First-time Mother's Knowledge and Practices on Exclusive Breastfeeding in the Post Natal Wards at Kenyatta National Hospital

Abstract

Background: As a global public health strategy World Health Organization (WHO) recommends exclusive breastfeeding (EBF)for the first six months as the optimal mode of infant feeding, providing adequate nutrition for the baby and protection against infectious diseases. It is the most effective intervention to improve child health and survival, especially in developing countries. Numerous health, financial, social, and economic benefits of EBF have been documented. Despite the documented short-term and long-term benefits of EBF to children and their families, rates remain low in most parts of the world. First-time mothers are regarded as a vulnerable group and highly likely to be influenced by anxiety and ease in receiving information relating to infant feeding. In studies conducted in different settings, first-time mothers are more accepting of non-scientific approaches to care from various community-based sources, which has a detrimental influence on the wellbeing of their children. Thus, understanding the knowledge and practice of exclusive breastfeeding among first-time mothers will help offer a more tailored health education messaging to ensure WHO recommendations are followed. The purpose of the study: To evaluate the level of knowledge and practices on exclusive breastfeeding among first-time mothers in the Post-natal wards at Kenyatta National Hospital. Methodology: The study adopted a cross-sectional research design utilizing quantitative and qualitative techniques. A consecutive sampling technique was used to sample 89 first-time mothers who met the inclusion criteria. Two Focus group discussions of 8 participants were also conducted to provide a detailed understanding of the study objective effectively. A purposive sampling technique was used to recruit participants into the two groups. Data analysis was done using Statistical Package for Social Sciences (SPSS version 26), and content analysis was done to analyze qualitative data to obtain themes. Proportions were used to calculate the level of knowledge and practice. The scores for the knowledge scale, including 14 questions, were measured on a 5-point Likert scale with total scores ranging from 14 to 70. A score above the mean was considered good knowledge. In addition, chi-square tests for association and binary logistic regression were conducted. Results: The mean score for knowledge scores was 61, with the lowest score reported being 46, and the highest score recorded being 68. The findings revealed that 73% of the respondents had good knowledge. The results established that 91% of the respondents knew that a baby should be put on the breast within one hour after delivery, 87.6% of the respondents knew that colostrum is highly nutritious to the baby,86.5% knew that a baby should be introduced to other foods after six months of exclusive breastfeeding. The findings also revealed that 82% of the respondents had received information on exclusive breastfeeding during the pregnancy, 71.9% asserted that they knew how to position the baby, therefore effective breastfeeding. In investigating the practice, 76% of the respondents started breastfeeding within one hour after safe delivery, 94.4% asserted that their babies had received colostrum. In comparison, 53.8% stated that they were expressing milk because the baby was unable to suckle. Education level, OR =2.11, 95%CI: 1.34 -3.69, p = 0.032) and knowledge level, OR =8.0, 95%CI: 2.8 - 22.6, p = 0.048) were significantly associated with practice. Conclusion and Recommendations: The findings have shown that the level of knowledge on EBF is high, although the practice is moderate. It is essential to emphasize improving the level of practice through continuous training and educating mothers on the benefits of exclusive breastfeeding and the need to improve infant health through positive practices such as proper latching, milk expression, and breastfeeding frequently.