Influence of maternal nutrition knowledge on infant :feeding practices among the Maasai community in Narok District, Kenya

Abstract

Little is documented about the relationship between maternal nutrition knowledge and infant feeding practices in the Maasai community. A cross sectional survey which employed both descriptive and analytical methods of data collection and presentation was designed to assess the influence of maternal nutrition on the infant (0 - 12 months) feeding practices in the community. A previously pretested structured questionnaire was used to interview a sample of 165 mothers with infants aged 0-12months and attending Maternal and Child Health Clinic (MCH) at Ololunga sub-District Hospital. The study also interviewed three Health Care Workers at the MCH clinic and five Traditional Birth Attendants (TBAs). Data was collected on social demography of the households, sanitation and hygiene, maternal nutrition knowledge, infant feeding practices, and the anthropometry and morbidity of the index child. Results showed that up to 86.7% of the infants studied had been delivered at home. Prelacteal feeding was practiced by 71.5% of mothers. Expression of breast milk was not common in the community and 99.4% of the mothers indicated unwillingness to express. The traditional infant feeding practices played a major role in influencing infant feeding practices. Up to 81.2% indicated having received traditional knowledge from their relatives. The main source of modern nutrition knowledge was indicated as the relatives (40.7%), followed by the mass media (39.8%) and Traditional Birth Attendants. MCH clinic was indicated as a source of knowledge by only 5.9% of the mothers. About 71% of mothers indicated having received instructions on the modern infant feeding practices but 53% demonstrated correct knowledge on the recommended period of exclusive breastfeeding while only 1.2% of the mothers practiced exclusive breastfeeding as recommended by the World Health Organizations. Traditionally, exclusive breastfeeding was not practiced. Only 41.2% of mothers demonstrated correct knowledge on the recommended breastfeeding frequency, but 78.2% were breastfeeding the infants on demand. About 76% of the mothers demonstrated correct knowledge on the recommended time to initiate breastfeeding and about 73% were practicing. With regard to time of initiation of breastfeeding and breastfeeding frequency, modern knowledge was similar to traditional knowledge. Sixty-three percent of mothers demonstrated correct knowledge on the recommended age of introducing complementary foods, but 98.8% of the mothers had introduced complementary foods before the age of one month similar to what is advocated by the traditional knowledge. About 93% of the mothers demonstrated correct knowledge on the frequency of feeding the complementary foods and about 94% were practicing. Bottlefeeding of liquid foods was common (86%), while 13% of mothers used cups. Cough/common cold and diarrhoea were the most prevalent diseases among the children at 75% and 22% respectively. Diarrhoea was more prevalent among infants 0 - 6 months than among the older infants (6 - 12 months). The nutritional status of the infants (0 - 6 months) was normal, with 96% having normal weight. High growth faltering was observed with the older infants. Poor hygiene and sanitation was evident in the study area with only about 27% of the homesteads having pit latrine and 73% using bushes for human waste disposal. About 98% of the households lived in temporary houses with inadequate ventilation. Only about 20% had access to clean drinking water but about 57% treated their drinking water. The results showed that when modern knowledge conflicted with the traditional knowledge, practice of modern knowledge was low. However, practice was high when modern knowledge acknowledged the traditional. This would imply that the mothers were still adhering to the traditional knowledge to make choices on infant feeding practices. The nutritional status of the infants (0 - 6 months) was normal and morbidity especially diarrhea disease not excessive. It does not seem therefore justified to recommend wholesale replacement of the traditional infant feeding practices with the modern practices. A multifaceted approach which takes into consideration factors such as maternal nutrition, social econorrucs status of households, traditional knowledge, maternal nutrition knowledge, beliefs and taboos is required in order to effectively improve infant feeding practices.