Barriers to appropriate breast feeding practices among mothers attending maternal and child health Clinic at Mbagathi District Hospital, Nairobi
Breastfeeding is a natural and recommended way of feeding all infants and young children Decline in this practice has resulted in increased morbidity and mortality of children under the age of five years globally and in Kenya. To address inconsistencies in breast feeding practice, it is necessary to understand maternal factors influencing the practice and role played by health facilities, the family unit, work environment and the community in acting as promoters or barriers to appropriate breast feeding practices. The objective of this study was to determine barriers to appropriate breast feeding practices among breast feeding mothers and their perception of breast feeding support provided by health care workers necessary to breast feed successfully. A descriptive cross sectional study involving 228 mothers to children below 12 months attending the MCH clinic at Mbagathi District Hospital was carried out between the months of April and June in the year 2011. Data was collected with assistance of two trained research assistants using a structured questionnaire consisting of open and closed ended questions. Analysis was done using SPSS version 15: Maternal characteristics were described and summarized using measures of central tendencies (mean, mode and median). Statistical measures of correlation (fisher's and chi-squared tests) were used to draw association between independent and outcome variables. Findings of this study showed that most clients were married (89%) and aged between 22-28 years (58.8%). Most of the participants were first time mothers (56%). Majority had primary (34.7%) and secondary (39.7%) level of education and the mean age of the index child was 5 months. Maternal knowledge about breast feeding was influenced by age (p=O.OOl)and level of education (p=0.002) of the mother. Intended duration of breast feeding was influenced by level of education of the mother (p=0.49). XVI Initiation of breast feeding was low (59.2%) while exclusive breast feeding rates in infants of the age group 4-6 months was (40%). Bottle feeding was associated with early introduction of complementary feeds (p<O.OOI) while increased frequency of breastfeeding delayed introduction of complementary feeds (p=0.009). Barriers to breastfeeding reported by mothers were work and breast feeding problems including painful and cracked nipples, inadequate milk supply, over supply of milk, breast engorgement and mastitis. Few mothers (29.5%) felt they were not adequately prepared by the health workers to breast feed their infants. Mothers reported lactation support from health care workers during immunization follow up of infants was minimal.