The Rate Of Acceptance Of Exclusive Breast Feeding Among Nursing Mother

ABSTRACT

Breastfeeding is a recognized means of ensuring optimal nutrition for the infant. Exclusive breastfeeding is defined as feeding an infant child breast milk only, and for optimal nutrition it is recommended that infants be exclusively breastfed for the first 6 months of life. The aim of this study was to examine the rate of acceptance of exclusive breastfeeding among nursing women in abakaliki metropolis, Ebonyi state Nigeria. This was a cross-sectional descriptive study. A total of 210 nursing mothers from abakaliki metropolis, Ebonyi state were selected using systematic sampling, with a response rate of 95%, so we had 200 respondents. A pretested, structured, self-administered questionnaire adapted from previous studies was used for data collection. The mean age of the respondents in this study was 33 years (range 21- 50 years). Of the 200 respondents 188 (94%) had a good knowledge of exclusive breastfeeding and 173 (86.5%) of them reported that the hospital was their source of information. More than 180 (90%) respondents had a positive acceptance of exclusive breastfeeding. Exclusive breastfeeding was practiced by 112 (56%) of the respondents, however, only 57 (28.5%) practiced exclusive breastfeeding for up to 6 months post-delivery. The major source of breastfeeding support came from the baby’s father for 88 (44%) respondents while the least breastfeeding support came from the workplace for three (1.5%) respondents who are working class. The duration of maternity leave was mostly 3 months, and less than 20 (10%) respondents reported having support for breastfeeding at the workplace.

In spite of the good knowledge of exclusive breastfeeding among the respondents as well as their good acceptance, the exclusive breastfeeding rate up to 6 months postpartum was very low. This may be related to the inadequate breastfeeding support from the various support systems especially in the workplace, as demonstrated in this survey. There should be advocacy for a government policy for a mandatory 6 month maternity leave for all working mothers.

TABLE OF CONTENTS

COVER PAGE

TITLE PAGE

APPROVAL PAGE

DEDICATION

ACKNOWELDGEMENT

ABSTRACT

CHAPTER ONE

1.0      INTRODUCTION

• BACKGROUND OF THE STUDY
• PROBLEM STATEMENT
• AIM OF THE STUDY
• OBJECTIVE OF THE STUDY
• SIGNIFICANCE OF THE STUDY
• SCOPE OF THE STUDY
• PURPOSE OF THE STUDY
• LIMITATION OF THE STUDY
• RESEARCH QUESTION
• DEFINITION OF TERMS

CHAPTER TWO

LITERATURE REVIEW

• THE CONCEPT OF EXCLUSIVE BREASTFEEDING
• THEORETICAL FRAMEWORK
• EXCLUSIVE BREASTFEEDING IN DEVELOPED COUNTRIES
• EXCLUSIVE BREASTFEEDING IN DEVELOPING COUNTRIES
• EXCLUSIVE BREASTFEEDING IN NIGERIA

CHAPTER THREE

3.0    RESEARCH METHODOLOGY

• STUDY AREA
• STUDY POPULATION
• SAMPLE SIZE
• SAMPLING METHOD
• DATA MEASURES
• DATA ANALYSIS
• ETHICAL ISSUES

CHAPTER FOUR

4.0    RESULT AND DISCUSSION

4.1    RESULT

4.2    DISCUSSION

CHAPTER FIVE

• CONCLUSION

Abbreviations

EBF: Exclusive breastfeeding

WHO: World Health Organisation

CHAPTER ONE

1.0                                                        INTRODUCTION

1.1                                           BACKGROUND OF THE STUDY

Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts (i.e. via lactation) rather than using infant formula from a baby bottle or other container (Await et al., 2010). Breastfeeding is the ideal method suited for the physiological and psychological needs of an infant. Under modern health care, human breast milk is considered the healthiest form of milk for babies. Breastfeeding has been accepted as the most vital intervention for reducing infant mortality and ensuring optimal growth and development of children (Gupta et al., 2010). The beneficial effects of breastfeeding in the prevention of morbidity and mortality from diarrhoea in infants have been documented. Scientific researches, such as 2012 review for the World Health Organization (WHO), have found numerous benefits of breastfeeding for the infant.

Breastfeeding promotes health for both mother and infant and helps to prevent disease. Longer breastfeeding has also been associated with better mental health through childhood and into adolescence (Oddy et al., 2010). Breastfeeding appears to reduce the risk of extreme obesity in children.

American Academy of Paediatrics (AAP), reported that breast feeding provides advantages with regard to general health, growth and development. It documents diverse and compelling advantages for infants, mothers, families, and society from breastfeeding and use of human milk for infant feeding. These advantages include health, nutritional, immunologic, developmental, psychological, social, economic, and environmental benefits. During breastfeeding, approximately 0.25-0.5 grams per day of secretory immuno-globulin (IgA) antibodies pass to the baby via the milk. Breastfeeding may decrease the risk of cardiovascular disease in later life, as indicated by lower cholesterol and C-reactive protein levels in adult women who had been breastfed as infants (Gupta et al., 2010).

The National Demographic and Health Survey (NDHS) 2013 study in Nigeria showed that while almost 70 % of children 0–23 months are predominantly breastfed (breast milk and only plain water or non-milk liquids such as juice and other liquids), only 17 % (17%) of children under age 6 months are exclusively breastfed [National Population Commission, 2013]. The aforementioned partially explains the high incidence of infant malnutrition and mortality experienced in developing countries which is mainly due to poor infant feeding practices [Ajibuah BJ, 2013].

Exclusive breastfeeding (EBF) is the feeding of infants with breast milk alone and allowing for drugs such as syrups and multivitamins (as prescribed by the doctor) in the first 6 months of life.[1] EBF is an important component of the child survival strategy and Baby‑Friendly Initiative (BFI).

As a result of rapid changes in the socio-cultural and economic situations worldwide, particularly the rapid urbanization and developing processes going on in developing countries, and the increasingly harsh economic environment, the need for income producing activity of women has increased. The educational and occupational status of the mother is an attribute that help determine the time allocation for women and children [Amosu AM, 2011]. Given the numerous benefits of breastfeeding it is important that employed women understand its importance and are given the required support at every level.

There is lack of data regarding the number of Nigerian women employed within 6 months following birth. The duration of statutory maternity leave for working mothers in Nigeria is only 3 months, and support such as facilities for breast milk pumping and storage in the workplace are not widely available. An unfavourable working environment can make it difficult for mothers to implement and continue exclusive breastfeeding. In recognition of the problems faced by working mothers in practicing exclusive breastfeeding, the World Breastfeeding Week 2015 adopted the theme, “Breastfeeding and work: let’s make it work”, to garner support from all sectors to enable women worldwide to work and breastfeed successfully [WABA, 2016].

There is paucity of data related to support systems for exclusive breastfeeding for mothers in the workplace in Nigeria. A study among female resident doctors in a tertiary institution in Nigeria found the most important barrier to exclusive breastfeeding of their infants to be return to work (61% of respondents) [Agbo HA, 2013]. A mixed methods study among breastfeeding mothers in Southwest Nigeria identified barriers to breastfeeding to include: perceived hunger after feeding baby (29%), maternal health problems (27%), fear of infant addiction to breast milk (26%), breast pains (25%), pressure from mother-in-law (25%), and return to work/business (24%) [Agunbiade OM, 2012]. A mixed methods study in three Nigerian cities found return to work to be an important barrier to exclusive breastfeeding [Olayemi OD, 2014].

Due to many health benefits of breastfeeding to mothers and children, governments of many nations have set goals for breastfeeding practices and rates.

Exclusive breastfeeding (EBF) means giving infants only breast milk with no addition of other foods or drinks, including water. EBF has dramatically reduced infant deaths in developing countries by reducing diarrhea and infectious diseases. It has also been shown to reduce HIV transmission from mother to child, compared to mix feeding.

National and international guidelines recommend that all infants be breastfed exclusively for the first six months of life. Breastfeeding may continue with the addition of appropriate foods, for two years or more. WHO (2010) recommends EBF for the first six months of life, after which infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues up to two years of age or beyond. AAP states that breast feeding also has economic health benefits because breastfeeding results in reduced health care costs. The significantly lower incidence of illness in the breastfed infant also allows the parents more time for attention to siblings and other family duties and reduces parental absence from work and lost income.

According to the centre for disease control and prevention (CDC), one of the most highly effective preventive measures a mother can take to protect the health of her infant is to breastfeed. The success rate among mothers who want to breastfeed can be greatly improved through active support from their families, friends, communities, clinicians, health care leaders, employers, and policymakers. Given the importance of breastfeeding for the health and well-being of mothers and children, it is critical that we take action across the country to support breastfeeding.

The aim of this study was to examine the rate of acceptance of exclusive breastfeeding among nursing mothers in Nigeria from abakaliki metropolis, Ebonyi state.

1.2                                          STATEMENT OF PROBLEM

Despite the effort and strategies that have been put in a place by WHO and UNICEF to increase awareness of exclusive breastfeeding through baby friendly hospitals initiatives in order to reduce complication associated with artificial feeding like respiratory and gastro intestinal infections. It has been observed by the researchers are still reluctant to accept exclusive breastfeeding.

Hence, the question “what is the rate of acceptance of exclusive breast feeding among nursing mothers in Abakaliki metropolis

1.3                                                     AIM OF THE STUDY

The main aim of the study is to find out the rate of acceptance of exclusive breastfeeding among nursing mothers in Abakaliki metropolis

1.4                                          OBLECTIVES OF THE STUDY

1. To assess the rate of acceptance of exclusive breastfeeding among nursing mothers in Abakaliki metropolis.
2. To find out the factors influencing the acceptance of exclusive breastfeeding among nursing mothers in Abakaliki metropolis
3. To ascertain the measures of improving exclusive breast feeding among nursing.
4. To identify the factors that influences exclusive

1.5                                          SIGNIFICANCE OF STUDY

It is hoped that at the end of the study, the result will:

1. Increase the knowledge of nursing mothers on exclusive breastfeeding
2. Lead to development of higher acceptance of exclusive

• Support optimal mechanisms for improving fathers’ and other familial attitudes regarding exclusive breastfeeding.

1. Help reduce public misperceptions on nursing mothers choices to exclusively
2. Provide more scientific evidence to health care givers in advocating the acceptance of exclusive breastfeeding.
3. Support effective strategies for improving public awareness regarding the benefits of exclusive breastfeeding.

• Promote further studies on exclusive
• Provide clinical data on exclusive breastfeeding and enrich the existing body of

1. Help in the realization of Millennium Development Goal number four (“to reduce infant mortality”).
   • RESEARCH QUESTION
2. What is the level of acceptance of exclusive breast feeding among working?
3. What are the factors influencing the acceptance of exclusive breastfeeding among nursing mothers in Abakaliki metropolis?

• What are the measures of improving exclusive breast feeding among nursing?

1. What are the factors that influence exclusive breastfeeding?

1.7                                          SCOPE OF STUDY

The scope of this work covers finding out the rate of acceptance of exclusive breastfeeding among nursing mothers in Abakaliki metropolis. A cross-sectional descriptive was done in this study. A total of 210 nursing mothers from abakaliki metropolis, Ebonyi state were selected using systematic sampling, with a response rate of 95%, so we had 200 respondents. A pretested, structured, self-administered questionnaire adapted from previous studies was used for data collection.

1.8                                          LIMITATION OF STUDY

1. Time factor the entire program is time consuming and the project has to be within time frame.
2. Lack of sufficient capital because of the economic situation of the country
3. Despite the favourable response rate, there are important limitations to this survey. Firstly, ten questionnaires were not returned. Although this is a small number it would have been useful to know the characteristics (e.g., age, socio-economic status, etc.) of the non-responders versus the responders so as to ascertain possible reasons for the non-response. Secondly, this was purely a quantitative study with no opportunity for participants to write down comments or express other concerns and not catered for by the questionnaire. Further surveys should include a qualitative assessment and possibly interviews so as to add more information to this field of study. Thirdly, the respondents had a few hours to complete the questionnaires before collection, as opposed to more time if it had been mailed to them or collected some days later.

1.9                              OPERATIONAL DEFINITION OF TERMS

Acceptance: the action of consenting to receive or undertaking exclusive breast feeding.

Exclusive breastfeeding: Feeding of a baby with breast milk only for the first time months of life.

Breast: Mammary gland that secrets milk after giving birth

Artificial milk: Milk synthesized from plant or animals used to feed a baby.

Complementary feeding: Artificial milk given to augment breast milk after 6 months of exclusive feeding.

BFH: Baby friendly hospital initiative

SIDs: Sudden infant death syndrome

CHAPTER FIVE

5.1                                                           CONCLUSION

This survey demonstrates that most of the mothers working in banks within Abakiliki metropolis in Ebonyi State have a good knowledge and positive attitude towards exclusive breastfeeding. The result of this survey highlights the importance and the need for an increased acceptance of exclusive breastfeeding among breastfeeding mothers who work in busy employment facilities. There should be advocacy for government policy for a mandatory 6 month maternity leave for all working mothers by health workers, professional bodies and other stakeholders.

5.2 RECOMMENDATIONS

Based on the findings of this study, the following recommendations are proposed to strengthen the knowledge of EBF and enhance attitude and practice thus encouraging an improved nutritional status of under-two children in Navy Town as well as in the general population:

1. Exclusive breast feeding information programmes should not only include the definition and recommended duration but should also include its benefits to the infant, mother, family and community.
2. The content of health talks regarding exclusive breast feeding by health workers need to be evaluated so that messages can be communicated effectively to mothers.
3. Health care providers should enlighten mothers about the possibility, process and storage of expressing breast milk for later use when separated from the child due to work or study.
4. There is also the need for periodic retraining of relevant health workers on the practice of EBF and strategies introduced for regular monitoring and evaluation of the practice.
5. Encourage breastfeeding on demand.
6. Myths and misconceptions should be addressed in a culturally sensitive manner, utilizing various modes and channels of communication.
7. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.