Relationship between breastfeeding practices and nutritional status of children aged 0-24 months in Nairobi, Kenya.

Abstract

Breast milk has a major impact on child health, growth and development. Infants should exclusively breastfeed (EBF) for six months, then, nutritionally adequate and safe complementary foods should be introduced. This study’s aim was to determine the breast feeding practices (initiating breastfeeding within one hour of child birth, exclusive breastfeeding for six months, no bottle feeding, and breastfeeding until or beyond two years and on demand breastfeeding) of mothers in Nairobi, and nutritional status of their children aged zero to twenty four months. A descriptive cross-sectional survey was used in the maternal child health (MCH) clinics in four selected Nairobi City Council health centres. A dyad (pair) of mother and her 0-24 month old child were targeted. The dyads were systematically selected based on the nth mother (where n was a fraction of desired sample size per actual number of mothers present in the clinic that day). A structured questionnaire was administered, which focused on maternal socio-demographic profiles and breastfeeding practices. Anthropometric assessments were conducted on the children. A total of 418 dyads were analysed, 99.0% of the mothers had breast fed, but only 12.6% children had been exclusively breastfed for the first six months. Only 34.0% of children aged less than six months were still exclusively breastfeeding, the rest were on complementary feeds. More than three quarters of the mothers had initiated breastfeeding within one hour of child birth, were not using bottles to feed their child, were breastfeeding on demand and had not weaned their child. On nutritional status assessment of children, 10.6 % were stunted, 6.2% underweight and 2.1% wasted. There was a significant association between delay in time of breastfeeding initiation after childbirth and stunting P≤.05 (odds ratio 2), discontinuation of breastfeeding and underweight P≤.05 (odds ratio 4.5), as well as weaning less than six months and underweight P≤.05 (odds ratio 2.5). There was no significant association between breastfeeding practices and wasting. Children on bottle feeding and those who had discontinued breastfeeding were likely to be wasted (odds ratio 1.6).However, these associations do not control for age, and both underweight and wasting are related to age. A majority of mothers were compliant with the recommended breastfeeding practices. Complementary feeding was introduced too early in life in several cases. Health care workers should emphasise the importance of exclusive breastfeeding for the first six months and the dangers of early complementary feeding.