Maternal breastfeeding practices in relation to growth and nutrition status of children aged 0-24 months in Nairobi, Kenya

Abstract

Bottle-feeding is common with more than half of the children given prelacteal feeds an hour after birth while median duration of breastfeeding (16.7 months) is also below the recommended duration. These inappropriate practices are likely to expose children to poor growth and malnutrition. The aim of this study was to determine the maternal breastfeeding practices and relate them to the growth and nutritional status of children 0-24 months of age. A descriptive cross-sectional survey was carried out in randomly selected city council health centres. The study tools included a questionnaire, which focused on assessing maternal socio-demographic profiles, attitude towards breastfeeding, knowledge of the recommended breastfeeding practices, knowledge of breastfeeding in a HIV positive status, actual breastfeeding practices and sources of breastfeeding information. Growth monitoring charts were evaluated. Eventually anthropometric measurements of the children were taken using a salter scale for weights and a length board for height. The study showed that over 70% of the mothers had adequate knowledge on the recommended breastfeeding practices but only 44% knew the recommended duration of exclusive breastfeeding. A majority (77%) knew that breastfeeding in a HIV positive mother should not be done due to the risk of mother-to-child transmission. In total, 99% of the mothers had breastfed, 98% were still breastfeeding also 90% were breastfeeding on demand, 80% did not use bottles with nipples in giving fluids to their child and 79% gave no prelacteal feeds. The high scores not withstanding, only 12.6% children (who were past age of six months) had been exclusively breastfed for the first six months of life and 34% of children aged less than six months were still exclusively breastfeeding. Majority (80%) of the mothers obtained breastfeeding information from the health care workers. Information from health care workers was mainly (52%) obtained during antenatal visits. Most children had experienced good growth trends (94%) with only 10.6 %, 6.2% and 2.1% being stunted, underweight and wasted respectively. Lack of adherence to most of the recommended breastfeeding practices was a risk factor to poor growth. In conclusion, mothers have positive attitude, adequate knowledge and were compliant with most of the recommended proper breastfeeding practices. However, exclusive breastfeeding for the first six months was rarely practised. Most mothers lacked knowledge on other options HIV positive mothers have other than avoidance of breastfeeding. It was also realised that health care workers offer health education on breastfeeding mainly during antenatal clinics. Adherence , to most of the recommended breastfeeding practices contributed to the good growth and nutrition status of the children. From the study tindings it is recommended that, health care workers plan breastfeeding information dissemination carefully in order to reach all targeted mothers thus reduce exclusion error; information to re-emphasis the benefits of breastfeeding, importance of giving colostrum and exclusive breastfeeding for the first six months and options that are in place, for an HIV positive mother who chooses to breastfeed.