Assessment of exclusive breastfeeding among postnatal mothers attending child welfare clinic at Kapsabet referral hospital - Nandi county, Kenya

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.