1.1 Introduction
Exclusive breastfeeding is defined as providing an infant only breast milk from birth up to six months of age without the inclusion of water, formula, or any other liquid and solid foods, except for oral rehydration solutions, drops, or syrups of vitamins, minerals, or medicines when necessary (World Health Organization, 2023). Weaning is the process of gradually introducing an infant to complementary foods while reducing reliance on breast milk and is usually recommended to begin around six months of age to meet the evolving nutritional needs of the growing child (UNICEF, 2022). Exclusive breastfeeding is globally recognized as a cornerstone of infant nutrition because it provides optimal nutrients, strengthens immunity, and reduces the risk of common childhood illnesses such as diarrhoea and pneumonia (Victora et al., 2016).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Breastfeeding is universally acknowledged as one of the most effective ways to ensure child health and survival, yet global and local trends show inconsistent adherence to recommended breastfeeding and weaning practices. According to the World Health Organization (2023), exclusive breastfeeding refers to the practice of feeding infants only breast milk for the first six months of life, with no additional food or drink, not even water, except for medically necessary liquids such as vitamins or oral rehydration. This period of exclusive breastfeeding is critical because breast milk provides all the essential nutrients, antibodies, and immune protective factors necessary for optimal infant growth and development. Researchers have repeatedly reported that infants who are exclusively breastfed up to six months have a lower risk of infectious morbidity and mortality, improved cognitive outcomes, and stronger immunological responses compared to those who receive mixed feeding early in life.
In many parts of sub Saharan Africa, including Nigeria, studies have shown that exclusive breastfeeding rates remain below national and international targets. For instance, Adewuyi and Adefemi (2019) stated that socio cultural barriers, gaps in maternal education, and inadequate support systems are among the factors contributing to lower rates of exclusive breastfeeding. Similarly, Ogbo et al. (2020) asserted that economic pressures, maternal employment outside the home, and limited maternity leave policies have been significant determinants affecting mothers' ability to sustain exclusive breastfeeding for the recommended six months.
According to UNICEF (2022), appropriate weaning should begin at around six months of age when breast milk alone is no longer sufficient to meet the infant's nutritional requirements. However, the timing and nature of weaning practices vary widely among populations. Some mothers introduce complementary foods too early due to perceived inadequate milk supply or family pressures, while others delay weaning, believing the infant is not ready or because of fear of allergic reactions. In a study conducted in Ethiopia, Abie and Goshu (2019) reported that delayed or inappropriate weaning was associated with an increased risk of micronutrient deficiencies and growth faltering in infants aged 6–12 months (Abie and Goshu, 2019).
In the context of health services, healthcare professionals play a critical role in shaping mothers' knowledge and attitudes. According to Smith and Jones (2019), effective breastfeeding counselling provided during antenatal visits and immediately after birth is associated with higher exclusive breastfeeding rates at six months. However, many mothers in resource limited settings may not receive adequate breastfeeding counselling due to understaffed health facilities, limited training of health workers, and poor continuity of care. It has been reported that when health workers lack confidence in counselling or when messages are inconsistent, mothers may become confused about recommended practices or revert to traditional feeding methods.
Exclusive breastfeeding and appropriate weaning are also influenced by broader social determinants of health such as household income, access to maternal leave, and support from family and peers. In an analysis of feeding practices in urban and rural Nigeria, Adepoju et al. (2021) stated that urban mothers with formal employment were less likely to practice exclusive breastfeeding due to workplace demands and lack of supportive breastfeeding policies. On the other hand, mothers in rural areas reported stronger community networks that encouraged traditional mixed feeding practices, which affected timely weaning and exclusive breastfeeding. This study is set against the backdrop of ongoing global and national efforts to promote exclusive breastfeeding and appropriate weaning as essential strategies for improving infant survival, growth, and development.
1.3 Statement of Problems
Investigation revealed that breastfeeding is universally recognized as a critical element in ensuring optimal infant health outcomes, yet many communities are still confronted with low rates of exclusive breastfeeding despite global recommendations by the World Health Organization that infants is exclusively breastfed for the first six months of life (WHO, 2023). In Nigeria, disparities in exclusive breastfeeding practices is persistently reported, with many mothers not practicing appropriate breastfeeding or timely weaning due to limited understanding of its benefits and misconceptions about breast milk sufficiency (UNICEF, 2022).
Furthermore, mothers' attitudes towards exclusive breastfeeding and weaning is influenced by cultural beliefs, employment demands, and perceived social norms, which is often negative or unsupportive of recommended practices (Adewuyi & Adefemi, 2019). Knowledge about the nutritional importance of exclusive breastfeeding and the appropriate age for introducing complementary foods is unevenly distributed among mothers, with some showing superficial awareness that is not matched by positive attitudes or safe feeding practices (Abie & Goshu, 2019). It is against this backdrop that this study seeks to investigate the knowledge, attitude, and practice of exclusive breastfeeding and weaning among mothers at Babcock University Medical Centre.
1.4 Aim and Objectives of Study
The aim of the study is to assess the knowledge, attitudes, and practices of exclusive breastfeeding and weaning among mothers at Babcock University Medical Centre. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the level of knowledge mothers have regarding exclusive breastfeeding and appropriate weaning practices.
- To examine the attitudes of mothers towards exclusive breastfeeding and weaning.
- To evaluate the actual practices of mothers concerning exclusive breastfeeding and the introduction of complementary foods.
- To identify socio-economic, cultural, and systemic factors that influence mothers' feeding behaviours.
- To provide recommendations for improving healthcare support, education, and community awareness regarding optimal infant feeding practices.
1.5 Research Questions
Based on the stated objectives, the following research questions guide the study:
- What is the level of knowledge among mothers regarding exclusive breastfeeding and weaning?
- What attitudes do mothers hold towards exclusive breastfeeding and weaning practices?
- How do mothers implement exclusive breastfeeding and weaning in practice?
- What socio-economic, cultural, and systemic factors influence mothers' feeding behaviours?
- What interventions or strategies could improve mothers' knowledge, attitudes, and practices regarding infant feeding?
1.6 Research Hypotheses
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between mothers' knowledge of exclusive breastfeeding and weaning and their actual feeding practices at Babcock University Medical Centre.
- H1: There is a significant relationship between mothers' knowledge of exclusive breastfeeding and weaning and their actual feeding practices at Babcock University Medical Centre.
Hypothesis Two
- H0: Mothers' knowledge of exclusive breastfeeding and weaning has no significant positive relationship with their actual feeding practices at Babcock University Medical Centre.
- H1: Mothers' knowledge of exclusive breastfeeding and weaning has a significant positive relationship with their actual feeding practices at Babcock University Medical Centre.
1.7 Significance of Study
It is believed that at the completion of the study, the findings will assist healthcare administrators at Babcock University Medical Centre in evaluating the effectiveness of their maternal and child health services. The study will also benefit mothers directly by accentuating the practical implications of breastfeeding and weaning on child health, growth, and immunity.
Furthermore, the study will inform healthcare practitioners about the specific needs of mothers, allowing them to design targeted educational programs and counselling interventions that improve infant nutrition and overall child health outcomes
Lastly, the research will contribute to the existing body of literature on maternal and child health by providing empirical data specific to the Babcock University Medical Centre context.
1.8 Scope of Study
The scope of the study is confined to maternal knowledge, attitude, and practice at Babcock University Medical Centre in Ogun State, Nigeria. The study was limited to mothers who attended the centre during the research period and excludes mothers from other healthcare facilities.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
- Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
1.10 Definition of Terms
Exclusive Breastfeeding: Feeding an infant only breast milk for the first six months of life without the addition of water, formula, or solid foods, except for medically required supplements (WHO, 2023).
Weaning: The gradual process of introducing complementary foods to an infant while reducing reliance on breast milk, usually beginning around six months of age (UNICEF, 2022).
Knowledge: Awareness and understanding of recommended breastfeeding and weaning practices, including benefits, duration, and nutritional importance (Abie & Goshu, 2019).
Attitude: Mothers' feelings, beliefs, and dispositions towards breastfeeding and weaning practices, which influence their willingness to adopt recommended behaviours (Adewuyi & Adefemi, 2019).
Practice: The actual implementation of breastfeeding and weaning behaviours by mothers in real-life contexts, including frequency, duration, and timing of complementary food introduction (Ogbo et al., 2020).
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