Exclusive breastfeeding up to six months in very and extremly low birth weight infants and determinants of breastfeeding practices at the Frere Hospital in the Eastern Cape, South Africa

- Haughton, Anna-Marie

Title
Exclusive breastfeeding up to six months in very and extremly low birth weight infants and determinants of breastfeeding practices at the Frere Hospital in the Eastern Cape, South Africa
Creator
Haughton, Anna-Marie
Description
INTRODUCTION: Breastmilk provides adequate nutrition for the optimal growth and development of infants globally. Breastfeeding is an incomparable practice that cannot sufficiently be replaced by any other substance. Breastmilk and breastfeeding offer numerous medical and non-medical advantages that influence the welfare not only of infants, but also of women, their families and society. The last few decades have shown a worldwide increase in the birth and survival rate of preterm, very low birth weight (VLBW) and extremely low birth weight (ELBW) infants. These infants have an increased risk of adverse outcomes, thus necessitating optimal management including best feeding practices of this vulnerable population. AIM: This study assessed the exclusive breastfeeding (EBF) rate in VLBW and ELBW infants at their corrected six months of age and aimed to identify reasons for premature cessation of EBF as well as appraising the association between maternal socio-demographic variables and breastfeeding practices. This study also investigated the type, volume and preparation of replacement feeds given to infants that were not EBF. iii METHOD: This retrospective, cross sectional descriptive study was conducted between December 2017 to November 2018 at Frere Hospital in the Eastern Cape. A comprehensive database was compiled with all the infants’ demographics and relevant maternal socio-demographic variables at birth. Information on the changeover of primary caregiver, feeding practices, reasons stated for premature discontinuation of EBF, and the infant’s anthropometry were documented at each follow up visit and included in the database. RESULTS: The prevalence of EBF at the corrected six month follow up was 22%. Insufficient breastmilk supply (23%, 43% and 13% at one, three and six months respectively) and maternal commitments to school or work (35%, 33% and 50% at one, three and six months respectively) were the predominant reasons stated by mothers for discontinuation of EBF. The number of other children a mother had was significantly related to EBF practices at months one and six (p = .029 and .025, respectively), and EBF was also significantly related to the level of maternal education at month three (p = .006). The percentage of mothers who breastfed exclusively was proportional to the number of other children they had, and inversely proportional to the level of their education. The volume of replacement feeds was known to be incorrect in over a third of cases at months one and three (35% and 34%, respectively), and in almost half of cases at month six (48%). Replacement feeds were being prepared most incorrectly at the three month follow up with almost half (46%) of these feeds being prepared iv inaccurately. These replacement feeds comprised of exclusive formula feeds (EFF) for 95% of cases that were not EBF at month one, 88% at month three, and 97% at month six. CONCLUSIONS: The prevalence of EBF in VLBW and ELBW infants at six months in this study remains sub-optimal compared with other low- and middle-income countries (LMICs) and is much lower than the target set by the World Health Organisation (WHO). Factors that affected EBF practices in this study include mother’s perception of insufficient breastmilk supply, maternal commitments to work/school, the number of other children in the household as well as the level of maternal education. A combination of various interventions is urgently needed to effectively increase EBF rates in this population.
Description
Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2024
Date
2024-03
Subject
Brestfeeding Practices
Type
Masters theses, text
Identifier
http://hdl.handle.net/11260/11065
Identifier
vital:75881
Format
computer, online resource, application/pdf, 1 online resource (76 pages), pdf
Publisher
Walter Sisulu University, Faculty of Medicine and Health Sciences
Language
English
Rights
Faculty of Finace and Economic Sciences, All Rights Reserved, Open Access
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