Knowledge, attitude and practices of mothers with malnourished children less than thirty six months regarding breastfeeding and complementary feeding in Kitui County Hospital.

Abstract

Introduction: Under nutrition remains one of the most common causes of morbidity and mortality among children globally. It causes about 3.5 million deaths, with 35% of the disease burden being in children under five years. Inadequate knowledge on breast feeding, inappropriate practices such as early and delayed introduction of complementary foods, low energy and nutrient density of food offered, feeding thin consistency feeds, small amounts and food restrictions due to cultural beliefs are often greater determinants of malnutrition than even the availability of food. Information on how to feed young children comes from family members, community practices and health workers. Since children are not able to look after themselves, they rely completely on people who are taking care of them, most often the mothers, so their source of nourishment is limited to what their mothers provide. Kitui County has a rapidly growing population, water scarcity, falling food production and low resilience to climate change. The combined effects lead to food insecurity, a major factor determining the children‟s nutritional status. Objectives Primary objective: To determine the knowledge, attitudes and practices of mothers with malnourished children less than 36 months, regarding breastfeeding and complimentary feeding in Kitui County Hospital. Secondary objective: To determine the socio-demographic factors associated with initiation of complementary feeding. Methodology: This was a cross sectional study design. It was conducted in Kitui County hospital. A total of 108 mothers with malnourished children were enrolled into the study and interviewed using a pretested questionnaire .Focus group discussions were also done to collect qualitative data which was recorded verbatim and later analyzed manually by themes. Results: The study enrolled 108 mother-child pair. Most of the respondents were aged 22-30years (54.6%) and 75% unemployed. Education level achieved 41.3% had incomplete primary education. Knowledge on appropriate time for initiating breastfeeding after delivery, 46.3% of the respondents said with one hour of birth. On the frequency of breastfeeding, 87.0% said it should be done on demand. On practices, 64.8% initiated breastfeeding within one hour of birth. But 20.4% of the mothers reported that their babies had been fed on foods and/or liquids prior to initiating breastfeeding. Out of the 81 mothers with children aged more than six months only 51.9% continued with breast feeding after introducing complementary feeding. On attitude, majority of the respondents (85.2%) agreed or strongly agreed that first milk (colostrum) is very nutritious to the baby. Nutritious foods were considered to be expensive by the majority at 60%. Association of socio demographic factors with inappropriate initiation of complementary feeding. Mothers who had failed to complete primary school education or had no formal education were about 80% less likely to have appropriately initiated complementary feeding as compared with their counterparts who had achieved, at least, secondary school education (odds ratio (OR)0.198; 95% confidence interval (CI) 0.048-0.823), p=0.025). A significantly lower proportion of appropriate initiation of complementary feeding was found among the respondents who were not married when evaluated against their counterparts who were married (40.9% versus 64.0% respectively, OR 0.390; 95% CI 0.150-1.016,p=0.050). Conclusion: Mothers‟ nutritional knowledge exists but it is low. There are gaps on the mother‟s practices on feeding and also negative cultural beliefs towards certain foods. Education positively affects the correct timing of initiation of complementary feeds.