER TWO
LITERATURE REVIEW
2.1 Dietary
Practices 7
2.1.1 Factors
influencing dietary pattern 7
2.1.1.1 Food
habits 8
2.1.2 Reasons
for Changes in Food Habits 12
2.1.2.1 Skipping of Meal 14
2.1.2.2 Consumption of Fast Foods and Alcohol/Drug 15
2.1.2.3 Snacking
on High-Calorie Food and Sweets 15
2.1.3 Nutrition issues of breastfeeding Mothers 16
2.1.4 Determinants of mothers’ and children
nutritional status 17
2.1.4.1 Household Economic Status 18
2.1.4.2 Educational Status of Women 18
2.1.4.3 Place of Residence 19
2.1.4.4 Employment Status of Women and the Control over
Income 19
2.1.4.5
Age of Women 19
2.1.4.6
Marital Status of Women 20
2.2 Dietary
Practices of Breastfeeding Mothers 20
2.3 Breastfeeding 23
2.3.1 History
of breastfeeding 24
2.3.2 Initiation of breastfeeding 27
2.3.4 Exclusive breastfeeding 27
2.4 Effects of Breastfeeding 28
2.5 Factors
Influencing Breastfeeding Practices 33
2.6 Improving the Dietary Practices of
Breastfeeding Mothers 37
CHAPTER THREE
MATERIALS AND METHODS
3.1 Study Design 41
3.2 Area of Study 41
3.3 Population
of the Study 42
3.4 Sampling
and Sampling Techniques 43
3.4.1 Sample
size 43
3.4.2 Sampling
Techniques 43
3.5 Preliminary
Activities 44
3.5.1 Preliminary
visits 44
3.5.2 Training
of research assistants 44
3.5.3 Informed
Consent 45
3.5.4 Ethical
Clearance 45
3.6 Questionnaire
Construction/Validation 45
3.6.1
Questionnaire
Construction 45
3.6.2 Validation
of Questionnaire 46
3.7 Data Collection 46
3.7.1 Questionnaire administration 47
3.7.2 Anthropometric Measurements 47
3.7.2.1 Weight measurement 47
3.7.2.2 Height measurement 48
3.7.2.3 Waist Circumference measurements 48
3.8 Data Analysis 49
3.9 Statistical
Analysis 49
CHAPTER FOUR
RESULTS AND DISCUSSION
4.1 Socio-Demographic/Economic
Characteristics of the Breastfeeding
Mothers 50
4.2 Dietary Habits of the Breastfeeding
Mothers 55
4.3 Food Consumption Pattern of the Breastfeeding
Mothers 59
4.4 Anthropometric Status of the
Breastfeeding Mothers 64
4.5 Relationship between dietary pattern and anthropometric
status
of the breastfeeding mothers 69
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
5.1 Conclusion 71
5.2 Recommendations 71
LIST
OF TABLES
Table
4.1: Socio-demographic/economic
characteristics of the
breastfeeding mothers 52
Table 4.2a: Dietary habits of the breastfeeding
mothers 56
Table 4.2b: Dietary habits of the breastfeeding mothers 58
Table
4.3: Food consumption pattern of
the breastfeeding
mothers (n=120) 61
Table
4.3: Food consumption pattern of
the breastfeeding
mothers (n-120) 63
Table
4.4a: Body mass index of the
breastfeeding mothers 66
Table
4.4b: Waist hip ratio of the
breastfeeding mothers 69
Table
4.5: Relationship between dietary
pattern and anthropometric
status of the
breastfeeding mothers 71
CHAPTER
ONE
INTRODUCTION
1.1 BACKGROUND TO THE STUDY
Malnutrition which is the improper
feeding can be consequences of poor dietary practices. However, dietary practices
refer to observable actions or behavior of dietary habit and can be classified
as having good dietary practices and poor dietary practices (Daba, Beyene,
Fekadu and Garoma, 2013). In the same vein, Shamsi et al. (2013) defined dietary practice as individualistic choices in food consumption based on
emphasis on intake of food with lower fat, higher fiber, and lower sodium. Also,
Tanton et al. (2015) opined that dietary
patterns seem to persist over the years, and thus academic years represent a
crucial period for modelling a healthy lifestyle.
Mothers
are the foremost providers of primary care for children. Their understanding of
basic nutrition and health measures strongly influence the care they provide
(Appoh and Krekling, 2005). Household socio-economic
characteristics of the mother also determine to a large extent the nutritional
status they can imbibe and offer and a positive relationship between
socio-economic status and the ability of mothers to provide adequate food and
primary care has been observed (Appoh and Krekling,
2005).
Nevertheless,
promoting maternal nutrition knowledge for these breastfeeding mothers may
represent an important avenue for improving diet amongst them and even in their
children (Williams et al., 2012). It
is universally accepted that under nutrition can have drastic and wide-ranging
effects on women and children if not managed optimally. When it does occur in
the severe form, usually as a result of food shortage, very high levels of
morbidity and mortality are recorded (Picot and Lacroix,
2012).
However, the emerging practice and behaviour of dieting
for weight loss and good-physique purposes among breastfeeding mothers (Tamin et al., 2006) and their effects on them
and the nursing child require public attention. These groups of individuals are
at higher risk of developing unhealthy eating behaviours with inadequate
nutrient intake, as shown by Gan et al.
(2011).
Some of these dietary behaviours which most of them are
associated with overweight, obesity, poise health issues include irregular
meals, spicy foods, snacking (usually on energy dense foods), intake of junk foods, ultra processed
foods, skipping of breakfast, reduced fruit and vegetable intake, increased
consumption of fried food; irregular and wide use of fast foods appear
quite common among nursing mothers mostly adolescents. (Ganasegeran et
al., 2006; Thompson-Mccormick et
al., 2010). Furthermore, Gan et al. (2011), reviewed that meal skipping; particularly breakfast,
snacking, eating of convenient foods and various weight loss dietary behaviours
such as sugar and fat-fortified foods, low-protein foods, vitamins and minerals
are some of the unhealthy eating behaviours depicted by most young adults. This
improper eating habits developed during this stage of life can continue into
later life and good poise a challenge to the infants who depend wholly on the
nutrients from breast milk (Papadaki and Scott, 2012).
Much
work has been done on this population group, on feeding habits, lifestyle and
nutritional status but there has not been much information on dietary practices
of breastfeeding mothers generally. Though, most of the works on dietary
practices of breastfeeding mothers have been on adolescent/teenage mothers. Given
to the determinant role of dietary practices in promoting health and increasing
quality of life of breastfeeding mothers and the child generally and due to the
sensitive condition as well as nutritional requirements of breastfeeding
mothers for proper child nutrition and infant development in Nigeria, the
present study is aimed to study the dietary practices of breastfeeding mothers
in Federal Medical Centre, Umuahia, Abia State.
1.2 STATEMENT OF THE PROBLEM
Breastfeeding periods of nursing mothers is
really a challenge phase of life as such much nutrients and nutritional factors
are increasing needed as to enable the mother withstand the stress associated
with such period and for the nursing child to attain optimum nutrient
requirement. However, lack of vital knowledge on the nutritional requirements,
unavailability of funds, financial constraints have impacted negatively on the
nursing mothers thereby leaving them with options of eating anything that comes
their way thereby negatively affecting their nutritional status, choice of
food, dietary behaviour and their overall food personalities of the nursing
mother.
It is also evident that the dietary pattern
of most nursing/breast feeding mothers are associated with faulty feeding
habits such as frequent unhealthy snacking and obesity. Also, the researcher
has observed at her clinical experience at FMC Umuahia that amongst
breastfeeding mothers both of various social classes depend mostly on fast
foods, junk foods and snacks to themselves going all through the day either
because of busy schedules or as a result of their varying food choices.
Conclusively, the food habits of
breastfeeding mothers on the above stated poor nutrient or dietary pattern
impacts on growth of the nursing children, hamper healthy body conditions as
well as lack of vital nutrients such as minerals and vitamins. It
is on this basis that this study is carried out to sensitize the breastfeeding
mothers on the relevance of nutritionally balanced diets and good dietary
practices and possibly to fill the existing gap in literature on this subject
matter.
1.3 OBJECTIVES OF THE STUDY
1.3.1 General
objective of the study
The general objective of this study is to
evaluate the dietary practices of breastfeeding mothers in Federal Medical
Centre, Umuahia, Abia State.
1.3.2 Specific
objectives of the study
The specific objectives include to:
i)
assess
the dietary pattern of the breastfeeding mothers in the study area,
ii)
assess the nutritional status of the breastfeeding
mothers in the study area.
iii)
determine the relationship between dietary
practices and nutritional status of the breastfeeding mothers in the study
area.
1.4 SIGNIFICANCE OF THE STUDY
The
findings of this study is believed to fill the existing information gap on this
subject matter in the study area as well as for individuals, government and
organizations who want to understand the current situations surrounding the
life of breastfeeding mothers, from their dietary practices to their
nutritional status as well as suggestions to aid the situation.
The
findings of this study will be of immense benefit to the breastfeeding mothers,
households, communities, the state government, the federal government and the
ministry of health in Nigeria as it will discuss the relationship between dietary
practices and nutritional status, its effects and benefits for the child and
mother. The research breastfeeding mothers in the field of Human nutrition,
public health and family nutrition especially those who are particularly
interested in the research of breastfeeding mothers will find the outcome of
this study invaluable in filling existing research gap and as well in
supporting their future research through available literature and result of
this study.
Finding
of this study will help the breastfeeding mothers understand how their dietary
practices/patterns affect their nutritional status and may possibly help them
improve on their dietary practices thereby paving ways for better nutritional
results not minding the challenges they are currently experiencing in the
household and in the community. The households with breastfeeding mothers will
be able to understand better the need for these mothers to be relieved from
some works to enable them have some time for beneficiary dietary exercise and
effective cooking and other physical exercise to help promote their health and
wellbeing. The community, government and ministry of health most importantly,
will also be able to make policies based on their deduction from the findings
of this study to improve on breastfeeding mothers’ support as a key to
improving their health and that of their families for the benefit of the nation.
Finally,
through the analyses, representation, interpretations and recommendations of
this study, the entire beneficiaries have a clearer understanding of breastfeeding
mothers’ dietary practices and nutritional status, this will go a long way in
improving the way breastfeeding mothers are handled. Considering all these, the
study will also discuss the factors influencing breastfeeding mothers’
nutritional status. The study will contribute to the body of the existing
literature on breastfeeding mothers’ wellbeing and nutritional status.
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