CHAPTER ONE

 INTRODUCTION

1.1   Background to the Study

Weaning is the introduction of supplementary food to a child’s diet after the first six months of life. Infant weaning with supplementary feeds of breast milk substitutes, early introduction of complementary feeding and incorrect weaning from breast milk are commonly found practices in communities around the world (Inayati, Scherbaum, Purwestri, Hormann, Wirawan, Suryantan, Hartono, Bloem, Pangaribuan, Biesalki, Hoffmann, & Bellows, 2012). The period of weaning could involve a lot of problems and usually information gap exist in relation to how and when weaning takes place. Adequate nutrition during infancy and early childhood is essential for growth and development of children (Ashmika, Deerajen, Prity & Rajesh, 2013). It has been recognized worldwide that breastfeeding is beneficial for both the mother and child as breastmilk is considered the best source of nutrition for an infant (Ku & Chow, 2010). The World Health Organization (WHO) as said by Hanif (2011 recommends that infants should be exclusively breastfed for the first six months after which complementary foods are introduced along with breastmilk for up to two years of age or beyond. The first two years of life are critical stages for a child’s growth and development. Any damage caused by nutritional deficiencies during this period could lead to impaired cognitive development, compromised educational achievement and low economic productivity (Kimani-Murage, Madise, Fotso, Kyobutungi, Mutau, Gitau & Yatich, 2011).

Poor breastfeeding and complementary feeding practices, together with high rates of morbidity from infectious diseases are the prime proximate causes of malnutrition in the first two years of life. Breastfeeding confers both short-term and long-term benefits to a child. It reduces infections and mortality among infants, improves mental and motor development, and protects against obesity and metabolic diseases later in life (WHO, 2010). According to Kimani-Murage et al., (2011), the WHO recommends exclusive breastfeeding in the first six months, beginning from the first hour of life, to meet the infant’s nutritional requirements and achieve optimal growth, development and health. The mother is advised to continue breastfeeding up to two years of age or more and begin nutritionally adequate, safe, and appropriately-fed complementary foods at the age of six months in order to meet the evolving needs of the growing infant. Since weaning is a process by which food other than breast milk is introduced gradually into baby’s diet, first to complement the breast milk and then to wean totally off breast milk involve selecting light nutritious food for easy absorption. Then later replace light nutritious food with thicker feed using hygiene practices when preparing them but majority of nutrition problems in rural areas are due to faulty weaning food (Shadia & Bedor, 2013).

Predictors of breastfeeding and weaning practices vary between and within countries. Factors that influence the weaning process include infant feeding problems such as refusal to eat, colic, diarrhoea and vomiting (Ashmika et al., 2013). These factors represent challenges for mothers and in turn may either directly or indirectly influence the feeding pattern. In view of the identified factors, which are early introduction of complementary feeding and incorrect weaning from breast milk, the researcher would carry out a study on infant weaning knowledge and practices among mothers in ikenne local government area, Ogun State

1.2 Statement of the Problem

Weaning has been one of the most wrongly practiced processes in the developmental stages of the children. It  was observed that mothers give their infant other food apart from breast milk right from birth while some delayed supplementary diet till above Nine months with either cases having negative effect on the infant. WHO (Hanif, 2011) recommends a gradual weaning period from 6 months to 2 years, this allows for the child to still receive the benefits from breastfeeding, while also consuming the necessary nutrients from the complementary foods. But almost half of the mothers (52%) abruptly weaned their children while only 11.6% gradually weaned their children as complementary food is being added to the children diet (Somiya, 2014). The time of weaning is one of the most critical aspects of child’s life. It is the transition period at which the child whose main food used to be milk changes over to adult food. Usually if this period of change in diet is well-planned and progresses smoothly, there will be no setbacks, but in a large number of children, malnutrition usuallytakes place during this period. Ten million children under the age of 5 years old die each year (Somiya, 2014). More than half of the deaths occur because of poor weaning that leads to malnutrition. If adequate health systems were in place nearly two-third of the deaths could be prevented. The most vulnerable period for developing under-nutrition remains the transition from breastfeeding to family foods. Malnourished children often suffer the loss of precious mental capacities. They fall ill more often. If they survive, they may grow up with lasting mental or physical disabilities (Dinesh & Sushilkumar, 2011).

Poor quality of weaning foods and improper weaning practices predispose infants to malnutrition, growth retardation, infection, diseases and high mortality (Somiya, 2014). Food is expected to be prepared adequately containing the required nutrients as well as appropriate with a suitable texture and temperature. Without the knowledge of proper weaning practices as well as a perception of the child’s hunger needs, malnutrition and illness may ensue. Thus, the weaning period is therefore a vulnerable time when the child should be attentively cared for and observed so as to maintain health (Somiya, 2014). Therefore, information gotten on weaning will improve mother’s practice of weaning since the mother is the most important person in a baby’s life for both its physical as well as its psychosocial care and growth. The mother-infant relationship is the most vital formative relationship for the child. There arises a need to prevent wrong assumption of mothers on weaning process and timing, there is need for sound education, effective information and sufficient knowledge of weaning to be instilled in mothers. Nurses can be agent of carrying out the educational needs for weaning infants in proper way. Therefore, the need for a study on infant weaning knowledge and practices among mothers in Ikenne Local Government Area, Ogun State.

1.3 Objective of the Study

The main objective of this study is to explore infant weaning knowledge and practices among mothers in Ikenne local government area, Ogun State. The specific objectives are to:

1. determine the knowledge level on infant weaning among mothers attending three Primary Healthcare Centres in Ikenne Local Government Area;
2. assess the practice level on infant weaning among mothers attending three Primary Healthcare Centres in Ikenne Local Government Area;
3. assess the relationship between occupation and infant weaning practices among mothers attending three Primary Healthcare Centres in Ikenne Local Government Area;
4. identify the relationship between ethnicity and infant weaning practices among mothers attending three Primary Healthcare Centres in Ikenne Local Government Area;
5. assess the relationship between educational level and infant weaning practices among mothers attending three Primary Healthcare Centres in Ikenne Local Government Area and
6. to determine the relationship between mothers knowledge level and infant weaning practices attending three Primary Healthcare Centres in Ikenne Local Government Area.

1. Research Questions                       

The following research questions were answered:

1. What is the knowledge level on infant weaning among mothers attending three Primary Healthcare Centres in Ikenne Local Government Area.
2. What is the practice level on infant weaning among mothers attending three Primary Healthcare Centres in Ikenne Local Government Area.
   1.  Hypotheses                                         

The following hypotheses were tested at 0.05 level of significance.

H_O1. There is no significant relationship between occupation and infant weaning      

         practices among mothers attending three Primary Healthcare Centres in Ikenne Local

         Government Area.

H_O2.There is no significant relationship between ethnicity and infant weaning practices among

        mothers attending three Primary Healthcare Centres in Ikenne Local Government Area.

H_O3.There is no significant relationship between educational level and infant weaning practices   

         among mothers attending three Primary Healthcare Centres in Ikenne Local Government       

        Area.

H_O4.There is no significant relationship between mothers knowledge level and infant weaning

         practices attending three Primary Healthcare Centres in Ikenne Local Government Area.

1.6 Scope of the Study

This study covered infant weaning knowledge and practices among mothers in Ikenne Local Government A rea, Ogun State. The study is limited by recruitment of participants

1.7 Justification for the Study

The study would help to establish inadequacy in infant weaning knowledge and practice among mothers and also provide baseline data for subsequent studies on infant weaning knowledge and practices among mothers.

This study would also help to provide recommendations for improving inadequacies in infant weaning knowledge and practices among mothers.

The study would also assist health institutions and the government at the federal, state and local level to plan strategies to improve infant weaning knowledge and practices among mothers.

1.8 Operational Definition of Terms

1. Weaning: introduction of supplementary food to a child’s diet after the first six months of life.
2. Mother: Women who has a child with age from birth to 24 months.
3. Knowledge: Mothers understanding regarding infant weaning as measured by knowledge score.
4. Practice: Mothers activity regarding infant weaning as measured by practice score.
5. Infants: children aged from birth to 24 months of age.

Ikenne local government area: A local government area in Ogun state.