Breastfeeding pattern, anthropometry and health status of infants attending child welfare clinics of a teaching hospital in Nigeria

Objective: To determine the breastfeeding pattern and its relationship with the physical growth and health status of infants aged 0–24 weeks.Design and setting: A prospective cohort study was carried out at three comprehensive health centres of Nnamdi Azikiwe University Teaching Hospital, Anambra State (Nigeria) from September 2006 to June 2007. The feeding pattern, body weight, length and morbidity of 228 infants were assessed at birth, 6, 10, 14, 20 and 24 weeks when they visited the child welfare clinics for routine immunisations or on appointment. The infants were recruited from the immunisation registers by a systematic random sampling method. Based on their current feeding pattern during the period under study, infants were classified into exclusive breastfeeding (EBF) and non-exclusive breastfeeding (non-EBF) groups. Data analysis was carried out using SPSS and Epi Info statistical computer software. A probability value (p-value) of less than 0.05 was considered statistically significant.Results: The EBF rate declined progressively from 64.9% at birth to 37.3% at 24 weeks of age. Maternal older age, multiparity and delivery at a government health facility were positively associated with higher rates of EBF (p < 0.05). Only 110 (48.2%) babies were put to the breast immediately (≤ 1 hour) after delivery. The numbers that received colostrum and prelacteal feed were 118 (82.5%) and 59 (25.9%), respectively. On-demand breastfeeding was more popular than timed feeding (95.5% vs 7.5%; p < 0.05). At 24 weeks of age EBF males and females achieved a better and more rapid growth in weight and length compared to those in the non-EBF group (p = 0.000). Episodes of diarrhoea and fever were significantly associated with non-EBF (p = 0.000).Conclusion: The study revealed that EBF had a positive effect on the physical growth and health status of infants, but the rate of EBF was low. It is suggested that activities that promote appropriate breastfeeding practices should be targeted at mothers and locations in which poor breastfeeding practices exist.Keywords: breastfeeding pattern; anthropometry; health status; infant

Bacterial Load In Expressed And Stored Breast Milk Of Lactating Mothers In Abia State, Nigeria

The use of expressed breast milk has been advocated as an effective way of encouraging and maintaining lactation when the mother is separated from the baby for a while. However, prospects of storage of expressed breast milk for any considerable period of time is hindered by the possibility of bacterial contamination and growth of infectious pathogens in the stored milk. Previous research worldwide has focused on optimal conditions for storing expressed breast milk. This study investigated bacterial growth in expressed breast milk stored at two different conditions and time periods. A total of 240 randomly selected lactating mothers participated in a survey used to elicit information on their practices concerning expressed and stored breast milk. Out of this, 20 lactating mothers were willing to donate their breast milk, which was used for microbial studies. Using antiseptic procedures, breast milk samples were collected from these 20 lactating mothers by manual expression and put into sterile containers. One half was stored at room temperature (30°C), while the other half was immersed in a container of water (26°C) for 0, 3, 6 and 9hrs. The samples at different time periods in both storage conditions were plated on three different culture media (Nutrient agar, MacConkey agar and Chocolate agar) and incubated for 24hrs. Bacterial load was enumerated and isolates were characterized and identified. Data was analyzed using one way ANOVA and presented as frequencies, percentages means and standard deviations. Results showed that in all the culture media, bacterial load was higher in breast milk samples stored at room temperature for up to 9hrs compared to that immersed in water (p<0.05). However, the average colony counts were within acceptable limits (<104CFU/ml). Enterococcus faecalis , Escherichia coli and Staphylococcus aureus were the predominant bacteria isolated in the breast milk samples under both storage conditions. The findings from this study revealed that storage of breast milk either at room temperature or immersed in a container of water appeared to be safe for up to 9 hours of storage in a tropical environment. Generally, the number of microbes was within levels considered acceptable in expressed breast milk

Determinants of breastfeeding pattern among nursing mothers in Anambra state, Nigeria

Objectives: The practice of optimal breastfeeding including exclusive breastfeeding for the first six months of life is still rare among nursing mothers despite numerous benefits of breastfeeding. This study was aimed at identifying the factors influencing breastfeeding pattern among nursing mothers in Anambra State, Nigeria.Methods: A cross sectional study was carried out in three comprehensive health centres of Nnamdi Azikiwe University Teaching Hospital (NAUTH) located at Neni, Ukpo and Nnewi communities of Anambra State. A semi structured questionnaire was interviewer administered on 228 nursing mothers consecutively selected by a systematic random sampling method as they visited the maternal and child welfare clinics. In addition, four sessions of focus group discussions (one in each centre) involving 8-10 nursing mothers were held.Results: Most mothers 190 (83.3%) were aged between 20 and 34 years. About 152 (66.6%) had attended or completed secondary education and were mainly traders 86 (37.7%) and full time house wives 66 (29.0%). Majority 208 (91.2%) had at least good knowledge of breastfeeding. Their main source of breastfeeding education was government health facilities (80.85%). Only 85 (37.3%) breastfed exclusively. Exclusively breastfeeding was significantly associated with maternal older age, parity, delivery at government facility, positive family attitude towards exclusive breastfeeding and breastfeeding education from government health facility (p&lt;0.05). Focus group discussion showed that mothers believed that adequate nutrition, physical, financial and emotional support to them would increase exclusive breastfeeding practice.Conclusion: Exclusive breastfeeding rate was low among the mothers and the factors identified to influence its practice have important implications to breastfeeding intervention programmes. Activities to promote exclusive breastfeeding should be focused on the group of women and location in which it was poorly practiced. In addition, support to the mothers would be necessary.Keywords: Breast feeding pattern, determinants, nursing mother

A Study on Workplace Violence Against Health Workers in a Nigerian Teaching Hospital

No Abstract

Correlates of obesity indices and systemic arterial hypertension in adult Nigerians: a community based study

Background: The aim of the study was to determine the correlation between indices of obesity and systemic arterial hypertension in adult Nigerians.Methods: This cross-sectional descriptive survey and was carried out in Abia state, southeast Nigeria. Two thousand nine hundred and ninety nine (2,999) subjects, aged =18years were selected by a multi-stage sampling technique from six Local Government Areas of Abia state, south east Nigeria. The World Health Organization Stepwise Approach to Surveillance of chronic disease risk factors was used. Body mass index, anthropometric measurements, and other relevant data were collected.Results: Two thousand eight hundred and seven subjects (2,807) gave all the relevant data required. The prevalence of hypertension by three obesity indices, body mass index (BMI), waist circumference (WC), and waist to hip ratio (WHR) was 16.7%, 27.2%, 42.3% respectively. The correlation coefficient (r) of the obesity indices with systolic BP for BMI was 0.141 and 0.110, for WC was 0.182 and 0.198, and for WHR was 0.130 and 0.167, in males and females respectively. The r coefficient of the obesity indices with diastolic BP for BMI was 0.205 and 0.171, for WC was 0.182 and 0.217, and for WHR was 123 and 0.118 in males and females respectively. The odds ratio of obesity indices with BP for BMI was 1.54, and 1.06, for WC was 1.72 and 2.13 and for WHR was 1.48 and 1.47 for males and females respectively. The OR of obesity indices with diastolic BP for BMI was 1.41 and 1.40, for WC was 1.14 and 1.40, and for WHR was 1.28, and 1.20 in males and females respectively.Conclusion: There exit a weak relationship between the indices of obesity and BP.Keywords: Body Mass Index, Waist Circumference, Waist to Hip Ratio, Hypertensio