Sources, content, maternal knowledge and practices on exclusive breastfeeding among mothers with infants (0-6 months) in Kibera Slums Nairobi County, Kenya
Mucheru, Patrick Kamau
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Exclusive breastfeeding (EBF) has been demonstrated to have numerous benefits both to the mother and the infant. Inappropriate feeding practices can have profound consequences for the growth, development and survival of infants and children. EBF protects infants against infections such as respiratory infections, diarrhoea and reduces the risk of the mother developing obesity, breast and ovarian cancer among others. Despite various efforts to promote exclusive breastfeeding, the rate in Kenya is still low at 61% though there has been major improvement. Various research findings have documented inadequate knowledge on exclusive breastfeeding as a contributing factor to the rate of exclusive breastfeeding. However, there is limited scientific data on the gap between the sources of information, content and maternal knowledge on exclusive breastfeeding in relation to exclusive breastfeeding of infants in Kenya’s urban slums. This study aimed to investigate the sources and content of maternal knowledge on exclusive breastfeeding among mothers with infants aged 0-6 months in Kibera urban informal settlements, Nairobi. The study adopted a cross-sectional analytical design and targeted 293 mothers-infant pairs who were selected using systematic random sampling. Simple random sampling was used to select ten health facilities where mothers from Kibera seek health services. A researcher-administered questionnaire was used to collect data on EBF. A key informant guide was administered to the nutritionists to elicit in-depth information on maternal knowledge on exclusive breastfeeding and information gap in relation to practice of exclusive breastfeeding. Focus group discussions (FGDs) were conducted with mothers in various health facilities to build up on the discussion. Data was entered using CS Pro software and analyzed using SPSS version 16 software. Results showed that more than a half (54.8%) of the mothers first learnt or heard about exclusive breastfeeding from the health professional, 30.5% obtained the information from relatives and friends while 2.1% obtained from television and mothers booklet respectively. Among the mothers who participated in the study, 57% reported that they had learnt about exclusive breastfeeding, 17% reported that breast milk improves immunity while 7% had learnt about proper attachment. The mean knowledge score for all mothers on exclusive breastfeeding was 7.70 ± 1.47 which was an indication that mothers were knowledgeable on exclusive breastfeeding. There was a significant association between sources and content received by the mothers (chi-square test; p=0.02). Moreover, there was a significant correlation between content and the knowledge scores among the mothers (Pearson correlation; r=0.93, p=0.01). There was no significant association between maternal knowledge and the mothers who ever breastfed their infants (chi-square test; P=0.93), maternal knowledge and breastfeeding initiation (chi-square test; P=0.75), maternal knowledge and mothers who gave pre-lacteal feeds (chi-square test; P=0.09), maternal knowledge and mothers who gave post-lacteal feeds (chi-square test; P=0.53), maternal knowledge and breastfeeding within the last 24 hours (chi-square test; P=0.19). However, There was a significant association between maternal knowledge and introduction to food by the mothers (chi-square test; P=0.01). The community needs to be more sensitized on EBF information. This will ensure that the friends/relatives or even the grandmothers are aware of the correct information on EBF therefore not misleading the nursing mothers.