THE ATTITUDE OF WORKING CLASS MOTHERS TOWARDS EXCLUSIVE BREASTFEEDING IN KARU LGA NASARAWA STATE.

THE ATTITUDE OF WORKING CLASS MOTHERS TOWARDS EXCLUSIVE BREASTFEEDING IN KARU LGA NASARAWA STATE. Abstract: The study on working mothers attitude and practice of exclusive breastfeeding in KARU. The respondents were selected through simple random sampling. In all a total of 324 were sample for the study. Data was collected randomly from various immunization clinics in KARU, and analyzed using simple percentage methods. The findings showed that the variables like mothers level of knowledge, mother's attitude towards exclusive breastfeeding, mothers, level of education among others were all significant to their practice of exclusive of breastfeeding, while cultural beliefs are not associated with exclusive breastfeeding practice. In conclusion, the study recommended for better practice of exclusive breastfeeding. More education for mother's and the general public on the benefits and need for exclusive breastfeeding. Also the extension of maternity leave to enable other's have enough time to practice exclusive breastfeeding, and provision of creches in all offices to enable working mothers breastfeed their babies properly and teaching of mothers ways of expressing of o breast milk and storage of expressed breast milk so as to improve the rate of exclusive breastfeeding practice by working mothers and the society at large. Keywords: Working-Mother, Attitude, Practices, Exclusive-Breastfeeding, KARU NASARAWA STATE CHAPTER ONE INTRODUCTION Breastfeeding is a natural process of infant feeding involving two main methods; exclusive and partial with the latter being trendiest. Nevertheless, exclusivity is the absolute and suitable scheme with finest domino effect. However, a good mental, emotional and physical collaboration between the mother and her newborn for desired outcome (Khresheh 2011). Breast milk consists of basic nutrients containing proteins, vitamins and carbohydrate. However, presence of minerals fulfills micronutrient needs and maternal antibodies improves the immune system inhibiting infantile infections like gastrointestinal, respiratory and skin infections and increases physical and neurological growth of the baby. There is increased production of hormones that are responsible for uterine contraction, preventing hemorrhage and maternal mortality. Lactational amenorrhea is mentioned as a natural contraceptive benefactor following exclusivity. On the other hand, breast cancer and ovarian cancer risk prospects are reduced with weight loss preventing early cardiac morbidity and mortality. (Fairbrother & Stanger-Ross 2009.) During 1940s, exclusive breastfeeding was a communal tradition in all corners of the globe; subsequent to the World War II the ritual instigated to diminish and converted to modern trend in the use of fabricated formula milk particularly in the western world in contemporary eras. The nutrients become inevitable as it started to become widespread despite the advice and presage from World Health Organization (WHO) which recommends exclusive infant breastfeeding for the first six months of life and continuing up to two years of age and beyond United Nations Children’s Fund (UNICEF) and Baby Friendly Organization in order to restore the Primitive Tradition. (Coates 2007.) Essentially, mother's milk has antibodies which are not present in infant formula. These antibodies are what protect the body and the boost the immune system of infant to enable them fight disease. The human milk in the right proportion also helps in robust and all round development of re infant (Jones, 1993: Tiwari, Zahariya and 2008). Hence absence of such antibodies and lack of adequate nutrients and vitamins in infant's formula, also the easy contamination of bottles and other artificial feeding methods exposes the infants to various diseases like respiratory tract disease, skin infection, diahorrea which is a serious problem in infants (Jone, 1993). Exclusive breastfeeding is encouraged and recommended to all mothers worldwide with efforts being made both in the private and public sector as a way of achieving the Millennium Development Goals (MDGs) on improving maternal health. These efforts are also directed at reducing infant morbidity and mortality related to mixed-feeding as breast milk is very vital for the newly born babies. According to UNICEF (2010), exclusive breastfeeding is giving baby breast milk only and nothing else, not even sips of water except for medicines prescribed by the doctor or nurse for the first six months of life. According to World Health Organization (2006), in 1991, United Nations International Children’s Fund (UNICEF) and World Health Organization (WHO) began an international campaign called Baby Friendly Hospital Initiative. This initiative was meant to promote, protect and support breastfeeding. Most hospitals in Nigeria have Baby Friendly Initiative. One of the ten steps for Baby Friendly Initiative states that there should be no advertising of formula products used for babies under six months. In line with this agreement, Nigeria prohibits the advertisement of such products on all media in an effort to promote exclusive breastfeeding. Consequently, this necessited the Innocent Declaration commendation of 1990 by WHO/UNICEF Policy makers that all infants should be fed exclusively on breast milk from birth to 6 months of age (Galtry, 2003). However, this clarion call is to be answered by all mothers, in our contemporary society women are actively involved in paid job which has strict laws and codes of conduct which may not enable them have adequate time, to practice exclusive breastfeeding. In this study the researcher sets out to unravel those socio-economic determinates of exclusive breastfeeding among working mother's in KARU in order to give recommendations that will help improve the rate of exclusive breastfeeding. Breastfeeding has been accepted as the most vital intervention for reducing infant mortality and ensuring optimal growth and development of children (Gupta & Arora, 2007). Breastfeeding is the ideal method suited for the physiological and psychological needs of an infant (Subbiah, 2003). It is estimated that sub-optimal breastfeeding, especially non-exclusive breastfeeding in the first 6 months of life, results in 1.4 million deaths and 10% of the disease burden in children younger than 5 years of age (WHO, 2009). Exclusive breastfeeding (EBF) for the first 6 months of life improves the growth, health and survival status of newborns (WHO, 2003) and is one of the most natural and best forms of preventive medicine (WHO, 2001). EBF plays a pivotal role in determining the optimal health and development of infants, and is associated with a decreased risk for many early life diseases and conditions, including otitis media, respiratory tract infection, diarrhoea and early childhood obesity (Ip et al., 2007). It has been estimated that EBF reduces infant mortality rates by up to 13% in low-income countries (Jones et al., 2003). A large cohort study undertaken in rural Ghana concluded that 22% of neonatal deaths could be prevented if all infants were put to breast within the first hour of birth (Edmund et al., 2006). Reviews of studies from developing countries show that infants who are not breastfed are 6 to 10 times more likely to die in the first months of life than infants who are breastfed (WHO, 2000; Bahl et al., 2005). Some researchers have proposed that lack of suitable facilities outside of the home, inconvenience, conflicts at work, family pressure and ignorance adversely affect the willingness of women to practise EBF (Ogbonna et al., 2000; Forbes et al., 2003). The need to return to work has also been implicated as a factor interfering with EBF (Mahgoub et al., 2002). The Nigerian government established the Baby-Friendly Hospital Initiative (BFHI) in Benin, Enugu, Maiduguri, Lagos, Jos and Port Harcourt with the aim of providing mothers and their infants a supportive environment for breastfeeding and to promote appropriate breastfeeding practices, thus helping to reduce infant morbidity and mortality rates. Despite these efforts, child and infant mortality continue to be major health issues affecting Nigeria. The infant mortality rate for the most recent five-year period (1999-2003) is about 100 deaths per 1,000 live births. The objective of the present study is to investigate the attitude of working mothers to exclusive breastfeeding (EBF) in Karu L.G.A., Nasarawa State, Nigeria. Background Breastfeeding is the act of milk transference from mother to baby that is needed for the survival and healthy growth of the baby into an adult. Breastfeeding creates an inimitable psychosocial bond between the mother and baby, enhances modest cognitive deve lopment and it is the underpinning of the infant’s wellbeing in the first year of life even into the second year of life with appropriate complementary foods from 6 months. Furthermore, breastfeeding reduces the risk of neonatal complications, respiratory and other varieties of illnesses. Based on anecdotal and empirical evidence on the benefits of breastfeeding to the mother and baby, the World Health Organization (WHO)has recommended 2 year breastfeeding; first 6 months exclusive breastfeeding; more than 8 times breastfeeding of the baby per day in the first 3 months of an infant’s life. The WHO and the United Nations Children’s Fund (UNICEF) global effort to implement practices that protect, promote and support breastfeeding through the Baby-Friendly Hospital Initiative has recorded attendant successes. However, a gamut of factors not limited to race and cultural beliefs, maternal characteristics, infant health problems, socio-economic status and some psychosocial factors may hamper the full realization of the baby-friendly initiative. Information about the beliefs and knowledge that may constitute barriers and in turn influence practices are needed in order to optimally utilize the benefits of the baby-friendly initiative. Consequently, a number of studies have assessed knowledge, attitude and practice of breastfeeding in different parts of the world; however, such studies are limited among Nigerian mothers. Furthermore, there is an apparent dearth of empirical data on breastfeeding techniques among nursing mothers in sub-Sahara Africa (SSA). This study assessed breastfeeding knowledge, attitude and techniques of postures, positioning, hold practice and latch-on among Nigerian mothers. ADVANTAGES OF BREASTFEEDING FOR THE INFANT 1. Provision of essential and adequate nutrients to the infant at the right temperature and with minimum stress to the absorptive capacities of the baby. 2. Reduces the sickness rate of children e.g. gastroenteritis and respiratory infections. 3. Reduces the incidence of allergic disorders. 4. Provides bonding between the mother and child, hence, improving the psychosocial development of the child. 5. It is hygienic, safe and always available to the infant. FOR THE MOTHER 1. Provides satisfaction to the mother. 2. Protects against breast and ovarian cancers. 3. Aids faster involution of the uterus with reduction in post partum morbidity. 4. Protects against early pregnancy post delivery. STATEMENT OF THE PROBLEM There has been an increase in infant mortality due to diarrhoeal diseases and illnesses, associated with malnutrition since the introduction of bottle feeding in our society. The economic burden on families and the community has substantially increased with bottle feeding and use of infant formulas. OBJECTIVES OF THE STUDY 1. To assess the knowledge of nursing mothers regarding exclusive breastfeeding. 2. To verify their attitudes and practices of exclusive breastfeeding. 3. To determine the factors that influence their attitudes and practices. RESEARCH QUESTIONS The purpose of this study was to investigate types of primigravidas´ knowledge regarding exclusive breastfeeding, to explore attitudes they have towards and identify the possible challenges they experience during exclusive breastfeeding period. The goal of the study was to provide knowledge for nurses and the professional teams to acquire the authentic depiction regarding exclusive breastfeeding by new mothers. The research questions included: 1. What kind of knowledge primigravidas had concerning exclusive breastfeeding? 2. What were the attitudes of working class mothers towards exclusive breastfeeding? 3. What were the possible challenges that primigravidas experience during exclusive breastfeeding period?