Volume 3 Issue 3 - 2018
Nutritional Status and Weaning Practices of Infants in Ogun State, Nigeria
1,2,3,4,5,7Department of Nutrition and Dietetics, Babcock University, Ilisan-Remo, Ogun State
6Biological Sciences Department, Crescent University, Abeokuta, Ogun State
6Biological Sciences Department, Crescent University, Abeokuta, Ogun State
*Corresponding Author: Ngozi Elizabeth O, Department of Nutrition and Dietetics, Babcock University, Ilisan-Remo, Ogun State.
Received: August 09, 2018; Published: October 23, 2018
Background: Most mothers in Ogun State, Nigeria, start weaning their infants in the sixth month. The major weaning foods given to the infants are corn pap, banana, fish and bean cake (moinmoin). The prevalence of malnutrition among infants in Ogun State is still high. The lack of education of mothers and absence of encouragement of the need to wean their infants with nourishing complemented and fortified foods to enhance their nutritional status, are the major contributory factors to poor infant weaning practices.
Objective: The study assessed infant (0-2 years) feeding practices of mothers in Ogun State, Nigeria, with reference to Ikenne Local Government Area and the nutritional status of these infants, based on their anthropometric indices.
Methods: This study involved 200 mother infant pairs who were randomly selected from various occupational groups in Ikenne Local Government Area of Ogun State, Nigeria. The data collected through structured and pretested questionnaire, was used to elicit information, on feeding practices, and anthropometric measurements for height/length and weight of infants measured following standard procedures. Descriptive statistics such as cross tabulation, frequency and percentages were used to analyse the data and determine the relationship between the variables. Significance was accepted at P < 0.05.
Results: Weaning was initiated in most homes in the sixth month. Most of the infants studied (69%) were normal while some (10%) were moderately malnourished and others were severely malnourished (21%). This study concluded that many of the infants studied had normal nutritional status though at lower level to the WHO standard. It is worrying however that up to 31% of the mother-infants relationship showed moderate to severe malnourishment owing to poor weaning practices employed. Proper nutrition education given to the mothers and monitoring of the infants weaning practices will further ensure adequate nutrition of the infants.
Keywords: Weaning practices; Infants; Nutritional status
In Ogun State, Nigeria, many women wean their infants at six months, but some do not resulting in malnourishment of the infants to various degrees from moderate to severe malnourishment. According to (Ayogu., et al. 2015), infant feeding is influenced greatly by socio-cultural factors such as beliefs, attitudes, practices and ignorance.
Exclusive Breast Feed (EBF) is good for the infant from birth to weaning. At weaning the food that the infant will eat in order to live and cope with the challenges of life becomes a pressing problem (Ayogu., et al. 2015). Adequate nutrition and health during the first few years of life is fundamental for child survival and prevention of malnutrition (Atinmo & Oyewole, 2008). The period between the introduction of mixed feeding and final stopping of breast feeding is commonly referred to as weaning period and is a time of particular danger to the infant. Child mortality is high during this period (Aminu & Agle, 2004) because of the lack of adequate, hygienically safe, easily consumed and digested foods for the baby.
The World Health Organisation recommends a gradual weaning period from 6 months to 2 years (WHO, 2006). This allowed the child to receive the benefits from breast feeding while also consuming the required additional nutrients from the complementary foods which should always be provided on demand. The weaning period is therefore a crucial time when the infant should be attentively cared for and observed so as to maintain good health (Dewery, 2001; Onofiok., et al. 2005). The present study was to assess the nutritional status of infants during weaning period to two years of age in the study area of Ikenne Local Government of Ogun State, Nigeria.
Material and Methods
This study employed a descriptive cross sectional design. Ikenne Local Government Area of Ogun State was selected for its urban and rural-based outlook. Twenty eight (28) Healthcare Centres were purposively selected from the healthcare centres in the Local Government Area (LGA). Simple random sampling was used to select a total 200 mother-infant respondents from the attendance at the post-natal clinics of the healthcare centres. They were interviewed using the structured questionnaire which had information on socio-economic characteristics, weaning practices of mothers, and the anthropometric measurements of the infants. Questionnaire written in English was administered through interpretation in Yoruba and Pidgin English to respondents. The Anthropometric measurement of weight and height/length of infants were obtained using the standard procedure explained in Cogill (2001). The values were related to age of infants i.e. weight-for-age, height/length-for-age. The nutritional status of children was determined by the values using the WHO anthro software.
The weaning practices found amongst the respondents were examined with structured questionnaires highlighting the following, to show the nutritional intake of infants.
- Currently breastfeeding at the time of the investigation.
- Age, weaning started between 3 and 7 months.
- Mode of preparation of weaning foods; home prepared, commercially (factory) products and combination of both home and factory made foods
- Frequency of feeding ranged from infant demand, once a day with food stored in a flask or bowl or food prepared for the entire family.
- Length of food storage ranging from 1-2 to 5-6 h.
- Mode of feeding: Involved feeding food to the infant on demand, scheduled timing and forced feeding at the demand of the mother
- Frequency of feeding per day. Varied from twice daily, thrice daily, four time daily and other frequencies of feeding in the day.
- Type of cereals used in weaning. Considered six types of cereal used for weaning infants in the study area. These cereals included Corn pap, Agidi, Custard, Cerelac, Nutrend, Rice and Noodles.
- Types of root and tubers used as weaning meals – included yams, cocoyam, Gari and starch.
- Protein sources used for weaning infants. Four (4) main sources of proteins commonly used are fish, meat, egg and chicken
- Vegetable protein sources used for weaning infants. These are beans, Akara and Moinmoin.
- Fruits and vegetables used for weaning infants. The sources are mainly five (5) in number; orange, paw-paw, banana, watermelon and plantains.
Statistical Analysis: The data was analysed with the aid of descriptive statistics of the SPSS (Statistical Package for Social Sciences) version 16 (SPSS Inc., USA) to generate the results in frequencies and percentages, and to determine the relationship between the variables. Significance was accepted at P < 0.05. The WHO anthro software procedure was used for classification of nutritional status of subject characteristics.
Characteristics of the Mother-Infant Pairs: Table 1 presented the socio-demographic background of the mothers. From Table 1, 55% of the infants were female while 45% were males. The highest age of mother examined ranged from 26-30 years (31.5%), and were commonest religion practiced in the area was Christianity (64%). The respondents were mostly traders (42%), and majority of the respondents were married (75.5%), while 38.5% and 36.5% of the respondents had secondary and tertiary school education, respectively, and 13.0% had no formal education. The highest household size was 4-7 and about 77% of the families examined were monogamous.
Table 1b showed that the Demographic characteristics of the infants. The highest range of numbers of children in the family was 1-4 (85%) and the most frequent age of the infants studied was 6-12 months (40.5%). There were more females (55%) than males (45%).
|Age of Mothers (Years)|
|No formal education||26||13.0|
Table 1a: Demographic characteristics of mother-infant pairs.
|No of the Children|
|Infants Age (Month)|
|Sex of Infants|
|Weight of Infants (Kg)|
Table 1b: Demographic characteristics of infants.
Table 2 presented the results of the weaning practices of infant/mother pairs used and their nutritional status were expressed in percentages add frequencies. The Table 2 showed that the most frequently served foods to the children were fish meals (67.8%) and corn pap (64.0%) and bananas (60%). Only 55% of the infants were breastfed, 32% of the infants were introduced to solid/semisolid food at the 6th month while 17%, 19.5%, 18%, and 13.5% were introduced to this food in the 3rd, 4th, 5th and 7th month, respectively. As regards the weaning food preparations, 51% of infants were fed home prepared foods mainly pap, 18% were fed on commercially prepared foods while 31% were fed on the combination of home and commercially prepared foods. This result also showed that 35% of the mothers stored the weaning food. The storage of the prepared food was for 1-4hrs (75.5%) and above 5hrs (27.5%). This could introduce contamination as earlier reported by Weaver (1994) that crude storage processes, poor hygiene and sanitation with inadequate knowledge of preservative methods could introduce parasitic contamination and risk of gastrointestinal infection.
In the present study, 44% of the respondents prepared food for the infants on demand, and so feeding on demand was common (68.5%) but some mothers practiced forced feeding (12%). This forced feeding is often at the time the infants do not need it and consequently results in infection with possibility of chocking the infant to death. This is in support of the observation of Imonikebe (2009). Some mothers practiced scheduled feeding of their infants (19.5%), a practice that is common mostly in the urban areas where mothers cannot practice “demand” feeding owing to their work schedule. The most frequent time of feeding was 4 times a day (44.5%) and for more than 4 times a day (31.5%).
|Introduction of Complementary Foods (Age)|
|Mode of Preparation|
|Frequency of Feeding|
|As soon as baby wants to eat||88||44.0|
|Once a day and food is stored in a flask||71||35.5|
|Once a day and food is stored in a bowl||12||6.0|
|Other members of the family wants to eat||24||12.0|
|Length of Storage|
|> 5 hours||55||27.5|
|Length of Feeding|
|Feeding on demand||137||68.5|
|Frequency of Feeding Per Day|
|More than four times||63||31.5|
|Rootss and Tubers|
|Meat and Fish|
|Fruits and Vegetables|
Table 2: Weaning Practices Infants-Mother Pairs.
Table 3 showed that some foods which were usually avoided and the reasons for avoidance as weaning foods in Ogun State. It also shows snail meat as the highly avoided by parents, who regard it as unclean for infants (40.0%). Another food meal hated by mothers for weaning infants is Pork. The hatred for Port emanates from the fact that it is said to contain large quantities of worm infection which can easily complicate the growth of infants.
|Food Avoided||Reasons for Avoidance||Frequency||Percentage|
|Snail||Believed to be unclean for human consumption||80||40.0|
|Beans||Not easily digested by the baby||14||7.0|
|Groundnut||Baby might accidentally swallow||40||20.0|
|Pork||Believed to be unclean for human consumption||53||26.5|
|Watermelon||Too many seeds and baby might swallow||10||5.0|
Table 3: Some foods which are seldom given to weaning infants.
|Nutritional Status of Infants||Frequency||Percentage|
Table 4: Nutritional Status of Infants using weight for age Ratio (WHO/UNICEF, 2003) (n = 200).
Table 4 showed that 138 out of the 200 infants examined were normally nourished (69%) and only 10% were moderately malnourished and more disturbing is the fact that 21% of the infants were severely malnourished. The growth chart showed that the growth rate of infants in Ikenne Local Government Area falls short of WHO standard growth rate using weight for age.
Factors Affecting the Weaning Practices Used and the Nutrition Status of Infants Based On Various Weaning Methods
Table 5 showed the feeding methods and their relationship with the nutritional status of the infants using weight for age. For infants who were fed “on demand” many of them were normal (64%), 10.2% were moderately malnourished and 25.6% were severely malnourished. Of the infants who were fed on schedule 82% were normal, and 10.3% were moderately malnourished and 7.7% were severely malnourished, while infants who were force fed, 75% of them were normal, infant, 8.3% were moderately malnourished, and 16.7% were severely malnourished.
|How infants were fed Total No. of Infants||Level of Nutritional Status of the Infants|
|Normal||Moderately malnourished||Severely malnourished|
|Feeding methods||Frequency||Percent (%)||Frequency||Percent (%)||Frequency||Percent (%)|
|Feeding on demand||137||88||64.2||14||10.2||35||25.6|
Table 5: Factors affecting weaning practices in relationship to nutritional status of infants.
Table 6 presented the relationship between type of food given to the infants and their nutritional status using weight for age assessment method. For infants who start eating solid/semi-solid food at the 3rd month, 79.4% were normal, 2.8% were moderately malnourished and 17.7% were severely malnourished. Infants who started eating foods at age 4 months, 74.4% of them were normal, 7.7% of them were moderately malnourished and 17.9% of them were severely malnourished while those who started eating foods at the 7th month, 63% were normal, 22.2% were moderately malnourished and 14.8% were severely malnourished.
Table 7 presented the relationship between age of introduction of food given to infants and their nutritional status based on weight for age (WHO/UNICEF, 2006). From Table 6, it can be seen that infants fed on home prepared foods (65%) especially when combined with complementary foods, prepared under hygienically prepared condition (93.6%) were saved from malnutrition and infection as early reported (Samuel & Golden, 2004).
Infants who were fed on commercially prepared food (36.1%) were normal while 22.2% were moderately malnourished and 41.7% were severely malnourished. Infants fed combined mode of preparation (93.6%) were normal and 4.8% severely malnourished.
|Mode of Preparation Total No. of Infants||Nutritional Status of the Infants|
|Normal||Moderately malnourished||Severely malnourished|
|Frequency||Percent (%)||Frequency||Percent (%)||Frequency|
|Combination of both||62||58||93.6||1||1.6||4.8|
Table 6: Relationship between Type of Food Given and the Nutritional Status of the Infants.
|Age Total No. of Infants||Nutritional Status of the Infants|
|Normal||Moderately Malnourished||Severely Malnourished|
|Frequency||Percent (%)||Frequency||Percent (%)||Frequency||Percent (%)|
Table 7: Relationship between Age of Introduction of Solid/Semi-Solid Food and the Nutritional Status of the Infants Using Weight for Age.
From the following analysis of the weaning practices and nutritional status of infants in Ogun State, Nigeria with special reference to Ikenne Local Government Area, the following can be concluded:
- Majority of the infants (69%) seen in this study had normal nutritional status although at a lower level to W.H.O standard.
- Infants exposed to poor weaning practices (31%) were moderately to severely malnourished.
- The introduction of timely, adequate, balanced and hygienically prepared complementary or weaning foods suffered little or no malnutrition.
- Nutrition education and monitoring of the weaning practices of mothers could be enhanced the nutritional status of the infants.
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Citation: Ngozi Elizabeth O., et al. “Nutritional Status and Weaning Practices of Infants in Ogun State, Nigeria”. Nutrition and Food Toxicology 3.3 (2018): 661-669.
Copyright: © 2018 Ngozi Elizabeth O., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.