Infant nutrition in the first seven days of life in rural northern Ghana

BMC Pregnancy and Childbirth

Cyril Engmann²  Abraham Hodgson¹  Gideon Affah¹  Gideon Logonia¹  John Williams¹  Philip Adongo³  Sarah Rominski⁴  Cheryl A Moyer⁴  Raymond Akawire Aborigo¹ 

[1] Navrongo Health Research Centre, Post Office Box 114, Navrongo, Ghana;University of North Carolina, North Carolina, USA;University of Ghana, Legon, Greater Accra Region, Ghana;University of Michigan, Ann Arbor, Michigan, USA

关键词: Neonatal;    Early neonatal;    Breastfeeding;    Infant feeding;   

Others  :  1152569
DOI  :  10.1186/1471-2393-12-76

 received in 2012-05-18, accepted in 2012-07-26,  发布年份 2012

【 摘 要 】

Background

Good nutrition is essential for increasing survival rates of infants. This study explored infant feeding practices in a resource-poor setting and assessed implications for future interventions focused on improving newborn health.

Methods

The study took place in the Kassena-Nankana District of the Upper East Region of northern Ghana. In-depth interviews were conducted with 35 women with newborn infants, 8 traditional birth attendants and local healers, and 16 community leaders. An additional 18 focus group discussions were conducted with household heads, compound heads and grandmothers. All interviews and discussions were audio taped, transcribed verbatim and analyzed using NVivo 9.0.

Results

Community members are knowledgeable about the importance of breastfeeding, and most women with newborn infants do attempt to breastfeed. However, data suggest that traditional practices related to breastfeeding and infant nutrition continue, despite knowledge of clinical guidelines. Such traditional practices include feeding newborn infants water, gripe water, local herbs, or traditionally meaningful foods such as water mixed with the flour of guinea corn (yara’na). In this region in Ghana, there are significant cultural traditions associated with breastfeeding. For example, colostrum from first-time mothers is often tested for bitterness by putting ants in it – a process that leads to a delay in initiating breastfeeding. Our data also indicate that grandmothers – typically the mother-in-laws – wield enormous power in these communities, and their desires significantly influence breastfeeding initiation, exclusivity, and maintenance.

Conclusion

Prelacteal feeding is still common in rural Ghana despite demonstrating high knowledge of appropriate feeding practices. Future interventions that focus on grandmothers and religious leaders are likely to prove valuable in changing community attitudes, beliefs, and practices with regard to infant nutrition.

【 授权许可】

   
2012 Aborigo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Onis M: Breastfeeding in the WHO Multicentre Growth Reference Study. Acta Paediatr 2006, 95:16-26.
• [2]WHO 10 facts on nutrition. 2011. Available: http://www.who.int/features/factfiles/nutrition/en/index.html webcite. Accessed 6 August 2011
• [3]Cattaneo A, Quintero-Romero S: Protection, promotion and support of breastfeeding in low-income countries. Semin Fetal Neonatal Med 2006, 11:48-53. Available: http://www.sciencedirect.com/science/article/pii/S1744165X05000880 webcite. Accessed 11 August 2011
• [4]WHO/UNICEF FU: Global Strategy for Infant and Young Child Feeding. 2003. Available: http://www.waba.org.my/pdf/gs_iycf.pdf webcite. Accessed 30 August 2011
• [5]Gartner LM, Morton J, Lawrence RA, Naylor AJ, O’Hare D, et al.: Breastfeeding and the use of human milk. Pediatrics 2005, 115:496-506. Available: http://www.ncbi.nlm.nih.gov/pubmed/15687461 webcite. Accessed 6 August 2011
• [6]Allen J, Hector D: Benefits of breastfeeding. NSW Public Health Bull 2005, 16:42-46. Available: http://www.publish.csiro.au/paper/NB05011 webcite. Accessed 6 August 2011
• [7]Fifty-fourth World Health Assembly: Geneva, 14-17 May 2001) Resolution WHA54.2: Infant and young child nutrition. (WHA54.2. World Health Organization, Geneva, Switzerland; 2001. http://www.who.int/gb/ebwha/pdf_files/WHA54/ea54r2.pdf webcite
• [8]WHO Global Strategy for Infant and Young Child Feeding (n.d.). WHO; Available: http://www.who.int/maternal_child_adolescent/topics/child/nutrition/global/en/index.html webcite. Accessed 31 July 2012
• [9]WHO Exclusive breastfeeding for six months best for babies everywhere (n.d.). WHO; Available: http://www.who.int/mediacentre/news/statements/2011/breastfeeding_20110115/en/ webcite. Accessed 31 July 2012
• [10]WHO The World Health Organization’s infant feeding recommendation. 2011. Available: http://www.who.int/nutrition/topics/infantfeeding_recommendation/en/index.html webcite. Accessed 6 August 2011
• [11]Arifeen S, Black RE, Antelman G, Baqui A, Caulfield L, et al.: Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics 2001, 108:E67. Available: http://www.ncbi.nlm.nih.gov/pubmed/11581475 webcite. Accessed 9 August 2011
• [12]Kramer MS, Kakuma R: The optimal duration of exclusive breastfeeding: a systematic review. Adv Exp Med Biol 2004, 554:63-77. Available: http://www.ncbi.nlm.nih.gov/pubmed/15384567 webcite. Accessed 31 July 2012
• [13]Mihrshahi S, Ichikawa N, Shuaib M, Oddy W, Ampon R, et al.: Prevalence of exclusive breastfeeding in Bangladesh and its association with diarrhoea and acute respiratory infection: results of the multiple indicator cluster survey 2003. J Health, Population, and Nutrition 2007, 25:195.
• [14]Vaahtera M, Kulmala T, Hietanen A, Ndekha M, Cullinan T, et al.: Breastfeeding and complementary feeding practices in rural Malawi. Acta Paediatr 2001, 90:328-332. Available: http://www.ncbi.nlm.nih.gov/pubmed/11332176 webcite. Accessed 31 July 2012
• [15]Lauer J, Betran A, Victora C, de Onis M, Barros A: Breastfeeding patterns and exposure to suboptimal breastfeeding among children in developing countries: review and analysis of nationally representative surveys. BMC Med 2004, 2:26. Available: http://www.biomedcentral.com/1741-7015/2/26 webcite. Accessed 11 August 2011 BioMed Central Full Text
• [16]NHRC: Navrongo Health Research Centre 2010 Annual Report. 2010. Available: http://www.navrongo-hrc/annreports/2010-ANNUAL-Report.pdf webcite. Accessed 24 February 2012
• [17]Moyer CA, Aborigo RA, Logonia G, Affah G, Rominski S, et al.: Clean delivery practices in rural northern Ghana: A qualitative study of community and provider knowledge, attitudes, and beliefs systems. BMC Pregnancy Childbirth 2012, 12:50. Available: http://www.biomedcentral.com/1471-2393/12/50/abstract webcite. Accessed 15 June 2012
• [18]Edmond KM, Zandoh C, Quigley MA, Amenga-Etego S, Owusu-Agyei S, et al.: Delayed Breastfeeding Initiation Increases Risk of Neonatal Mortality. Pediatrics 2006, 117:e380-e386. Available: http://pediatrics.aappublications.org/content/117/3/e380.abstract webcite. Accessed 12 August 2011
• [19]Tawiah-Agyemang C, Kirkwood BR, Edmond K, Bazzano A, Hill Z, Suppl 2: Early initiation of breast-feeding in Ghana: barriers and facilitators. J Perinatol 2008, 28:S46-S52. Available: http://www.ncbi.nlm.nih.gov/pubmed/19057568 webcite. Accessed 14 August 2011
• [20]Ramara NS, Maputle MS, Lekhuleni ME: Infant feeding and HIV positive mothers in the Capricorn District of Limpopo province. Curationis 2010, 33:5-16. Available: http://www.ncbi.nlm.nih.gov/pubmed/21469459 webcite. Accessed 16 April 2011
• [21]Ott MA, Schwarz DF, Ellen JM: The relationship between grandmothers’ involvement in child care and emergency department utilization. Pediatr Emerg Care 1995, 11:223-225.
• [22]Arts M, Geelhoed D, De Schacht C, Prosser W, Alons C, et al.: Knowledge, beliefs, and practices regarding exclusive breastfeeding of infants younger than 6 months in Mozambique: a qualitative study. J Hum Lact 2011, 27:25-32. quiz 63–65. Available: http://www.ncbi.nlm.nih.gov/pubmed/21177988 webcite. Accessed 31 July 2012
• [23]Nelson A, Sethi S: The breastfeeding experiences of Canadian teenage mothers. J Obstet Gynecol Neonatal Nurs 2005, 34:615-624. Available: http://www.ncbi.nlm.nih.gov/pubmed/16227517 webcite. Accessed 14 August 2011
• [24]Littman H, VanderBrug Medendorp S, Goldfarb J: The Decision to Breastfeed. Clin Pediatr 1994, 33:214-219. Available: http://cpj.sagepub.com/content/33/4/214.abstract webcite. Accessed 14 August 2011
• [25]Holman DJ, Grimes MA: Patterns for the initiation of breastfeeding in humans. Am J Hum Biol 2003, 15:765-780. Available: http://www.ncbi.nlm.nih.gov/pubmed/14595868 webcite. Accessed 14 August 2011
• [26]Masvie H: The role of Tamang mothers-in-law in promoting breast feeding in Makwanpur District, Nepal. Midwifery 2006, 22:23-31. Available: http://www.ncbi.nlm.nih.gov/pubmed/15967547 webcite. Accessed 14 August 2011
• [27]Aubel J, Touré I, Diagne M: Senegalese grandmothers promote improved maternal and child nutrition practices: the guardians of tradition are not averse to change. Soc Sci Med 2004, 59:945-959. Available: http://www.ncbi.nlm.nih.gov/pubmed/15186896 webcite. Accessed 31 July 2012
• [28]CANAH: Partnering with Grandmothers and Healers to Eliminate the “Disease of Dust” in Senegal: A Case Study in Community-based Tuberclosis Control. 2008. Available: http://www.coregroup.org/storage/documents/Workingpapers/TB_case_study_Senegal03.pdf webcite. Accessed 10 March 2012