Knowledge, attitudes and practices on early breastfeeding among mothers delivering at moi teaching and referral hospital in Uasin-Gishu County, Kenya
Boor, Felix Kiplagat
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The prevalence of timely initiation of breastfeeding within 1 hour of birth is 43% globally, 48% in Sub-Saharan Africa, 62% in Kenya, and 69.4% in Rift Valley province. The World Health Organization (WHO) and United Nations International Children‟s Emergency Fund (UNICEF) recommends initiation of breastfeeding within 30-60 minutes of birth, giving colostrum, not giving pre and post-lacteals and also exclusive breastfeeding (EBF) for first six months. Early breastfeeding practices are still suboptimal in most settings because much of the focus of breastfeeding advocacy and research has been on exclusive breastfeeding. Few studies have however investigated early maternal breastfeeding knowledge, attitudes and practices. Hence, there is limited literature in Kenya and Uasin Gishu County. The purpose of this study, therefore, was to determine the knowledge, attitudes, and practices on early breastfeeding among mothers who deliver at Moi Teaching and Referral Hospital (MTRH), in Uasin-Gishu County. This study adapted the cross-sectional analytical study design with qualitative and quantitative techniques in data collection, analysis, and presentation. A sample size of 283 women who had delivered in the last 72 hours at MTRH participated in the study. The researcher administered a questionnaire to mothers of newborn babies. Key Informant Interviews (KIIs) were also conducted with the nutritionist and the nurse in charge of the labour ward. The Statistical Package for Social Sciences version 23.0 was used to analyze quantitative data. Maternal attitudes was measured using a five-point Likert scale. Mean scores were calculated for maternal knowledge and attitude. The association between categorical data such as the early breastfeeding knowledge, attitudes, and practices was determined using the odds ratio. Pearson‟s correlation was used to test the association between knowledge scores and attitude scores. Statistical significance was set at p<0.05. Content analysis was conducted on qualitative data from the questionnaires and KIIs and categorized into key themes. The majority of the mothers (74.2%) were knowledgeable on timely initiation of breastfeeding, 91.9% knew that colostrum should be given, while 99.6% and 91.2% knew that pre and post-lacteals should not be given respectively. Most mothers had a positive attitude towards aspects of early breastfeeding: timely initiation of breastfeeding (80.6%); giving colostrum (95.0%) not giving pre and post-lacteals (83.4% and 72.8% respectively), and practicing exclusive breastfeeding (91.8%). The mothers who practiced timely initiation of breastfeeding were 96.5%. About 98.2% gave breast milk only as the first feed, 90.5% did not give post-lacteal, while 94% gave colostrum. There were positive associations between knowledge scores and attitude scores (r=0.389, N=283, p<0.05), other associations were knowledge and practices, and attitudes and practices of mothers on early breastfeeding. Challenges to early breastfeeding were breast problems, low milk production, not being able to position and attach the baby correctly. In conclusion, mothers had good knowledge and positive attitudes towards early breastfeeding, and practiced early breastfeeding as recommended by WHO and Kenya‟s MoH. Based on the findings of the study, it is recommended that the Ministry of Health in Kenya develop a policy targeting the mothers on the continuation of breastfeeding education after discharge from hospital as it has proven to be have a positive outcome towards early breastfeeding.