Abstract

Breastfeeding is widely acknowledged as the ideal method of providing optimal infant nutrition. Breast milk is the most complete food for babies and provides all of the nutrients needed for the first 6 months.

This current study seeks to assess the knowledge and practices of breastfeeding among lactating mothers in Makar II Integrated Health Center. The study would employ a cross-sectional descriptive study design, using random sampling techniques to sample 60 lactating mothers using a structure-questionnaire. Collected data would be analyze using both descriptive and inferential statistics in SPSS (25.0). Results would be presented using Tables and charts.

Findings revealed that majority of the respondents have good knowledge (60.0%) on breastfeeding and (35.0%) actually practices exclusive breastfeeding. Also, it was found that early practices that support the success of exclusive breastfeeding were done by most of the mothers (60.0%).

However, majority of the respondents (70.0%) encountered certain challenges such as inadequate breast milk, baby refusing to breastfeed, pain in the breasts, workload and pressure from relatives and family members. The concluded that there is a need for health care system interventions, family interventions, and public health education campaigns to promote optimal BF practices, especially in less educated women.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Breastfeeding is the universally accepted mode of infant feeding. Appropriate Infant and Young Child Nutrition (breastfeeding and complementary feeding) have the single largest impact on child mortality (19%) of all preventive interventions (Akinremi & Samuel, 2015). The protection, promotion and support of breastfeeding are now major public health priorities, as emphasized in the Global Strategy for Infant and Young Child Feeding.

WHO and UNICEF recommend initiation of breastfeeding within the first one hour after birth; exclusively breastfeeding within the first six months of age and continuation of breastfeeding up to two years of age or beyond in addition to adequate complementary foods (UNICEF, 2018).

Despite WHO recommendations and benefits of exclusive breastfeeding, worldwide, only 39% of newborns were put to the breast within one hour of birth and only 37% of infants were exclusively breastfed.

According to Black et al., 2013 in Series on Maternal and Child Under nutrition, failure to exclusively breastfeed for 6 months is associated with an increased risk of childhood mortality and morbidity). In the same series, breastfed infants were shown to have at least six times greater chance of survival in the early months than non-breastfed children and an exclusively breastfed child is 14 times less likely to die in the first six months than a non-breastfed.

Historically, breastfeeding has generally been considered by health professionals as the ideal feeding practice for infants. It is the first communication pathway between the mother and her infant. Previous studies confirm that breastfeeding has advantages for both babies and mothers, including providing the needed nutrition for the babies, boosting the baby’s immune system, helping mothers to lose weight after pregnancy, and stimulating the uterus to return to its previous position before pregnancy (Tanash, 2014). In addition, infants can absorb and digest breast milk more easily than baby formula (The Office on Women’s Health, 2012).

Globally, Cai et al., (2012) discovered that 39% of infants 0-5 months were breastfed exclusively. Also, the regions with high rates of infants exclusively breastfed for less than 6 months were Eastern/Southern Africa (52%), as well as South Asia (47%). Hence Sub-Saharan Africa recorded the lowest coverage of 37% where Uganda is among, them (WHO, 2012).

Breastfeeding practices include the timing and initiation of breastfeeding, exclusive breastfeeding, giving of pre lacteal feeds, breastfeeding on demand, giving of supplementary feeds, and whether or not a feeding bottle is used. To derive maximum benefits from breastfeeding, the World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life. Thereafter, nutritious and safe complementary foods are to be added while  the mother continues to breastfeed the infant till the  age of two years or beyond (Muchina, 2010).

The prevalence of breastfeeding differs from one country to another and from one society to another, this of course is due to cultural and religious believes. Delayed breastfeeding initiation, colostrum deprivation, supplementary feeding of breast milk substitutes, early introduction of complementary feeding, and incorrect weaning from breast milk are commonly found practices in communities around the world (Kimani-Murage et al., 2011).

In Africa, more than 95% of infants are currently breastfeeding, but feeding practices are often inadequate; feeding water and other liquids to breastfed infants is widely spread. Exclusive breastfeeding provides low-cost, complete nutrition for the infant, protects him/her against infections including infant diarrhoea, and prolongs lactation amenorrhea, thereby increasing birth spacing (Oche et al., 2011).

In Cameroon, a Public survey indicates that exclusive Breastfeeding is still a struggle and its breastfeeding rate stands at 40% as the Public Health Minister Mananouda Malachie launched the 2019 National Breastfeeding in Yaounde on October 22 2019. Dr. Habimana Phanuel, World Health Organization (W.H.O) resident representative in Cameroon said the figure for the rate of Exclusive Breastfeeding (EBF) should move up to 50% in 2025.

In low-income and developing countries, due to poor sanitation conditions, high disease burden and limitedness in availability of clean drinking water, it is more necessary to practice exclusive breastfeeding in the initial stages of life (first six months of the child’s life). This practice of exclusive breastfeeding is more safe, hygienic and the most economical way of providing food for the newborn (UNICEF 2013). It has been reported in several articles on breastfeeding that proper practice of breastfeeding can save about 800,000 infant lives in the developing world alone (UNICEF 2015, WHO 2016).

National and international guidelines recommend that all infants be breastfed exclusively for the first six months of life. Breastfeeding may continue with the addition of appropriate foods, for two years or more. WHO (2003) recommends EBF for the first six months of life, after which infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues up to two years of age or beyond.

The WHO recommends that national authorities in each country decide which infant feeding practice should be promoted and supported by their maternal and child health services to best avoid HIV infection transmission from mother to child.

Breastfeeding virtually important to health and well-being of infant and mother and topic of global concern, particularly in developing countries. Human milk recommended as the exclusive nutrient source for feeding term infants for the first six months of life and should be continued with the addition of solid foods after six months age .Breastfeeding for all infants is strongly supported by both governmental and medical professional organization because of acknowledged benefits with respect to nutrition, gastrointestinal function, host defense and psychological well –being, (Tahiruetal., 2020).

Breast milk considers the ideal food for human infant. Beyond the nutritional value, breastfeeding reduces infection susceptibility and neonatal mortality through active protection against infections. Breastfeeding has been shown to have a positive correlation in reducing diseases in an infant life. Effects of breastfeeding in infants help prevent adverse health outcomes for the entirety of lifespan. In addition, breastfeeding establishes a unique bond between mother and infant, which supports maternal role, (Lackey et al., 2021).

Although breast milk is the best nutritional choice for infants, breastfeeding may not be possible for all women. For many women, the decision to breastfeed or formula feed is based on their comfort level, lifestyle, and specific medical considerations that they might have. Complementary feeding is intended as an effective substitute for infant feeding (Stevens and Patrick, 2009).

Although production of an identical product to breast milk in not feasible, every effort has been taken to mimic profile of human breast milk for normal infant growth and development. Cow milk or soy milk are most commonly used as the base, with supplemental ingredients added to better approximate the composition to human breast milk and to attain health benefits. During the first six months of infant life, providing optimal nutrition is critical as the consequences of inadequate nutrition can be very severe.

Breastfeeding also found to associate with various positive impact on maternal health, including decreased postpartum bleeding, facilitated postpartum weight loss, and decreased risk of postpartum depression and osteoporosis, breast cancer, ovarian cancer and endometrial cancer in later life. Breastfeeding ‘yields’ health care saving by reducing illness events, (UvnäsMoberg et al., 2020).As well as Breastfeeding can be successful in different ways, but support that a mother receives can be essential to success. Support from a spouse, family members, clinician support, social support and employer support can be crucial in determining the duration of breastfeeding. the support of a breastfeeding mother is crucial in the initiation and duration of breastfeeding, (Cazorla-Ortiz et al., 2020).

1.2 Statement of the Problem

Despite the numerous proven benefits of breastfeeding for both mothers and infants, global rates of breastfeeding and adherence to recommended durations remain suboptimal. This discrepancy between knowledge and practice poses a significant public health challenge across the world.

Many mothers across the world lack accurate and comprehensive information about breastfeeding benefits, latching techniques, overcoming challenges, and managing expectations (Kimani-Murage et al., 2011). Cultural beliefs, societal pressures, and misinformation can influence negative attitudes towards breastfeeding, leading to early cessation or improper practices.

In Africa, although exclusive breastfeeding offers infants with low-cost, full nutrition, protects them from diseases, feeding habits are among many mothers are frequently poor; the practice of giving breastfed infants water and other liquids is widespread (Oche et al., (2011).

 

The World Health Organisation, UNICEF and Cameroon Ministry of Public Health recommended that children be exclusively breastfed from birth to six months and continue breastfeeding to 24 months and beyond for optimal survival and growth and development. However, only 20% of children aged less than 6 months in the country are exclusively breastfed (Chiabi et al., 2011). This means that if no action is taking to protect, promote and support breastfeeding, thousands of Cameroon children may die due to poor feeding practices. The unnecessary introduction of water and other fluids before six months reduces intake of breast milk and energy, absorption of iron, transfer of immune factors from breastfeeding and thus increases exposure to infection agents

No published study has been done in Makar II Foumbot Community to give a clear picture of knowledge and practice on breastfeeding practices among lactating mothers, thus this study sought to assess knowledge and practice of breastfeeding among lactating mothers in Makar II Integrated Health Center.

1.3 Research Questions

1.3.1 Main Question

What is the knowledge, practices and challenges on exclusive breast feeding among lactating mothers of babies aged 0-6 months in Makar II Integrated Health Center?

1.3.2 Specific Questions

1. What is the knowledge of breastfeeding among lactating mothers of babies aged 0-6 months in Makar II Integrated Health Center?
2. What are the practices of breastfeeding among lactating mothers of babies aged 0-6 months in Makar II Integrated Health Center?
3. What are the challenges faced by lactating mothers on exclusive breastfeeding of babies aged 0-6 months in Makar II Integrated Health Center?

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