ASSESSING THE KNOWLEDAGE AND PRACTICE OF INFANT FEEDING AND WEANING AMONG MOTHERS IN OWERRI, IMO STATE

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Infants and young child feeding is critical for child health and survival; it is recommended that infants should be exclusively breastfed for the first 6 months of life and thereafter receive adequate complementary foods in addition to continued breastfeeding until 2 years of age or beyond. Weaning is the process of gradually introducing an infant to adult foods while gradually withdrawing breast milk. The child is not abruptly taken off breast milk, the process of weaning should be started after the age of 6 months and natural weaning happens as the infant starts to accept increasing amounts and different variety of complementary feedings although still breastfeeding on request (Mohammed, 2014; Ogunsuyi, 2016). Weaning is traditionally described as withdrawal from breast feeding i.e. when breast feeding is gradually replaced by semisolid food. The shift from exclusive breastfeeding to family foods is referred to as complementary feeding and complementary feeding is defined by World Health Organization (WHO) as the addition of energy as well as non-energy containing fluids, non-human milk and semi- solids or solids to children's diet which covers the time from 6 months to 18 – 24 months of age (WHO, 2021).

The weaning period, which usually corresponds with the eruption of the child’s major dentition implies that the child is ready to chew (Aliyu et al., 2019). The weaning period is a very susceptible period, since it is the point in which malnutrition set offs in many infants. Infants are predisposed to malnutrition as a result of poor quality of weaning foods, improper feeding and weaning practices, which can also predispose the infants to growth retardation, infectious diseases and high mortality rate (Rahul, Mohd and Rakesh, 2014; Mohammed, 2014).

It is indicated that poor infant feeding and their consequences are one of the world’s major problems and a serious obstacle to social and economic development. During the first two years of life, poor feeding practices and weaning practices have both instant and long-standing consequences. Inappropriate feeding of infants has long been observed in our society to be one of the global problems responsible for about one-third of the cases of malnutrition worldwide (Anoshirike et al., 2014). According to Mohammed (2014) about ten million children below the age of 5 years old die annually and more than half of the deaths occur because of malnutrition. In Nigeria, complementary foods are usually semi-solids and they differ in homes but most homes use maize based cereal (Aliyu et al., 2019). Due to introduction of westernized food and other factors like the advertising tactics taken up by most food and beverage companies and the readily preparation of most of these foods, these factors may influence the feeding practices like reducing the age of initiation of complementary feeding and early cessation of breastfeeding. Due to the high prevalence rate of malnutrition, there will be a burden on the economic development because huge amount of money will be spent towards treating these children (Aliyu et al., 2019).

Among preventive measures that would reduce the excess mortality for children under the age of five years, good quality complementary feeding, proper breastfeeding and complementary feeding practices have been listed as part and about 19% of this death can be prevented (Kavitha, Nadhiya and Parimalavalli, 2014). Improved breastfeeding practices and reduction of artificial feeding is reported to save an estimated 1.5 million children a year hence the need for this study.

1.2 Statement of the Problem

The problem of infant feeding and weaning practices among mothers attending immunisation clinics is a complex issue that is influenced by various cultural and socio-economic factors. This issue significantly impacts the health and development of infants and young children, necessitating a comprehensive understanding to improve child health outcomes globally.

Breastfeeding practices, especially exclusive breastfeeding (EBF), are of utmost importance in supplying vital nutrients and antibodies to infants within the initial six months of their existence. However, adherence to exclusive breastfeeding (EBF) recommendations continues to be disappointingly low in numerous regions. In Nigeria, for instance, it is worth noting that a mere 28.7% of infants were exclusively breastfed in the year 2018. It is important to highlight that the rates were even lower in rural areas, where only 24.3% of infants were exclusively breastfed (Ipinnimo et al., 2024). This discrepancy highlights a substantial gap in knowledge and practice among mothers, influenced by socio-economic and cultural factors.

Timely initiation of breastfeeding, ideally within the first hour of birth, is another critical practice influencing infant health. Nevertheless, this practice is not widely observed in numerous regions. According to a study conducted in India, it was found that only 36% of mothers initiated breastfeeding within one hour of birth (Public Health Nutrition, 2024). Delayed initiation of breastfeeding can lead to suboptimal infant nutrition and heightened vulnerability to infections and diseases.

Complementary feeding, which should commence at approximately six months of age, also encounters notable obstacles. Many mothers lack adequate knowledge about the appropriate time and types of complementary foods to introduce. According to a systematic review conducted in East Africa, it was discovered that although 42% of mothers had knowledge about the significance of exclusive breastfeeding (EBF), only 55.9% of them actually followed the recommended practice of EBF for the recommended duration of six months (International Breastfeeding Journal, 2023). It is important to note that insufficient complementary feeding practices can result in malnutrition, stunting, and various other growth-related problems.

Socio-demographic factors, such as maternal education, household income, and family structure, are of utmost importance in shaping feeding practices. According to a study conducted in Saudi Arabia, it has been found that maternal age and socio-economic status play a crucial role in determining breastfeeding and complementary feeding practices (Journal of Nutritional Science, 2023). Similarly, in Ethiopia, despite a high percentage of mothers being knowledgeable about infant and young child feeding (IYCF) practices, socio-economic challenges hindered optimal feeding practices (Archives of Public Health, 2023).

The health implications of inadequate feeding practices are quite severe, as malnutrition, which includes stunting, being underweight, and experiencing wasting, continues to be prevalent in numerous regions. According to a study published in Public Health Nutrition in 2024, the prevalence of underweight, stunting, and wasting among children in India was reported to be 38%, 41%, and 22%, respectively. These conditions are worsened by insufficient feeding practices and unfavourable socio-economic conditions.

Addressing the problem of infant feeding and weaning practices requires a multi-faceted approach involving comprehensive education and support programmes. These programmes should aim to target both mothers and the broader community in order to cultivate supportive environments that promote optimal infant feeding. Health education campaigns, access to healthcare services, and socio-economic support are essential components of a holistic approach to improving infant nutrition and health outcomes globally.

1.3 Objectives of the Study

The general objective of the study is to examine the knowledage and practice of infant feeding and weaning among mothers in Owerri, Imo State. The specific objective is as follows:

To investigate the level of knowledge of mothers regarding recommended infant feeding and weaning practices.

To examine the different infant feeding practices among mothers attending immunization clinics at Christiana Specialist Hospital, Egbu, Owerri, Imo State.

To explore the factors influencing the knowledage and practice of infant feeding and weaning among mothers in Owerri, Imo State.

To investigate the common challenges mothers face in following recommended feeding practices among mothers attending immunization clinics at Christiana Specialist Hospital, Egbu, Owerri, Imo State.

1.4  Research Question

The following research questions will be answered in this study;

What is the level of knowledge of mothers regarding recommended infant feeding and weaning practices?

What are the different infant feeding practices among mothers attending immunization clinics at Christiana Specialist Hospital, Egbu, Owerri, Imo State?

What are the factors influencing the knowledage and practice of infant feeding and weaning among mothers in Owerri, Imo State?

What are the common challenges mothers face in following recommended feeding practices among mothers attending immunization clinics at Christiana Specialist Hospital, Egbu, Owerri, Imo State?

1.5 Research Hypothesis

The following hypothesis have been formulated for the study

H0: The level of knowledge of mothers regarding recommended infant feeding and weaning practices is low.

1.6  Significance of Study

This research will be useful in so many ways to different people and other related fields.

To the nurses, medical doctors and other health care givers, the outcome of this research will inform policy recommendations on the choices of infant feeding options among mothers attending immunization clinics.

To health care providers in the voluntary counseling sessions and other stand alone facilities and support groups, the outcome of this research will be a useful guide and reference materials during their counseling sessions and support group activities.

To infant mothers, it will serve as a guide to their choices of infant feeding options. To other researchers in this field and other related fields, the outcome of this research will serve as a guide during intervention project design and planning.

1.7  Scope of the Study

This study will broadly focus on the knowledage and practice of infant feeding and weaning among mothers in Owerri, Imo State. Empirically, this study will investigate the level of knowledge of mothers regarding recommended infant feeding and weaning practices, the different infant feeding practices among mothers attending immunization clinics, the factors influencing infant feeding and weaning practices among mothers attending immunization clinics and the common challenges mothers face in following recommended feeding practices among mothers attending immunization clinics.

This study will be carried out in Christiana Specialist Hospital, Egbu, Owerri, Imo State.

1.8 Limitation of the study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed. More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other schools, local governments, states, and other countries in the world.

1.9 Definition of Terms

Infant: An infant typically refers to a very young child, usually from birth to around one year old. This stage marks the early phase of human development characterized by rapid growth and dependency on caregivers for basic needs.

Infant feeding: Infant feeding refers to the process of providing appropriate nutrition to babies and young children, typically through breastfeeding or the use of infant formula, to support their growth and development during their early stages of life.

Weaning: Weaning generally refers to the process of gradually introducing a young mammal, such as a baby human or animal, to solid food and reducing its dependency on mother's milk or formula for nourishment. In broader terms, it can also refer to the gradual withdrawal or transition from one situation or dependency to another, often in a controlled or gradual manner.

Weaning practices: Weaning practices refer to the gradual process of transitioning an infant or young animal from consuming milk (typically breast milk or formula) to consuming solid foods or other sources of nutrition. It involves introducing new foods or liquids while reducing the dependency on milk, tailored to the developmental stage and nutritional needs of the child or animal.