FACTORS INFLUENCING THE PRACTICE OF EXCLUSIVE BREASTFEEDING AMONG WORKING CLASS MOTHERS

        CHAPTER ONE

             INTRODUCTION

1.1     Background of the study

Breastfeeding is an unequaled way of providing ideal nutrition for the healthy growth and development of infants. The global public health recommendation is that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health (WHO, 2003). Exclusive breastfeeding in the first six months of life stimulates babies’ immune systems and protects them from diarrhea and acute respiratory infections, two of the major causes of infant mortality in the developing world and improves their responses to vaccination (UNICEF, 2006).

         Exclusively breastfed infants obtain most of the nutrients required to support growth until six months. Vitamin D which is insufficient in breast milk is supplemented by exposure to sunlight for the skin to synthesize it while iron and zinc are supplemented by prenatal stores (Garza, 2002). Exclusive breastfeeding during the initial months of life and continued breastfeeding through at least the first year of life is associated with substantial reduction in the burden of infections (Fisk et al., 2010; Arifeen et al., 2001; Brown et al., 1989). Breastfeeding reduces the mother's risk of fatal postpartum hemorrhage, the risk of breast and ovarian cancer, and of anemia, and by spacing births, breastfeeding allows the mother to recuperate before she conceives again (Leon-Cava et al., 2002).

Over the years breastfeeding has been regarded as the best way of feeding new borns by mothers as it is healthier and natural, it is a way of fulfilling their God given roles as mothers who are the nurtures of family life. The reason having being that breast feeding has been accepted as the most vital intervention for reducing infant mortality and ensuring optimal growth and development of children as it contains antibodies and lymphocytes that help the body resist infections Gruptal and Arora (2007).

In Nigeria, the level of infant mortality is rated among the highest in the world. This is attributed to, among other factors such as non-practice of exclusive breastfeeding by working class mothers in Nigeria Yewande as reported by Oyebade (2013). According to the 2003 Nigeria Demographic Health Survey (NDHS) exclusive breastfeeding rate was 17%. In 2008 it was rated 13% with 34% of infants aged 0-5 months who were given plain water in addition to breast milk, while 10% were given milk other than breast milk. Then rated 17% in 2013. Despite progress in some countries, Nigeria is still with a low percentage of infants exclusively breastfed to the age of 6 months as expressed by the NDHS.

This is in line with the report by World Health Organization (2009), that sub-optimal breast feeding especially non-exclusive breastfeeding in the first 6 months of life, results in 1 million deaths and 10% of the disease burden in children younger than 5 years of age. Accordingly the United Nations Children Education Fund (UNICEF) in 2012 stated that the leading cause of death among children under age five are pneumonia, diarrhea, malaria and under nutrition. It is estimated that 22% of new born deaths of these diseases would be prevented if exclusive breastfeeding started within the first hours of births. To this end, Adekoya (2013), opined that infants who are not exclusively breastfed are 15 times more likely to die from pneumonia and 11 times more likely to die of diarrhea than those who are exclusively breastfed for the 6 months of life.

Fewtrell (2007) defined exclusive breast feeding as a means that an infant receives only breast milk with no additional foods or liquids not even water WHO and UNICEF (2009), the recommended that children be exclusively breastfed no other liquids, solid food or plain water during the first six months of life. However, appropriate infant feeding practices are needed if Nigeria is to reach the child survival Millenium Development Goals (MDGs) of reducing infant mortality from about 100 deaths per 1000 live births to a target of 35 deaths per 1000 live births. On this note the Nigerian government established the Baby Friendly Hospital Initiative (BFHI) in Benin, Enugu, Maidugri, Lagos, Jos and Port-Harcourt with the aim of providing mothers and their infants a supportive environment to promote appropriate exclusive breastfeeding practices, thus helping to reduce infant mortality. Despite these efforts child and infant mortality continue to be major health issues affecting Nigeria. Exclusive breastfeeding rates in Nigeria continue to fall well below the World Health Organization and United Nations Children Fund recommendation of 90% exclusive breastfeeding in children less than 6 months WHO (2009).

A more detailed understanding of the factors that influence the practice of exclusive breast feeding (EBF) in Nigeria is needed to develop effective interventions to improve the rate of exclusive breastfeeding practices and thus reduce infant mortality.

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