CHAPTER ONE

INTRODUCTION

1.1 Background

Over the past 20 years, Exclusive Breastfeeding (EBF) has gained significant attention as the preferred feeding method for newborns, driven by growing scientific evidence on its role in reducing infant morbidity and mortality (Khan et al., 2022). This shift is largely due to research highlighting the benefits of exclusive breastfeeding in promoting infant health and well-being (Adu-Afarwuah et al., 2023). Breast milk is the ideal food for infants and it is safe, clean and equally contains antibodies which helps protect against many common childhood illnesses. Breast milk provides all the energy and nutrients that infants need for the first six months of life (WHO, 2022). Breastfed children perform better on intelligence tests, are less likely to be overweight or obese and less prone to diabetes later in life. Women who breastfeed also have a reduced risk of breast and ovarian cancer (WHO, 2023).

EBF is the most efficient type of infant feeding for the first six months of life. The United States Breastfeeding Committee (USBC) and the American Academy of Pediatrics (AAP) have declared that breastfeeding is a physiologically normal form of infant and child nutrition (Mehta et al., 2022). Exclusive breastfeeding (EBF) is defined as the exclusive intake of breast milk by an infant from its mother or wet nurse or expressed milk with addition of no other liquid or solid with the exception of drops or syrups consisting of vitamins, minerals supplements, or medicine and nothing else for the first six months of life (Oche M.O et al 2018)

EBF is an important public health strategy for improving children’s and mother’s health by reducing child morbidity and mortality and helping to control healthcare cost in society, particularly in low and middle-income countries (Albinali AM et al, 2012). Every year, exclusive breastfeeding practice can prevent about 1.4 million deaths worldwide among children under five (Sinshowy et al, 2015). Beyond the benefits that breastfeeding confers to the mother-child relationship, EBF lowers the incidence of many childhood illnesses, such as middle infections pneumonia, sudden infant death syndrome, diabetes mellitus, malocclusion and diarrhea (Agbo et al, 2018). However, contrary to WHO recommendations, fewer than half of infants under six months old are exclusively breastfed. Worldwide, the prevalence of children receiving Breast milk within an hour after birth is only 44% of the infants (WHO/UNICEF, 2017).

Studies have focused on the benefits of breastfeeding to infants, young children, mothers and communities  (Sokol, et al., 2020). Breastfeeding is also shown to have important benefits throughout the life cycle (Kramer, et al., 2019; Patel et al., 2020). Indeed breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers. Exclusive breastfeeding (EBF) for six months is the optimal way of feeding infants. Thereafter, infants should receive complementary foods with continued breastfeeding up to two years of age and beyond (Kramer et al, 2019; Patel & Cooper, 2021; Oluwatosin, 2020). EBF of infants for the first six months of life is considered a global public health goal that is linked to the reduction of morbidity and mortality in infants especially in low middle-incomecountries (Almirew M. W et al 2017).

EBF is the first prized gift from mother to the baby that exists to benefit the baby, mother, and community (Sankar M.J, Sinha B et al, 2015). Moreover, despite the documented importance and advantages of practicing EBF, the practice is still not widespread with an unsatisfactory level recorded across the globe and most especially in developing countries (Arage G et al, 2016). In Cameroon, about 92% of children less than six months old are exposed to breastfeeding, but of these, less than 50% are exclusively breastfed for six months and about 88.8% received colostrum (Gejo N G, Weldearegay H G et al, 2019). Mothers also face the barrier to exclusive breastfeeding due to the need to return to work outside the home or the feeling of uncomfortable to breastfeed in public places, such as restaurants, workplaces, shopping centers, and public transport (Coomson & Aryeetey, 2018).Therefore this study was aimed at assessing the knowledge, attitude, and practice (KAP) of exclusive breastfeeding among women of reproductive age (15-49 years) in the Teke Community.

1.2 Problem statement

A study conducted in Cameroon indicated that approximately 97.4% of the women of reproductive age adhered to early initiation of EBF in the first life of a child; however, only 20% continued to exclusively breastfeed their babies within the first six months, as recommended by the WHO and UNICEF. (Ngamni et al, 2019). This gradual decrease in EBF practices among women of the reproductive age is linked to poor physical and social support from families, undesired pregnancy, and a lack of knowledge on maternal role. The studies that have been conducted on breastfeeding and associated factors have focused on women in general, and little is known about the reproductive populations who may have different perceptions; moreover, these studies have reported disproportionate low breastfeeding rates among women of the reproductive age. This gap that our study intends to address is to explore in depth the knowledge, attitudes, and practices of the reproductive age women towards exclusive breastfeeding. Therefore, this study was aimed to assess the level of knowledge of the reproductive age women regarding exclusive breastfeeding and their attitudes and practices in the Teke community. The findings will contribute to improving EBF practices among adolescent mothers to sustain the healthy growth of a child and health benefits for the mother.

1.3 Significance of the study

This study will help to educate women of reproductive age on the many benefits of Exclusive breastfeeding such as nutritional, developmental, psychological, neurological, social, environmental, and immunological benefits for the infant, mother, and community. This study will also promote and support the practice of exclusive breastfeeding among women of reproductive age in the Teke community and increase the number of mothers who want to achieve the better development of their children. It will also help policymaker to come up with an intervention that could improve knowledge, attitude, and practice of women of reproductive age regarding exclusive breastfeeding.

1.4  Research Objectives

• General objective

The aim of this study is to assess the level of knowledge, attitude, and practice of exclusive breastfeeding among women of the reproductive age in the Teke community.

1.4.2 Specific Objectives

1. To determine the level of knowledge of exclusive breastfeeding among women of reproductive age (15-49 years) in the Teke community.
2. To evaluate the attitude of exclusive breastfeeding among women of reproductive age (15-49 years) in the Teke community.
3. To determine the level of practice of exclusive breastfeeding among women of  reproductive age (15-49 years) in the Teke community.

1.5 Research Questions

1. What is the level of knowledge on exclusive breastfeeding among women of reproductive age (15-49 year) in Teke community?
2. What is the attitude of women of reproductive age (15-49 years) towards exclusive breastfeeding in Teke community?
3. What is the level of practice of exclusive breastfeeding among women of reproductive age (15-49 years) in Teke community?