EVALUATION OF MOTHERS' KNOWLEDGE AND PRACTICES REGARDING INFANT WEANING

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

The growth and development of children, particularly in the first two years of life, are significantly influenced by an appropriate diet (Aggarwal, Verma, Faridi & Dayachand, 2018). The mother is the most critical individual in a baby's existence, as she is responsible for the physical and psychosocial care and development of the child. The mother-infant relationship is the most critical formative relationship for the offspring. A baby begins to interact with its mother from the very first moments of existence. Consequently, the health, education, beliefs, and attitude of the mother regarding child rearing are critical milestones in the development of the child's health, beginning with the in utero period. Additionally, the socioeconomic and educational status of the parents, their cultural beliefs, the number and spacing of siblings, and the employment status of the mother are all factors that contribute to the development of defective breast-feeding and weaning practices. An estimated 1.5 million infants could be saved annually through the implementation of improved breast feeding practices and the reduction of artificial feeding (UNICEF, 2018). In South Asia, the delayed introduction of semisolid foods is a significant contributor to infant malnutrition. The majority of children do not receive semisolids until after the age of nine months, and many do not receive them until their second year of life (UNICEF, 2018).On average, over 26,000 infants under the age of five die globally each day. More than half of these fatalities are attributable to malnutrition (UNICEF, 2018). Precious mental capacities are frequently forfeited by malnourished children. They are more susceptible to illness. If they survive, they may develop permanent mental or physical impairments.Children are unable to realise their maximum potential in terms of their physical and mental capabilities due to malnutrition. The health and physical consequences of prolonged malnourishment in children include a delay in their physical growth and motor development, a lower intellectual quotient (IQ), greater behavioural problems, and deficient social skills, and a higher susceptibility to contracting diseases (FAO: State of Food Insecurity in the World, 2018). Additionally, infant malnutrition is responsible for approximately 60% of under-five mortality in Sub-Saharan Africa (UNICEF, 2018).Poongou, Ezzati, and Salomon (2020) have analysed the socioeconomic, demographic, and cultural factors that are associated with child malnutrition and described the prevalence of malnutrition among under-five children in the preponderance of studies on child nutritional status. After the age of six months, weaning should commence, and the diet should consist of semi-solid foods that are high in calorie. The process of natural weaning is characterised by the infant's acceptance of a growing variety of complementary feedings while continuing to breastfeed on demand. Complete weaning typically occurs between the ages of two and four when natural weaning is implemented. Planned weaning is the process by which the mother decides to wean without receiving signals from the infant that he is prepared to discontinue breastfeeding. The following are some of the most frequently cited reasons for planned weaning: insufficient milk or concerns regarding the baby's growth, excruciating feedings or mastitis, returning to work, a new pregnancy, and so forth (Imtiaz & Izhar, 2020).Malnutrition increases mortality and morbidity by increasing the susceptibility of a child to infections and the delay in recovery (Chatterjee & Saha, 2018). The rapid growth of the infant during the first year of life, and particularly the first six months postpartum, necessitates an adequate supply of nutrients to accommodate the rapid accumulation of body muscle and other tissues (Domellof, Lonnerdal, Abram & Hernell, 2019). This critical transition period is linked to a significant increase in malnutrition among neonates. The family, community, and healthcare system must provide accurate information and competent support in order to ensure that complementary feeding is appropriate. Malnutrition is frequently more prevalent due to inadequate information regarding suitable foods and feeding practices than a lack of sustenance (WHO, 2019). A study was conducted to evaluate the determinants of early weaning in infants. The results indicated that early weaning was statistically associated with young maternal age, low maternal education, low socioeconomic status, absence or short duration of breastfeeding, maternal smoking, and lack of information or advice from health care providers (Wijndaele, Lakshman, Landsbaugh, Ong & Ogilvie, 2019).During the transition period, when complementary nutrition commences, infants are particularly susceptible. In order to guarantee that the nutritional requirements of infants are met, it is necessary for complementary foods to be: timely - introduced when the demand for energy and nutrients exceeds the capacity of exclusive and frequent breastfeeding; adequate - providing an adequate amount of energy, protein, and micronutrients to meet the nutritional requirements of a growing child; safe - stored and prepared in a hygienic manner, and fed with clean hands using clean utensils rather than bottles and teats; properly fed - given in accordance with the child's signals of appetite and satiety, and that the meal frequency and feeding method are appropriate for the child's age, actively encouraging the child to consume an appropriate amount of food using fingers, spoons, or self-feeding, even during illness.The optimal lactation practice is to exclusively breastfeed for the first six months of life, and then to introduce cereals while continuing to breastfeed until the age of two and beyond (WHO, 2019). The barriers to BF and weaning practices include a lack of knowledge among mothers regarding BF and weaning practices, insufficient IEC activities in hospitals, the advertisement of breast milk substitutes, the lack of support for the act, and the fact that many women identify employment as a barrier (Stewart-Glenn, 2019).

1.2   Statement Of The Problem

Poor weaning practices are linked to inadequate awareness of weaning guidelines, which is particularly notable among young mothers, those receiving benefits, and those with low educational attainment. Additionally, they may elevate the likelihood of gastrointestinal infections, respiratory infections, underweight, and mortality (Naseem and Masher et al. 2018). 

Consequently, it is imperative that the infant consumes appropriate foods after the age of six months, in addition to breast milk, to ensure that they receive an adequate amount of nutrients (Venugopal et al. 2021). The mother-infant relationship is the most critical formative relationship for the offspring. A baby begins to interact with its mother from the very first moments of existence. Therefore, the health, education, beliefs, and attitude of the mother regarding child rearing are critical milestones in the development of the child's health, beginning with the in utero period (Ogunsuyi, et al., 2020). 

Foods should be varied and balanced mixtures containing cereals, pulses, foods of animal and vegetable origin, and lipids should be offered starting in the sixth month. Consequently, infants should be initially provided with foods that are reduced in sugar and salt. It is crucial to provide four animal-derived foods (which are high in iron and protein), as well as fruit and vegetables, particularly those that are vitamin-rich, on a daily basis, if feasible. Soft drinks and other sugary beverages should be avoided, as they may reduce the infant's appetite for more nutritious foods and may soften the stools. Additionally, tea and coffee are not recommended, as they may interfere with iron absorption (Foterek et al., 2018; Vajramala, 2022). 

Many factors influence the behaviours of infant carers, as well as the manner in which families, infants, and young people procure and prepare food. Additionally, the manner in which infants are fed and supervised. These encompass levels of physical activity, appetite, taste preferences, nutritional knowledge, and dietary patterns. Socioeconomic factors, including food and dietary taboos, and the inclination in certain cultures to prioritise boys and men over girls and women during mealtimes, are also significant. An essential response to influence lifelong behaviour in favour of healthier food choices, practices, and overall nutrition is nutrition education, counselling, and information (UNICEF 2018). Malnutrition is frequently more prevalent due to inadequate knowledge regarding appropriate foods and feeding practices than a lack of sustenance. Individuals are uncertain about the appropriate method to employ during the weaning process (Subba, Bhattarai, & Roy, 2021). A positive parenteral attitude towards infant feeding is a critical element of the nutritional welfare of a child. The most vulnerable segment of any community remains the infancy period (Juneja, 2018).

1.3   Objectives Of The Study

The main objective is to evaluate mothers' knowledge and practices regarding infant weaning. The specific objectives include the following:

To assess the level of knowledge about infant weaning among mothers

To examine the weaning practices adopted by mothers

To identify common challenges faced by mothers during the weaning process

1.4 Research Questions

The study will be guided by the following questions;

What is the level of knowledge about infant weaning among mothers

What are the weaning practices adopted by mothers

What are common challenges faced by mothers during the weaning process

1.5 Research Hypothesis

Ho: Mothers do not have adequate knowledge of infant weaning 

Ha: Mothers have adequate knowledge of infant weaning.

1.6 Significance Of The Study

The significance of this study on "Assessment of Infant Weaning Knowledge and Practices Among Mothers" will be profound, offering essential insights and benefits to various stakeholders.

Mothers will be the primary beneficiaries. The study will provide them with valuable information on best practices for weaning, which is a critical stage in an infant’s development. By understanding the optimal timing, methods, and types of foods to introduce during weaning, mothers will be able to ensure that their infants receive proper nutrition. This will lead to better health outcomes, improved growth, and a reduced risk of malnutrition and related health issues for their children.

Healthcare providers, including pediatricians, nurses, and nutritionists, will also benefit significantly from this research. The study will highlight common gaps in knowledge and practices among mothers regarding weaning. Armed with this information, healthcare providers can develop more effective educational programs and support services to guide mothers through the weaning process. This will enhance the quality of care provided to infants and support their healthy development.

Public health organizations and policymakers will find the study’s findings valuable for shaping health promotion strategies and policies. By understanding the current state of weaning knowledge and practices, these entities can design targeted interventions and public health campaigns to educate and support mothers. This will help to improve infant health at a population level and contribute to the overall well-being of communities.

Non-governmental organizations (NGOs) and community-based organizations focused on maternal and child health will also gain insights from the study. The research will provide these organizations with data to support their advocacy and program initiatives aimed at improving infant nutrition and health. This will strengthen their ability to mobilize resources, influence policy changes, and implement effective programs that promote healthy weaning practices.

Academics and researchers in the fields of public health, nutrition, and maternal and child health will benefit from the study’s contribution to the existing body of knowledge. The research will provide empirical data and insights into weaning practices and challenges faced by mothers. This will stimulate further academic inquiry and inform future studies, promoting a deeper understanding of infant nutrition and development.

Community health workers and local health educators will find the study valuable for designing and implementing grassroots educational initiatives. By understanding the specific knowledge gaps and misconceptions prevalent in their communities, health workers can tailor their educational messages and support services to meet the needs of mothers more effectively. This will lead to improved health literacy and better weaning practices at the community level.

1.7 Scope Of The Study

This study is structured to generally evaluate mothers' knowledge and practices regarding infant weaning. Hence, the study will be Etinan Local Government Area, Akwa Ibom State.

1.8 Limitations of the Study

The researcher encountered minor obstacles when conducting the study, as with any human endeavor. The significant constraint was the scarcity of literature on the subject due to the nature of the discourse, so the researcher incurred more financial expenses and spent more time sourcing for relevant materials, literature, or information and in the data collection process, which is why the researcher resorted to a limited choice of sample size. Furthermore, the researcher did this investigation alongside other academic activities. Furthermore, the sample size was limited because only a few respondents were chosen to answer the research instrument, therefore the results cannot be generalized to other secondary schools outside the state. Despite the constraints encountered during the research, all elements were minimized in order to provide the best results and make the research effective.

1.9 Definition Of Terms

Infant Weaning: refers to the period starting from the introduction of the first solid food to the point where the infant is no longer breastfed or bottle-fed regularly. 

Mothers Knowledge: in this study refers to the information and awareness that mothers have about the appropriate timing, types of foods, nutritional requirements, and methods of introducing solid foods to infants.