Abstract:

Exclusive breast feeding (EBF)means that the infant receives only breast milk with no other additional foods or liquid, not even water. Breastfeeding has many health benefits for both the mother and infant.

The aim of the study was to assess factors that hide exclusive breast feeding among the mothers attending Immunization clinic in Kericho county Hospital. The target population was all the mothers with children aged 0-6 months attending immunization clinic, Kericho County Hospital. The study design was descriptive cross-sectional study. Convenience sampling was used, as quite a number of women go for immunization at the hospital. All mothers (aged 18-49 years) with children 0-6 months old visiting Kericho County Hospital immunization clinic were included in the study. Fisher et al, 1998 was used to calculate the sample size, where 40 respondents were interviewed. Data was collected by use of a questionnaire. SPSS version 20.0 was used to analyze the data, which was summarized into percentages and presented in Text, figures, tables and graphs. Odd ratio was used to calculate the Respondents relationship distribution in terms of Education level versus Knowledge on EBF and Occupation versus complementary feeding.

Majority (62.5% ) of the respondents were aged 18-27 years followed by those with 28-37 years (25% ) while in the level of education, those with secondary were 55% , tertiary 20% and primary were 25% . For marital status, 50% were married, 32% single, 10% widowed, 5% separated and 3% divorced. The distributions for religion, 95% were Christians and only 5% were Muslims. In occupation self-employed were the majority 45% followed by those without employment at 35% and the employed at 20% .

The sources of exclusive breastfeeding as quoted by the respondents were Health center 50% , friends 25% , CHW 12.5, Books 7.5% and Childs grand-Mother 5% . On the duration of EBF, those who breastfeed for 6 Months were the majority at 62.5% , 4-5 Months at 25% and 0-3 Months at 12.5% . On whether the EBF is possible with HIV infected mothers, 75% answered yes and not possible at 25% and when asked how possible it was, 62.5% said through healthcare workers advice, 32.5% through EBF only and those who did not have an idea 5% .

On terms of the age of their children, respondents with 0-3 years were 60% and 4-6 months were 40% while 42.5% had introduced other feeds such as milk, porridge, fruits, water and 57.5 had not introduced the feeds. When requested to explain their reasons to introduce others feeds, 60% said it was because of work, advice from child’s grand-mother were 22.5% and those lucking enough milk were at 17.5% .

The odd ratio suggested that salaried respondents are twice more likely to introduce complementary than the non-salaried respondents while those with primary education were 6 times more likely to lack knowledge on EBF than the salaried. Despite high level of knowledge on exclusive breastfeeding, challenges affecting its optimal uptake there’s still need to address it in community in order to bolster its uptake. There’s need to return to work by breastfeeding mothers was noted as one of barriers of exclusive breastfeeding.

The county government should make necessary legislation to create supportive work. Environment for breasting mothers who are not covered by National Maternity Policy.

References:

[1.] Aatekah Owais, Shiyam S. Tikmani, Shazia Sultana, Umber Zaman, Imran Ahmed, Salim Allana and Anita K. M. Zaidi (2010) Incidence of pneumonia, bacteremia and invasive pnuemonoccal disease in Pakistani children. Tropical medicine & International health. 15(90), pg 1029-1036.

[2.] American Academy of Pediatrics. Breasting feeding and the use of Human milk. Pediatrics Vol. 29 (3)2012.

[3.] Arun Gupta, J. P. Dadhich, and Shoba Suri. How Can Global Rates of Exclusive Breastfeeding for the First 6 Months be Enhanced? ICAN: Infant, Child, & Adolescent Nutrition. Vol. x • no. x. 2013

[4.] County government of Kericho, Kericho sub-county Hospital Health records, 2015.

[5.] Denis, C. L. (2001 )Breastfeeding initiation and duration: A 1990-2000 Literature review. WHO report, 31(1 ).

[6.] Fisher AA, Laing JE, Strocker J E (1998) Handbook for family planning, operation research design in sampling. Population Council. 40-45.

[7.] Foss, K. A. & Southwell, B. G (2006) Infant feeding and the media: the relationship between parents magazine content and breastfeeding. 1972-2000. International breastfeeding journal. 1(10)pg 1 -9

[8.] Goldman, A. S., Hopkinson, J. M., Rassin D K (2017)Benefits and risks of breastfeeding. Advances in pediatrics. Vol. 54(1 )pg. 275-304. 14

[9.] Jessri, M., Farmer, A. P., & Olson, K. (2013). Exploring middle-eastern mother’s perceptions and experiences of breastfeeding in Canada: An ethnographic study. Maternal & child nutrition.

[10.] Juana Willumsen (2013) breast feeding education or increased duration: biological, behavioral and contextual rationale. Dept of nutrition for health and development, WHO, Geneva. Accessed on 12th March, 2015.

[11.] Kosmala-Aderson, J., & Wallace, L. M (2014) Breastfeeding works: The role of employers in supporting women who wish to breastfeed and work in four organizations in England. WHO journal of public health. 28(3)pg. 183-191 .

[12.] Kenya National bureau of statistics, (2010)The Kenya national health survey 2008-2009. Nairobi Kenya

[13.] Kimani-murage, E., Wekesah, F., wanjohi, M., Muriuki., Kwobutungi, C., Norris, S., & Griffiths, P (2013) “Because most mothers are hustlers’’: Challenges of an urban poor 15 breastfeeding mothers in Nairobi slums. In Annals of Nutrition and metabolism. Vol. 63, pg 742-742. Basel, Switzerland.

[14.] Raiser, N. S., Laudermilk, M. J., West, J. L., Thompson, P. A & Thomson. C. A(2011 ) recruitment of lactating women into a randomized dietary intervention: Successful strategies and factors promoting enrollment and retention. Contemporary clinical trials. 32(4).

[15.] Rita, 2012 Accessed from

www.consultancyafrica.com/index.php?option=com_content&view=article&id=1180:knowledge-attitudes-and-practices-regarding-exclusive-breastfeeding-in-southern-africapart-2&catid=61:hiv-aids-discussion-papers&Itemid=268. Accessed on 12th March, 2015

[16.] Shazia Memon et. al, (2010)Assessment of infant feeding practices at a tertiary care hospital, Journal of Pakistani Medical Association, Vol. 60, (12)December, 1010-1015.

[17.] Tomasoni, L. R., Moche G., Declich, S., Pietra, V., Croce, F., Pignatelli, S., Castelli, F (2011 )Knowledge , altitude and practice regarding newborn feeding modalities in HIV - infected and HIV uninfected pregnant women in sub-Saharan Africa: A multicenter study. International health journal. 3(1 )pg 56-65.

[18.] UNICEF (2007)The state of the world’s children 2008. Child survival. Vol. 8, UNICEF.

[19.] Vieth, R., Bischoff-Ferreri, H., Boucher, B. J., Dawson-Hughes, B., Garland, C.F., Heaney, R. P & Zittermann, A (2007)The urgent need to recommend an intake of vitamin Dthat is effective. The American journal of clinical medicine nutrition 85(3)pg 649-650.

[20.] www.en.wikipedia.org/wiki/Breastfeeding.Assessed 6th March, 2015.

[21.] www.jica.go.jp/kenya/english/office/topics/topics100908.html.Accessed on 7th March, 2015.

[22.] WHO (2010) Guidelines on HIV and infant feeding 2010: Principles and recommendations for infant feeding in the context of HIV and a summary of evidence.