ABSTRACT
This study was conducted to assess the infant feeding practices of mothers and anthropometric status of their infants in Ebonyi State Rural Area (Afikpo South Local Government Area). A structured questionnaire was administered to the mothers where types of infant feeding they practiced and the anthropometric status (weight-for-height, height-for-age, weight-for-age, BMI-for-age, mid upper arm circumference) of their infants were obtained. The questionnaire was distributed to a total of 311 mothers. The mean and standard deviation were obtained, frequency and percentage were calculated using computer software, statistical product service solution (SPSS) version 21. The result showed that Majority (72%) of the mothers were between the ages of 18-35 years, 20.6% were less than 18 years, while 7.4% were between 38-55 years. Majority (94.9%) of the mothers were married, 3.5% were single, while very few (1.6%) were separated. Furthermore 33.8% of the mothers had no formal education, 33.1% were primary school holders, and 28.6% were secondary school graduates, while very few 4.5% were graduates of a tertiary institution. Majority of the mothers started with a good infant feeding practice, this could be traced to 88.7% who gave breast milk as the first food to their infants and 96.8% who gave colostrum to their infants. Despite the fact that they started with a good practice of infant feeding practices, it was not continued as only 15.4 practiced exclusive breastfeeding and majority of the mothers (84.6%) did not practice exclusive breastfeeding for six months, very few (7.4%) did initiate semi-solid food at the right age and 75.6% did not know the right age to introduce family foods. Thus the effect of the negative practice could be traced to, 79.7% of the infants that were severely stunted, 51.8% who were wasted and 75.2% who were moderately malnourished. Mothers should be sensitized on the importance of good infant and young child feeding practices in order to improve the IYCF knowledge. Emphasis should be made on promotion of exclusive breastfeeding and good infant feeding practices through nutrition education, prints, mass media, good education, television, books, radio or magazine and short drama/food demonstration during ante-natal visit.
TABLE OF CONTENTS
TITLE PAGE i
CERTIFICATION iii
DEDICATION iv
ACKNOWLEDGEMENT v
TABLE OF CONTENT vi
LIST OF TABLE ix
ABSTRACT x
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 objective of the study 4
1.3.2 Specific objectives 5
1.4 Significance of the study 5
CHAPTER TWO
LITERATURE REVIEW
2.1 Infant feeding practices 7
2.2 Breastfeeding 9
2.2.1 Timely initiation of breastfeeding 9 2.2.2 Advantages of breastfeeding 10 2.2.3 Problems associated with breastfeeding 11
2.2.4 Exclusive breastfeeding 11 2.2.5 Benefits of exclusive breastfeeding for infants and mothers 12
2.2.5.1 The infants 12
2.2.5.2 The mothers 13
2.2.6 Professional working mothers and exclusive breastfeeding 14
2.3 Infants formula feeding, advantages and disadvantages 14
2.4 Complementary feeding 16 2.4.1 Introduction to complementary foods 16
2.4.2 Early and late introduction of complementary food 17
2.5 Anthropometric measurements 19 2.6 Anthropometric Indices 19 2.6.1 Weight-for-age (W/A) 20 2.6.2 Height-for-age (H/A) 20 2.6.3 Weight-for-height (W/H) 21 2.6.4 Body mass index (BMI) 21 2.6.5 Circumference and skinfolds 22 2.7 Methods of evaluating dietary intake 23 2.7.1 Twenty four hour dietary recall 24 2.7.2 Dietary history 25 2.7.3 Food frequency questionnaire 25
CHAPTER THREE
MATERIALS AND METHODS
3.1 Study design 27
3.2 Area of study 27 3.3 Population of the study 27
3.4 Sample and sampling techniques 28 3.4.1 Sample size 28 3.4.2 Sampling technique 29
3.5 Preliminary activities 30 3.5.1 Preliminary visits 30 3.5.2 Training of research assistants 30 3.5.3 Consent form 31 3.5.4 Questionnaire validation 31 3.6 Data collection 31 3.6.1 Questionnaire 31 3.6.2 Interview 32
3.6.3 Anthropometric measurements 32 3.6.3.1 Weight measurement 32 3.6.3.2 Height measurement 33 3.6.3.3 Mid-arm circumference measurement 33 3.7 Data analysis 34 3.8 Statistical analysis 35
CHAPTER FOUR
RESULTS AND DISCUSSSION
4.1a Social-demographic characteristics of infants’ parents 38
4.1b Social-economic characteristics of infants’ parents 40
4.1c Social-economic characteristics of infants’ parents 42
4.2 Mothers’ infant feeding practices 45
4.3 Infants food frequency table 47
4.4 Anthropometric parameters 49
4.5 Relationship between infant feeding practices and thropometric 51
CHAPTER FIVE
CONCLUSION AND RECOMMENDATION
5.1 Conclusion 52
5.2 Recommendation 53
REFERENCES
Appendix I
Appendix II
LIST OF TABLES
Table 4.1a; Socio-demographic characteristics of infants’ parents 38
Table 4.1b; Socio-economic characteristics of infants’ parents 40
Table 4.1c; Socio-economic characteristics of infants’ parents 42
Table 4.2; Mothers’ infant feeding practices 45
Table 4.3; Infants food frequency table 47
Table 4.4; Anthropometric parameters 49
Table 4.5; Relationship between infant feeding practices and Anthropometric indices 51
CHAPTER 1
INTRODUCTION
1.1 Background of the Study.
Adequate nutrition during infancy is essential for long life health and wellbeing. It is generally known that children are able to survive on breast milk alone for the first six months of life and should be continually breastfed up to two years of age or more while receiving nutritionally adequate and safe complementary food (World Health Organization (WHO), 2019).
Globally it is estimated that under nutrition 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). Under nutrition is also a major cause of disability, preventing surviving children from reaching their full developmental potential (World 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 breast feeding and complementary feeding practices coupled with high rates of infections (Nigeria Demographic and Health Survey, (NDHS) 2008). These underlying factors themselves are influenced by the socioeconomic 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). Infants 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 for the first months of life, and thereafter should receive nutritionally adequate and safe complementary foods, while breastfeeding continues up to two years (Sultana et al.,2014). Optimal Infant Feeding Practices recommended by World Health Organization (WHO) and United Nations International Children’s Emergency Fund (UNICEF) involves exclusive breastfeeding for the first 6months of life, followed by adequate complementary feeding and continued breastfeeding until the child is at least two years old. Benefits to infants when breastfeed appropriately includes reduced risk of diarrheal and gastro intestinal illness, allergies, acute respiratory infections, bacterial meningitis, childhood asthma and childhood leukemia (Anoshirike et al.,2014). Promoting adequate infant feeding practices such as early initiation of breastfeeding and exclusive breastfeeding for up to six months is an effective strategy for improving child survival.
The direct consequences of these inappropriate feeding practices are the poor nutritional status of Nigeria's under five as revealed in the most recent Nigeria Demographic and Health Survey (National Population Commissioned and NDHS, 2013). The data revealed that 37% of under-fives in Nigeria are stunted; with 21% severely stunted,18% of Nigerian children are wasted with wasting peaking at age 9 to 11 months, 29% are underweight and 25% are obsessed (NPC and NDHS, 2013).
Recognizing the role of infant 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.
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 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 child mortality was attributed directly 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 rates 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 micro nutrients such as Iron, Iodine, zinc and Vitamin A. The frequency of feeding is usually low while the quantities given are less than required for the ages of the children.
Poor infant feeding practices such as not breastfeeding the child for up to six months, starting complimentary feeding before the child is up to six months old, using of water mixed with honey and herbs, use of animal milk as prelacteal feed. All these are the kinds of poor infant feeding practices in Afikpo South. Thus, the study was conducted to assess the infant feeding practices and proffer proper feeding practices.
1.3 Objectives of the study.
1.3.1 General objective of the study.
The general objective of this study is to assess the infant feeding practices of mothers and assess the anthropometric status of their infants in the rural Area of Ebonyi State.
1.3.2 Specific objectives.
1.Determine the socio- economic characteristics of mothers with infants in the rural area of Ebonyi state.
2.To assess infant feeding practices in rural area of Ebonyi State.
3.To assess the anthropometric status (weight-for-height, height-for-age, weight-for-age and mid upper arm circumference) of infants in rural Area of Ebonyi state.
4.Determine the relationship between the infant feeding practices and anthropometric status of the infants in the study area.
1.4. Significance of the study.
The study will provide information on the various infant feeding practices of mothers to the community nutritionist, 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 used by the Ministry of Health in planning their health program for the rural community as well as making policies that will promote the practice of appropriate infant feeding.
It will further sensitize the government and NGOS (Non-governmental Organizations) on the necessity of developing important strategies and concepts that center on promoting nutrition education in the society, since this is an essential factor in providing nutritional intervention to the children at risk of malnutrition
Doctors and nurses and other allied medical professionals will use this information gathered to educate mothers on exclusive breastfeeding and good infant feedings practices to reduce and eradicate the prevalence of malnutrition in Nigeria particularly the vulnerable groups like the children. It will also serve as a baseline for further studies.
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