Factors associated with exclusive breast feeding among mothers attending child welfare clinic at Moi Teaching and Referral Hospital, Uasin Gishu County, Kenya

Abstract

Introduction: Exclusive breastfeeding is the optimal way of feeding the infant; its health benefits on child and maternal wellbeing are documented. Promoting, protecting and supporting breastfeeding is paramount in meeting sustainable development goals by 2030; however, exclusive breastfeeding uptake in Kenya is sub-optimal. In spite of high rates of breastfeeding among mothers at Moi Teaching and Referral Hospital, the practices of EBF still remain low with 53.4 % mothers exclusively breastfeed their babies which is below the national level. Objective: To determine the knowledge, practice and barriers of exclusive breastfeeding among mothers attending child welfare clinic at Moi Teaching and Referral Hospital (MTRH). Methods: Descriptive cross sectional study design was used in this study. A total of 370 mothers with babies less than 6 months were systematically sampled and data collected using interviewer administered questionnaires. Data was presented using frequency tables, bar graphs and pie charts. The level of knowledge, and socio-demographic characteristics were measured against exclusive breastfeeding and associations between variables determined using Chi-square test. Univariate analysis was used to analyze the association between various factors that influence practice. Barriers of exclusive breast feeding were identified and multiple logistic regressions was used to determine the association. Results: The mean age of participants was 29.74 years. Among the participants 337 (92.6%) were knowledgeable on the concept of Exclusive Breast Feeding (EBF). Participants who practiced EBF were 356 (97%). Information on EBF was sought from the health care providers by 305(83.1%) of the mothers. There was an association between infant age and knowledge on appropriate time for complimentary feeds, χ 2 = 128.718, df. 96(p<0.015) and between age and number of times per day the baby is breastfed χ2 = 98.625, df.72, p<0.020. There was an association between maternal age and practice of EBF, χ2 = 370.144, df. 208, (p<0.031). Lack of breast milk 56(45%) was the reason mothers gave other feeds to the baby and a relationship between age and reasons for giving other food was significant (χ2 = 119.116, df. 72, p (0.00). Majority 293(80%) of the mothers experienced breastfeeding disorders, univariate statistics depicts a strong relationship between having a breast disorder and practice of exclusive breast feeding (F=16.049, df. 3, p (0.000). Conclusion: Majority of the mothers attending child welfare clinic were knowledgeable about the meaning and importance of EBF. Healthcare workers were the highest providers of information to mothers on practice of EBF. Younger mothers between the ages of 20-38 years were likely to adhere to the practice of EBF. Breast milk insufficiency was the main reason why mothers gave other feeds to the baby, while breast disorders were a major hindrance to the practice of EBF. Recommendations: This study recommends the healthcare providers and media channels to optimize the knowledge on exclusive breast feeding and create awareness timing of complimentary feeds according to the Baby friendly child birth initiative. Health information and support for extreme ages should be enhanced. There is also need to enhance partner, family, employer and community support on promotion and protection of EBF according to Maternal, Infant and Young Child Nutrition Policy and to enhance proper nutrition to the mother and proper breastfeeding techniques in the practice of EBF.