JUSTIFICATION OF THE STUDY
Distribution of respondents by age
Age of the infants
Knowledge on exclusive breast feeding
Knowledge on exclusive breast feeding
Source of information on exclusive breast feeding
View on the duration of exclusive breast feeding
Position of the baby during breast feeding
Challenges experienced during breast feeding
Problems encountered during breast feeding
Alternative means when experiencing breast feeding difficulties
Knowledge on exclusive breast feeding
Difficulties experienced during breast feeding
Effects of the problems encountered
This study aimed at assessing the knowledge, attitude and identifying the challenges experienced during the practice of exclusive breastfeeding among mothers of infants less than 6 months in Rusinga West Location. This study had three specific objectives namely; to assess mother`s knowledge on exclusive breast feeding, to determine mother`s attitude towards exclusive breast feeding and to identify challenges faced by mother`s during exclusive breast feeding practice. A descriptive cross-sectional study design was utilized. The study targeted mothers with infants less than six months of age in the location. Data was collected by administering structured questionnaires with closed and open ended questions to the targeted respondents. Data was entered into Microsoft Excel and analyzed using descriptive statistics and presented using tables and graph.
A total of 84 respondents participated and the study findings showed that majority of the respondents 98%, (n=82) had heard of exclusive breast feeding and knew what it mean. Half of the respondents, 50%, (n=42) said they had experience difficulties while breast feeding and half of the respondents 50%, (n=42) also said they have not experienced any difficulty while breast feeding. It’s worth noting that majority of the respondents still face challenges such as baby refusal to breast feed, inadequate breast milk, breast tenderness, pain during breast feed and sore nipples.
Key words: Breastfeeding, exclusive breastfeeding, human Immunodeficiency Virus, maternal and Child Health, antenatal care, infant and Young Children Feeding, traditional birth attendant and community health extension worker.
According to Alade ;( 2013 ) , exclusive breastfeeding is defined as infant feeding with no other food or drink, not even water, except breast milk (including milk expressed or from a wet nurse) for 6 months of life, but allows the infant to receive oral rehydration solution ( OR S), drops and syrups (vitamins, minerals and medicines). The World Health Organization (2010) recommends that breastfeeding should start immediately following delivery for the baby to get Colostrum. The infant should thereafter be exclusively breastfed for up to six months of life, day and night on child’s demand. During this period, no fluid including water should be given to the baby;(Ike , 2013 ). Exclusive breastfeeding up to 6 months is associated with low risk of morbidity and mortality among infants (WHO, 2010). Human milk provide sufficient energy and protein to meet requirements during the first 6 months of infancy. Early introduction of foods and other liquids reduces breast milk intake, decreases the full absorption of nutrients from breast milk, and increases the risk of diarrhoea and acute respiratory infections for infants. It also limits the duration of the mother’s postpartum amenorrhea and may result in shortened birth intervals;(Makena , 2014).
Despite the strong evidences available in support of EBF and extensive information on EBF for the first six months of life, its prevalence has remained low worldwide (WHO, 2010). Only about 39% of infants in the developing countries and 25% in Africa are exclusively breastfed for the first six months (Makena, 2014). The same report indicates that 6% of infants in developing countries are never breastfed (WHO, 2010). In Kenya, only 61% of children below six months are exclusively breastfed KDHS, (2014).Kenya still falls below the widely accepted “universal coverage” target for exclusive breast feeding of 90% hence there is need for more efforts and interventions to be put in place to promote EBF practice; ( Odindo et al., 2014).
Globally, it is estimated that about 18% of women practice EBF while in developing countries it is 39%. The implication of this is that 39 percent of Kenyan infants are being exposed daily to an increasing risk of disease and have lowered immunity because they are given foods other than breast milk before the age of six months of age .Government of Kenya is implementing the Baby friendly hospital initiative (BFHI) that has been found to be effective in several settings in the developing world initiated through Kenya in the National Strategy on Infant and Young Child feeding; (MoPHS, 2007) .Since the introduction of BFHI there has been great improvement in the proportion of children who are exclusively breastfed from 13% in 2003,32% in 2008 and to 61% in 2014 (KDHS, 2014).However, the rates are still low hence need to find out the reasons for such. The purpose of the study is to investigate the knowledge mothers have towards exclusive breastfeeding, to identify attitudes mothers have towards exclusive breastfeeding and to identify the possible challenges experienced during exclusive breastfeeding period. The decline in exclusive breastfeeding rates despite the efforts made by the governmental and non-governmental organizations interested the researcher in identifying the reason behind these low percentiles.
While almost all Kenyan mothers initiate breastfeeding, 85% to 90% of them offer water and other liquids to their babies in the first month. According to KDHS, (2014 ) 15% of children less than 6 months are fed complementary foods, 10% consume plain water, 10% consume other milks, and 3% consume non- milk liquids during the first 6 months. Further, the same survey indicates that bottle feeding is prevalent in Kenya with 11% of children aged 6 months or younger were using a bottle with a nipple while 30% of children aged 6-9 months use a bottle with a nipple; (Jolly ,2008). This may result in increased morbidity due to unsafe preparation techniques and because a large proportion of the population do not have access to safe water sources.
JUSTIFICATION OF THE STUDY.
High infant mortality rates associated with diarrhoea, acute respiratory infections and poor responses to vaccinations that result from lack of exclusive breastfeeding can greatly be reduced if exclusive breastfeeding of infants is encouraged. This is because breast milk is the ideal nourishment for infant’s survival, growth and development as it contains all the nutrients, antibodies, hormones, immune factors and anti-oxidants an infant needs to thrive; (Nekesa & Ec, 2010). In addition, the mother’s antibodies in breast milk provide immunity to disease. Early supplementation is discouraged for several reasons. First, it exposes infants to pathogens and increases their risk of infection, especially disease. Second, it decreases infants’ intake of breast milk and therefore suckling, which reduces breast milk production. Third, supplementary food is often nutritionally inferior to breast milk; (Makena, 2014). Exclusive breastfeeding has to be practiced in order to contribute to achieving Sustainable Development Goal number 3 which aims at ensuring healthy lives and promoting well-being for all at all stages by 2030.The findings of this research will generate information on knowledge, attitude and challenges experienced by mothers of children from less than six months during exclusive breastfeeding practice. This will from a basis for training mothers and caregivers on the importance of adhering to breastfeeding recommendations. It will also be useful to the Ministry of Health and organizations concerned with infant and young child feeding in determining the type of interventions to design in order to improve maternal and child health and promote exclusive breastfeeding among new upcoming mothers in order to realize international feeding practices of the infants .Health education on breastfeeding should also be improved in order to eliminate barriers to exclusive breastfeeding and build confidence among these mothers in order to improve on the practice.
This study utilized descriptive cross- sectional study design. The design was appropriate for the study as it gave an overview of the status of exclusive breastfeeding.
This study was carried out in Rusinga West Location, Rusinga Island, Homa Bay County, Kenya. Rusinga Island is situated in Mbita Sub-County along Lake Victoria. The location has 3 sub locations namely: Kamasengre East, Kamasengre West and Kaswanga sub-location. The residents of this area engage in various economic activities such as fishing, subsistence farming, livestock keeping and businesses in the local markets.
Study population and target population
The study population included all mothers currently breastfeeding and are inhabitants of Rusinga West location who are approximately while the target population included the mothers who have infants less than 6 months of age during the time of the study.
Inclusion and exclusion criteria.
The inclusion criteria was that one must a resident of Rusinga West Location, consent by signing the informed consent form attached to the questionnaire, have an infant who is 6 months old or less and be18 years and above. The study however, excluded mothers who are non-residents of Rusinga West Location, mothers who fail to consent, mothers who have babies who are above 6 months of age and mothers who are not in the age bracket of 18-45years.
Snow balling sampling technique was used in this study. This technique was suitable for this study since it was easy to carry out and included all the respondents with suitable characteristics. This technique was effective since it helped the researcher identify one suitable respondent to the next until the researcher reached his sample size in the community.
Data collection tool.
Interview administered questionnaire were used to collect the desired data. The questionnaire had both open ended questions and closed ended questions. The tool consisted of 4 components namely (demographic information, knowledge on exclusive breast feeding, attitude on exclusive breast feeding and challenges experienced on exclusive breastfeeding) which tackled the three objectives with each objective in its own component. The researcher helped the illiterate respondents in language translation. The questionnaire was administered by the researcher to the respondents. The tool was pretested 2 weeks before actual study time to ensure validity and reliability of the tool. The completed questionnaires were cleaned, coded and entered into Microsoft Excel. Descriptive statistics were used for data analysis and findings presented using graphs and tables.