Attitude, Knowledge and Practice of Exclusive Breastfeeding Among Nursing Mothers in Badawa Area of Nassarawa Local Government Area Kano State
CHAPTER ONE
Objectives of study
The objectives of the study were to:
- Determine the mother‟s knowledge on early breastfeeding at Murtala mohammed teaching hospital(MMTH).
- Assessthe mother‟s attitudes towards early breastfeeding practices at
- Establish the early breastfeeding practices among mothers who deliver at
- Evaluate the challenges experienced by mothers during early breastfeeding at MMTH.
- Establish relationships between early breastfeeding knowledge, attitudes, and practices of mothers who deliver at MMTH
CHAPTER TWO
LITERATURE REVIEW
Maternal knowledge of early breastfeeding
Adequate maternal knowledge is one of the factors that can influence breastfeeding intentions but may not have much effect by itself. Thus giving mothers information about the benefits of breastfeeding might affect those who have not already made a decision, or those whose decision is not final. Increasing social support may also be useful in enabling women to decide to breastfeed and to actually carry out their decision (WHO, 1998). Maternal knowledge on early breastfeeding is vital as it has a direct influence on the maternal attitudes and practices. Globally It has been observed that increased maternal knowledge on breastfeeding benefits and support may help boost breastfeeding rates including early initiation of breastfeeding. A recent study revealed that early breastfeeding knowledge was inadequate among mothers in rural Punjab (Garg et al., 2010).
According to Shommo, Sohair, and Shubrumi, (2014), in a study conducted in Saudi Arabia, adverse effects in infants may result due to limited maternal knowledge about breastfeeding. The study, which did not focus on early breastfeeding, reported that participant‟s general knowledge of breastfeeding was inadequate. This is in spite of the well-documented advantages of breastfeeding. Another study in Saudi Arabia by Al- Binali, (2012) points out that insufficient knowledge and improper practices of breastfeeding may adversely affect the health of both the child and the mother, for instance a study by Kornides and Kitsantas, (2013) in USA discovered that women with greater knowledge about breastfeeding benefits were more likely to initiate breastfeeding earlier than their counterparts. Garg et al., (2010) observed a huge knowledge gap concerning early breastfeeding in Punjab. Nguyen et al., (2013), in a study conducted in Vietnam, pointed out that lack of awareness among mothers and absence of supportive milieu could contribute to poor breastfeeding practices.
In Africa, a study in El-Mina University Hospital in Egypt documented that most (more than 80%) of the pregnant women and mothers were knowledgeable about the importance of colostrum and lactation (Sallam et al., 2012). While in Nigeria a study by Ogada, (2014), in Nyando district, reported that women in their third trimester were knowledgeable on early breastfeeding. The majority (95.7%) of the mothers knew that breast milk should be baby‟s first food, while 87.4% knew that a baby should be put to the breast within 1 hour after delivery, and 76.6% knew that colostrum should be given to the baby.
CHAPTER THREE
METHODOLOGY
Research design
This study adopted a cross-sectional analytical design as data was collected at only one point in time. This design was suitable for testing the associations among variables e.g. timely initiation, not giving pre and post-lacteal and giving colostrum (Mugenda & Mugenda, 2003). Mixed methods (qualitative and quantitative techniques) were applied in data collection, analysis, and presentation. The qualitative data has been used to complement and triangulate the quantitative findings.
CHAPTER FOUR
RESULTS
Demographic and socioeconomic characteristics of the participants
Maternal demographic characteristics
The mean age of the mothers was 28.89±6.67 years, with the youngest and the oldest mother being 15 years and 47 years respectively
CHAPTER FIVE
SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS
Summary
The purpose of this study was to establish the knowledge, attitudes, and practices on early breastfeeding among mothers who deliver at the Murtala mohammed teaching hospital (MMTH), in Badawa. The findings indicate that most mothers were knowledgeable on the early breastfeeding practices and had positive attitudes towards maternal practices. This was proved by the maternal knowledge and attitude scores, which were 6.75±1.26 (Median=7.0) and 24.21±3.14 (Median=25.0) respectively. It was found that majority of the mothers knew the importance of breastfeeding, that giving pre and post-lacteals is not a recommended practice, and that giving colostrum to a baby was very important and necessary for the development of the baby. A higher percentage of the mothers‟ also indicated that a baby should be breastfed within the first hour.
On the practices, majority of the mothers‟ breastfed their babies within one hour of birth, gave breast milk only as the first feed, and did not give anything to the baby after breastmilk initiation apart from breastmilk. Findings also indicated that babies had been given colostrum within the first 72 hours of birth. A few mothers reported to have faced challenges when practicing early breastfeeding. These included problems with the breast (pain while breastfeeding, blocked nipples, etc.), low milk production, and not being able to position and attach the baby correctly, maternal illness, and baby crying while breastfeeding. Associations were found between knowledge, attitudes and practices.
Conclusions
Knowledge on early breastfeeding is high among mothers delivering at Moi Teaching and Referral Hospital. Most mothers have positive attitudes towards the recommended early breastfeeding practices. Most mothers practiced what is recommended by the MoH, and WHO/UNICEF during early breastfeeding. The challenges encountered by the mothers are modifiable factors and were mainly cultural beliefs and practices, knowledge on early breastfeeding, breast problems, and lack or low milk production. There is an associations between knowledge and practices, attitudes and practices, and knowledge and attitudes of mothers on early breastfeeding hence all the three hypotheses were rejected.
H0₁: There is no significant relationship between early breastfeeding knowledge and practices among mothers; rejected
H0₂: There is no significant relationship between the early breastfeeding attitudes and practices of mothers; rejected
H0₃: There is no significant relationship between the early breastfeeding knowledge and attitudes of mothers; rejected.
Recommendations
Recommendation for practice
The Ministry of Health (Division of nutrition) together with the county government of Badawa, the MMTH, and other related facilities should strengthen post-natal education on coping with early breastfeeding challenges both at the health facility and after discharge from the hospital. The negative impact of culture and cultural practices on early breastfeeding should be eliminated by ensuring that their effects are understood by all mothers. The gaps in early breastfeeding education e.g. the benefit it has on mothers, knowledge, and practice on complementary feeds and breastfeeding on demand, should be addressed by ensuring that all mothers attending pre and postnatal clinics are educated during visits to the clinic on these aspects.
Recommendation for policy
The Ministries of Health both at the national and county level should formulate a policy targeting the mothers on the continuation of breastfeeding education after discharge from hospital, as it has proven to be have a positive outcome towards early breastfeeding.
Recommendation for further research
A study to determine the maternal early breastfeeding knowledge and practices after discharge. Similar studies should be conducted in other hospitals or communities to establish early breastfeeding maternal knowledge, attitudes and practices. An intervention study on strategies/ methods of effectively educating mothers on early breastfeeding will have more weight taking into cognizance other social influences.
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