Newborn cord care practices and knowledge among postnatal mothers at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Introduction: Neonatal period represents the most vulnerable time for child survival. Although improved cord care around the time of birth reduces the incidence of neonatal death, umbilical cord infections continue to cause a significant number of neonatal mortalities globally. To reduce these cord infections, the World Health Organization recommends that the umbilical cord be cleaned with chlorhexidine, or any other antiseptic solution. Despite these recommendations, diverse cord care practices, with some resulting in fatal infections have been reported in Asia, West and East African countries. The cord care practices in Moi Teaching and Referral Hospital (MTRH) have, however, not been clearly evaluated. Objective: To evaluate newborn cord care practices, assess the level of knowledge and determine factors associated with cord care practices. Methods: A cross-sectional descriptive study was done at (MTRH) among 114 conveniently sampled postnatal mothers attending child welfare clinic. A semistructured researcher-administered questionnaire was pilot-tested and used for data collection. Data were analysed using Statistical Package for Social Sciences version 20. Descriptive statistics including mean, standard deviation and range were computed for continuous variables while frequencies were computed for categorical variables. Chi-square test was used to check for association between categorical variable and cord care practices. Results: The study results showed that 73(64%) of the mothers used chlorhexidine on the cord, 9(8%) used surgical spirit while 17(14.9%) did not apply anything on the cord. Fourteen (12.9%) respondents applied either breast milk, saliva, soil, shea butter or ash on the baby‟s cord. Although most of the mothers (n = 94, 82.5%) were knowledgeable on cord cleaning and the need for hand hygiene during cord cleaning, some had inadequate knowledge on signs of umbilical cord infection. Mothers who attended four antenatal clinic visits were more likely to practice recommended cord care (χ 2 =16.02, p. = 0.03). Conclusions: Although most of the mothers used chlorhexidine for cord care, a significant number used substances considered harmful to the cord. Mothers had knowledge on cord cleaning and importance of hand hygiene, however, few did not know signs of an infected cord. Antenatal clinic visits were associated with better cord care practices. Recommendations: Mothers should be encouraged to attend the recommended antenatal clinic visits where information on cord care is provided. Future observational studies should focus on documenting the actual cord care practices of mothers.