Assessment of the knowledge and practice on infant weaning among breastfeeding mothers in the Batoke community Limbe

ABSTRACT

 This study aimed to assess the knowledge and practice of weaning among mothers in the Batoke community in Limbe, South West Region of Cameroon. The specific objectives were; to assess the knowledge of breastfeeding mothers (with children age 4 months – 2years), to assess the practice of weaning process among breastfeeding mothers (with age 4 months – 2years), to assess the challenges faced by breastfeeding mothers (with age 4 months – 2years). A descriptive cross-sectional, community-based study was conducted involving 139 participants selected through non-probability convenient sampling technique. The data was collected using a well-structured questionnaires based on the specific objective. The results were presented on tables and pie chart.  The study found that 76 (55%) of the participants could rightly define weaning as introducing a child to new food and less on milk, and 60 (43%) weaned their baby at 6 months. It also revealed that 93 (67%) of the participants faced challenges during breast feeding, with baby falling sick and painful breast being the most common. Furthermore, the study indicated that participants with low level of education were more likely to wean their baby at 6 months compared to those with high level of education, who weaned their baby at 1 year of age. The study provides insight into the current knowledge and practices of weaning among mothers in the Batoke community, and highlights the need for educational interventions to improve the weaning process and address the challenges faced during breastfeeding.   

CHAPTER ONE

INTRODUCTION

Background

Weaning is a maternal practice that is believed to have been a part of human history for thousands of years. In traditional societies, infants were often breastfed for several years before being slowly introduced to solid foods. Relatively short period of breastfeeding of about 6 months, traceable as far back as the 15^th century in Britain which later spread to other parts of the world (University of Aberdeen, 2018). In recent years third world countries, international donor agencies, and the nutrition community at large have begun to focus greater attention on the consequences of poor weaning process of children. Weaning is the process of gradually introducing an infant diet while withdrawing the supply of its mother’s milk. The infant is fully weaned once it is no longer fed any breast milk (Quinn, 2018). Weaning an infant from breast feeding to complementary food is a common cultural practice followed by Cameroonian mothers, which plays vital role in the child’s milestone for growth and development. The right practice of weaning is necessary to prevent children from various health related complications like allergy, diarrhea and choking (Cameron et al.,2012) furthermore, delayed weaning may result in nutritional deficiency, protein energy malnutrition (Gupta et al., 2010) and, childhood illness, developmental delay (Wadgave et al. 2018) stunting (Padmadas et al., 2019) and sometimes even death. Weaning is often advantageous in reducing early infant mortality death. Preferred time and method to wean a human infant is controversial. The American Academy of Pediatrics recommends feeding a baby only breast milk for the first six months of its life (Meek et al., 2017).

Recently, breastfeeding has become challenging as many mothers must return to work relatively soon after the birth of their child. Although, foods are given to children between 4 and 6 months old with the precaution that the food is available to be consumed besides breast milk or formula and is just for practice. These practice foods are generally soft and runny. Examples include mashed fruit and vegetables (Ahmed et al., 2014 and Pang et al., 2020). The United Kingdom NHS recommends avoiding foods including those that contain wheat, gluten, nuts, peanuts and its derivatives, seeds, liver, eggs, fish, shellfish, cow milk and soft or unpasteurized cheese till the age of six months, due to fear of food allergies or may make the baby ill (Santika et al., 2009). In Cameroon, a study carried out in Adamawa to make an inventory of the socio-economic characteristics of mothers, their weaning practices, their choices of staples and ingredients as well as the processing techniques commonly used in the preparation of the foods and results showed that 77.1% of mothers introduced complementary foods between the ages of 3-6 months. Maize, sorghum, millet and cassava flours were in common use, with maize. Information indicates that almost one in every three children in the Adamawa Region is malnourished (Njongmeta et al., 2018).

 Factors affecting weaning are different and related to socioeconomic status of the mothers, mothers’ level education, culture, norms and beliefs and taboos (Al-Shoshan et al., 2007 and Lopes et al., 2017). According to Bonni et al., 2020, younger age, lower education, employment within 6 months post-birth, caesareans and living in low-income households are the most significant predictors of early weaning. Bohler in 1996 explained that though timing of weaning varies across societies it is always determined by the mothers’ characteristics, choices, knowledge and perceptions about child’s health or cultural beliefs related to feeding (Bonni et al., 2020).

In this study we attempted to assess the knowledge, attitude, and practice of weaning among mothers with children age (4 months to 2 years) at the Batoke community located in the South West Region.

Statement of the Problem

Weaning is an entire process during which an infant change from full dependence on breast milk to independence from it. This period which is a critical one, if not properly done has the following consequences on children: diarrhea and allergic diseases, underfeeding, anemia, malnutrition, and even complications that may lead to infant death. And despite the antenatal and postnatal education given to mothers, the prevalence of poor knowledge and practice of weaning is alarming, this confirms with the work of Al-Gashanin et al. who identified that the knowledge levels of mother in Najran Region, Saudi Arabia were alarmingly unsatisfactory about weaning (Al-Gashanin et al., 2021).

Ten million children under the age of 5 years old die each year (Bryce et al., 2020). More than half of the deaths occur because of malnutrition. If at all feasible breastfeeding is recommended during the first six months, the most vulnerable period for developing under-nutrition remains the transition from breastfeeding to family foods (Mohammed et al., 2014).

The researcher during her clinical internship at witness more than 5 cases of children with complications resulting from poor weaning from the Batoke community. Therefore, the researcher seeks to study or find the adequacy of the weaning process of children at the Batoke community by their mothers because the problem is gradually affecting children and their parents and if not properly handled, it may result to death.

 Objectives

General Objective

The main aim of this study is to assess the knowledge and practice of weaning among Breastfeeding mothers (with children age 4 months to 2 years) at the Batoke community Limbe, South West Region.

Specific Objectives

1. To assess the knowledge of breastfeeding mothers (with children age 4 months – 2 years) on the weaning process in the Batoke community.
2. To assess the practice of weaning process among breastfeeding mothers (with children age 4 months – 2 years) in the Batoke community.
3. To assess the challenges faced by breastfeeding mothers (with children age 4 months – 2 years) in infant weaning in the Batoke community.