Prelacteal feeding practices among lactating mothers in Benin City, Nigeria

Background: Exclusive breastfeeding is the cornerstone of adequate early infant nutrition. Despite the acknowledged gains of Baby Friendly Hospital Initiative (BFHI) and other interventional measures in ensuring optimal infant nutrition, it is still a common practice for newborn babies to be givensubstances other than breast milk within the first day of life.Methods: To re-examine why this is so, a prospective, cross-sectionalstudy involving mothers with recent history of lactation was carried. Itinvolved 403 mothers attending the well Baby Clinic of the Universityof Benin Teaching Hospital in 2009. A semi structured questionnairewas used in obtaining relevant information on pre-lacteal feeding.Results: The prevalence of prelacteal feeding was 11.7%. Wateronly constituted the most common (44.3%) pre-lacteal feed. Otherfeeds administered included glucose drink, (37.2%), and honey (4.6%).The reasons for pre-lacteal feeding included perceived delayed lactationand the need to keep the body warm and mouth moist. The younger the respondents, the more likely she would practice pre-lacteal feeding (X2 = 11.4; p = 0.022). Also significantly associated with pre-lacteal feeding is the route of delivery. Pre-lacteal feeding was commoner with surgical deliveries (X2 = 7.0; p = 0.05). Pre-lacteal feeding was however un-associated with respondents’ tribe, educational status, religion and place of delivery. Pre-lacteal feeding remains a challenge to adequate infant nutrition.Conclusion/Recommendations: There is need for further enlightenmenton the dangers inherent in the practice. Education of the populacewould need to be improved upon if the initial gains accruing fromBFHI are not to be reversed.Key words: Pre-lacteal feeding Infant, Nutrition, Benin City

Some economic and socio-cultural factors associated with cerebral malaria among under-fives in Benin City, Nigeria.

Introduction: Risk factors associated with the occurrence of cerebral malaria in under fives are well documented. Outside these acknowledged factors of age, location, and nutrition, other socioeconomic/cultural factors could contribute to the maze of factors determining the occurrence of the morbidity. Methods: To unravel such factors a key informant interview was conducted among resident doctors in paediatrics at the University of Benin Teaching Hospital. Factors identified formed the basis of this cross-sectional, case control study involving 64 cases each of subjects and controls with uncomplicated malaria carried out at the Hospital. Such factors as delay in accessing competent intervention, prolonged use of anti-pyretics, material educational status, use of substandard medication and abdominal scarification as identified were evaluated in the two sets of patients. Others evaluated included mothers’ occupation and health seeking behaviours. Results: Factors found to be significantly associated with occurrence of cerebral malaria were initial treatment in clinics (X2 = 6.43, p = 0.011) presence of fresh abdominal scarification (X2 = 4.30, p=0.038) late presentation (X2 = 32.64; p=0.000) and non- use of mosquito nets (X2 = 9.14; p=0.002). Conclusion/Recommendations: Initial treatment either in clinics or non orthodox facilities contributed significantly to the occurrence of cerebral malaria. The implication of these is that pre- teaching hospital treatments were inadequate in managing the child meant to develop cerebral malaria. Attention should therefore be directed at these areas alongside use of mosquito nets if the objective is to minimise the occurrence of cerebral malaria.Key words: Cerebral malaria, Risk factors, Under fives, Economic factors & Socio-cultural factors

Childhood Acute Glomerulonephritis in Benin City

A prospective study of consecutive cases of acute glomerulonephritis (AGN) in 63 children was conducted at the University of Benin Teaching Hospital (UBTH), between January 1996 and December 2000. There were 28 (44.4 percent) males and 35 (56.6 percent) females whose ages ranged from 0.2-15.0 years. The mean age of the males (6.6 + 4.3 years) did not vary significantly from that of the females (7.6 + 3.6 years) (t = 0.30; p > 0.50). The peak age incidence for both genders was three years. The lowest annual incidence of nine was seen in 1997 while the highest of 17 occurred in 2000. About 90 percent of the patients came from low socio-economic class families. Presenting features included oedema (93.7 percent), hypertension (82.5 percent), oliguria (47.6 percent) and pulmonary oedema (39.7 percent). Others were headache (11.1 percent) and convulsion (4.8 percent). Haematuria and proteinuria of varying degrees occurred in all the patients, while antecedent infections were noted in 49.2 percent. Complications included congestive cardiac failure (39.7 percent), urinary tract infection (20.6 percent), acute renal failure (12.7 percent), and hypertensive encephalopathy (4.8 percent), while mortality was 3.2 percent. Two cases each, developed nephrotic syndrome and chronic renal failure after about two years of follow up. Despite geographical variations, the pattern of the disease was similar to what obtains in other centres in the country. Nigerian Journal of Paediatrics 2003; 30:45-4

Current Practices In Infant Nutrition In Benin City, Nigeria

A community based prospective study was carried out amongst 780 mothers who had children aged less than one year in Benin City, between March and June 1998. Study subjects were selected using multistage cluster sampling method while information on child's nutrition: maternal socio-demographic parameters were obtained with the aid of a semi-structured questionnaire. Of the 780 mothers 432 (55.6%) had children who were less than 6 months while 348(44.6%) had older infants. About 98.0% of the mothers were practicing one form of breast-feeding or the other. The exclusive breastfeeding rate (EBR), predominant breastfeeding rate (PBR) and bottle-feed rates (BOTFR) were respectively 38.0% 38.8% and 19.4%. Breastfeeding practice was significantly associated with maternal age (X2=25.8;df=12;

Alpha-Tocopherol Levels in Milk of Exclusively Breast-Feeding Mothers in Benin City, Nigeria

The influence of prolonged breastfeeding on breast-milk alpha tocopherol was assessed in 112 lactating mothers practicing exclusive breast-feeding on term infants. The cross sectional study was carried out between May 1st and 30th, 2005 at the University of Benin/University of Benin Teaching Hospital, Benin City among lactating mothers. Employing the Quaife’s method, mean alpha-tocopherol values were determined in spot samples of breast milk. Though not significant mean Breast-milk (BM) alphatocopheroltended to decline with maternal age (p > 0.05) parity (p > 0.05) and duration of breastfeeding. Similarly, family socio-economic status did not significantly influence mean BM alphatocopherol levels. Exclusive and or prolonged breast feeding do not predispose the infant to lowvitamin E supplies through the breast milk. Further studies are advocated to evaluate the effects of other biosocial variables on the levels of BM anti-oxidant vitamins including alpha-tocopherol (Afr J Reprod Health 2009; 13[2]:55-60)

Evaluation of some predisposing factors to malaria related anaemia among children in Benin City, Nigeria

Predisposing factors to severe anaemia in children must be determined and controlled before blood transfusion rate can be reduced among them. Malaria related anaemia remains common indication for blood transfusion in endemic areas and this study was carried out in order to evaluate some of these predisposing factors. It was carried out at the University of Benin Teaching Hospital, Benin City between June and December 2003. Children with malaria related moderate-severe anaemia were recruited for the study while children with uncomplicated malaria were used as controls. Only 6.4% of the 357 cases received treatment in orthodox health facilities within 48 hours of onset of illness. Reasons adduced for delay, included confidence in other facilities (38.0%), financial constraints, 8.5% and parental ill health (1.5%). In 32.3% of cases, children were considered not ill enough. First aid treatment offered by caregivers included, paracetamol only, paracetamol and chloroquine at sub-optimal doses in 39.2% of cases. Moderate- severe anaemia was significantly associated with time of presentation in hospital (χ2 = 4.97,

Micro-Albuminuria In Adolescent/Young Adult Offsprings Of Hypertensive Nigerian Adults - A Preliminary Report

Objectives: To determine the prevalence of micro-albuminuria in adolescent/young adult offsprings of Nigeria hypertensive adults. Background: On the premise that micro-albuminuria is a predictor of early stage hypertensive disease and the fact that heredity plays an important role in the aetiology of essential hypertension, the prevalence of micro-albuminuria in children of hypertensive adults was assessed. Setting: Medical wards of the University of Benin Teaching Hospital, Benin City. Subjects: Normotensive, non-diabetic, non-obese adolescents/young adult offsprings of known adult hypertensives, receiving in-patient care. Controls had similar characteristics but born to normotensive adults. Design: Prospective, cross-sectional involving 42 subjects and 50 controls. Results: Mean age of the 42 study subjects (24 males and 18 females) was 17.95+0.52years (range 13 – 24 years). Eight (19.0-%) had microalbuminuria as compared to 4(8.0%) in controls. Five (62.5%) of the micro-albuminuric subjects had fathers who were hypertensive while none had maternal history of hypertension. The incidence of microalbuminuria in subjects with positive paternal history of hypertension was 21.1% as against 0.0% in those with positive maternal history of hypertension. Parental history of diabetes mellitus did not enhance the risk of micro-albuminuria. Similarly, combined morbidities of hypertension and diabetes mellitus in either parents or both were unassociated with increased incidence of micro-albuminuria. Mean duration of paternal hypertension of 9.20± 2.09 years did not vary from 8.90±1.13years in the parents of those who were micro-albuminuria negative. Conclusion: Microalbuminuria could be a predictor of early phase adolescent hypertensive disease and such may have more relevance in offsprings of Nigerians at risk of hypertensive fathers. Recommendation: Longitudinal and more detailed work employing timed urine sample is advocated to further examine these relationships. Key Words: Micro-albuminuria, Adolescents, Parental essential hypertension, Africans. Nigerian Journal of Clinical Practice Vol. 7(2) 2004: 60-6