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KNOWLEDGE
AND ATTITUDE OF NURSING MOTHERS ON EXCLUSIVE BREASTFEEDING
CHAPTER ONE
INTRODUCTION
Background
of Study
Nurses play
a major role in the promotion and implementation of Primary Health care
(www.paho.org/English/DD/DIN/alma-ata declaration.htm). Since nurses are the bedrock
in the delivery of healthcare, they frequently need to be updated with adequate
knowledge so that they, in turn, spread adequate information and skills to
mothers and the community as a whole. However, the health and nutritional
status of children and mothers are intimately linked. This means that mothers
and their children form a biological and social unit; the health and nutrition
of one cannot be divorced from another. Therefore, children have the right to
access safe and nutritious food. These factors are important for achieving full
potential growth and development. Women also have the right to adequate food
and the right to decide how to feed their children and to have correct
information and conditions that will enable them carry their decisions. They
also have the right to maternity protection and nutrition (NIYCF, 2006-2010).
Breastfeeding provides the healthiest beginning for the infant. With the risk
of Mother to Child Transmission of HIV through breast feeding, health workers
need guidance on how to address issues of optimal infant feeding on one hand
whilst minimizing the risk of MTCT and the risk of infants dying from improper
feeding practices on the other hand (NIYCF, 2006-2010). In the recent past with
the unfolding detail about HIV/AIDS and MTCT, the need for consistent and clear
messages in relation to optimal infant and young child feeding practices has
become more apparent. The National Infant Young Child Feeding (NIYCF)
operational Strategy builds on the past and continuing achievements in
promoting optimal infant and young child feeding. These include exclusive
breast feeding for six months and continued breastfeeding up to 2 years with
introduction of appropriate timely complementary feeding, the implementation
and monitoring of the International Code of Marketing of breast milk
substitutes and the rights of working women to maternity protection. In the
past decade, the government has implemented programmes aimed at improving the
welfare of infants and young children. The government has 1 also enacted a
legislation to reduce the marketing of breast-milk substitutes. Currently,
various community-based initiatives (HIV positive living support groups, Home
based Care support groups, etc), do not adequately include infant feeding
issues in their agenda. However, recognition of these structures is cardinal
for the implementation of various chosen successful breastfeeding initiatives
in the Baby Friendly Hospital Initiative (BFHI). These include breast feeding
and child survival and Baby Friendly Hospital Initiatives. Additionally, the
effective referral system between health facilities and community needs to be
strengthened where they do not exist.
1.2
Statement of the Problem:
There has
not been a mechanism put in place to keep proper or concrete records on the
activities as well as indicators of Exclusive Breastfeeding and mothers support
groups in hospitals, polyclinics and health centres in Nigeria. There has
however been occasional figures produced from special exercises or survey carried
out. For instance, (World Linkages, Nigeria, July 2000; Country Profile), in a
study in the upper East region in Nigeria, revealed that among children less
than two months old, 43 percent are exclusively breastfed. By the fourth to the
fifth month, the figure drops to 22 percent. Moreover, on the average,
globally, only 39 per cent of babies breastfeed exclusively, even in the first
four months of life (UNICEF; WABA, 2003).
1.3 Research
Questions
The question
therefore is what the contemporary views of mothers and helpers about exclusive
Breastfeeding at University of Benin Teaching Hospital (UBTH) are, though
without previous concrete reports or record in place.
Do the
breastfeeding mothers know how important the exclusive breastfeeding is and how
to do it?
Do they have
confidence and where do they turn to when they face difficulty?
Are people
around them such as fathers and grandmothers supportive especially when mothers
have to resume employment soon after delivery?
1.4 The
Purpose of the Study:
The purpose
of the study is to ascertain the current feelings and views of a cross-section
of the Breastfeeding mothers on a MCH clinic day at University of Benin Teaching
Hospital (UBTH), about exclusive Breastfeeding in order to develop appropriate
strategies.
1.5
Significance
It is hoped
that the findings of the study will provide a current perceptual database that
will inform all of us and more importantly the policy makers on the feelings
and views of the mothers about exclusive breastfeeding so that appropriate
alternatives to motivate the indulgence of exclusive breastfeeding and its
support, would be developed by Breastfeeding mothers, helpers and the populace
of Nigeria.
1.6
Objectives of the Study
1.6.1 Main objective
The main
objective of the study is to find out the perception on exclusive breastfeeding
among postnatal mothers.
1.6.2 Specific Objectives
Assess the
level of Breastfeeding mothers’ views about the benefits of exclusive
breastfeeding;
Determine
the level of breastfeeding mother’s views about barriers to exclusive
breastfeeding;
Find the
feelings towards exclusive breastfeeding
Identify the
behaviour of participants;
Investigate
any kind of support for breastfeeding mothers on exclusive breastfeeding.
1.7
Operational Definitions: – These are precise descriptions of how to derive a
value for characteristics the researcher is measuring. It also entails how
specific these characteristics are ;
Exclusive
breastfeeding – This means giving a baby only breast milk, and no other liquids
or solids, not even water unless medically indicated. This should be for the
first 6 months (NIYCF, 2007).
Exclusive
replacement feeding – This is the process of feeding a child who is not
breastfeeding with a diet that provides all the nutrients the child needs until
the child is fully fed on family foods. Infant formula is recommended for
exclusive replacement feeding when AFASS (Acceptable, feasible, affordable,
sustainable and safe) is met (NIYCF, 2007).
Heat Treated
Expressed Breast milk – This means that a mother expresses breast milk and
heats it so that the HIV present in breast milk is destroyed making it safe to
feed the infant (NIYCF, 2007),
Wet Nursing
-This refers to breastfeeding by another woman, who is HIV-negative.
This may
only be considered in special situations such as in case of an orphaned infant
and
the family
can not meet AFASS. The wet nurse should be tested every three months (NIYCF,
2007).
Infant – A
baby under one year of age or from birth to 12 months of age (NIYCF, 2007),
Knowledge –
To have information in one’s mind as a result of experience or because you have
learned or been told (Oxford Advanced Learner’s Dictionary, 2005).
Attitude –
The way one thinks, feels or behaves about somebody or something (Oxford
Advanced Learner’s Dictionary, 2005).
Bottle
feeding – Feeding an infant from a bottle, whatever is in the bottle including
expressed milk (NIYCF, 2007).
Breast milk
substitute – Any food being marketed or otherwise represented as a partial or
total replacement for breast milk, whether or not suitable for that purpose
(NIYCF, 2007).
Complementary
feeding – Child receives both breast milk or a breast substitute and solid (or
semi-solid) food, recommended from the time the baby is 6 months old (NIYCF,
2007).
Complementary
food – Any food, whether manufactured or locally prepared; suitable as a
complement to breast milk or to infant formula when either becomes insufficient
to satisfy the nutritional requirements of the infant (NIYCF, 2007).
Mixed
feeding – Partial breast feeding and giving some other milk (NIYCF, 2007).
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