Infant And Toddler Feeding Practices In The Baby Friendly Initiative (BFI) Era In Ilesa, Nigeria

摘要

Background:Most previous studies focused on feeding practices within the first six months of life with respect to the Baby Friendly Initiative (BFI). Objective:To describe the pattern of infant and toddler feeding practices in the BFI era in Ilesa, Nigeria. Methods:A hospital-based cross-sectional study. Consecutive mothers of children aged 0 to 24 months were studied for their personal data, places of delivery and their infant and toddler feeding practices. Results:A total of 262 mothers were studied; 200 (76.3%) of these had received counselling on breastfeeding according to the BFI. Of these, 158 (60.3%) infants were delivered in health facilities and 184 (70.2%) were still on breast milk. Breastfeeding was commenced within the first hour life among 98 (37.4%) infants, glucose drink was offered to 87 (33.2%) infants at birth while 96 (36.6%) had pre-lacteal feeds. Only 56 (21.4%) infants were exclusively breastfed for the first 6 months. Supplementary feeding was commenced between 2 and 6 months among 96 (36.6%) children. Bottle feeding was practiced by 79 (30.2%). The use of cow's milk was associated with the use of feeding bottle (p = 0.000000), commencement of weaning before 6 months (p = 0.00012) and professional mothers (p = 0.000000). Conclusion:The quality of breast feeding practices was poor and the duration was mostly short. The use of cow's milk and the tendency to commence supplementary feeding before six months were also prominent. Improved health information and education drives are needed. Introduction Following the 1990 Innocenti declaration to promote, protect and support breastfeeding, 1 the Baby Friendly Hospital Initiative (BFHI) was launched in Nigeria in 1992. Thus, some tertiary health facilities, including the Wesley Guild Hospital (WGH), Ilesa, were designated “Baby Friendly” for the purpose of influencing mothers who come in contact with them to breastfeed appropriately.Timely institution of breastfeeding, including exclusive breastfeeding for the first six months of life and subsequent appropriate weaning as well as breastfeeding for two years were the tools earmarked for achieving this study. Several studies have reported the success of the BFI in terms of exclusive breastfeeding over the first 6 months of life 2 apparently justifying the focus on exclusive breastfeeding with very minimal emphasis on subsequent feeding of infants as very scanty information is available on feeding pattern in the post-six months period.The WGH, Ilesa, serves the semi-urban population of Ilesa, the surrounding Ijesa and other adjacent communities in Osun, Ondo and Ekiti States of Nigeria. Mothers attending the various Maternal and Child Health Clinics in the hospital and those patronising the hospital's delivery services are routinely counselled on appropriate breastfeeding according to the BFI. Thus, it is expected that the BFI message would spread far and wide in its wide catchments area.This study aims at describing the pattern of infant and toddler feeding practices in the BFI era in Ilesa, Nigeria. Patients and Methods This cross-sectional, descriptive study was prospectively carried out at the General Paediatric Out - Patient Clinic of the WGH, Ilesa, Nigeria between January and March, 2005. The study population comprised of consecutive mothers of children aged 0 to 24 months. An open-ended questionnaire designed for the study was administered to the mothers. Socio-demographic information including the ages of the children and mothers, maternal occupation and place of delivery were obtained. The details of breastfeeding, bottle feeding and weaning practices and awareness of the BFI were also recorded.Mothers were classified into two broad occupational groups: the professionals (teachers, bankers, nurses, administrators) and the non-professionals (traders, farmers, weavers, hair dressers, seamstresses). The places of delivery were also classified into health facilities (which included WGH, General Hospital, Prim