الفهرس | Only 14 pages are availabe for public view |
Abstract The nutritional knowledge of lactating mothers is a key factor in determining the health and well-being in both short and long term for the infants and mothers. It is also an important preventive health behavior with implications for both infants and maternal health, and for health costs. Epidemiological studies indicate that early nutrition during the pre- and post-natal life can have an impact on long-term health. Balanced nutrition during pregnancy helps for the expected weight gain of the mother and the growth and development of the fetus. Exclusive breastfeeding for 6 months together with healthy nutritious complementary feeding help preventing infants from malnutritional problems mainly obesity and stunting, as well as insulin resistance, diabetes type 2, atherosclerosis, and associated cardiovascular ill-health later in life. According to EDHS 2014, the highest percentage of obesity and stunting (19.5%) was found among under 6 months infants indicating that malnutritional problems develop early in life. Both global and Egyptian data show that nutritional knowledge indicators are not satisfactory and there are many malnutritional problems which need to be studied aiming to find suitable solutions and recommendations which would help to reach satisfactory condition of nutritional knowledge with its major role in public health. This study intended to assess nutritional knowledge and practices of lactating mother attending health care facilities and family health units in Alexandria, determine the growth indices and health status of the infant and investigate the relationship between the nutritional knowledge of the mother and the growth indices of her infant. A cross sectional study was conducted on 400 mothers of infants aged of 2-18 months attending health care facilities in four family health units in Alexandria. A predesigned interviewing questionnaire was constructed to collect the data required from mothers. It included the following: personal characteristics, obstetric history, infant’s data, breastfeeding experience, complementary feeding practices, maternal nutritional knowledge, dietary habits and intake and current visit data. Anthropometric assessments were carried out for each infant to measure weight, height/ length, head circumference then anthropometric indices were calculated. Assessment of dietary intake and adequacy were done for mothers by 24-hour recall and the findings were analyzed by ESHA food processor. The conclusions of the study can be summarized as follows: 1- About two third of mothers in the studied sample 63% were of fair nutritional knowledge especially concerning lactational knowledge. 2- The highest percentage of good nutritional knowledge was among mothers of normal BMI while only 10% of obese mothers were of good nutritional knowledge. 3- The level of maternal nutritional knowledge is inversely proportional to the WLZ of the infants as only 4% of mothers with good nutritional knowledge have obese infants. 4- More than half of infants started complementary feeding early between 4-6 months which might contribute to high WLZ of infants (P=0.06). Summary, Conclusion and Recommendations 66 5- The most significant factor that might predict high WLZ of infants is the mother’s pre gestational BMI. 6- The highest percentage of obesity and stunting was found in infants under 6 months of age with the presence of dual burden of stunting and obesity as 47.6% of stunted infants were obese. 7- The rate of exclusive breast feeding for 6 months is found to be very low. 8- There is a huge gap between the current infant feeding practices and the global recommendations for optimal infant feeding practices. 9- There is inadequacy of both macro and micronutrients maternal intake. 10- Almost all mothers reported family, neighbors, and friends as their source of information about breast feeding and nutritional knowledge which in turn leads to the unsatisfactory level of knowledge about breast feeding and nutrition which impact negatively on their infants. Based on the results of this study, the following can be recommended: 1- At governmental level: The promotion and support of breastfeeding should be emerged as a national public health priority and government should ensure the continuity of programs on breastfeeding through the establishment of long-term plans. Regular reassessment of baby friendly hospitals according to application of the ten steps. Health education programs about breastfeeding and practices of complementary feeding through mass media should be directed to all mothers. Nutrition education programs through mass media should focus on obesity and its negative impact on mothers and early infancy. 2- At community level: Enhancing the role of community support through extension of non-governmental committees for promoting and supporting breastfeeding. Increasing the community awareness about healthy eating habits for lactating mothers aiming at more healthy generations with less obesity problems. 3- At health facilities level: Raising the level of knowledge of mothers regarding proper infant feeding practice during antenatal period, the immediate postnatal period and during visits to well-baby clinic with stressing on the definition and importance of exclusive breastfeeding. All maternity care providers at different health facilities should receive an externally evaluated structured program in order to develop the knowledge, skill and attitudes to implement nutrition education policy and to support lactating mothers in controlling weight gain. Periodic refreshing training should be also done. Encourage formation of mother support groups, breastfeeding clinics and ensure the availability of nutrition consultants in pediatric and maternity hospitals and all facilities providing maternity and childcare services to support lactating mothers |