CHAPTER
ONE
INTRODUCTION
1.1
Background of the Study
Infant
feeding practices play a pivotal role in determining optimal development of
infants. Poor breast feeding and infant feeding practices have adverse
consequences for the health and nutritional status of children, which in turn
has adverse consequences on the mental and physical development. The three
forms o f malnutrition; mild, moderate and severe have varying degrees of
effects on the development of the child. It has been reported that more than
80% of deaths associated with childhood malnutrition result from mild and
moderate malnutrition (WHO/UNICEF, 1999). Adequate nutritional well-being during early
childhood is critical and fundamental to long term development and attainment
of each child’s full human potential (World Health Organization, 2005).
Childhood malnutrition is a worldwide problem and the most widely spread
disorder in tropical and sub-tropical areas, responsible for high infant
morbidity and mortality rate observed among young children in poor households
of developing countries(Smith & Haddad, 2000). Although the number of
malnourished children in some regions of the world is decreasing, the
proportion of malnourished children in developing countries and Sub-Saharan
Africa in particular seems to be increasing rapidly. Inadequate infant and
young child feeding practices coupled with high rate of infectious diseases due
to poor hygiene and caring practices are proximate causes of malnutrition
during the first two years of life (Semba & Bloem, 2008). The second half
of an infant’s first year is an especially vulnerable time, when breast milk
alone is no longer sufficient to meet his or her nutritional requirement and
complementary feeding should start (WHO, 2001).
Feeding
practices during infancy are critical for the growth, development and health of
a child during the first two years of life (WHO, 1979)
and of important for the early prevention of chronic degenerative diseases.
Progress in improving infant and young child feeding practices in the
developing world has been remarkably slow (Ruel, 2003)
due to several factors. It is estimated that among children living in the 42
countries with 90% of global child deaths, a package of effective nutrition
interventions could save 25% of childhood deaths each year (Jones et
al., 2003).
Poor
dietary quality is characteristic of complementary feeding diet consumed in
rural and disadvantaged environment. This contributes to multiple deficiencies
and their associated adverse effect on infants’ health, growth and long term
development (Dewey& Brown,2003). Many children suffer under nutrition and
growth faltering during this period with consequences that persist throughout
life. This is largely due to a lack of adequate knowledge of proper infant and
child feeding and care practices and their usefulness in nutritional wellbeing.
Infant and young child feeding and health intervention are critical in
promoting growth, development, and survival of children. It is estimated that
over a third of all deaths of children under five years of age are directly or
indirectly caused by under nutrition.It is also estimated that 1.4 million
child lives could be saved through improved breastfeeding and an additional
0.55 million child lives through improved complementary feeding and care
practices(Dewey& Brown,2003)
The
survival risks of early childhood in Nigeria remain considerable. A newborn
Nigerian baby has a 30 times higher chance of dying before the age of 5 years
than a baby born in the developed, industrialized countries. The data available
on the regional prevalence of diarrhoea, undernutrition and under 5 mortality
in Nigeria showed that each of them are far more prevalent in the northern than
in the southern part of Nigeria (UNICEF, 2001).
Attention
need to be refocused on the promotion of household level feeding practices that
are beneficial to the survival of children and caregivers in this part of Nigeria
in order to be able to meet the commitment of Nigeria to the United Nations
Millennium Development Goals (MDGs) for reduction in childhood mortality by
two-thirds and a reduction in the number of people who suffer from hunger by
half by the year 2015 (Daelmans and
Saadeh, 2003). Therefore, it is vital that a comprehensive study on
the risk factors such as infant feeding practice is conducted which will help
to identify current good practices to be supported for improving the feeding
practices as effective strategies for solving childhood malnutrition.
1.2
Statement of Problem
Important causes of
death among children under five years old include acute respiratory infection,
diarrhea, measles, malaria, and anemia. Poor breast feeding and infant feeding
practices have adverse consequences for the health and nutritional status o f
children, which in turn has consequences on the mental and physical development
of the child. For optimal growth, it is recommended that infants should be
breastfed for the first six months of life. Exclusive breastfeeding in the
early life is correlated strongly with increased child survival and reduced
risk of morbidity, particularly from diarrheal diseases.
Some communities
practice prelacteal feeding with specific foods only because of the belief in
the beneficial health effects associated with the practice as advocated by the
traditional knowledge deeply entrenched in the cultures. The products given as
prelacteal in most cases continue to be administered for a long while thereafter.
Prelacteal foods could prevent the infant from suckling because the baby does
not feel hungry. Therefore, the baby may not benefit from the colostrum which a
normal baby needs at this time. Also, if the conditions for the preparation and
feeding of the prelacteal foods are not adequately hygienic the baby may suffer
from diarrhea and other diseases.
In Nigeria, there has
been many initiatives and campaigns to educate mothers and communities on the
recommended infant feeding practices by the Ministry of Health (MOH) and United
Nations Children's Funds (UNICEF). A lot of resources have been used on these
campaigns but very little impact seems to have been created. For example,
studies indicate that only 13 % of infants are exclusively breastfed for the
first six months of life as recommended by WHO (CBS, 2003). This implies that
87% of the infants are given complementary foods earlier in life than the
recommended time. The question is whether maternal nutrition knowledge plays a
significant role in infant feeding practices.
A good understanding of
knowledge on infant nutrition and feeding by mothers and its influence on
current infant feeding practices among the pastoral community is needed in
order to help in the formulation of strategies for improving nutrition
education and communication interventions to help mothers improve infant
feeding practices. This will translate into improved nutritional status and the
health of the infants.
1.3
Objectives of the Study
The main objective of
this study is to determine the infant feeding practices adopted buy nursing
mothers in Amasiri, Afikpo, Ebonyi State.
Specific
Objectives include:
1. To determine the
social, economic and demographic characteristics of the households.
2. To determine the
current infant feeding practices among the Amasiri community.
3. To determine
maternal nutrition knowledge on infant feeding practices.
4. To assess infant
nutritional status and morbidity experience.
1.4
Significance of the Study
The causes of
malnutrition are both behavioral and resource related. Poor breastfeeding and
complementary’ feeding, coupled with diarrhea and acute respiratory infection,
are immediate direct causes. Household poverty and inadequate environmental
sanitation and health care are the underlying causes (SCN, 2003).
Health Care Managers
and Supervisors are encouraged to integrate promotion of infant and young child
feeding, including HIV and infant issues into MCH services and community
programmes. Trained counselors provide information on infant feeding practices
including benefits of breastfeeding and the risks associated with early
introduction o f complementary feeding. Feeding practices play a pivotal role
in determining optimal development o f infants. Poor breast feeding and infant
feeding practices have adverse consequences on the health and nutritional status
o f children, which in turn has consequences on the mental and physical
development (WHO/UNICEF, 2003).
Health workers strive
to provide accurate and complete information on recommended infant and young
child feeding practices, hopefully taking into account the prevailing social,
cultural and environmental circumstances. Mothers are supposedly keen to ensure
that they have accurate information to make appropriate choices. Unfortunately,
all these efforts have not yielded much change on the malnutrition levels
country wide. Still. 30% of children under five are stunted which reflects
cumulative effects of chronic malnutrition (CBS, 2003). Only 13% of the infants
are exclusively breastfed against the WHO recommendation of exclusive
breastfeeding for six month (CBS, 2003). Training is intended to change
behavior in the traditional infant feeding practices which would translate into
discernible improvement on nutritional and health status among infants.
Influencing change in established behavior is enormously complex, and no single
communication tool will suffice. Different tools are required to address
different audiences and to achieve different objectives at different points in
time (WHO/UNICEF. 2003). It also requires a clear understanding of the established
behaviour and the reasons for its deep entrenchment.
It is therefore
important to study the influence of nutrition knowledge on the current feeding
practices against the backdrop of the traditional infant feeding practices
among mothers attending postnatal clinics, in a pastoral community which has
low literacy level and a weak resource base. The study will provide information
required to formulate strategies to effectively carry out nutrition education
and change entrenched behaviour in infant feeding practices for the purpose of
improving the health and nutrition among infants and young children.
CLICK TO DOWNLOAD FULL MATERIAL >>>
CLICK TO DOWNLOAD FULL MATERIAL >>>
No comments:
Post a Comment