CHAPTER ONE
INTRODUCTION
1.1 Background of the study
In the first few years of life, some of the things that are critical for growth and development of children are good infant feeding and healthcare. As recommended by World Health Organisation (WHO) and United Nations Children’s fund, the optimal infant feeding practices of children involves exclusive feeding for the first 6 months after child delivery, which is then followed by sufficient complementary feeding coupled with breastfeeding until the child is at least 2 years old (Azubuike&Nkanginieme, 2012). The feeding pattern adopted by parents is required to provide the necessary macro and micronutrients needed for optimal growth and development of children. According to Geneva (2010), lack of exclusive breastfeeding has resulted to an estimation of about 1.3 million lives, are lost each year globally, and about 600,000 lives are been lost yearly as a result of mothers not continuing breastfeeding with the required complementary feeding. An essential factor between life and death for most children in developing countries (like Nigeria) is breastfeeding, but the present analysis shows that majority of Nigerian others (about 55%) are not well informed on the relevance of exclusive breastfeeding ( IITA; 2011). According to UNICEF (2008), under-nutrition is the principal factor responsible for about 50% of all the mortality among children in Nigeria.
The complete nutritional source for toddlers is known as breastfeeding because some of the components of breast milk are carbohydrate, proteins, essential fats and immunological factors required for toddlers to combat diseases and infections in the first two years of a child’s life. During the analysis of the strategies for child survival, it was discovered that the only most effective preventive measures in reducing the rate of mortality among children is exclusive breastfeeding in the first half of the infant’s first year and continued breastfeeding from 6 to 24 months. Exclusive breastfeeding has the potential of saving 1.3 million lives of children annually (Jones, Steketee, Black, Bhutta, and Morris, 2008). Though, it has been revealed by campaigners of breastfeeding that there is a global degeneration in the act of breastfeeding among nursing mothers. This is particularly more pronounced in developing countries (Leon-Cava, Lutter, Ross and Martin, 2012). A very high percentage of mothers chose not to breastfeed regardless all the endorsement of experts on the importance of breastfeeding for the first 6 months of life. Going by population studies in developing countries, it has been shown that the greatest risk of nutritional deficiency and growth retardation occurs in children between 3 and 15 months of age, a period noted for suboptimal breastfeeding (Jones et al., 2008)
Appropriate complementary feeding requires not only introducing foods too early or too late to infants but also feeding infants and young children between 6 and 24 months foods considered safe and nutritionally adequate without discontinuing breastfeeding (Frongillo, 2006). It was discovered by Geneva (2010) that only 35% if toddlers are breastfed in the first 6 months of their lives despite the unmatched benefits of infant feeding. A study has shown from a research in a northern state in Nigeria (Kano) that the percentage of women who exclusively breastfeed their babies for 4 weeks, 12 weeks and 24 weeks after their last delivery are 26%, 24.8%, and 22% respectively, this reveals that there is decrease in the population of mothers that breastfeed that infants between the first 6 months (Iliyasu, Kabir, Abubakar and Galadanchi, 2005). A similar study from southern part of Nigeria also stated that over 90% of mothers had the sufficient knowledge of exclusive breastfeeding (EBF), only 21.2% of the mothers practiced exclusive breastfeeding for all their babies and about half of the population (51.6%) had never practiced exclusive breastfeeding with any of their children (Uchendu, Ikefuna, and Emodi, 2009).
Nutritional status of children is an indicator of the level of development and future potential of the community. The nutritional status of infants and children under five years of age is of particular concern since the early years of life are crucial for optimal growth and development (Preschulek, Aldana and Hassan, 2009).
Therefore, this study will fill the missing link and add to the compendium of knowledge by investigating the socio-economic status of parents, the nutritional status of children and educational level of parents, on how all this tenets affects or influence the feeding pattern of children between 0-3 years.
1.2 Statement of the Problem
Children that are well fed during infancy develop very well, thereby avoiding health problems (morbidity and mortality) that can result from malnutrition. According to Sandoval-Priego, Reyes-Morals, Perez-Cuevas, Abrego-Blass, and Orrico-Torres (2012), one of the major problems recorded in the health sector all over the world is malnutrition, and study has revealed that about malnutrition is responsible for about 41% (approximately 2.3 million people) of the mortality that occurs yearly in children between the age 6 to 24 months in developing countries.
One of the major factor influencing nutritional status is breastfeeding. WHO, UNICEF and Nigeria’s National breastfeeding policy recommended that infants be exclusively breastfed from birth to 6 months and continue breastfeeding to 24 months and beyond for optimal survival, growth development unfortunately only 17% of infants under six months of age are exclusively breastfed in Nigeria (Quadri and Ojure, 2013). This pose a serious problem to their health as the poor breastfeeding and inadequate complementary feeding explains the protein energy malnutrition level in children as they grow older.
Moreover, a large number of children suffer from chronic malnutrition and anemia, which adversely impacts their health and development (WHO 2006). The complex myriad of physiological as well as psychological changes, accompanied by rapid growth and increase in physical activity, creates special nutritional needs that are higher during adolescence than at any other time in life. Failure to consume adequate diet at this time can potentially retard physical growth, intellectual capacity and delay sexual maturation (WHO 1999). Addressing the nutrition needs of school going children could be an important step towards breaking the vicious cycle of intergenerational malnutrition, chronic diseases and poverty. Epidemiological evidence from both the developed and developing countries indicates that there is a link between fontal under-nutrition and increased risk of various chronic diseases during adulthood (Alamu, Atawobi and Edokpayi, 2011).
Due to the premises of problem identified above this study will intend to examine the factors influencing nutritional status of children between 0 and 3 years in selected primary health care centre in Ikenne Community of Ogun State. Specifically, the study will examine how breastfeeding, feeding pattern and dietary intake influence the nutritional status of children between 0 and 3 years within this community.
1.3 Objectives of the Study
The general objective of this study is to examine the factors influencing nutritional status of children between 0 and 3 years in selected primary health care centers in Ikenne, Ogun state. The specific objectives include the following:
1. To examine the extent to which parents’ breastfeed children between 0 and 3 years in two primary health care centers in Ikenne, Ogun state.
2. To ascertainif feeding pattern influences the nutritional status of children between 0 and 3 years in selected primary health care centers twoIkenne, Ogun state.
3. To assess the usual dietary intake of children between 0 and 3 years and assess the adequacy on their health.
4. To investigate the impact the current nutritional status has on children’s health
1.4 Research questions
1. To what extent do parents’ breastfeed children between 0 and 3 years and the impact it has on their nutritional status?
2. Does feeding pattern influence the nutritional status of children between 0-3?
3. What is the usual dietary intake of children between 0 and 3 years and its adequacy on their health?
4. Does the current nutritional status have any impact on children’s health?
1.5Research Hypothesis
Hypothesis 1:
H1: Feeding pattern influences the nutritional status of children between 0 and 3 years
H0: Feeding pattern does not influence the nutritional status of children between 0 and 3 years
Hypothesis 2:
H2:The current nutritional status have significant impact on children’s health
H0: The current nutritional status does not have significant impact on children’s health
1.6 SIGNIFICANCE OF THE STUDY
The findings from this study will be relevant to mothers, health care centers, ministry of health, and researchers.
The mother will benefit from the findings this study with the chances elaborating the knowledge of the parents and their socio-economic status variable on how it affects the feeding pattern of a child, when growing up to become of age.
The health care centers will benefit from the findings of the study, due to the fact that it will enable them to be able to sieve out needful precaution and health advice for children and nutritional balance of child.
The ministry of health will be able to know the needful policies and regulation that will be given to health parastatals on the diet related issues of the child within the age of 0-3 years of age.
1.7 Scope of the Study
This study will be carried out to examine the factors influencing nutritional status of children between 0 and 3 years in the two selected primary health care Centers in Ikenne Ogun state. The study will employ the questionnaire as a research instrument to draw-out qualitative view/data from the respondents.
1.8 Definition of terms
Feeding pattern: it is the process of feeding during a period of time.
Nutritional status: This is the level of nutrient that the body is able to sustain during feeding.
Infant: They are children between the age brackets of 0-3.
Health care: it is the organized provision of medical care to individual or community.