Infant Feeding Practices in Khartoum Province

Abstract

Infant feeding the most beneficial form of feeding children in their early life, is of great importance as a determinant of child wellbeing as well as setting roots for better health in adulthood. The study we have endeavored to perform is a community based, descriptive, comparative, retrospective and randomized study. It was conducted in Khartoum Province in three different areas, Al-Riadh (urban elite), Al-Salama (peri-urban moderate) and Mayo (peri-urban poor) in the period from Jan 2000 to Jun 2000. The study was designed and conducted in order to evaluate the current infant feeding practices among mothers in Khartoum, to evaluate their knowledge about the optimum infant-feeding practices and to study the effect of different infant feeding practices on children's physical growth and haemoglobin status. 435 children were included in the study, 137 from Al-Riadh, 146 from Al-Salama and 152 from Mayo. Breast-feeding was practiced by (96.1%) of the population mothers, with no difference in this practice in the three areas of study. Breast-feeding initiation was early in 61.1%, delay being commoner among peri-urban poor population. Colostrum feeding rate was also high being 88.7%. Most mothers (90.2%) fed their children on demand, mothers who practiced scheduled feeding were mainly from the urban elite population where (21.4%) of the mothers there fed their children on hourly schedule. The main mode of feeding practiced by the mothers during infancy was breast-feeding in (58.6%), (19.1%) were artificially fed while (22.3%) were given mixed feeding. Exclusive breast-feeding was practiced by only (45.9%) of the population, (78.6%) of urban elite mothers, while in peri-urban moderate and peri urban poor only (32.4%) and (29.7%) practiced it respectively. Early supplementation before the age of two weeks was a common practice in (34.0%), the practice was commoner among peri-urban moderate and peri-urban poor where they constituted (41.1%) and (41.5%) respectively. Solid food introduction was initiated in (71.5%) between the age of 4-7 months in the three areas. Feeding bottles were used by (38.9%) while (61.1%) used cups and spoons in giving fluids. Urban elite mothers used feeding bottles much more (73.7%) than the other two groups. Most mothers in peri-urban moderate and poor areas who used feeding bottled had one bottle only (31.8%) in the former and (70.8%) in the latter, while mothers from urban elite had two or more bottles (79.2%). Weaning was gradual in most children (63.9%), sudden weaning mostly due to a new pregnancy was practiced by peri-urban mothers. Urban elite mothers weaned their babies earlier, mostly at the age of 12- 17 months, while the other two groups weaned their babies at the age of 18-24 months. The knowledge of mothers was good in (52.2%), while attitude score was good in (72.2%), practice score was good in (80%). Mothers from the peri-urban areas had lower scores, especially so in the knowledge, where only (47.9%) in the moderate and (32.2%) in the poor areas scored good in knowledge. In the urban mothers, good knowledge was scored by (78.8%) of mothers. The number of diarrhoeal episodes was found to be related to exclusive breast-feeding. (34.3%) of the exclusively breast-fed population had no diarrhoea in the first year of life, while in the supplemented group they were only (3.6%). More diarrhoeal episodes per year were recorded among the supplemented group, the difference being of high significance. However, age at the first episode of diarrhoea did not show significant correlation with mode of feeding. Growth parameters in relation to mode of feeding showed no statistically significant differences in the three study areas. Haemoglobin tended to be higher among the breast-fed (mean = 11.5 gm/dl) group in comparison with the artificially fed (10.8 gm/dl) and the mixed fed children (10.9 gm/dl). The variation in haemoglobin in relation to mode of feeding was found to be of statistical significance only in Mayo, where anaemia tended to be less common among breastfed infants than the other two modes of feeding