Abstract
BackgroundMalnutrition is an underlying factor in more than 50% of the major cause of infant mortality-Pneumonia, diarrhoeal disease and measles which account for 70% of infant mortality. Therefore, programs to promote adequate nutrition for age can help reduce mortality from these disease conditions and indispensible to achievement of MDG 4.AimTo describe the feeding practices of infants below six months of age and determine maternal socio-demographic factors that influences the practice of exclusive breastfeeding (EBF) among mothers in Nnewi, south-east Nigeria.MethodsFour hundred mother-infant pairs attending the infant welfare clinic of the Nnamdi Azikiwe University teaching hospital (NAUTH) during 2012 were consecutively recruited after meeting the study inclusion criteria. Data on breastfeeding were based on infant feeding practice in the previous 24 hours. Exclusive breastfeeding was defined as infant feeding with only breast milk.ResultsAwareness (95.3%) and knowledge (82.0%) of EBF was high among surveyed mother but the practice of EBF (33.5%) was very low. Positive attitude towards EBF practice was shown by many (71.0%) of surveyed mothers. EBF practice decreased with increasing infant age, OR 0.72 (95% CI 0.34, 1.51) for 1–2 months, OR 0.58 (95% CI 0.23, 1.44) for 3–4 months and OR 0.20 (95% CI 0.06, 0.73) for 5–6 months compared to infants < 1 month old. Maternal education, socioeconomic class, mode of delivery and infants first feed were retained as important maternal predictors of EBF practice after adjustment for confounders. Decreased likelihood of EBF practice was found among mothers of lower educational attainment, OR 0.33 (95% CI 0.13, 0.81), mothers who delivered through caesarean section, OR 0.38 (95% CI 0.18, 0.84), mothers of higher socio-economic status [(middle class, OR 0.46 (95% CI 0.22, 0.99) and upper class, OR 0.32 (95% CI 0.14, 0.74)] while increased likelihood of EBF practice was seen in mothers who gave their infants breast milk as their first feed, OR 3.36 (95% CI 1.75, 6.66).ConclusionKnowledge and awareness does not translate to practice of EBF. More effort by health workers and policy makers should be directed to mothers along the fault lines to encourage the practice of EBF.
Highlights
Malnutrition is an underlying factor in more than 50% of the major cause of infant mortality-Pneumonia, diarrhoeal disease and measles which account for 70% of infant mortality
This is very representative of the clientele in the study area as poorer families due to the cheaper service fee in Nnamdi Azikiwe University teaching hospital (NAUTH) compared to private hospital patronizes the teaching hospital relatively more
exclusive breastfeeding (EBF) practice decreased with increasing infant age, OR 0.72 for 1–2 months, OR 0.58 for 3–4 months and OR 0.20 for 5–6 months compared to infants less than 1 month old
Summary
Malnutrition is an underlying factor in more than 50% of the major cause of infant mortality-Pneumonia, diarrhoeal disease and measles which account for 70% of infant mortality. Programs to promote adequate nutrition for age can help reduce mortality from these disease conditions and indispensible to achievement of MDG 4. Despite some improvements in child mortality rate in Africa, neonatal mortality has largely remained the same or worsened in many countries. Because malnutrition increases a child’s risk of dying from many diseases — most prominently measles, pneumonia, and diarrhoea which are the highest cause (70%) of neonatal deaths — programs to improve nutrition can reduce mortality from several diseases simultaneously. Efforts to promote modest nutritional improvements such as changes in feeding behaviour will have a beneficial impact on mortality rates over time. Owing to the known nutritional and health benefits to the infant, the World Health Organization recommends that women in resource-poor countries exclusively breastfeed until their babies reach 6 months of age [3]
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