Assessment of factors influencing child-feeding practices among first-time mothers in Wekhomo location, Luanda sub-county, Kenya

Abstract

Improper child-feeding practices directly affect the nutritional status of under-fives and ultimately impact on their survival. Improving child-feeding practices of under- fives is critical to their overall health and developmental milestones. In 2001, the World Health Organization (WHO) recommended exclusive breastfeeding for 180 days a change from the previous proposal to introduce complementary foods at four to six months. Luanda Sub-County experiences massive population explosion and pressure on the resources like land, infrastructure and agriculture. Despite the favorable climate for crop production activities undertaken in rural areas where the majority live, agricultural productivity in the county is low and declining and 57% of the population and households live below poverty food line. This study undertook a community-based cross-sectional design that sought to assess the economic, social and cultural factors that influence child-feeding practices of first-time mothers of children under five years of age, residing in Ebuhando, Ebusundi and Iboona Sub-locations in Wekhomo Location, Luanda Sub-County. Snowball sampling was used and structured questionnaires administered to 422 respondents. Proportions were determined using chi-square analysis. The independent variables; economic, social and cultural factors, were regressed against exclusive breastfeeding and complementary feeding, the dependent variables. Chi-square analysis revealed that the economic factors that were significantly associated with exclusive breastfeeding practices of first-time mothers included; the primary source of food (P= 0.003), sustainability of the primary source of food (P=0.049), household food security (P= 0.013) and type of complementary feeds given (P= 0.014). Regression analysis of economic factors demonstrated that household food security has a considerable influence on child-feeding practices where first-time mothers who practice farming were six times more likely to observe the exclusive breastfeeding period (OR 6.115, 95% CI, 2.165-17.268; P=0.001) while those who purchase food were three times more likely to adhere to the exclusive breastfeeding period (OR 3.172, 95%CI, 1.175-8.562; P=0.023). First-time mothers who practice farming (OR 4.079, 95%CI, 0.979-16.995; P=0.054) and those who purchase food from the market (OR 4.266, 95%CI, 1.125-16.184; P=0.033) were four times more likely to adhere to the recommended complementary feeding period. Chi-square and regression analysis on social variables did not reveal any significant influence on child-feeding practices of first-time mothers. Regression analysis of cultural factors showed that food taboos influence feeding practices since those who do not have any taboos are three times more likely to observe the recommended complementary feeding period (OR 3.558, 95%CI 0.958-13.216; P=0.058). The analysis also revealed that first-time mothers who received child-feeding information from the clinic were seventeen times more likely to adhere to the recommended complementary feeding period (OR 17.506, 95%CI 1.011-303.166; P=0.049) where as those who received information from social gatherings were less likely to observe the recommended weaning period (OR 0.034, 95%CI 0.003-0.428; P=0.009). This study recommends alternative economic activities, social support through engagement of grandmothers and fathers and support of cultural roles and realities by healthcare providers.