Knowledge and belief of nursing mothers on nutritional management of acute diarrhoea in infants, Ibadan, Nigeria.

Abstract

Malnutrition continues to be a major public health problem in Nigeria, and this contributes substantially to childhood mortality. Culturally related food restriction and reduction in feeding frequency during common childhood illnesses such as diarrhoeal diseases further contributes to the burden of malnutrition and thus to childhood morbidity and mortality. This study was designed to determine the knowledge, attitudes and practices of nursing mothers with respect to food restriction during acute diarrhoea in Ibadan, South West Nigeria. This single round cross-sectional study adopted a purposive sampling procedure to select 250 nursing mothers aged between 17 and 45 years from the sick-baby and immunization clinics of two health facilities in Ibadan, between November 2003 and February 2004. Information on nutritional management of acute diarrhoea was collected with a structured intervieweradministered questionnaire and two focus group discussions exploring food withdrawal practices during acute diarrhoea. Data analysis was done using SPSS 11.0. Descriptive and inferential statistics were generated to test for associations. About half (46.8%) of the respondents had secondary education. Only 6.0% had knowledge of nutritional management of diarrhoea while 54.8% had knowledge of oral rehydration therapy. Seventy-one percent of respondents reported food withdrawal during acute diarrhoea in infants, 44% also reported reduction in breastfeeding frequency during acute diarrhoea and more than two-thirds of these (71.2%) cited cultural reasons for withholding breastfeeding. Mothers' educational level had no significant effect on their knowledge of nutritional management of acute diarrhoea in infants (p =0.610). Mothers' knowledge of nutritional management of acute diarrhoea had a significant effect on their attitude (p = 0.03) but not on their practice (p = 0.257). Relatives and health care providers were the sources of advice on food restriction/withdrawal during acute diarrhoea. Appropriate nutritional management during acute illness is important, and this has been found to be deficient among caregivers in the family setting. Targeting appropriate health and nutrition education to caregivers particularly mother would reduce morbidity and mortality commonly associated with childhood diarrhoea.

Home-based management of acute diarrhoeal disease in an urban slum of Aligarh, India

“…Similar findings were reported by other authors [17]. In a study from Nigeria, 71% of the respondents reported food withdrawal during diarrhoea in infants, 44% also reported reduction in breastfeeding frequency during diarrhoea, and more than two thirds of these cited cultural reasons for withholding breastfeeding [18]. In the present study, although 46.5 % of the mothers were aware of oral rehydration salts, only 29.8% knew the correct method of its preparation.…”

Harmful practices in the management of childhood diarrhea in low- and middle-income countries: a systematic review

“…Mothers reported stopping or reducing breastfeeding because of beliefs that breastmilk was too fatty to be digested [ 20 ]. Others reported continued breastfeeding would not reduce the duration of diarrhea [ 20 , 29 ] or could cause or worsen the diarrhea [ 18 , 19 , 29 ]. Caregivers in two studies believed specific types of diarrhea must be treated with breastfeeding cessation [ 29 , 30 ].…”

“…Others reported continued breastfeeding would not reduce the duration of diarrhea [ 20 , 29 ] or could cause or worsen the diarrhea [ 18 , 19 , 29 ]. Caregivers in two studies believed specific types of diarrhea must be treated with breastfeeding cessation [ 29 , 30 ]. In multiple cultures, “dirty” breast milk or secretion of ingested food through breast milk was thought to cause certain types of diarrhea.…”

“…Older relatives were also important sources of information on feeding practices during diarrhea episodes [ 25 , 31 ]. In some studies, mothers continued feeding but diluted milk or formula [ 29 ], switched to powdered or goat’s milk [ 37 ], or only gave water [ 38 ].…”

“…Some caregivers reported that a child’s diet should be restricted because of beliefs that a child cannot eat or digest as much during a diarrhea episode [ 22 , 43 ] and feeding can exacerbate or prolong diarrhea episodes [ 19 , 22 , 29 , 44 – 46 ]. Belief that only certain foods should be restricted because they can aggravate diarrhea was common across countries and included a range of foods such as meat, milk, sweet food, greasy food, high carbohydrate and high protein foods [ 29 , 37 , 38 , 43 , 47 – 54 ]. Alternatively, in two studies some caregivers reported that specific foods were customary and should be given during a diarrhea episode to strengthen the bowel or soothe the stomach [ 36 , 52 ].…”