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Promoting Exclusive Breastfeeding in Sokoto: The Role of Counseling, Parental Support, and Health Education
Main Article Content
Abstract
Purpose – This study aims to investigate exclusive breastfeeding (EBF) in Sokoto.
Design/methods/approach – A survey type of 300 respondents was used; data were analyzed with frequency counts/percentages and an X2 test.
Findings – All respondents were female (100.0%), aged 26-35 (100.0%). The majority of the participants were single (66.7%) and unemployed (66.7%), with a secondary school education (66.7%). However, 33.3% of the participants were married, were civil servants, and had tertiary education. The study revealed that the majority (66.7%) had received breastfeeding counseling during antenatal care. All respondents (100.0%) received proper guidance/counseling at home on exclusive breastfeeding. Fathers (66.7%) and mothers (33.3%) supported exclusive breastfeeding. The respondents reported exclusively breastfeeding their child for the first six months after delivery (100.0%), and weaning occurred between 19-24 months. The reasons for avoiding exclusive breastfeeding were the sickness of the mother (66.7%) and insufficient milk (33.3%). All respondents (100.0%) agreed that exclusive breastfeeding improved the baby’s health, and health awareness encourages breastfeeding (100.0%).
Research implications/limitations – This study provides a limit in the form of maximum exclusive breastfeeding for children aged 24 months.
Practical implications – The study suggests that counseling, support from parents, and health awareness can improve exclusive breastfeeding, and healthcare providers should provide such services during antenatal care while promoting the practice through health education campaigns.
Originality/value – This study highlights the importance of counseling, parental support, and health education in promoting exclusive breastfeeding and improving the health of infants in Sokoto.
Paper type Research paper
Keywords:
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1. Introduction
Breast milk provides essential nutrition for infants during their first six months of life. It is composed of water (87%), fat (3.8%), protein (1.0%), and lactose (7%), which together provide 40-50% of the total energy derived from milk. In addition to its nutritional value, breast milk contains immune cells, microRNA, hormones, and bioactive compounds with anti-inflammatory and antibiotic properties. Necessary chemicals in breast milk include cytokines, chemokines, immunoglobulins, growth factors, oligosaccharides, and antimicrobial peptides such as bacteriocin and ketoferrin. The composition of breast milk can vary depending on various factors, including maternal and environmental factors, to meet the complex nutritional needs of the baby. Breast milk is considered the best gift a mother can give her child, as it is the natural and ideal way to provide infant nutrition and is a unique biological and emotional foundation for their development(, 2017).
Breastfeeding a child with human breast milk provides nutritional and immunological benefits during breastfeeding. Several reports suggest a minimum breastfeeding period of one year, while the WHO recommends a breastfeeding period of two years or more. Weaning a child before the age of 2 years has been reported to increase the risk of illness(Aborigo et al., 2012)(Ahmad et al., 2017).
Breastfeeding should begin within the first hour after birth, and exclusive breastfeeding should continue for the first six months. It is essential to enhance colostrum feeding(Ahmad et al., 2017). Suckling stimulates milk production, so breastfeeding should occur when the infant desires it, day and night, at least eight times within 24 hours(Ahmad et al., 2017)(, 2017). Breastfed children in developing countries are at least six times more likely to survive in the early months than non-breastfed children. Proper breastfeeding practices could prevent the deaths of one million children every year(, 2017).
Although breastfeeding is considered a universal practice in Nigeria, socio-demographic factors influence its success. The Nigerian Demographic and Health Survey (NDHS) 2013 reported that only 17% of babies were breastfed, and just 40.8% of babies were put on breast milk within an hour of delivery, as recommended by the World Health Organization (WHO). Furthermore, despite WHO’s strong discouragement of pre-lacteal feeding more than a decade ago, 91.2% of babies received pre-lacteal feeds within the first six months of life, complicating proper breastfeeding practices(, 2017).
Several cultural beliefs and misunderstandings discourage the continuation of breastfeeding, especially after a temporary interruption. Therefore, understanding these cultural beliefs and misconceptions can provide appropriate counseling to those affected(Ahmad et al., 2017)(Nukpezah et al., 2018). In Sokoto state, 87% of the population lives in rural areas and faces unique child health and survival challenges, including poor environmental conditions. As a result, babies born in these areas are likely to have suboptimal breastfeeding practices(Kaoje et al., 2019)(, 2017).
Furthermore, an analysis of previous research conducted in Sokoto state reveals a problem concerning exclusive breastfeeding. A previous study investigated the use of community volunteers to promote exclusive breastfeeding practices in Sokoto state. This study highlighted the importance of providing women with tangible information about the benefits of infant nutrition. However, the results showed reduced breastfeeding among working mothers, poorly educated mothers, and young women. One way to address this trend is by providing counseling and support for working mothers(Qureshi et al., 2011).
Another study conducted in Kware, an outskirts area of Sokoto, in the same year reported a low level of knowledge and practice of exclusive breastfeeding(Oche et al., 2011). A survey on patterns and determinants of breastfeeding practices among rural women in Sokoto state revealed a significant lack of early initiation of breastfeeding and low rates of exclusive breastfeeding, which were associated with economic, biological, and healthcare system issues(, 2017). An investigation on breastfeeding support and factors that influence expressed breastfeeding practices among employed workers in Sokoto revealed low support for breastfeeding and inadequate knowledge and activity regarding expressed breastfeeding(Attahiru et al., 2018). A cross-sectional survey conducted in Wamakko local government area in Sokoto state showed that higher levels of awareness regarding exclusive breastfeeding were associated with an education based on men’s attitudes in the area(Meme & Oche, 2019). Finally, a study examining breastfeeding among HIV-infected mothers in Sokoto city showed that they continued breastfeeding their children beyond the recommended period suggested by the World Health Organization, and their children did not become infected.
Further research is needed to investigate this trend(Yusuf & Jega, 2020). Currently, there are no data on the effectiveness of counseling, parental support, and health education in promoting exclusive breastfeeding among women in Sokoto. This paper attempts to show that these interventions are essential in improving exclusive breastfeeding rates and the health of infants in the region. This study provides new insights into the factors influencing exclusive breastfeeding in Sokoto.
2. Methods
2. 1. Research setting
The article provides an overview of Nigeria, located in West Africa between 5⁰ North Equator and 3⁰ to 4⁰ East of the Greenwich Meridian. The research was conducted in Sokoto, Sokoto state, which is one of the thirty-six states in Nigeria. The country has a federal system of government with three levels: the Federal, the state, and the local government areas, with Abuja serving as the Federal Capital Territory. Sokoto, located in northwestern Nigeria, shares borders with the Niger Republic and
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