ABSTRACT
Globally it is estimated that undernutrition is directly and indirectly responsible for at least 35% of deaths in children less than five years of age. The immediate causes of malnutrition in the first two years of life are inappropriate breastfeeding and complementary feeding practices coupled with high rates of infections. Thus, this study was carried out to assess the infant and young child feeding practices and their anthropometric status in selected rural communities in Nsukka Local Government Area of Enugu State. A cross-sectional study design was used. Data were collected by using pretested questionnaires. A total of 250 mothers and their children were included in the study and a simple random sampling technique was used. The results obtained in this research showed that a few (19.6%) of the respondents introduced breastfeeding within 30 minutes after birth, majority (84.8%) of the mothers gave the first milk flow (colostrums) and only 34.8% gave only breast milk for the first six months. Millet pap (25.6%), maize pap (25.2%) and cerelac (19.6%) are the major semi-solid foods given to the children. Some (23.2%) of the respondents added Soyabean powder, 11.6% and 10.8% of them added sugar and milk respectively, while 16.0% of them added nothing to the porridge given to the child. A few (20.40%) of the mothers introduced semi solid food at six months while 33.6% of them introduced it below six months. Food and snacks commonly consumed by the children were akamu, bread, moi-moi, yam, garri, biscuits, pop-corn, bobo and mineral (coke, sprite, Fanta) etc. while orange, pinapple and cucumber were the fruits and vegetables commonly consumed by the children . The weight-for-height status reveals that 19.3 % of the male children were severely stunted while 20.2% of the female were severely stunted. Also, the weight –for-height status reveals that 4.5% of the children were severely wasted as the weight-for-age status reveals that 7.6% were severely underweight. There is a significant relationship (p<0.05) between the first food given to the child after birth and the child’s BMI for age status. Also the BMI for age and weight for height of the children was observed to be significantly (p<0.05) affected by what was added to porridge given to child. However, there is no significant relationship (p>0.05) between when breastfeeding was started, how the child was breastfeed for first 6 months, number of times the child do breastfeed in a day, when semi-solid was started, whether infant formula is given to the child, age family food was introduced and the anthropometric status (WHZ, HAZ, WAZ, and BMI for age) of the children. Therefore, emphases should be based on improving the breastfeeding and complementary feeding practices adopted by these women which could help to reduce the number of children at risk of undernutrition based on their weight-for-age, height-for-age and weight-for-height z-scores.
TABLE OF CONTENTS
TITLE PAGE i
CERTIFICATION ii
DEDICATION iii
ACKNOWLEDGEMENT iv
TABLE OF CONTENT v
LISTS OF TABLES viii
ABSTRACT ix
CHAPTER 1
INTRODUCTION
1.1 Background of the Study 1
1.2 Statement of the Problem 3
1.3 Objectives of the Study 4
1.3.1 General objectives of the study 4
1.3. 2 Specific objectives of the study 4
1.4 Significance of the Study 5
CHAPTER 2
LITERATURE REVIEW
2.1 Review of Related Literature 6
2.2 Breastfeeding 8
2.2.1 Exclusive breastfeeding 9
2.2.2 Benefits of exclusive breastfeeding for infants and mothers 11
2.2.3 Professional working mothers and exclusive breastfeeding 13
2.2.4 Timely initiation of breastfeeding 14
2.24.1 Factors Associated to Timely initiation of breastfeeding 15
2.3 Nutritional Composition of Human Breast Milk 17
2.3.1 Advantage of Human Breast Milk over Cow Milk 21
2.4 Contraindications to Breastfeeding 24
2.4.1 Medical problems 24
2.4.2 Viruses 25
2.4.3 Medications 25
2.5 Complementary Feeding (CF) 26
2.5.1 Types of Complementary Foods of Introduce 28
2.5.1.1 Iron-Fortified Infant Cereal 29
2.5.1.1.1 Types of Infant Cereal to Feed 29
2.5.1.1.2 Avoid Adult Cereals 30
2.5.1.2 Fruit Juice 30
2.5.1.2.1 Guidelines on Introducing Fruit Juice 31
2.5.1.3 Vegetables and Fruits 32
2.5.1.3.1 Introducing Home and Commercially Prepared Vegetables and
Fruits 32
2.5.1.3.2 Use of Commercially Prepared Vegetable or Fruit Infant Foods 33
2.5.1.4 Protein-Rich Foods 33
2.5.1.4.1 Home-Prepared Meats, Poultry, and Fish 34
2.5.1.4..2 Eggs 34
2.5.1.4..3 Cheese and Yogurt 34
2.5.1.5 Legumes (Dry Beans or Peas) and Tofu 35
2.5.1.5.1 Nuts 35
2.5.1.5.2 Feeding Water Once Protein-rich Foods Are Introduced 36
2.5.1.5.3 Protein-Rich Foods That May Cause Choking 36
2.5.1.6 Grain Products 37
2.5.1.6.1 Grain Products that may Cause Choking 37
2.5.1.7 Finger Foods 38
2.6 Formula Feeding and its Impact on Breastfeeding Rate 39
2.7 Anthropometric Measurements 41
2.8 Anthropometric Indices 42
2.8.1 Weight-for-age 43
2.8.2 Height-for-age 43
2.8.3 Weight-for-height 44
2.8.4 Body Mass Index (BMI)-for-age 45
2.8.5 Circumferences and skinfolds 45
2.9 Methods of Evaluating Dietary Intake 46
2.9.1 Twenty-four-hour dietary recall and dietary record in a conservative
Approach 47
2.9.2 Twenty-four-hour dietary recall and dietary record with
newer technologies 49
2.9.3 Dietary history 53
2.9.4. Food Frequency Questionnaire (FFQ) 53
CHAPTER 3
MATERIALS AND METHODS
3.1 Study Design 56
3.2 Area of Study 56
3.3 Population of the Study 57
3.4 Sampling and Sampling Techniques 57
3.4.1 Sample Size 57
3.4.2 Sampling Procedure 59
3.5 Preliminary Activities 59
3.5.1 Preliminary visits 59
3.5.2 Training of research assistants 60
3.5.3 Consent form 60
3.6 Data Collection 60
3.6.1 Questionnaire administration 61
3.6.2 Questionnaire validation 62
3.6.3 Interview 62
3.6.4 Anthropometric measurement 62
3. 6. 4.1 Weight measurement 62
3.6.4.2 Height Measurement 63
3.6.4.3 Mid-arm Circumference Measurement 64
3.6.4.4 Age assessment 64
3.7 Data Analysis 64
3.8 Statistical Analysis 65
CHAPTER 4
RESULT AND DISCUSSION
4.1 Personal Information of the Infants and Young Child’s Parents 67
4.2 Socio-Economic Characteristics of the Parents 69
4.3 Information on the Infant and Young Child Breastfeeding Practices 72
4.4 Information on the Infant and Young Child Bottle Feeding Practice 76
4.5 Information on the Infant and Young Child Complementary Feeding Practices 78
4.6 Food Frequency Consumption of the Child 83
4.7: Anthropometric Indices of the Children 87
4.8 Relationship between Feeding Practices and Anthropometric Indices of the Children 92
CHAPTER 5
CONCLUSION AND RECOMMENDATIONS
5.1 Conclusion 95
5.2 Recommendations 96
REFERENCES
APPENDIX
LIST OF TABLES
Table 2.3 a: Macronutrient (g/dL) and energy (Kcal/dL) composition of human milk from specified references 19
Table 2.5 Impacts of Inappropriate Complementary Freeding Practices at the Population Level 28
Table 4.1 Personal information of the infants and young child’s parents 70
Table 4.2 Socio-economic characteristics of the parents 73
Table 4.3 Information on the infant and young child breastfeeding practice 74
Table 4.4 Information on the infant and young child bottle feeding practices 77
Table 4.5a: Information on the infant and young child complementary feeding practices 79
Table 4.5b: Information on the infant and young child complementary feeding practices 80
Table 4.6a: Food frequency consumption of the child 84
Table 4.6b: Food frequency consumption of the child 85
Table 4.7a: Weight for height status of the children by sex and age group 88
Table 4.7b: Height for age status of the children by sex and age group 89
Table 4.7c: Weight for age status of the children by sex and age group 90
Table 4.7d: BMI for age status of the children by sex and age group 91
Table 4.8: Relationship between feeding practices and anthropometric indices of the children 93
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Globally it is estimated that undernutrition is directly and indirectly responsible for at least 35% of deaths in children less than five years of age (United Nations International Children's Emergency Fund, 2007). Undernutrition is also a major cause of disability, preventing surviving children from reaching their full developmental potential (Word Health Organization, 2009). The causes of malnutrition in Nigeria are many and complex. The immediate causes of malnutrition in the first two years of life are inappropriate breastfeeding and complementary feeding practices coupled with high rates of infections (Nigeria Demographic and Health Survey, 2008). These underlying factors themselves are influenced by the socio-economic status of parents/caregivers (Amsalu and Tigabu, 2008; Muller and Krawinkel, 2005). Poor knowledge on feeding practices and low education of mothers have also been implicated in malnutrition of children (Appoh and Klekling, 2005; Mananga et al., 2014). Infant feeding practices have a major role in determining the nutritional status of a child (Betran et al., 2001). For proper physical and mental development, infants should be breastfed within half an hour of birth, exclusively breastfed for the first six months of life, and thereafter should receive nutritionally-adequate and safe complementary foods while breastfeeding continues up to two years (Sultana et al., 2014). However, the 2013 Nigeria Demographic and Health Survey (NDHS) reported an exclusive breastfeeding rate of 17% for the first 6 months of life. In Nigeria it has been identified that over 50% of infants are given complementary foods too early and they are often of poor nutritional value mostly inadequate in terms of energy, protein and micronutrients such as iron, zinc, iodine and vitamin A. The frequency of feeding is usually low, while the quantities given are less than that required for the ages of the children. The direct consequences of these inappropriate feeding practices is the poor nutritional status of Nigeria’s under-fives as revealed in the most recent Nigeria Demographic and Health Survey (National Population Commission and NDHS, 2013). The data revealed that 37% of under-fives in Nigeria are stunted; with 21% severely stunted. The prevalence of stunting increases with age from 16% at age 6 months to 46% between 24 to 35 months. Additionally 18% of Nigerian children are wasted with wasting peaking at age 9 to 11 months (NPC and NDHS, 2013).
Recognizing the role of infant and young child feeding practices on the nutritional status of children less than two years of age, the World Health Organization (WHO) developed and validated a set of core indicators to assess infant and young child feeding practices (WHO, 2008). These indicators encompass both breastfeeding and complementary feeding related practices.
Therefore, this study is aimed at assessing the infant/young child feeding practices in Nsukka L. G. A. of Enugu State, to ascertain the rate of undernutrition in the area.
1.2 STATEMENT OF THE PROBLEM
Malnutrition is one of the biggest health problems that the world currently faces and is associated with more than 41% of the deaths that occur annually in children from 6 to 24 months of age in developing countries which total approximately 2.3 million (Sandoval-Priego et al ., 2002). WHO (2001) reported that 54% of all childhood mortality was attributable, directly or indirectly, to malnutrition.
In Nigeria, malnutrition is widespread, for example, 41% of all children less than five years of age are stunted, 14% wasted and 23% are underweight (NDHS, 2008). Exclusive breastfeeding rate has decreased from 17% in 2003 to 13% in 2008 (National Population Commission (NPC) Nigeria and ICF, 2009). This malnutrition in Nigerian infants was found to be as a result of inappropriate child feeding practices, for instance, 35% of Nigerian infants are given complementary foods too early and they are often of poor nutritional value, mostly inadequate in terms of energy, protein and micronutrients such as iron, zinc, iodine and vitamin A. The frequency of feeding is usually low, while the quantities given are less than that required for the ages of the children. Thus, this study was conducted to assess the infant/young child feeding practices and proffer proper feeding practices.
1.3 OBJECTIVES OF THE STUDY
1.3.1 General objectives of the study
The general objective of this study is to assess the infant/young child (0-5 years) feeding practices and their anthropometric status in selected rural communities in Nsukka Local Government Area of Enugu State.
1.3. 2 Specific objectives of the study
The specific objectives of the study are to:
a. determine the socio-economic characteristics of mothers with infants and young children (0-5 years) in selected rural communities in Nsukka Local Government Area of Enugu State using questionnaire;
b. identify the feeding practices in Nsukka L.G.A.
c. assess the anthropometric indices (weight-for-height, height-for-age, weight-for-age and mid upper arm circumference) of infants/young children in Nsukka L.G.A using stadiometer, weighing scale, Shakir stripe etc.
d. determine the relationship between the feeding practices and anthropometric status of infants (0-5 years) in the study area.
1.4 SIGNIFICANCE OF THE STUDY
The study will provide information on the various feeding practices to the community nutritionists, dietitians, home economists and those in related professions as this will enable them plan programs to address the poor breastfeeding and complementary feeding practices.
The data provided will also be of use to the ministry of health in planning their health programmes for the rural community. It will further sensitize the government and NGOs (Non-Governmental Organizations) on the necessity of developing important strategies and concepts that center on elevating nutritional education in the society, since this is an essential factor for providing nutritional intervention to children at risk of malnutrition. Doctors and nurses will use these information gathered to educate mothers on the benefits of proper exclusive breast feeding practices, with this mothers will know the benefit and imbibe proper exclusive breastfeeding practices, for the healthy growth of their children. This will in turn promote childhood survival.
Click “DOWNLOAD NOW” below to get the complete Projects
FOR QUICK HELP CHAT WITH US NOW!
+(234) 0814 780 1594
Login To Comment