ABSTRACT
Breast feeding is the feeding of an infant or young child with breast milk directly from the female human breast rather than a baby bottle or container. Infant and young child feeding is the corner stone of assuring growth and congnitive development in children. The use of bottle feeding and pacifier is discourage as it is associated with poor hygiene and risk of gastrointestinal infection to the infant exclusive breastfeeding has been recommended the world over, as the optimal feeding mode for infants. In Nigeria, various factors such as unsafe water, unhygienic handling of food, storage of food at ambient temperature for a long time and poor domestic and personal hygiene are all associated with diarrhea diseases can occur mainly in bottle feed babies. The specific objective of the study is to: determine social-demographic and social economic characteristics of mothers practicing exclusive breast feeding in Ukehe Igbo Etiti L.G.A of Enugu State, identify the numbers of mothers practicing exclusive breast feeding in Ukehe Igbo Etiti L.G.A of Enugu State, determine the factors inhibiting exclusive breast feeding in Ukehe Igbo Etiti L.G.A of Enugu State and determine the factors encouraging exclusive breast feeding in Igbo Etiti L.G.A of Enugu state. This study is a descriptive cross-sectional survey. In conclusion, This study has showed that mothers were knowledgeable of the importance of breastfeeding and about 85% of them had good knowledge of exclusive breastfeeding and a mean score of 50.14 was recorded indicating that there is good knowledge about exclusive breast feeding within the nursing mothers in the study area The overall responses of the nursing mothers showed that majority of them had positive attitudes towards exclusive breast feeding in the study area. The result of the study also affirms that majority of the nursing mothers practise exclusive breast feeding in the study area.
TABLE OF CONTENTS
Cover Page
Title Page i
Certification ii
Dedication iii
Acknowledgement iv
Table of contents v
List of tables viii
Abstract ix
CHAPTER1
INTRODUCTION
1.1 Background of the study 1
1.2 Statement of problem 2
1.3 Objective of the study 4
1.3.1 General objective of the study 4
1.3.2 Specific Objective of the Study 4
1.4 Significance of the study 4
CHAPTER2
LITERATURE REVIEW
2.1 Concept of breastfeeding 6
2.2 Nutritional qualities of human milk 6
2.3 Composition of breast milk 7
2.3.1 Carbohydrate content of breast milk 7
2.3.2 Protein content of breast milk 7
2.3.3 Fats content of breast milk 8
2.3.4 Vitamins content of breast milk 8
2.3.5 Minerals content of breast milk 9
2.3.6 Water contact of breast milk 9
2.3.7 Anti-Effective properties of breast milk 9
2.4 Types Of Breast Milk 10
2.4.1 Colostrum 10
2.4.2 Fore milk 11
2.4.3 Hind milk 11
2.4.4 Transition milk 11
2.5 Physiology of lactation 11
2.6 Breastfeeding 12
2.7 Types of infant feeding practices 13
2.8 Formula feeding 13
2.8.1 Shared Breastfeeding 14
2.8.2 Complementary feeding 14
2.8.3 Exclusive Breastfeeding 14
2.8.4 Mixed feeding 14
2.8.5 Expressing Breast milk 15
2.8.6 Demand or Need Feeding 15
2.8.7 Extended Breastfeeding 16
2.8.8 Tandem Breastfeeding 16
2.8.9 Practice of Breast Feeding in Nigeria 16
2.9 Knowledge and attitude to breastfeeding 17
2.10 Advantages of breastfeeding to infants 18
2.11 Advantages of breastfeeding to mother 20
2.12 Benefits to the society/nation 21
2.13 Disadvantages of bottle feeding 22
2.15 Barriers of breastfeeding 22
2.16 Strategies in promoting exclusive breastfeeding 24
CHAPTER 3
MATERIALS AND METHODS
3.1 Study design 27
3.2 Area of study 27
3.3 Population of the study 27
3.4 Sampling and sampling techniques 27
3.4.1 Sample size 27
3.4.2 Sampling procedure 29
3.5 Preliminary Activities 29
3.5.1 Preliminary Visit 29
3.5.2 Training of Research Assistant 29
3.5.3 informed consent 30
3.5.3 Ethical approval 30
3.6 Data Collection 30
3.6.1 Questionnaire Administration 30
3.7 Data Analysis 31
3.8 Statistical Analysis 31
CHAPTER 4
RESULTS AND DISCUSSIONS
4.1 Socio-demographic/Socio-economic Characteristics of Mothers Practicing
Exclusive Breast Feeding 33
4.2 Numbers of Mothers Practicing Exclusive Breast Feeding in the study area 36
4.3 Factors Inhibiting/Encouraging Exclusive Breast Feeding 41
CHAPTER 5
CONCLUSION AND RECOMMENDATION
5.1 Conclusion 44
5.3 Recommendations 44
REFERENCES
APPENDIX
LIST OF TABLES
Table 1 Nutrient composition of breast milk pair 100mi 10
Table 4.1a Socio-demographic/Socio-economic Characteristics of Mothers Practicing Exclusive Breast Feeding 33
Table 4.2 Knowledge of Exclusive Breast Feeding 36
Table 4.3 Attitudes of Mothers towards Exclusive Breast Feeding 37
Table 4.4 Practice of Exclusive Breast Feeding 39
Table 4.5 Socio-demographic Factors Inhibiting/Encouraging Exclusive Breast Feeding 41
CHAPTER1
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Breast feeding is the feeding of an infant or young child with breast milk directly from the female human breast rather than a baby bottle or container (WHO, 2013)Infant and young child feeding is the corner stone of assuring growth and congnitive development in children. Breastfeeding initiated within the first hour of birth, provided exclusively for six(6) months, and continued up to two years or beyond, improves breastfeeding rates and save the lives of more than 820,000 children under age 5 every year,(Victora et al., 2016) In addition to improving child survival and protecting against life-threatening and chronic illnesses, breastfeeding promotes healthy brain development, and is associated with higher performance in intelligence tests among children and adolescents across all income levels,(Anstey et al.,2011),Breastfeeding has been shown to also protect against post-partum haemorrhage, postpartum depression, ovarian and breast cancer, heart disease and type 2 diabetes in mothers; It is estimated that improving breastfeeding rates could prevent maternal deaths from breast cancer (Chowdhury et al .,2015) In other worlds, Breastfeeding is among the most effective ways to protect maternal and child health and promote healthy growth and optimal development in early childhood. Empowering and enabling women to breast should be at the heart of countries efforts to keep every child alive and to build healthy, smart and productive societies.(Victora et al., 2016).
UNICEF and WHO (2013) recommended that mothers should breastfeed for six(6) months without the addition of infant formula or solid food and continue breast feeding for two(2) years. This is called exclusive breast feeding (EBF). The World Health Organization (WHO,2013) recommendations on breast feeding stipulated that breast feeding should start immediately after child delivery for the baby to get colostrums. Colostrum is the first form of milk produce by the mammary glands of mammals immediately following delivery of the newborn, Colostrum contains antibodies to protect the newborn against disease (Pallasch, 2003). The infant should thereafter be exclusively breast fed for up to six(6) months of life, day and night on child`s demand, should be given to the baby (Emeaso, 2012).
The use of bottle feeding and pacifier is discourage as it is associated with poor hygiene and risk of gastrointestinal infection to the infant (WHO, 2015) exclusive breastfeeding has been recommended the world over, as the optimal feeding mode for infants. Despite all the recommendations and benefits, infant and children`s breast feeding is not widely accepted and practical in many societies (WHO, 2015). The study is designed to determine prevalence of exclusive breast feeding and factors inhibiting exclusive breast feeding in Ukehe Igbo Etiti L.G.A. of Enugu state.
1.2 STATEMENT OF PROBLEM
Thus it has been found that babies given cow`s milk or formula by bottle and no breast milk have over 60%more risk of being malnourished (Victora et al., 2016). Almost 5 million babies each year are at risk of poor nutrition due to inadequate breastfeeding in urban and rural areas contributing to increasing rate of infant and child mortality (UNICEF, 2013).
In Nigeria, various factors such as unsafe water, unhygienic handling of food, storage of food at ambient temperature for a long time and poor domestic and personal hygiene are all associated with diarrhea diseases can occur mainly in bottle feed babies.
At the same time, young urban woman are increasingly being separated from their own mothers and their female relations and thus, have lost their traditional source of inadequate milk supply, nipple or breast soreness and other problems also lead to premature cessation of breast feeding due to inadequate information on how to overcome these problems (EMEASO, 2012). In Nigeria malnutrition is one of the major causes of infant mortality and this usually peaks between 1-2 years of life when baby is taken off breast milk and inappropriate complementary feeding instituted.
The nutrient intakes of these babies deteriorate because of poor knowledge; attitude, practices and ignorance of most mothers towards adequate nutrient intake (EMESON, 2012).Some believe that the baby is hungry. This result in failure to thrive with results in failure the baby is hungry. This results in failure to thrive with resultant high mortality rate. Despite strong evidences in support of exclusive breastfeeding it`s prevalence has remained low worldwide, in Nigeria, breastfeeding universal with almost all babies being breastfed. However, the practice of exclusive breastfeeding is rare with only; 17; of children young than six(6) months been exclusively breastfed (NDHS,2014).
Approximately 7million children are born in Nigeria every year and only 25% are exclusively breastfed from 0-6months of age (NNHs, 2014). Dangers that could arise when infants and young children are not exclusively breastfed include, diarrhea, pneumonia ear infection (otitis) meningitis and low growth (fatoumate et al.,2012).This study is designed to study the prevalence of exclusive breast feeding and factors inhibiting exclusive breast feeding to provide information to mothers to enable them make the right choices. Therefore, increased breastfeeding rates would gave money spent on infant formula and health care.
1.3 OBJECTIVE OF THE STUDY
1.3.1 General objective of the study
The general objective of the study is to assess the prevalence of exclusive breast feeding and factors inhibiting exclusive breast feeding in Ukehe Igbo Etiti L.G. A of Enugu State.
1.3.2 Specific Objective of the Study
The specific objective of the study is to:
1. determine social-demographic and social economic characteristics of mothers practicing exclusive breast feeding in Ukehe Igbo Etiti L.G.A of Enugu State.
2. identify the numbers of mothers practicing exclusive breast feeding in Ukehe Igbo Etiti L.G.A of Enugu State.
3. determine the factors inhibiting exclusive breast feeding in Ukehe Igbo Etiti L.G.A of Enugu State.
4 determine the factors encouraging exclusive breast feeding in Igbo Etiti L.G.A of Enugu state.
1.4 SIGNIFICANCE OF THE STUDY
At the end of this research, the result obtained will provide information to the health workers such as medical doctors, dieticians, and commercial health workers on the prevalence of exclusive breast feeding and factors inhibiting exclusive breast feeding in Ukehe Igbo Etiti L.G.A of Enugu state, It will contribute to the information on exclusive breastfeeding practices of Nigeria mothers. Based on the result generated, future researchers will know the prevalence of exclusive breast feeding and factors inhibiting exclusive breast feeding and device other ways to improve on their practice. This work will also help to tackle some nutrition related problems that are associated with poor breast feeding practice and also help to reduce death rate among children in the society.
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