CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

Adequate infant feeding and weaning practices are crucial for the wellbeing of
infants.

World Health Organization (2023a) recommended early initiation of breastfeeding

within

1 hour of birth; exclusive breastfeeding for the first 6 months of life and
introduction of

nutritionallyadequate and safe complementary (solid) foods at 6 months

together with

continued breastfeeding up to 2 years of age or beyond. It also reported that

about 44%

of infant 0-6 months are exclusively breastfed, few children receive

nutritionally

adequate and safe complementary foods; in many countries, less than a fourth of
infant

6-23 months of age meet the criteria of dietary diversity and feeding frequency
that are

appropriate for their age. WHO further reported over 820,000 children’s life
could be

saved every year among children under age of 5 years, if all the children from
0-23

months are optimally breastfed.

Breast milk is the ideal for infant (WHO, 2023b). It is safe, clean and contain
antibodies

which help protect against many common childhood illnesses.Breast milk

provide all

the energy and nutrient that the infant needs for the first month of life and it
continue to
ovarian cancers (WHO, 2023b).

Breastfeedingchildren exclusively during the first 6 months of birth confer the

baby with

a passive immunity that is essential in the absenceof a well-developed immune

system.

Moreover, the children are supplemented with complementary food after 6

months to

meet the increasing nutritional requirements necessary for growth and

development.

This process is defined as weaning and mothers who carryout weaning must be
well

informed about the timing and types of complementary food along with other
aspects

of nutrition (Nuzzi et al., 2022). Improper nutrition could predispose

children to

irreversible cognitive damage and affect their physical and psychological

health.

Considering the importance of complementary food and because there is no

specific

guideline about the composition and quality of such food, it is essential for
mothers to

improve their knowledge. Moreover, the low nutritional value of

complementary food

predisposes children to stunted growth, low immune system responses

and

cardiovascular diseases (Jabeen et al., 2022).

Globally, infant feeding which include patterns of breastfeeding, the use of

formula

feeding, solid foods, other complementary foods and liquid still fallshort of
UNICEF

recommendation. According to WHO(2023a), about 149 million children under 5

were
system(Parker et al.,2021). The withdrawal of breastfeeding, turn to weaning
and the

nature of complementary feeding differ with the social, cultural, economic

and

geographical patterns globally (Babik et al., 2021).

Although many studies have been carried out on infant feeding and weaning
practices,

but there were no same studies conducted in Federal Medical Center Umuahia ,
Abia

State, Nigeria. Therefore, the aim of this study is to determine breastfeeding

practices

and common weaning diets used by postpartum mothers attending Immunization

clinic

in Federal Medical Center, Umuahia Abia State.

STATEMENT OF PROBLEMS

Globally, under nutrition is estimated to be associated with 2.7 million child

dead

annually or 45% of all child dead (WHO, 2023a). The United Nations Children
Fund

(UNICEF) and World Health Organization (WHO) have decried the poor
exclusive

breastfeeding status of nursing mothers in Nigeria, as over 70% of the

infants are

denied its benefits. According to Aniete &Waliat (2022), in Nngeria the

exclusive

breastfeeding rate is 29%, meaning that over 70% of infant in Nigeria are
denied the

aforementioned benefits of breast milk in their formative years. Despite

people’s

awareness campaign programs by the government and stakeholders, while on

hospital
Federal Medical Center Umuahia, Abia State.

OBJECTIVES OF THE STUDY

 To assess breastfeeding practices used by postpartum mothers.

 To assess weaning practices used by postpartum mothers.

 To identify common complementary foods used by postpartum mothers.

RESEARCH QUESTIONS

 What are the breastfeeding practices used by postpartum mothers?

 What are the weaning practices used by postpartum mothers?

 What are the common complementary foods used by postpartum mothers?

SIGNIFICANCE OF THE STUDY

This study helps to assess breastfeeding and weaning practices by

postpartum

mothers. The result of this study will serve as evidence for counseling mothers
on the

choice of a safer infant nutrition. It will further inform evidence-based but

government

targeted intervention programs towards an improved exclusive breastfeeding

initiation

and duration by postpartum mothers. This will do by adding more support to

already

existing knowledge on breastfeeding and weaning practices.

The finding of this study would result in enhanced exclusive breastfeeding and
weaning
child health practitioners and midwives were to use it in crafting maternal and
child

health intervention programs on breastfeeding . It will eventually serve as

reference for

future empirical studies on related topics.The researcher is of the opinion that a

study

of this nature might help to provide information for evidence based practice and
further

assist women and parents in making informed mother and child health
related

decisions.

SCOPE OF THE STUDY

The study is delimited to assessing breastfeeding and weaning practices

among

postpartum mothers of childbearing age (15-49 years) in Federal Medical

Center,

Umuahia, Abia State, Nigeria. It is delimited to mothers at 20-26 weeks

postpartum.

Firstly, because anecdotal reports has it that mothers are most tempted to wean
around

20-26 weeks (a period of infant’s frequent feeding and rapid growth); secondly
because

many mothers at 20-26 weeks postpartum routinely report to health

facilities for

routine immunization of their infants hence opportunity for a large accessible

target

population ; thirdly because streamlining the postpartum period to 20-26 weeks

ensure
 of time of commencement of breastfeeding. It will be graded as adequate
(mean

>30 minutes) and inadequate (mean <30 minutes).

 Weaning practice: For the purpose of this study, it will be measured in

terms of

time of commencement of other oral foods apart from breast milk. It

will be

graded as adequate (mean >6 months), and inadequate (mean <6 months).

 Postpartum mothers: For the purpose of this study, postpartum mothers

refers

to women (15-49 years) who gave birth to a living infant 12-16 weeks,
and

nutritionally caring for the living infant.

 Infant feeding: For the purpose of this study, infant feeding refers to
infant (0-1

year) receiving breast milk directly from the breast of the mother.

CHAPTER TWO

LITERATURE REVIEW

The literature related to the study will be reviewed under the following headings:

 Conceptual review.

 Theoretical review.

 Empirical review.

CONCEPTUAL REVIEW
Breastfeeding is one of the most effective ways to ensure child health and
survival

(WHO, 2023b). In the view of WHO/UNICEF (2020), breastfeeding refers a

child

receiving breast milk directly from the breast of a woman.Breastfeeding also

called

nursing and chest feeding, is feeding a baby human milk from the breast, usually
breast

milk is giving directly from the breast (Kathi, 2021).

WHO (2023a) recommends early breastfeeding within 1 hour of birth,

exclusive

breastfeeding for the first 6 months of life and introducing a nutritionally

adequate and

safe complementary (solid) foods at 6 moths together with continue

breastfeeding up

to 2 years of age or beyond.According to Mercedes et al. (2022), the scaling

up of

breastfeeding to near- universal level internationally could prevent 823,000

annual

deaths in children younger than 5 years and 20,000 annual dead from breast
cancer.

BENEFITS OF BREASTFEEDING TO THE CHILD

1. Breast milk provides ideal nutritionfor babies. Breast milk contains every
nutrient

baby needs for the first 6 months of life, in all the right proportion.

2. Breast milk contains important antibodies, this particularly applies to

colostrum
 babies risk from many illnesses and diseases including, middle ear
infection,

respiratory tract disease, cold and Infections, gut infections, diabetes,

allergic

diseases, bowl diseases, childhood leukemia etc.

4.

Breastfeeding improves infant cognitive development. Breastfed children

have

higher intellectual development and are less likely to develop

behavioral

problems.

1.
BENEFITS OF BREASTFEEDING TO THE MOTHER

Breastfeeding helps the uterus contract. Oxytocin released during

breastfeeding
2.
helps the uterus to return to its pre – gravid size, known as involution.

Breastfeeding enhances weight loss. It burn more calories and after 3

months of

3. lactation, there will be increase in fat burning compare to non –

lactating

mothers

Breastfeeding lower risks of depression. Postpartum depression (PPD) is a

4. type

of depression that can develop shortly after child birth. Women who
breastfeed

are less likely to develop postpartum depression.

5.
Breastfeeding reduces disease risks. Breastfeeding provides long
term

8
 6. Breastfeedingsaves time and money.

BREASTFEEDING INITIATION

Broadly speaking, breastfeeding initiation refers to the period of

commencement of

breastfeeding after birth. The American Academy of Pediatrics (AAP) and the
American

College of Obstetricians of Gynecologists (ACOG) has increasing research

evidence and

suggest that early skin to skin contact (also called kangaroo care) between
mother and

child stimulate breastfeeding behavior in the baby. Infant who are allowed
uninterrupted

skin to skin contact immediately after birth and who self- attach to the mother’s
nipple

may continue to nurse more effectively (Autisticeditor, 2023).In addition to

more

successful breastfeeding and bonding, immediate skin to skin contact reduces

crying

and warms the baby. Based on this, WHO(2023a), recommends the

commencement of

breastfeeding within 1 hour of birth as a standard for concept of breastfeeding

initiation.

The characteristics associated with this practice have been little investigated
however,

certain facilitating factors have already been described. previous studies show
that new

born, whether premature or full term who have skin to skin with their mothers
have

better and more stable physiological function than new born who do not have
skin to

skin care (Bigelow & Michelle, 2020).

solid with the exception of medicine (WHO,2024).According to WHO (2023c),
exclusive

breastfeeding (EBF) is the situation in which an infant receives only breast milk
from

his/her motheror wet nurse for the first 6 months and no other solid or liquid
with the

exception of drugs or syrup consisting of vitamins, minerals, supplements or

medicines.

The world health organization (WHO) recommends exclusive breastfeeding

until the

age of 6 months, and then to start adequate and safe complementary feeding of
other

liquid and food with continual breastfeeding up to 2 years of age or beyond.

This has

been widely accepted as standard for the concept of exclusive

breastfeeding in

professional nursing and midwifery council.

COMPLEMENTARY FEEDING

Complementary foods or top-ups are foods given to the baby after a

breastfeed.

Complementary foods of breast milk substitutes (formula milk) should be given

as a

last resort, not as an alternative to helping the mother with breastfeeding or

expressing

milk.

WHO(2023a) recommends introduction of nutritionally adequate and

safe

complementary (solid) foods at 6 months of age or beyond. The transition

from

exclusive breastfeeding to family foods is referred to as complementary

feeding.The