Abstract:
Introduction: Despite the benefits of exclusive breastfeeding (EBF), mothers globally
have not reached the World Health Organization recommendation of six months. In many
Low and Middle Income Countries (LMICs), other liquids are added to infant‟s diet in
the first month of life, predisposing them to high morbidity and mortality. EBF for the
first six months could reduce infant mortality rate by 25%. LMICs‟ EBF is at 39% and
32% in Kenya.
Objective: To assess EBF practices among postnatal mothers attending child welfare
clinic at Kapsabet Referral Hospital- Nandi County, Kenya.
Methods: Simple random sampling was used. Data collection was by an interviewer
administered questionnaire and recorded narratives from 5 conducted focused group
discussions (FDGs). Both quantitative and qualitative research methods were used. Study
site was Kapsabet Referral Hospital- Nandi County, child welfare clinic and population
were postnatal mothers with infants‟ age 0-12 months old.
Data analysis: Quantitative data was coded and analyzed using statistical package for
social sciences (SPSS) version 21.Chi-square was used to establish associations;
Variance used to test for significant differences in the means. The critical value for
significance was p < 0.05. Qualitative data (FGDs) were transcribed, coded using an
Nvivo application software, common themes identified, analysed and inferences made by
triangulation.
Results: Six months exclusive breast feeding (EBF) was 20%. Mean knowledge on EBF
was 54%. There was association between knowledge and EBF (P = 0.0000, Chisquare=94.1614), between breast milk quantity and EBF (P = 0.0000, X2 = 261.08, OR =
3.00). Maternal parity influenced time of initiation of EBF and frequency of EBF (P =
0.0000, X2 = 107.9767).Time of breastfeeding initiations was a good predictor of EBF
(P-value = 0.0001 & variance = 0.0343).
Conclusions: EBF prevalence was at 20%, sub- optimal EBF was cited in FGDs to be
associated with infants‟ ill health, the participants mean knowledge on EBF was at 54%,
but the gap was in the practices of the same. Factors cited to hinder EBF were
employment, insufficient breast milk, culture and family influences, predictors of EBF
were mode of the delivery i.e. cesarean section and delays initiation of breastfeeding.
Recommendations: To the Ministry of Health Nandi County nurses / midwives and
nutritionists; you have responsibilities to increase awareness, promote and protect EBF
practices, address challenges faced by mothers in expressing and storing breast milk.
Address hindrances to EBF practices, such as influences of the relatives, culture and
ensure early initiation of breastfeeding regardless of mode of delivery.