ABSTRACT

Inappropriate feeding practices can have profound consequences on the growth, development and survival of infants. The World Health Organizationrecommended exclusive breastfeeding because it has been shown to reduce the occurrence of adverse health outcomes on the infant and mother, and so isregarded as the best form of preventive medicine. Despite the health and economic benefits associated with exclusive breastfeeding, the practicestill remains low in various parts of the world. In Nigeria, the practice rate remains low with just 17-25% of infants, exclusively breastfed. This justified the objective of assessing women’s knowledge, attitude andpractice of exclusive breastfeeding in Kaduna metropolis. It also justified the need to investigate factors affectingthe non-practice of exclusive breastfeeding. The study also verified the hypothesis raised with regards to the relationship between the knowledgeand attitude towards exclusive breastfeeding, respondents’knowledge and practice of exclusive breastfeeding and therelationship between the attitudeand practice of exclusive breastfeeding. The social cognitive theory was adopted as the theoretical framework of the study. The study used the survey research design where both probability and non-probability sampling techniques were used.The targeted population was nursing mothers, pregnant women and experienced mothers in Kaduna metropolis. Multi stage cluster sampling was used in selecting respondents.Simple random sampling method was used to select eight wards within the metropolis. purposive sampling method was used to select two (2) streets from the eight wards selected, making a total number of sixteen (16) streets. Fourteen (14) households were selected each from the sixteen 16 streets using availability sampling technique, making a sample size of 224 respondents. The study used frequencies, percentages and cross tabulations to analyse responses derived from the questionnaire and to testthe stated hypotheses of the study. The study also made use of in-depth interview to compliment the questionnaire and to cover issues that could not be obtained through the questionnaire. At the end of the data gathering exercise,the study revealed thatmajority (96%) of the respondents have knowledge of exclusive breastfeeding and 58% have a favourable attitude towards it. These results, however, did not have much effect on their practice as only34% practiced exclusive breastfeeding. The study identified other factors hindering the practice of exclusive breastfeeding, such as employment and school, breast problems, lack of commitment, socio- cultural factors, poor milk supply, poverty, medical conditions of mothers and infants,amongst others. Chi square results revealed that there wasa relationship between knowledge and attitude as well as knowledge and practice towards exclusive breastfeeding but no relationship between attitude and practice.The study, therefore recommends that there is need to educate caregivers and not mothers alone on the benefits of practice.This will motivate them to provide the needed support for the practiceof exclusive breastfeeding. Mothers also need to be educated on breastfeeding techniques, as this will help in preventing breast feeding problems, thereby ensuring a successful practice. The study also recommends adequate support from management at work places onthe need for the extension of maternity leave or reduced working hours for nursing mothers, and the provision of facilities to enable mothers breastfeed their babies at work.

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CHAPTER ONE

INTRODUCTION

1.1       Backgroundto the Study

Over the years, breastfeeding has been a universal means of feeding infants and a common

feature of all cultures since the survival of mankind. It is a phenomenon that is deeply rooted in

the tradition of human culture. Although, breastfeeding practices have fluctuated over the years,

it is widely regarded as an unequalled way of providing ideal nutrition for the healthy growth and

development of infants (World Health Organization, 2002a). Breast milk is mostly referred to as

nature‘s most precious gift to the newborn and the ideal food for the human infant of which an

equivalent is yet to be developed by the scientific community despite tremendous advances in

science and technology (Nanthini and Jeganathan, 2012).

There are several methods of infant feeding, prior to the discovery and recommendation of

exclusive breastfeeding. Mixed feeding has been a common practice, where infants received

breast milk and other food or liquids and predominant feeding, where infants receive breastmilk

as a predominant source of nourishment and also receive water and water-based drinks or liquids

(WHO, 2008).

Exclusive breastfeeding means only breast milk is allowed with the exception of medicine,

vitamin syrup and oral rehydration solutionfor the first six months of life to achieve optimal

growth, development and health. Thereafter, infants should receive nutritionally adequate and

safe complementary foods (WHO, 2002b). Complementary feeding means infants can

receivebreast milk, expressed milk or milk from a wet nurse, as well as solid or semi-solid foods,

liquids, formula milk,while continuing to breastfeed for up to two years or more (United nations

children‘s funds, 2009). This has been one of the primary aims of nutrition and public health

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programmes across the world with the aim of improving infant and child morbidity and mortality

and also to improve maternal health. Exclusive breastfeeding is internationally the most

preferred way of feeding infants during the first six months of their lives, and it is recognized as

being one of the most natural and best formsof preventive medicine (WHO, 2002b).

During the first few days after delivery, colostrum, known asthe first fluid that comes from the

breast immediately after birth, is produced and should be fed to the new-born, while awaiting the

production of regular breast milk (Makena, 2014). It is yellowish in colour, contains high

proteinand anti-bodies and often described as the first form of immunization because it is an

important source of nutrition and antibody protection for a newborn child. Therefore, it is

recommended that infants should be put on the breast immediately or within one hour after birth,

which enables the stimulation of breast milk production (WHO, 2002b).

Although, the composition of breast milk varies according to factors such as maternal nutritional

status, genetic makeup, maternal dietary habits, and so on, it contains nutrients, anti-bodies, and

properties important for growth and development, which makes it a uniquely perfect food for

babies with nutrient in the right proportion and ready in the right temperature (Riordan, 2005).

Breast milk is the most complete form of nutrition because it has the right amount of fat, sugar,

water, and protein which most babies find easier to digest than formula (United nations