Relationship between breastfeeding practices and nutritional status of children aged 6-24 months in South-west Nigeria
Background: Breastfeeding is the ideal form of nutrition for the healthy growth of infants, and it reduces the risk of malnutrition and several childhood morbidities.
Objectives: To assess the breastfeeding practices of mothers and the relationship between these practices and the nutritional status of their children.
Methods: It was a descriptive, hospital-based, cross-sectional study that involved children aged six to 24 months in Ilesa, Osun State, Nigeria. Socio-demographic characteristics and breastfeeding practices were documented, anthropometric measurements were obtained, and nutritional status was determined for the children. Underweight, stunting and wasting were defined as z-score < -2 for the weight-for-age, length-for-age and weight-for-length, respectively. A child was taken to be undernourished if any of underweight, stunting or wasting was present.
Results: Fifteen (3.6%) of the 420 children studied had mixed feeding from birth, while 273 (65.0%) were exclusively breastfed for six months. Two hundred and sixty-eight (63.8%) of them were still breastfeeding at the time of the study, while 152 (36.2%) had stopped breastfeeding. Nearly one-quarter (103/420; 24.5%) of the children were undernourished. A significantly lower proportion of children who had exclusive breastfeeding were undernourished, compared to those who were not exclusively breastfed (p = 0.033). Exclusive breastfeeding was independently associated with reduced odds of undernutrition (OR = 1.62, 95% CI = 1.02-2.57, p = 0.039).
Conclusion: Exclusive breastfeeding for six months significantly reduces the risk of undernutrition among young children.
WHO/UNICEF. Global strategy for infant and young child feeding. Geneva: World Health Organization; 2003. URL: https://apps.who.int/iris/bitstream/handle/10665/42590/9241562218.pdf/jsessionid=0372B1AB1BCA172CED40BA3435FBA3CC?sequence=1
Lamberti LM, Fischer-Walker CL, Noiman A, Victora C, Black RE. Breastfeeding and the risk for diarrhea morbidity and mortality. BMC Public Health 2011; 11: S15-27. https://doi.org/10.1186/1471-2458-11-S3-Ss15
Hanieh S, Ha TT, Simpson JA, Thuy TT, Khuong NC, Thoang DD, et al. Exclusive breastfeeding in early infancy reduces the risk of inpatient admission for diarrhea and suspected pneumonia in rural Vietnam: a prospective cohort study. BMC Public Health 2015; 15: 1166. https://doi.org/10.1186/s12889-015-2431-9
Story L, Parish T. Breastfeeding helps prevent two major infant illnesses. Internet J Allied Health Sci Pract 2008; 6: 1-5.
Bowatte G, Tham R, Allen K, Tan D, Lau M, Dai X, et al. Breastfeeding and childhood acute otitis media: a systematic review and meta‐analysis. Acta Paediatr 2015; 104: 85-95. https://doi.org/10.1111/apa.13151
WHO/UNICEF. Indicators for assessing infant and young child feeding practices: Part 1; Definitions. Geneva: World Health Organization; 2008. URL: https://apps.who.int/iris/bitstream/handle/10665/43895/9789241596664_eng.pdf?sequence=1
National Population Commission (NPC) [Nigeria] and ICF. Nigeria Demographic and Health Survey (NDHS) 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF; 2019. URL: https://www.dhsprogram.com/pubs/pdf/FR359/FR359.pdf
Ella RE, Ndep AO, Akpan MI. Factors affecting exclusive breastfeeding practice in rural communities of Cross River State, Nigeria. Int J Human Soc Sci Edu 2016; 3: 101-110. https://doi.org/10.20431/2349-0381.0304012
Liben ML, Gemechu YB, Adugnew M, Asrade A, Adamie B, Gebremedin E, et al. Factors associated with exclusive breastfeeding practices among mothers in Dubti town, afar regional state, northeast Ethiopia: a community based cross-sectional study. Int Breastfeed J 2016; 11: 4. https://doi.org/10.1186/s13006-016-0064-y
Wanjohi M, Griffiths P, Wekesah F, Muriuki P, Muhia N, Musoke RN, et al. Sociocultural factors influencing breastfeeding practices in two slums in Nairobi, Kenya. Int Breastfeed J 2016; 12. https://doi.org/10.1186/s13006-016-0092-7
Nangalu R, Pooni PA, Bhargav S, Bains HS. Impact of malnutrition on the pediatric risk of mortality score and outcome in Pediatric Intensive Care Unit. Indian J Crit Care Med 2016; 20: 385-90. https://doi.org/10.4103/0972-5229.186218
Caulfield LE, de Onis M, Blössner M, Black RE. Undernutrition as an underlying cause of child deaths associated with diarrhoea, pneumonia, malaria, and measles. Am J Clin Nutr 2004; 80: 193–198. https://doi.org/10.1093/ajcn/80.1.193
McDonald CM, Olofin I, Flaxman S, Fawzi WW, Spiegelman D, Caulfield LE, et al. The effect of multiple anthropometric deficits on child mortality: a meta-analysis of individual data in 10 prospective studies from developing countries. Am J Clin Nutr 2013; 97: 896-901. https://doi.org/10.3945/ajcn.112.047639
Kuchenbecker J, Jordan I, Reinbott A, Herrmann J, Jeremias T, Kennedy G, et al. Exclusive breastfeeding and its effect on growth of Malawian infants: results from a cross-sectional study. Paediatr Int Child Health 2015; 35: 14-23. https://doi.org/10.1179/2046905514Y.00000000134
Ahmed R, Sultana P, Al-Fuad S, Islam A. Association between breastfeeding practices and nutritional status of children aged 6-24 months in Jessore, Bangladesh. Int J Health Sci Res 2017; 7: 247-251.
Muchina EN, Waithaka PM. Relationship between breastfeeding practices and nutritional status of children aged 0-24 months in Nairobi, Kenya. Afr J Food Agric Nutr Dev 2010; 10: 2358-2378. https://doi.org/10.4314/ajfand.v10i4.55329
Okolo AA, Omoyibo E, Chimah UO. Breastfeeding practices and growth. Niger J Paediatr 2015; 42: 335-339. https://doi.org/10.4314/njp.v42i4.10
Oyedeji GA. Socioeconomic and cultural background of hospitalized children in Ilesa. Niger J Paediatr 1985; 13: 111-8.
WHO. WHO child growth standards; Methods and development: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age. Geneva: World Health Organization; 2006. URL: https://www.who.int/childgrowth/standards/Technical_report.pdf
Onayade AA, Abiona TC, Abayomi IO, Makanjuola RO. The first six-month growth and illness of exclusively and non-exclusively breastfed infants in Nigeria. East Afr Med J 2004; 81: 146-153. https://doi.org/10.4314/eamj.v8i3.9145
Ogunlesi T, Dedeke O, Okeniyi J, Oyedeji G. Infant and toddler feeding practices in the Baby-Friendly Initiative (BFI) era in Ilesa, Nigeria. Internet J Nutr Wellness 2004; 1 (2).
Lawoyin TO, Olawuyi JF, Onadeko MO. Factors associated with exclusive breastfeeding in Ibadan, Nigeria. J Hum Lact 2001; 17: 321-325. https://doi.org/10.1177/089033440101700406
Akodu SO, Njokanma OF, Disu EA, Anga AL, Kehinde OA. Exclusive breastfeeding practices among women attending a private health facility in Lagos, Nigeria. Niger J Paediatr 2014; 41: 345-349. https://doi.org/10.4314/njp.v41i4.11
Ukegbu AU, Ukegbu PO, Onyeonoro UU, Ubajaka CF. Determinants of breastfeeding patterns among mothers in Anambra State, Nigeria. South Afr J Child Health 2011; 5: 112-116.
Balogun MR, Okpalugo OA, Ogunyemi AO, Sekoni AO. Knowledge, attitude, and practice of breastfeeding: A comparative study of mothers in urban and rural communities of Lagos, Southwest Nigeria. Niger Med J 2017; 58: 123-130. https://doi.org/10.4103/nmj.NMJ_289_16
Joseph FI, Earland J. A qualitative exploration of the sociocultural determinants of exclusive breastfeeding practices among rural mothers, North-West Nigeria. Int Breastfeed J 2019; 14: 38. https://doi.org/10.1186/s13006-019-0231-z
Oluwafemi RO, Alonge AO, Abiodun MT. Malnutrition survey among children aged one to five years in an outpatient setting. Ann Health Res 2020; 6: 370-381. https://doi.org/10.30442/ahr.0604-02-100
Babatunde RO, Olagunju FI, Fakayode SB, Sola-Ojo FE. Prevalence and determinants of malnutrition among under-five children of farming households in Kwara State, Nigeria. J Agric Sci 2011; 3: 173-181. https://doi.org/10.5539/jas.v3n3p173
Igbokwe O, Adimorah G, Ikefuna A, Ibeziako N, Ubesie A, Ekeh C, et al. Socio-demographic determinants of malnutrition among primary school-aged children in Enugu, Nigeria. Pan Afr Med J 2017; 28: 248. https://doi.org/10.11604/pamj.2017.28.248.13171
Aguree S, Soyiri IN, Ziem JB. Maternal educational attainment is associated with child nutrition status in Northern Ghana. Act Sci Nutr Health 2020; 4: 91-98.
Makoka D. The Impact of Maternal Education on Child Nutrition: Evidence from Malawi, Tanzania and Zimbabwe. DHS Working Papers no. 84. ICF International; Calverton, MD: 2013. URL: https://dhsprogram.com/pubs/pdf/WP84/WP84.pdf
Ndukwu CI, Egbuonu I, Ulasi TO, Ebenebe JC. Determinants of undernutrition among primary school children residing in slum areas of a Nigerian city. Niger J Clin Pract 2013; 16: 178-183. https://doi.org/10.4103/1119-3077.110142
Lawan UM, Amole GT, Jahum MG, Sani A. Age-appropriate feeding practices and nutritional status of infants attending child welfare clinic at a teaching hospital in Nigeria. J Family Community Med 2014; 21: 6-12. https://doi.org/10.4103/2230-8229.128766
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