KNOWLEDEGE, ATTITUDE AND PRACTICE OF EXCLUSIVE BREASTFEEDING AMONG NURSING MOTHERS ATTENDING POST NATAL CLINIC IN FEDERAL MEDICAL CENTRE,UMUAHIA, ABIA STATE

ABSTRACT

The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life and continua breasfeeding and adequate complementary foods for up to two years of age or beyond. The objective of this study was to assess the knowledge, attitude and practice of exclusive breastfeeding among nursing mothers attending post natal clinic in Federal Medical Centre, umuahia, Abia State, Using a descriptive research design and a self-structured questionnaire, data was collected from 348 respondents, presented in frequency tables, interpreted and analyzed using the statistical production for service solution (SPSS) version 25. Result showed that more than half of the respondents (86.5%) are within the age range 20-40years and a majority (86.5%) were married, most (95.7%) practice Christianity, majority (61.5%) had the secondary level of educational qualification, 23.3% were self-employed with more than  half the respondent (55.5%) earning an average income .  In this study, majority of the respondents 44.5% have good knowledge an  26.7% have average knowledge on exclusive breastfeeding and most (70%) got their information from the antenatal clinic in the hospital, likewise majority (52.9%) have good practice of breastfeeding. The most challenging factors of exclusive breastfeeding identify in this study were: 25.6% health condition of the mother (cracked or sore nipples and bitter breast milk), lack of help to mothers (22.1%), inadequate time to breastfeed due to mother’s busy schedule (28,7%), mothers are not on maternity leave (10.1%), and inadequate breast milk secretion(13.5%). There is a significant relationship between knowledge of exclusive breastfeeding and its practice among working mothers attending antenatal clinic in Federal Medical Centre, Umuahia, Abia State. Similarly there is a significant relationship between practice of exclusive breastfeeding and respondents’ educational qualification. In conclusion the practice of EBF is influenced by its' knowledge and also educational qualification of respondents., health condition of mother and baby as well as cracked or sore nipples also hindered the practice of EBF. It is therefore recommended that Health sector should mandate that proper health education is carried out in hospitals for pregnant women receiving antenatal care  in their facilities and Nurses/Midwives should encourage and ensure post-partum care is adequately given to both the mother and baby.

TABLE OF CONTENTS

TITLE PAGE                                                                                                            i

CERTIFICATION                                                                                                    ii

DEDICATION                                                                                                          iii

ACKNOWLEDGEMENT                                                                                       iv

TABLE OF CONTENTS                                                                                         v

LIST OF TABLES                                                                                                    viii

ABSTRACT                                                                                                               ix

CHAPTER 1

INTRODUCTION

1.0       Background of the study                                                                                 1

1.1       Statement of Problem                                                                                     3

1.2       Objective of the Study                                                                                    4

1.2.1    General Objective of the Study                                                                      4

1.2.2    Specific Objective of the Study                                                                      4

1.3       Significance of the Study                                                                               4

CHAPTER 2

LITERATURE REVIEW

2.1       Breast Milk                                                                                                     6

2.2       Composition of human milk                                                                           8

2.3       Knowledge and attitude of breastfeeding                                                       12

2.4   .   Factors affecting exclusive breastfeeding                                                      14

2.4.1   Oppositions to other source of breast milk                                                                                                                              16

2.4.2. Benefits of exclusive breastfeeding for infants                                                18

2.4.3    Importance of exclusive breastfeeding to mothers                                         19

2.4.4    Types of infant feeding practice                                                                     21

2.4.5    Effect of early weaning                                                                                  22

2.4.6    Strategies in promoting exclusive breastfeeding                                            24

2.4.7     Breast Feeding  positions                                                                                                   26

2.4.8   Good attachment                                                                             27

2.4.9    Prevalence of exclusive breastfeeding in Nigeria                                          28

CHAPTER 3

MATERIALS AND METHODS

3.1       Research Design                                                                                             29

3.2       Research Area of Study                                                                                  29

3.3       Population Size                                                                                               30

3.4       Sampling and Sampling size                                                                          30

3.4.1    Sample size                                                                                                     30

 3.5.     Sample techniques                                                                                          31

3.6        preliminary activities                                                                                32

3.7        Study instrument                                                                                      32

3.8.      Data collection                                                                                               32

3.8.1    Instrument for data collection                                                                        33

3.9       Statistical Analysis                                                                                         33

CHAPTER 4

DATA PRESENTATION, INTERPRETATION AND ANALYSIS

4.0       Result and discussion                                                                                    35

4.1       Socio Economic Characteristics of the respondent                                        35

4.2       Awareness and Knowledge of respondent on exclusive breastfeeding  39

4.3       Attitude of exclusive breast feeding by the respondent                                 42

4.4       Mother’s breastfeeding practice                                                                     44

45        Factors that influence knowledge, attitude and practice of                            47

 Exclusive breastfeeding

4.6       Relationship between knowledge, attitude and practice                                48

          Of respondent towards exclusive breastfeeding

CHAPTER 5

SUMMARY, CONCLUSION AND RECOMMENDATION

5.1       Conclusion                                                                                                      50

5.3       Recommendation                                                                                           51                   

References                                                                                                                  52

Appendix i                                                                                                                  57

Appendix ii                                                                                                                 66

Appendix iii                                                                                                                68

LIST OF TABLES

Table 4.1         Socio Economic Characteristics of the respondent                           38

Table 4.2a       Awareness of respondent on   Exclusive breastfeeding.                     41

Table 4.2b       Knowledge of respondent towards Exclusive breastfeeding.             41

Table 4.2c       Level of Knowledge of respondent towards                                        42

Exclusive breastfeeding.            

Table 4.3a       Attitude of exclusive breast feeding by                                       43

The respondent          

Table 4.3b       Level of Attitude of the respondent                                                     44

Table 4.4         Mother’s breastfeeding practice                                                           46      

Table 4.5         Factors that influence knowledge, attitude and practice                         48

                        Of  Exclusive breastfeeding                          

Table 4.6         Relationship between knowledge, attitude and practice                         49                   

 CHAPTER 1

INTRODUCTION

1.0 BACKGROUND OF THE STUDY

According to the definition the world Health Organization (WHO), Exclusive breastfeeding (EBF) is the situation in which an infant receives only breast milk from his/hér mother or a wet nurse or the first 6 months and no other solids or liquids with the exception of drops or syrups consisting of vitamins, minerals, supplements, or medicines. The World Health Organization (WHO) and the United Nation Children’s Fund (UNICEF) recommend initiation of breastfeeding within the first hour after birth; exclusively breastfeed for the first six months of age and continuation of breastfeeding for up to two years of age or beyond in addition to adequate complementary foods (UNICEF, 2018), because breast milk is the ideal food for infant, it is safe, clean and contains antibodies which helps protect against many common childhood illnesses. Breast milk provides all the energy and nutrient that the infant needs for the first months of life, and it continues to provide up to half of the first year and up to one third during the second year of life

EBF is an important public health strategy for improving children’s and mother’s health by reducing child morbidity and mortality and helping to control healthcare costs in society (Al-Binali, 2017). Additionally, EBF is one of the major strategies which help the most widely known and effective intervention for preventing early childhood deaths.

In mothers, breastfeeding has been shown to decrease the frequency of hemorrhage, postpartum  depression, breast cancer, ovarian and endometrial cancer, as well as facilitating weight loss (Holtzman and Usherwood, 2018). The lactation amenorrhea method is an important choice for postpartum family planning (Idris et al., 2015).

Despite WHO’s recommendations on breastfeeding, the global picture falls short of the world standards, as only 44% of infants aged 0_6 months worldwide were exclusively breastfed  over the period of 2015- 2020. The Nigeria demographic and Health Survey (NDHS) (2018) reported that only 38% of mothers initiate breastfeeding early and low socioeconomic status was found to be associated with a decrease in the exclusive breastfeeding rates. The Health for all initiative (HFAI) sought to increase the percentage of all infants being exclusively breastfed to 80% by 2018. The United Nations Children’s Fund (UNICEF) (2018) recommended that 90% infants less than 6 months of age in developing countries should be exclusively breastfed. For Nigeria to meet these recommendations, an understanding of the factors associated with reduced exclusive breastfeeding rates is important for solutions addressing these factors to be proffered. It is against this backdrop that this study intends to assess the Knowledge, attitude and practice of exclusive breast feeding by mothers attending postnatal clinic in FMC, Umuahia, Abia State.

1.1       STATEMENT OF PROBLEM

Human breast have been discovered to be an adequate food for infants 0-2 years (0-24 months). It is the best nutrition for infants with the introduction of complementary foods at 6 months and continued breastfeeding beyond 2 years. In Umuahia, majority of mothers fail to practice exclusive breastfeeding as recommended. This is caused by factors such as lack of self-security, breast soreness, poor infant positioning, mother’s perception of inadequate milk supply and lack of necessary support and information from health care provider.  There are cultural, social and economic barriers to exclusive breastfeeding including pre-lacteal feeding, giving drinking water and herbal tea. Poor exclusive breastfeeding rates might have result from the absence of knowledge of breastfeeding during antenatal, nutrition education. Infants that are subjected to poor breastfeeding practices may easily become malnourished with the tendency of contributing to increasing rate of infant mortality.  Another factors that affects the practice of exclusive breastfeeding among nursing mothers in Umuahia metropolis are educational, social class, culture, locale, nature of work and health status of both the nursing mothers and their infants.

1.2       OBJECTIVES OF THE STUDY

1.2.1    General objective of the study

The general objective of this study is to assess the Knowledge, attitude and practice of exclusive breast feeding by mothers attending postnatal clinic in FMC, Umuahia, Abia State

1.2.2    Specific objectives of the study             

Specific Objectives are to:

i.         Assess the socio-demographic/economic characteristics of the respondents

ii.         Ascertain the awareness and knowledge of respondents towards exclusive breast feeding

iii.         Assess the attitude of respondents towards exclusive breastfeeding

iv.         Determine the practice of exclusive breastfeeding among the respondents

v.         Assess the socio-demographic/economic factors influencing exclusive breastfeeding

vi.         Determine the relationship between knowledge, attitude and practise of exclusive breastfeeding among the respondents.

1.3       SIGNIFICANCE OF THE STUDY

At the end of this research, the result obtain from this study will provide information to the health workers such as medical doctors, dieticians, teachers and commercial health workers in Abia state. This work will help to tackle some nutrition related problems that is associated with poor breastfeeding practices and also reduce death rate among children in the society. Through the result of this research, it will help to motivate and encourage mothers’ interest in exclusive breastfeeding. The information generated from this study, will be used to note the need for further sensitization on breastfeeding in post-natal and pre-natal out-patient clinic in all the Primary Health Centers in Abia State where nutrition education goes on, in educating expectant mothers and the nursing mothers on the need and importance of exclusive breastfeeding.

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