This research investigated the demographic determinants of exclusive breastfeeding among nursing mothers in Oye local government area of Ekiti State. Although breastfeeding is universal in the country, the trend is towards giving other feeds in addition to breast milk. Generally, the practices are more diversified and are characterized by late initiation of breastfeeding, the administration of substances other than maternal milk, and the introduction of weaning foods within one month following the infant’s birth. The research design that was used for this study was survey design of the descriptive type of research. The sample size of three hundred (478) respondents was sampled for the study using random sampling technique. The respondents were drawn from the four (4) basic health centre. The instrument for data collection for the study was a self constructed questionnaire. The split half method of reliability was used to ascertain the reliability of the instrument using Pearson’s Product Moment Correlation and Spearman Brown’s formula. A coefficient of 1.00 was obtained. formulated hypotheses were tested using inferential statistics of t-test and anova, the hypotheses were tested at 0.05 level of significance. The researcher concluded that maternal nutrition status influenced exclusive breastfeeding among nursing mothers, maternal employment status influenced exclusive breastfeeding among nursing mothers, that maternal age status influenced exclusive breastfeeding among nursing mothers, maternal level of education influenced exclusive breastfeeding among nursing mothers, child sex status influenced exclusive breastfeeding among nursing mothers. that nursing mothers in urban area breastfed more than those in the rural area, family income influenced exclusive breastfeeding among nursing mothers, Place of delivery influenced exclusive breastfeeding among nursing mothers. The following recommendation were made based on the findings of the study, The researcher recommended that nursing mother should give adequate attention to their nutrition in the course of pregnancy and after baby delivery so as to enrich and enhance exclusive breastfeeding of their babies, it was also recommended those nursing mothers who are employed either by government or private company should always have their babies in the crèche close to where they are working as this could help the babies to have access to exclusive breastfeeding, however, it was recommended that nursing mother should age should be given attention when considering the time to conceive in order to help in exclusive breastfeeding.
Background of the study
Infant feeding methods are a major determinant of infant nutritional status, which in turn, affects infant morbidity and mortality. Among feeding methods, breastfeeding is of particular importance because this practice is fundamental for growth, development, health and survival of infants. Diallo, Bell, Moutquine, & Garrant (2005) stated that about 5.6 million infants die annually because they do not receive adequate nutrition. Breastfeeding therefore has been classified by scientists and health workers as the best natural food for babies and breast milk contains all the necessary nutrients for the healthy growth of the child. The benefits of breastfeeding are numerous ranging from providing the infant with antibodies, to helping ward off risks of illnesses and providing the baby with all his/her nutritional needs (Mundi, 2008). According to the World Health Organization (WHO) (2004), breast milk provides all the energy and nutrients that the infant needs for the first six months of life, and it provides about 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 of life. Furthermore, breast milk not only protects the infant against infectious and chronic diseases, but also promotes sensory and cognitive development in addition to contributing to the health and well-being of mothers, helping in birth spacing, reducing the risks of ovarian and breast cancers as well as increasing family and national resources (WHO, 2004). Generally, breastfeeding is practiced all over the world, though with variation in duration. Considering that the introduction of other food supplements at an early age often increase the risks of infections to the infant which may at times lead to life-threatening conditions such as diarrhea, the WHO and United Nations Children’s Fund (UNICEF) (2004), recommended that infants be exclusively breastfed for six months and, thereafter, up to 24 months, introducing other supplements to support the infant’s growth and development. In view of the many benefits afforded by mothers and infants in breastfeeding, governments have also set goals and rates for breastfeeding practices.
The Nigerian government has earmarked six University Teaching Hospitals as Baby Friendly Hospital Initiative (BFHI) centres, in Benin, Enugu, Maiduguri, Lagos, Jos, and Port-Harcourt, with the objective of reducing infant malnutrition, morbidity and mortality, as well as promoting the health of mothers. Since the inception of BFHI in 1991, a series of programmes, seminars, workshops and conferences aimed at promoting breastfeeding practices have been organized. The BFHI itself has proved to be an effective method of improving breastfeeding practices worldwide (Salami, 2006). To further strengthen the practice of exclusive breastfeeding, government also approved a breastfeeding policy in 1998. The code on the marketing of substitutes of breast milk was reviewed and amended in May, 1999, to further introduce stiffer fines and a clearer definition of breast milk substitutes. These measures are aimed at increasing the rate of exclusive breastfeeding as well as the early initiation of breastfeeding so as to achieve the World Summit on Children 1990 goal of universal exclusive breastfeeding for infants up to six months of age (Mundi, 2008).
Considering the percentage of mothers practicing breastfeeding, it should not be surprising that Nigeria is still saddled with high incidence of malnutrition and its associated infant mortality. Many factors have been adduced to influence these practices. The decisions are very often influenced more by other factors than by health considerations alone. According to Sika-Bright (2010), the factors which influence the decision to exclusively breastfeed include; mother’s marital status, employment status, friends method of feeding their babies, social support and baby’s age. Several other demographic studies conducted over the years (i.e 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 also identified similar factors to include; mother’s level of education, occupation, and income level to influence mother’s choice of exclusive breastfeeding. While significantly expanded in content, the primary objective of the previous surveys has been on emerging issues such as awareness and behavior regarding HIV/AIDS and other sexually transmitted infection, poverty, gender inequality, fertility, mortality,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 practices. However, these factors are apparent in the studies conducted over the years. The existence of a large scale of mothers practicing exclusive breastfeeding, and its associated causes remained elusive in the studies. The survey indicated a decline from 56% in 2000 to 34% in 2002. The Nigeria Demographic and Health Survey (NDHS, 2008) reports, also revealed a 13% exclusive breastfeeding rate which is a decline from 17% indicated in 2003 report. The 2008 report further revealed that 34% of infants aged 0-5 months were given plain water in addition to breast milk, while 10% were given milk other than breast milk. Only 32% of infants under 24 months of age were still on breast milk.
These measures notwithstanding, evidence showed that the practice of exclusive breastfeeding (though fast improving) is still low in many parts of the world. In Nigeria, the rate increased from 2% to 20% in infants 0-3 months and from 1% to 8% in infants 4-6 months between 1990 and 1999 (National Planning Commission (NPC)/UNICEF, 2001). The Nigeria Demographic and Health Survey (NDHS) (2008), however, revealed that 97% of Nigerian children under age five were breastfed at some point in their life. A small proportion of infant (13%) were exclusively breastfed throughout the first six months of life. More than seven in ten (76%) children of ages 6-9 months received complementary foods. 16% of 3 infants less than six months of age were fed with a bottle with nipple, and the proportion bottle fed peaked at 17% among infant in the age ranges of 2-3 and 4-5 months. However, less than half of infants (38%) were put to the breast within one hour of birth and only 68% started breastfeeding within the first day. Relatively, among children born in the five year preceding the survey in Benue State, showed that 97.8% of children ever breastfed. 64.1% started breastfeeding within one hour of birth. 90.2% began breastfeeding within 1 day and 38.7% introduce pre-lacteal feed. Only 0.5% children were exclusively breastfed. These proportions indicate a marginal level of decline from the 1990, 1991, 1999, 2003 and the 2008 surveys (NDHS, 2008). These dwindling attitudes regarding the practice of exclusive breastfeeding have been attributed to several socio-economic, cultural and socio-demographic factors. Thus, this study purposed to examine the influence of demographic determinants of exclusive breastfeeding among nursing mothers in Oye Local Government Area of Ekiti State.
Statement of the problem
Breastfeeding practices have undergone tremendous medical, cultural and sometimes religious challenges and debate. In an attempt to achieve successful breastfeeding globally by the year 2000, the World Health Organization and United Nations Children’s Fund (1993), launched the Baby Friendly Hospital Initiative (BFHI) in 1991. The BFHI is a global effort involving 160 countries, of which 95 of them are in the developing world where Nigeria is inclusive (Salami, 2006). This project is to support, protect, and promote the practice of exclusive breastfeeding for six months and thereafter until 24 months of age. Several medical literatures have also established the superiority of breast milk over the other types of milk for the nourishment of the human infants, offering better health benefits.
Although breastfeeding is universal in the country, the trend is towards giving other feeds in addition to breast milk. Generally, the practices are more diversified and are characterized by late initiation of breastfeeding, the administration of substances other than maternal milk, and the introduction of weaning foods within one month following the infant’s birth. The Nigerian Integrated Child Health Cluster Survey (ICHCS, 2003), indicated that a major area of need in infant breastfeeding was early initiation. It is not definite or clear whether demographic factors significantly or insignificantly influence the practice of exclusive breastfeeding. It is worthy of note that up till recently, the principal focus of attention has been demographic factors and the determinant of exclusive breastfeeding. None of the studies conducted over the years concern itself much with demographic factors and the determinant of exclusive breastfeeding of babies and Oye Local Government Area in particular. Therefore, the study purposed to examine demographic determinants of exclusive breastfeeding among nursing mothers in Oye Local Government Area of Ekiti State.