AN ASSESSMENT OF EXCLUSIVE BREASTFEEDING AND ITS EFFECTIVENESS IN THE DEVELOPMENT OF UNDER 5 CHILDREN

AN ASSESSMENT OF EXCLUSIVE BREASTFEEDING AND ITS EFFECTIVENESS IN THE DEVELOPMENT OF UNDER 5 CHILDREN

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Background of Study

Infant feeding practices are a significant driver of infant nutritional status, which has an impact on infant morbidity and death. Breastfeeding is one of the most important feeding strategies since it is essential for an infant's growth, development, health, and survival. According to Diallo, Bell, Moutquine, and Garrant (2005), around 5.6 million newborns die each year due to inadequate nutrition. As a result, scientists and health professionals consider breastfeeding to be the greatest natural nourishment for newborns, as breast milk provides all of the nutrients required for a child's healthy development. Breastfeeding has various advantages, including supplying antibodies to the infant, reducing the risk of sickness, and meeting all of the baby's nutritional demands (Mundi, 2008). Breast milk supplies all of an infant's energy and nutrients for the first six months of life, and roughly half or more of a child's nutritional needs during the second half of the first year, up to one third during the second year, according to the World Health Organization (WHO) (2004). In addition, breast milk not only protects the infant from infectious and chronic diseases, but also promotes sensory and cognitive development, as well as contributing to the health and well-being of mothers, assisting in birth spacing, reducing the risk of ovarian and breast cancers, and increasing family and national resources (WHO, 2004).

Breastfeeding is generally done all around the world, however the length varies. Because the introduction of other food supplements at a young age increases the risk of infections in the infant, which can lead to life-threatening conditions like diarrhoea, the WHO and UNICEF (2004) recommended that infants be exclusively breastfed for six months and then given other supplements to support their growth and development for up to 24 months.

Because of the numerous benefits that breastfeeding provides for women and newborns, governments have established objectives and rates for breastfeeding habits. The Nigerian government has designated six University Teaching Hospitals in Benin, Enugu, Maiduguri, Lagos, Jos, and Port-Harcourt as Baby Friendly Hospital Initiative (BFHI) centers, with the goal of reducing infant malnutrition, illness, and death, as well as enhancing maternal health. BFHI has hosted a number of programs, seminars, workshops, and conferences targeted at encouraging breastfeeding habits since its foundation in 1991. The BFHI has shown to be a successful tool for improving breastfeeding practices across the world (Salami, 2006). In 1998, the government adopted a breastfeeding policy to further strengthen the practice of exclusive breastfeeding. In May of 1999, the regulation on the marketing of breast milk replacements was reviewed and revised to include higher fines and a clearer description of breast milk substitutes. These efforts attempt to increase the rate of exclusive breastfeeding and early breastfeeding start in order to meet the World Summit on Children's objective of universal exclusive breastfeeding for children up to six months of age, which was set in 1990. (Mundi, 2008).

Despite these steps, research shows that exclusive breastfeeding is still uncommon in many regions of the world (though it is improving). Between 1990 and 1999, the rate in Nigeria grew from 2% to 20% for newborns 0-3 months and from 1% to 8% for infants 4-6 months (National Planning Commission (NPC)/UNICEF, 2001). However, according to the Nigeria Demographic and Health Survey (NDHS) (2008), 97 percent of Nigerian children under the age of five were nursed at some time throughout their lives. Only a tiny percentage of babies (13%) were exclusively breastfed during the first six months of their lives. Complementary foods were given to more than seven out of ten (76%) youngsters aged six to nine months. 16 percent of newborns under the age of six months were fed with a bottle with a nipple, and 17 percent of infants between the ages of 2-3 and 4-5 months were bottle fed. However, only 38% of newborns (38%) were breastfed within one hour after delivery, and only 68 percent started breastfeeding during the first day. In Benue State, 97.8 percent of infants born in the five years before to the study ever nursed. Within an hour after birth, 64.1 percent of mothers began breastfeeding. 90.2 percent started breastfeeding within one day, and 38.7% started pre-lacteal feeding. Only 0.5 percent of children were nursed entirely. These figures show a slight decrease from the 1990, 1991, 1999, 2003, and 2008 polls (NDHS, 2008).

These changing attitudes on exclusive and non-exclusive breastfeeding have been related to a variety of socio-economic, cultural, and socio-demographic variables that influence children's development. As a result, the goal of this study was to see how successful exclusive breastfeeding is in the development of under-five children in Benue State, Nigeria.

1.2     Statement of Problem

Breastfeeding practices have been subjected to a great deal of medical, cultural, and religious scrutiny and discussion. The World Health Organization and the United Nations Children's Fund (1993) created the Baby Friendly Hospital Initiative (BFHI) in 1991 in an attempt to promote effective breastfeeding universally by the year 2000. The BFHI is a worldwide initiative encompassing 160 nations, 95 of which are in the poor world, including Nigeria (Salami, 2006). The goal of this initiative is to encourage, defend, and promote exclusive breastfeeding for six months and thereafter until the child reaches the age of 24 months. Breast milk is superior to other forms of milk in terms of nourishing human newborns and providing higher health advantages, according to several medical studies.

Despite the fact that breastfeeding is mandatory in the country, the tendency is to supplement breast milk with other foods. In general, the practices are more varied, with late commencement of breastfeeding, the administration of substances other than mother milk, and the introduction of weaning meals within one month of the infant's birth being the most common. Early commencement of infant breastfeeding was identified as a critical need in the Nigerian Integrated Child Health Cluster Survey (ICHCS, 2003). According to the poll, there was a drop from 56 percent in 2000 to 34 percent in 2002. The Nigeria Demographic and Health Survey (NDHS, 2008) reported a 13 percent exclusive breastfeeding rate, down from 17 percent in the previous study from 2003. In addition to breast milk, 34% of newborns aged 0-5 months were given plain water, while 10% were given milk other than breast milk, according to the 2008 survey. Only 32% of infants under the age of 24 months were still receiving breast milk.

Given the low number of moms who breastfeed their children, it is unsurprising that Nigeria continues to have a high rate of malnutrition and infant death. Many reasons have been suggested as having an impact on these behaviors. Other variables, rather than health considerations alone, frequently impact decisions. According to Sika-Bright (2010), the mother's marital situation, job position, friends' way of feeding their kids, social support, and the baby's age are all variables that impact the decision to exclusively or non-exclusively breastfeed. Several other demographic studies conducted over the years (e.g., National Demographic Sample Survey (NDSS), 1966; Nigeria Fertility Survey (NFS), 1982; National Population Policy (NPP), 1988; Integrated Child Health Cluster Survey (ICHCS), 2003; Nigeria Demographic and Health Survey (NDHS), 1990, 1999, 2003, & 2008) have found similar factors to influence mothers' choice of exclusive breastfeeding, such as mother's level of education, occupation, and income level. The previous surveys' primary focus was on emerging issues such as HIV/AIDS and other sexually transmitted infections, poverty, gender inequality, fertility, mortality, nuptiality, awareness and use of family planning methods, sexual activity, nutritional status of mothers and infants, early childhood mortality and maternal mortality, maternal and child health, and, of course, breastfeeding. These characteristics, however, are evident in research undertaken over time. The presence of a significant number of mothers who practice exclusive and non-exclusive breastfeeding, as well as the factors that contribute to this, remained a mystery in the research. It is unclear if demographic variables impact the practice of exclusive and non-exclusive breastfeeding in a substantial or negligible way. It's worth noting that, until recently, demographic variables and the practice of exclusive breastfeeding were the main focus of research. In Benue State, none of the research undertaken over the years have focused on demographic characteristics or the efficiency of exclusive breastfeeding in the development of children under the age of five. As a result, the study's goal was to see how successful exclusive breastfeeding is in the development of children under the age of five in Benue State.

1.3     Purpose of the Study

The main purpose of this research project was to examine the effectiveness of exclusive breastfeeding in the development of under-five children in Benue State, Nigeria.  The specific purposes of the study are:

1. To assess whether mother’s age, level of education and occupation has influence on the practice of exclusive breastfeeding.
2. To assess how effective exclusive breastfeeding is for children under-five.
3. To assess whether mothers have knowledge of the benefits and role that exclusive breastfeeding plays in child development (under-fives).
4. To determine if family views regarding breastfeeding influence mother’s decision to exclusively breastfeed.

1.4     Research Questions

This study sought to provide answers to the following specific research questions:

1. Does mother’s age, level of education and occupation influence the practice of exclusive breastfeeding?
2. How effective is exclusive breastfeeding for children under-five?
3. Do mothers have knowledge of the benefits and role that exclusive breastfeeding plays in child development (under-fives)?
4. Do family views regarding breastfeeding influence mother’s decision to exclusively breastfeed?

1.5 Research Hypotheses

H01: Mother’s age does not influence the practice of exclusive and non-exclusive breastfeeding of babies in Benue State.

H02: Mother’s level of education does not influence the practice of exclusive and non-exclusive breastfeeding of babies in Benue State.

1.6 Significance of Study

The findings of this study would give an insight into areas where health education campaigns are required to influence and promote the adoption of exclusive breastfeeding. Specifically:

It would also make progress towards obtaining demographic data on exclusive breastfeeding among nursing mothers attending antenatal clinics in Benue State. This, in addition, will benefit nutritionists, health planners in Benue State to formulate policies and strategies that are geared towards the promotion of exclusive breastfeeding on specific group of women and locations in which it is poorly practiced.

The findings of the study would benefit health workers to develop special intervention measures on specific age ranges of mothers who poorly practice exclusive breastfeeding.

The findings of this study would help health educators, nurses, nutritionists and curriculum planners to develop informed programmes for nursing mothers on the benefits of breastfeeding. This in addition, would update the curriculum to educate students in higher institutions of learning in preparing for future parenthood to adopt an effective method of breastfeeding the baby.

1.7     Scope of Study

This research project is focused on examining the effectiveness of exclusive breastfeeding in the development of under-five children in Benue State.

1.8     Limitations of the Study

The researcher experienced the following limitations. First, the relationship between types of breastfeeding and the infant mortality and morbidity were probably underestimated by some mothers as they did not attend post-natal care for further assessment and possible advice by the health care providers. Such nursing mothers were not included in the sample of the study. The study considered only nursing mothers that attended postnatal clinics.

The study did not take into account the differences between the infants who were raised by their biological mothers and those raised by significant others and this could involve some bias in the decision to exclusively or non-exclusively breastfeed the infant. Based on this, the researcher convinced the nursing mothers to provide accurate information on the method they feed their babies, as this was not to “witch hunt” them but was merely for academic purpose. Time and finances were limiting constraints to the work, notwithstanding the researcher was able to successfully complete the work.

1.9     Operational Definition of terms

Exclusive Breastfeeding: Exclusive breastfeeding means that the infant receives only breast milk. No other liquids or solids are given – not even water – with the exception of oral rehydration solution or drops/syrups of vitamins, minerals or medicines.

Under-fives: children who are less than five years old, especially those who are not in full-time education.

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