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Title: Assessment of Exclusive Breastfeeding among Mothers Attending Immunization Clinic in Kenya: A Case S

Article Number: EC2/2015/021

Authors: Taratisio Ndwiga

Topic: Public Health


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 28-37years (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.


    COMMENT - 1

  • Dr. AJIT V PANDYA (Viewer) 16th Nov 2015 - 12:07 PM
    good morning dr ajit pandya from ahmedabad,,india

    my question are....1. how it increases immunisation in baby feeding from mother...?
    .....2. how many different types of vaccines are recommended to mother and baby ?
    ......3 when the baby get immunisation from mother (antibldies)..are not getting digested in baby ?
    • NDWIGA TARATISIO (Author) 16th Nov 2015 - 3:20 PM
      1. On average, breast-fed babies have fewer infections in their early life. The main reason for this is that antibodies are passed in the breast milk from mother to baby. Antibodies are proteins that help to fight infection. Compared with babies who are not breast-fed, babies who are breast-fed have less diarrhoea and are sick (vomit) less; they have fewer chest infections and fewer ear infections.
      2. There are several types. Tdap An example of a vaccine that should be given during pregnancy, between 27 and 36 weeks gestation, is the Tdap, which protects against pertussis ‘whooping cough’ as well as diphtheria and tetanus. Another example of a vaccine that should be given during pregnancy is the inactivated or shot form of the flu vaccine. A vaccine against hepatitis B may be recommended during pregnancy. A vaccine against hepatitis A may be recommended if the mother has a history of chronic liver disease.
      3. When a mother comes into contact with germs in her environment, she makes antibodies to fight those germs. These antibodies pass into the breastmilk and therefore into the baby. Since a mother and her baby are generally in contact with the same germs, this helps to protect her baby from the illnesses they are both exposed to. The main type of antibody in breastmilk is IgA. IgA antibodies protect the internal surfaces of the body, such as the mouth, stomach, intestines and lungs. They are not digested by the baby, they just coat the gut and block the entry of infections that could otherwise cause illness.
      A mother who breastfeeds her baby passively transfers antibodies in breast milk to her child. Although this is one way of protecting a newborn baby against infectious disease it is still very important to immunize newborn babies according to the recommended immunization schedule.

  • COMMENT - 2

  • Dr. AJIT V PANDYA (Viewer) 16th Nov 2015 - 5:12 PM
    i am aspecting answers for above questions as part of general discussion....
    • NDWIGA TARATISIO (Author) 16th Nov 2015 - 9:12 PM
      Dr pandya, I hope you got my answer.
    • NDWIGA TARATISIO (Author) 19th Nov 2015 - 6:29 PM
      Dr. AJIT V PANDYA, a) -the body of exclusively breastfeed baby quickly response to the vaccines
      - EBF helps distract pain during administration of vaccines as the baby suckles.
      b)Types of vaccines recommended to the mother and the baby.
      Vaccines recommended to the mother
      -tetanus toxoid.

      vaccines recommended to the baby
      - BCG
      - OPV
      - rotavix
      - measles
      - PCV

      .c).....3 when the baby get immunisation from mother (antibldies)..are not getting digested
      in baby ?
      - the antibodies from the mother are not digested in body of the baby, they just coat gut and block the entry of infection that could otherwise cause disease.

  • COMMENT - 3

  • OBAJEMU ALICE OLUWATOSIN (Viewer) 17th Nov 2015 - 1:33 PM
    This is a job well done. Athough, I think you should have summarised your abstract better. What are your recommendations about the educational level of nursing mothers as related to EBF. Is there any relationship between the level of education and yielding to exclusive breastfeeding among these mothers?

  • COMMENT - 4

  • NDWIGA TARATISIO (Author) 17th Nov 2015 - 4:52 PM
    Thanks for the questions. I tried to capture everything in the abstract and that's why its a bit long. The recommendations on the educational level of mothers related to EBF are captured in recommendation 3. The relationship between he level of education and yielding to exclusive breastfeeding among these mothers is on Pg 9 paragraph 2. thats is those who had the highest level of education also had more
    knowledge on exclusive breastfeeding as confirmed by the odd ratio.

    Hope i have answered your question.

  • COMMENT - 5

  • MACLAWRENCE KOLAPO OYEYEMI FAMUYIWA (Viewer) 17th Nov 2015 - 11:16 PM
    Without mincing words you have made an encouraging attempts in presenting a good research article, kudos to you. but I also feel you would have done a great deal of this attempt by you including the confidence interval (CI) especially at 95% of your Odd ratio to show its precision, also you did not include the p-values which would have shown the statistical significance of these your variables. I also believe that you ought to have eliminated confounding variables by doing stratification or multiple regression of your values to produce adjusted odd ratio, so as to colour your beautiful work in a more scientific garb. All the same, it is a beautiful piece, and I wish you the best in this beautiful world of research.
    • NDWIGA TARATISIO (Author) 18th Nov 2015 - 11:56 AM
      Thanks my friend MACLAWRENCE KOLAPO OYEYEMI FAMUYIWA for the encouragement. All the comments will be included in the final paper.

  • COMMENT - 6

  • OLUKAYODE ALEWI (Viewer) 19th Nov 2015 - 11:51 AM
    Thank you for this study, Ndwiga. In line with your study aim- to ''assess factors that hide exclusive breastfeeding among the mothers...." , you mention in your results that 20 % of the study population were not aware of exclusive breastfeeding; what is (are) the factors responsible for this unawareness?
    Thank you

  • COMMENT - 7

  • UMWANGANGE MARIE LOUISE (Viewer) 19th Nov 2015 - 3:49 PM
    Thank you Ndwiga for your work.What do you think to involve men in strengthening the exclusive breastfeeding habit, as we know in African countries culture, men are influencing familial decision making, and when men really understand the role of exclusive breastfeeding, it will become easier to abide to that healthy habit.
    Regarding the article, what do you think about the small sample size? Do you think the results from the sample could be generalized to whole county?
    On the other hand, What is the writing style used? If APA was used, you should adjust the reference list according to APA. Thank you for your effort.

  • COMMENT - 8

  • NDWIGA TARATISIO (Author) 20th Nov 2015 - 7:37 PM
    Thanks Kayode alewi alewi for your question. The factors responsible for the lack of awareness are: Low level of education amongst the mothers which results in failure to understand the need to attend antenatal clinics where EBF message is disseminated. Another factor is failure of health professionals to conduct EBF campaigns from door to door.

  • COMMENT - 9

  • NDWIGA TARATISIO (Author) 20th Nov 2015 - 7:42 PM
    Thanks for your question Umwangange Marie Louise. Involving men can indeed boost the uptake of EBF. When they fully understand the health benefits of EBF the can give support e.g. by excusing their wives from some domestic chores for them to exercise EBF. The sample size is not a representative of the whole county since it was carried out in cosmopolitans’ urban area with diverse economic factors. More research is therefore needed to include the rural areas of the county. The APA style was used. all the corrections including this one will be done and APA formatt done for the references. Thank you once again.