Qureshi Asma Misbah, Oche Oche Mansur, Sadiq Umar Abubakar, Kabiru Sabitu
University Research Co LLC, Bethesda, MD, USA.
Pan Afr Med J. 2011;10:8. doi: 10.4314/pamj.v10i0.72215. Epub 2011 Sep 23.
Exclusive Breastfeeding (EBF) refers to the practice of feeding breast milk only, (including expressed breast milk) to infants; and excluding water, other liquids, breast milk substitutes, and solid foods. Inadequately breastfed infants are likely to be undernourished and have childhood infections. EBF knowledge and infant feeding practices have not been studied sufficiently in Sokoto State, Nigeria. We describe the results of a randomized community trial to promote Exclusive Breastfeeding (EBF) in two local government areas Kware and Bodinga selected as intervention and control groups respectively.
During advocacy meetings with community leaders, a Committee was formed. Members of the Committee were consulted for informed consent and selection of ten female volunteers who would educate mothers about breastfeeding during home visits. Participants comprised mothers of infants who were breastfeeding at the time of the study. A total of 179 mothers were recruited through systematic random sampling from each community. Volunteers conducted in-person interviews using a structured questionnaire and counseled mothers in the intervention group only.
At baseline, intervention and control groups differed significantly regarding maternal occupation (P=0.07), and age of the index child (P=0.07). 42% of infants in the intervention group were up to 6 months old and about 30% of them were exclusively breastfed. Intention to EBF was significantly associated with maternal age (P=0.01), education (P=0.00) and women who were exclusively breastfeeding (P=0.00). After counseling, all infants up to 6 months of age were exclusively breastfed. The proportion of mothers with intention to EBF increased significantly with maternal age (P=0.00), occupation (P=0.00) and women who were exclusively breastfeeding (P=0.01). Post-intervention surveys showed that source of information and late initiation of breastfeeding was not significantly associated with intention to EBF. Mothers who reported practicing EBF for 6 months, were older (P=0.00) multi-parous (P=0.05) and more educated (P=0.00) compared to those who did not practice EBF. Among them, significantly increased proportion of women agreed that EBF should be continued during the night (P=0.03), infant should be fed on demand (P=0.05), sick child could be given medication (P=0.02), EBF offered protection against childhood diarrhea (P=0.01), and helped mothers with birth spacing (P=0.00).
This study shows that there is a need for reaching women with reliable information about infant nutrition in Sokoto State. The results show decreased EBF practice among working mothers, young women, mothers with poor education and fewer than five children. Counseling is a useful strategy for promoting the duration of EBF for six months and for developing support systems for nursing mothers. Working mothers may need additional resources in this setting to enable them to practice EBF.
纯母乳喂养（EBF）是指仅用母乳（包括挤出的母乳）喂养婴儿；不包括水、其他液体、母乳代用品和固体食物。母乳喂养不足的婴儿可能营养不良并易患儿童期感染。在尼日利亚索科托州，纯母乳喂养知识和婴儿喂养方式尚未得到充分研究。我们描述了一项随机社区试验的结果，该试验在分别选为干预组和对照组的夸雷和博丁加两个地方政府辖区推广纯母乳喂养（EBF）。
在与社区领袖的宣传会议期间，成立了一个委员会。就知情同意事宜咨询了委员会成员，并挑选了十名女性志愿者，她们将在家庭访视期间向母亲们传授母乳喂养知识。参与者包括研究期间正在进行母乳喂养的婴儿的母亲。通过从每个社区进行系统随机抽样，共招募了179名母亲。志愿者使用结构化问卷进行面对面访谈，且仅对干预组的母亲进行咨询。
在基线时，干预组和对照组在母亲职业（P = 0.07）和指标儿童年龄（P = 0.07）方面存在显著差异。干预组中42%的婴儿年龄在6个月及以下，其中约30%为纯母乳喂养。纯母乳喂养的意愿与母亲年龄（P = 0.01）、教育程度（P = 0.00）以及纯母乳喂养的女性（P = 0.00）显著相关。咨询后，所有6个月及以下的婴儿均进行纯母乳喂养。有纯母乳喂养意愿的母亲比例随着母亲年龄（P = 0.00）、职业（P = 0.00）以及纯母乳喂养的女性（P = 0.01）显著增加。干预后的调查显示，信息来源和母乳喂养开始较晚与纯母乳喂养意愿无显著关联。报告纯母乳喂养6个月的母亲与未进行纯母乳喂养的母亲相比，年龄更大（P = 0.00）、多胎（P = 0.05）且受教育程度更高（P = 0.00）。其中，同意夜间应继续纯母乳喂养（P = 0.03）、婴儿应按需喂养（P = 0.05）、患病儿童可给药（P = 0.02）、纯母乳喂养可预防儿童腹泻（P = 0.01）以及有助于母亲控制生育间隔（P = 0.00）的女性比例显著增加。
本研究表明，在索科托州有必要向女性提供关于婴儿营养的可靠信息。结果显示，在职母亲、年轻女性、教育程度低且子女少于五个的母亲中纯母乳喂养的比例较低。咨询是促进纯母乳喂养持续六个月以及为哺乳母亲建立支持系统的有用策略。在这种情况下，在职母亲可能需要额外的资源以使其能够进行纯母乳喂养。
