The knowledge and practice toward the importance of exclusive breastfeeding

CHAPTER ONE

INTRODUCTION

Introduction

This chapter comprises of introduction, background of the study, statement of the problem, research questions, research aim, research objectives, significance of the study, the scope of the study, and operational definition of terms.

1.1 INTRODUCTION

According to a statement by the World Health Organization WHO (2015), “Breastfeeding is the cornerstone for an infant’s survival, nutrition and development”. Early initiation of breastfeeding and exclusive breastfeeding help in child survival, it accounts for healthy brain development, promotes cognitive and sensory performance and is noted for enhancing intelligence and academic performance in children (Isaacs ET AL. 2010, AAP 2012, UNICEF 2015). Feeding an infant with only breast milk is advocated by stakeholders in health; is one of the most important practices in an infant’s life and the best way a mother can invest into the wellbeing of her child. Among the numerous benefits of breastfeeding, UNICEF in a breastfeeding Campaign in 2013, termed the essence of breastfeeding as a “first immunization and an inexpensive life saver”. Mortality among newborns accounts for almost half of child deaths in the world. However, previous studies have shown that placing a newborn to the mother’s breast shortly after delivery helps reduce mortality to a very large extent (UNICEF 2015, WHO 2016). Breastfeeding promotes the health of mothers as well. At current breastfeeding rates, WHO, in 2016, had reported that “close to 20,000 breast cancer deaths can be prevented and an additional 20,000 will be saved if breastfeeding conditions are improved”. It reduces the risk of post-partum hemorrhage, protects mothers against the risks of ovarian and breast cancer and increases the bond between a mother and child (NHMRC 2012). In low income and developing countries, due to poor sanitation conditions, high disease burden and limitedness in the availability of clean drinking water, it is more necessary to practice exclusive breastfeeding (EBF) in the initial stages in life (first six months of the child’s life). This practice of exclusive breastfeeding is more safe, hygienic and the most economical way of providing food for the newborn (UNICEF 2013). It has been reported in several articles on breastfeeding that the proper practice of breastfeeding can save about 800,000 infant lives in the developing world alone (UNICEF 2015, WHO 2016). In spite of these recommendations, it has been documented over the years that the practice of exclusive breastfeeding has not been adopted universally; most mothers embrace the idea but fail to breastfeed exclusively a few weeks after giving birth to their babies. Exclusively Breastfeeding will be much easier and attractive to mothers if the right health education, support and motivation are given (Mogre ET AL. 2016). An idea about the level of knowledge and practice of exclusive breastfeeding and the social support system available to mothers are very imperative for improvement in breastfeeding practices. It helps in reducing child mortality, promotes growth and immunity (AAP 2012, NHMRC 2012, WHO/UNICEF 2017). This study aims to explore the knowledge of mothers towards exclusive breastfeeding and their willingness to practice it in a developing country setting like Cameroon.

1.2 Background of Study

Breastfeeding is the very first stage of improving child’s survival. Breast milk as food for infants is very beneficial for the growth of a child. I Enhances the physical, mental, and social growth of a child. Breast milk contains many nutritional values like antibodies which boost the immunity of a child, prevent child mortality and morbidity. Breast milk has an enormous impact on the health of infants, most especially those who weighed less at birth. It has been discovered that breast milk is far more nutritious than processed milk. Aside from the benefits of breast milk on an infant, breastfeeding creates an inevitable bond between a mother and her child (Heckman J.J, 2011). World Health Organization (WHO) and United Nation International Children Emergence Fund (UNICEF) recommended breast milk as an ideal food for infants, and that is why in the past decades, these organizations have been encouraging mothers worldwide to embrace the practice of breastfeeding, particularly exclusive breastfeeding which according to WHO entails feeding an infant with just breast milk (and syrups if need be) for six months and after that period of time give the infant complementary food (Cattaneo ET AL., 2000). It has been revealed by a study that infants who are not fed with breast milk at the first six months of their birth are likely to die from infections than those who are breastfeed (WHO,2014). Childhood mortality is high in low and middle-income countries where EBF prevalence is low. Exclusive breastfeeding has a dual advantage on both a child and his mother. The benefits of EBF are bigger in settings of poverty, poor nutrition, poor hygiene and culture beliefs as some traditions, where baseline disease rate are higher. A part from ensuring the good health of child, it saves cost for the mother; as well as prevent her from breast cancer and other related diseases. However, despite the recommendation of exclusive breastfeeding by WHO, the rate of Cameroonian mothers who practice EBF is slow (20% in Dec. 2014). The prevalence of exclusive breastfeeding for the first six months of life has remained low worldwide, despite strong evidence in support of its practice.

1.3 Statement of Problem

Exclusive breastfeeding (EBF) is a method of breast feeding which has been recommended by WHO-UNICEF. These two bodies have tested it and found it successful for solving many problems in an infant. Unfortunately, mothers’ poor knowledge on the importance of EBF and towards suboptimal breastfeeding practices is the reason of poor health of the babies. In addition, many children are admitted in hospitals due to gastrointestinal infections, pneumonia and other allergies and infections. One of the contributing factors in child mortality is suboptimal breastfeeding at times due to the discarding of colostrum.

 In Cameroon especially in the community of Molyko of Buea, poor EBF rates might have resulted from knowledge deficit on the importance of breastfeeding during antenatal nutrition, education sessions and infant that are subjected to poor breastfeeding practice may easily become malnourished thus contributing to the increasing rate of infant mortality. Diarrhea is one of the problems associated with the use of feeding bottles while growth retardation in babies has been found to coincide with the introduction of milk substitutes. Moreover, mothers are unaware of the benefits of EBF and the risks associated with bottle feed. So, there is need to investigate the knowledge of mothers of the Molyko community towards the practice so that newborn babies health problems can be avoided.

1.4 Research Goal

To assess mothers’ knowledge towards the importance of exclusive breastfeeding and how this practice influences the health of children

1.5 Research Questions 

1.5.1 Research question

 What are the level of mothers’ knowledge towards the importance of exclusive breastfeeding and how this practice influences the health of children? 

  1.5.2 Specific research question                          

1. What is mothers’ knowledge on the importance of EBF?
2. How do mothers’ practice EBF?
3. What are the problems which hinder the practice of EBF? 

1.6 Research Objectives

1.6.1 General objective

To assess the knowledge and practice toward the importance of exclusive breastfeeding

1.6.2 Specific objective                  

1. To assess mothers’ knowledge about the concept, recommendations and benefits on importance of EBF.
2. To find out how the mothers practice EBF.
3. To investigate the problems which hinder the practice of EBF.