Importance Of Exclusive Breastfeeding On The Health Of Infant

INTRODUCTION 

1.1. Background

World Health Organization (WHO) defines exclusive breastfeeding as the condition where the infant has received only breast milk from the mother without any other liquid or any kind of food to replace breast milk but except for drops of syrups containing vitamins and minerals supplements or medicines for the infants (WHO, 2017). The health of women and children has been the target set by WHO. It has been focused on as the significant factor responsible for increasing population. According to WHO about 21.9 million children are exclusively breastfed for the first six (6) months of life in about 49 developed countries worldwide. In 2012, who presented the implementation plan for maternal, infants, and young child nutrition has been (According to UNICEF & WHO, 2018). Globally, the average of breastfeeding is estimated to be 37% and is expected to increase to 50% by 2025 given the guidelines and measures put in place (UNICEF, 2018; WHO, 2018).

According to UNICEF (2012), 15% of Nigerian children die before their 1st birthday, one of the highest rates of under-five infant death in the world. Thus, the low level of breastfeeding is a major problem in Nigeria. The myths that breastfeeding is harmful has influenced many parents of not breastfeeding their babies. A recent report by Save the Children's (Year) shows that 80% of mothers in Nigeria exclusively breastfeed their children immediately after birth. However, the number decreases rapidly after three months to 40% and only 30% continue breastfeeding up to six months. The likelihood of an infant that is exclusively breastfed becoming sick or dying from diarrhea and infections is low. Further, they are less likely to get pneumonia, meningitis, and ear infection compare to those that were not fed exclusively with breast milk thus leading to a low rate of hospital visit.

The risk for hospitalization is to protect against single and repeated incidences of otitis media or a particular lower respiratory tract infection during the first year of life. In addition, by breastfeeding benefits the society by reducing healthcare costs, absence of parents from job, and the loss of family income that is associated with formula feeding (Dagbie et al., 2020; UNICEF, 2015). Norms of culture and belief have a powerful influence on human nutrition and has been pointed out as one of the determinants of breastfeeding practices. For example, in Nigerian culture, mothers are advised not to breastfeed their new born babies for the first three to four months. This because some cultures believe that breasts milk is toxic for infants. Hence, the design of interventions that seek to improve health and nutrition of new born should take into consideration the culture beliefs of the parents. Wanjohi, Griffiths & Wekesah (2016) emphasized the need to consider the cultural beliefs and practices of the parents in designing health and nutrition interventions. They further argued that the strategy that has been designed globally for young child feeding added more emphasis on the need to promote breastfeeding to understand the environmental situation and the social culture concerning breastfeeding.

1.2. Statement of the problem

According to UNICEF (2016), feeding new-borns with food or liquid in the first few days of life is a common practice in many parts of the world. This is linked to cultural norms, traditional beliefs and family practices. However, they are not based on scientific evidence. In most developing countries, including Nigeria, beliefs and misconceptions have negative effect on breastfeeding during the first hour of birth. For example, some beliefs hold that colostrum is dangerous and could cause harm or death for the new born, thus causing them to discard the precious substance. According to Kumeh et al. (2020), colostrum is the first breast milk discharged from the mother’s breast immediately after birth and is considered very nutritious and rich in antibodies for the growth of an infant. It is believed that colostrum was a part of the waste of giving birth in addition to the placenta. Furthermore, Kumeh et al. (2020) noted that health workers in South-eastern Nigeria confirmed the myths about colostrum that most people believe that its yellowish hue is a sign of ill health of the mother, thereby substituting the breast milk with water in the first hour of birth. Additionally, in some culture, new-borns are fed with complementary foods such as tea, butter, sugar water or honey before they are fed with breast milk. They believe that introducing complementary foods in the early stages of an infant’s life helps to complement the breast milk (Hitachi et al., 2019).

Poor breastfeeding practices increase the risk of morbidity and mortality among infants mainly resulting to diarrheal and respiratory diseases. It also impairs their physical and mental development. According to the United Nations Inter-Agency Group for Child Mortality Estimation report (UNICEF 2018), Nigeria has one of the highest under-five mortality rates in the world. The report further adds that more than 15% of children in Nigeria die before reaching their first birthday. The World Health Organization (WHO) recommends that children are fed exclusively with breast milk for the first six months of life. According to Nigeria’s Demographic and Health Survey report (LISGIS & ICF, 2021), less than two-thirds (55%) of children under six months are exclusively breastfed, while 6% are not breastfed.

Furthermore, breastfeeding and feeding with complementary foods are very common in Nigeria with 97% of children reported ever breastfed. Additionally, about one-third were not breastfed within the first hour of life and nine percent were not breastfed within 24 hours after delivery. Complementary foods should be introduced when a child is six months old to reduce the risk of malnutrition (LISGIS & ICE, 2021). The report also shows that 30% of children under 5 were stunted, 3% were wasted and 11% were underweight. However, the proportion is much higher in the children between 0 – 12 months. Mortality among infants in Nigeria is mainly attributed mother’s education, and household wealth. Children whose mothers have no formal or only primary education or who are from poor households are more likely to die before their 5th birthday.

Understanding the exclusive breastfeeding and health of infants may help to highlight important determinants that could improving breastfeeding for children 0 – 12 months, particularly among mothers who may not have formal education, access to key resources and health education. Analysis of these factors has shown that socio-economic and other factors that shape infants breastfeeding practices, as well as decisions for and against seeking better nutritional practices (Kumbe et al., 2020). It also highlights the complexity of breastfeeding behaviour and the relationship between infant feeding with economic status and the perceived social norms that underpin the development of a child.

Previous studies have explored the experience of breastfeeding among women (Gallegos et al., 2013), identified the prevalence and correlates of exclusive breastfeeding (Hitachi et al., 2019) and structural factors that enable or constrain the adoption of evidence-based recommendations (Kumeh et al., 2020). Furthermore, public health interventions intended to improve healthy behaviour usually promote nutritional awareness and knowledge for children under-five. However, they do not consider the cultural practices that support or deprive the use of exclusive breastfeeding and nutrition among infants. Consequently, in a post-conflict country such as Nigeria with high child stunting rate, cultural practices that negatively affect exclusively breastfeeding and health of infants (0-12 months) contributes malnutrition and mortality.

1.3. Justification of the study 

Exclusive Breastfeeding provides optimal health of infants and contributes to desirable child growth and development. Specifically, it has economic and significant health impact at the household, community, and nation level. The importance of the economic and health impact of exclusive breastfeeding is that it helps reduce economic burden for the poor people, particularly in developing countries such as Nigeria. Such people are economically disadvantaged and grieved from the lack of basic social services and sustainable livelihood sources. With the best breastfeeding applies, poor mothers would save money that may have been used to purchase formula feedings and other liquids. It is essential to have enough access to a complete, precise, impartial and scientific facts about exclusive breastfeeding to encourage the continuous practice of breastfeeding, information that provides knowledge on the cultural practices of mothers of children between 0 - 12 months are highly needed to revise and improve unsuitable practices that affect the growth of infants. Access to, availability and control of accurate and precise information is essential to the infant feeding decision-making process of any mother (Wanjohi et al., 2017). Additionally, knowledge of the nutritional status of children aged 0 – 12 months is critical because it will provide evidence that policymakers and stakeholders can use to drive interventions that could increase food consumption among young children. Also, an insight into the breastfeeding practices on the nutritional status of children aged 0 – 12 months will provide information on the different breastfeeding practices amongst mothers of infants and how it affects the nutritional status of the child. Furthermore, the findings on the relationship between cultural practices and education level of mothers on exclusive breastfeeding practices and nutritional status will inform government and partners about what need to be address in order to sustain exclusive breastfeeding practices among mothers of children aged 0 -12 months in Nigeria. Finally, the outcome of the study will fill the existing gap in knowledge about exclusive breastfeeding in Nigeria and contribute to the Sustainable Development Goal (SDG) 3.

1.4. Aim of the study

The study aims to contribute towards the improvement of exclusive breastfeeding practices among mothers and health of children of infants in Uyo, Nigeria.

1.5 Purpose of the Study

The purpose of this study is to generate data that can be used to improve the cultural practice, exclusive breastfeeding, and health of children of infants in Uyo, Akwa Ibom state, Nigeria.

1.6 Objectives of the study

1.6.1 General objective

The main objective of the study is to determine the exclusive breastfeeding and health of infants in Uyo, Nigeria

1.6.2 Specific objectives

1. To establish the cultural practices, demographic and socio-economic characteristics of mothers of infants Uyo, Nigeria

2. To assess the nutritional status of infants in Uyo, Nigeria.

3. To determine the breastfeeding practices on nutritional status of infants in Uyo, Nigeria.

4. To establish the relationship between cultural practices and education level of mothers on exclusive breastfeeding practices and health of infants Uyo, Nigeria.

1.7. Research questions

1. What are the demographic and socio-economic characteristics of mothers on the health of infants Uyo, Nigeria?

2. What is the level of nutritional knowledge of mothers on the health of infants Uyo, Nigeria?

3. What are the exclusive breastfeeding and the nutritional status of infants in Uyo, Nigeria?

4. What is the relation between cultural practices and the education level of mothers on the health of infants Uyo, Nigeria?

1.8. Risks and potential adverse effects of the study

1. During data collections, it was observed that mothers and caregivers were faced with anxiety and depression thus influencing them not to give actual information about breastfeeding.

2. Mothers feared that they will lose respect if they disclosed that they do not breastfeed their children (0- 12 months) properly.

3. Ensure confidentiality of identifiable information regarding children 0-12 months was a major consideration during the field work.

4. The study ensure that the privacy of mothers was not invaded and the protection of their dignity regarding breastfeeding practices was assured.