THE STUDY OF EXCLUSIVE BREASTFEEDING AMONG NURSING MOTHERS (CASE STUDY OF SELECTED NURSING MOTHERS IN ENUGU STATE COLLEGE OF EDUCATION TECHNICAL) FAMILY PLANNING
Breast feeding which is the act of feeding babies with breast milk. This is a universal cultural practice among human species of all races. However, there are commonly observable variations in the frequency and exclusiveness of application of breast milk in the feeding of babies. This is noted by Berg and Brenms (1989) who asserted that the question about breastfeeding is not whether it is being practiced or not, but the degree of practice. There are, therefore types of breastfeeding of which three categories are discernible from literature: Exclusive, predominant and complementary breastfeeding.
Exclusive breastfeeding (EBF) is the application of breast milk alone in the feeding of a baby for at least four months and if possible six months of life, without the addition of water, food or drinks. The baby however receives vitamins, minerals and medicines in the form of drops and syrup as need arises (WHO,1981). The World Health Organization WHO (2001) received the optional duration of EBF to six months of life. The second type of breastfeeding, predominant breastfeeding (PBF), on the other hand, implies that the infants predominant source of nourishment is breast milk. The infant in this type receives in addition of breast milk, water and water based drinks (WHO 2001). Complimentary breastfeeding (CBF) or mixed feeding occurs where factory produced baby formula is the primary source of nourishment for the infant, the breast milk given occasionally. This practice offers mother chance to attend to their daily activities while nannies and house helps attend to babies: This present study was however concerned with exclusive breastfeeding.
Promotion of breastfeeding, particularly EBF, has been the focus of many public health and nutrition programmes and activities in recent years. Thus a joint World health Organization/ united Nations children’s fund (WHO/UNICEF) meeting on infant and young child feeding was held in Genera in 1979 and the emphasis was on breast feeding. In 1981 the combined force of the W.H.O and UNICEF produced the W.H.O international code of marketing of breast milk substitute. The main aim of the code obviously was to safeguard the practice of breast feeding. To enhance breastfeeding practices, WHO launched the baby friendly hospital initiative in 1992 as a primary intervention strategy for promoting and strengthening national health systems. The initiative has been implemented in 138 countries (including Nigeria) and the number of hospitals world wide designated baby friendly has risen from 6,300 in 1995 to nearly 40,000 by mid 2008 (WHO, 2009). Cataldo De Bryne and whitney (1999) asserted that EBF is an unequalled way of providing ideal food for the healthy growth and development of infants. The authors explained that nutritionally, breast milk is a complete food for the infant, providing all the nutrients needed for the first month of life.
Psychologically, breastfeeding permits an initial bonding between mother and child. Economically, breast-milk economizes on house hold expenditures on food and requires no itensils, water or fuel for preparation. However, the lactating woman do not have higher nutrient requirements and make substantial time to breastfeeding. Berg and Brenms (1989) cited breast milk for it’s anti-infective properties, lower incidence of diarrhea diseases, allergies and other illness among breastfed infants. It removes the danger of malnutrition caused by dilution of bottle feed and of infection caused by unhygienic preparation (Berg and Brenms, 1989).
However, it seems that EBF is still not widely accepted campaign by government and non-governmental organizations has gone far, but it appears not to be yielding expected dividend. The question that are yet to be answered, lies in determining those factors which can predict levels of acceptance or rejection of EBF. Possible predictor could be sourced from social mographic circumstances of the mothers. For instance such social demographic factors as religious affiliation, occupation, educational status, parity, age, as well as location are deemed to be capable of influencing adoption of exclusive breastfeeding. Parity has to do with the number of deliveries a woman has had. Breastfeeding, in Nigeria is still the norm as most mothers breastfeed their babies traditionally. However, exclusive breastfeeding is an innovation to the traditional way of feeding an infant where mothers starts complementary feeding as early as two months of life or even less. A woman who has nursed several babies successfully before may not be easily convinced to stop by giving her infant water and native concoction. She may not see why she should change her method of feeding, since she has successfully used such to nurse her older children (Mathai, 1983).
Age is sometimes associated with breast feeding. Omololu (1996) pointed out that younger mothers tended to be fashion conscious believing that their breast would sag if they get involved in breastfeeding. The younger mothers may also be over conscious of their body and looks and may not be willing to breastfeed the baby anywhere as the baby demand. Location as indicated by Okehialam (1986), Berg and Brems (1989), Barnes, Harjit and Stephers (1990), Cataldo (1990), Guashuddin and kalair (2004), Okehialam is an environmental factor, which could also be associated with breast feeding pattern. In the rural area, the extended family system still predominates and the nursing mothers to adopt or reject exclusive breastfeeding may be dependent on who takes health decision in the family. This, of course, could be the mother-in-law, father-in-law, or any of the extended family members who is close by. In the urban area, the nuclear family predominates and the decision to adopt EBF will be only between the woman and her husband. Apart from this, the mother in the urban area may have to go to school or work which will take her out of the house regularly.
This may have an impact on adoption of EBF, since the mother is likely not going to school with her baby and may not have opportunity to comeback and breastfeed the baby when necessary.
Occupation of the mother place the mother in a social class. The mother may tend to follow what is fashionable or acceptable within the social class in which she be long (Wanmani and Tumwine, 2005). Hence if the social class sees bottle feeding as a mark of affluence, a mother in that class will likely go for bottle feeding. Religion is a predicate and a repository of culture which is a way of life of a people. The mother’s religion may be a pointer to the choice of feeding method the mother is likely to adopt for her infant (Njepuome, 1995). The success of any programme, to a large extent, depends on identification of factors that are susceptible to it’s intervention. The programme of EBF and the intensive media campaign attendant to it as part of the baby friendly initiative of WHO/UNICEF are receiving differential responses from Nigeria population. It seemed that no elaborate study has been conducted in the Enugu State College of Education Technical to identify fact or rejection f EBF. The study of EBF factors are most likely to serve the predictive function in Enugu State College of Education Technical.
STATEMENT OF PROBLEMS
Exclusive breastfeeding is a new method of breastfeeding which has been introduced by WHO/UNIEF. These two bodies have tasted it and find it successful for solving many problems in an infant.
Unfortunately, few mothers adopt exclusive breast feeding (Grange, 1992); WHO, 2001) What could be peculiar to them? What do they have in common which are lacking among those who reject exclusive breastfeeding? This study explore nursing mothers with a view of finding answers to these questions.
PURPOSE OF THE STUDY
The study is embarked up to enable the researcher address the following objectives.
1. The degree of EBF by nursing mothers.
2. The relationship between educational status and the nursing mothers level of adoption of EBF.
3. The relationship between age an the nursing mothers’ level of adoption of EBF.
4. Extent of relationship between parity and the nursing mothers level of adoption of EBF.
SIGNIFICANCE OF THE STUDY.
A study of this kind will be useful in many ways. There will be research if the nursing mothers in Enugu State College of Education Technical do practice EBF. The finding will be useful to health educators and all those interested in passing the information based on the principles of EBF. If the finding prove negative, then suggestions will be to health educators especially those working with mothers the need to increase their effort towards the teaching of the principles and practice of EBF to mothers.
This finding will be useful to such government agencies as UNICEF and WHO, who are interested in promoting EBF. Thus they will use the finding to evaluate the EBF programe so far and also plan strategies for improvement.
There will be research on parity, religious affiliation, age and location to the effect of EBF adoption in the area of study. Knowing this will help health workers, particularly health educators in planning their health instruction and teachings of EBF. Attention should then be given to all nursing mothers irrespective of parity, age, religious affiliation to help and encourage them to adopt EBF.
SCOPE OF STUDY
The research attempts to give an insight into the importance of adopting Exclusive breast feeding. The area covered by this study is Enugu State College of Education (Technical).
The following research questions will guide the study.
1. What is the extent of EBF adoption by nursing mothers in Enugu State College of Education (Technical).
2. How does educational status of nursing mothers relate to their extent of adoption of EBF.
3. To What extent does parity relate to adoption of EBF by nursing mothers in the College.
4. What is the relationship between the age of the mother and adoption of EBF.