Research Article
Volume 3 Issue 3 - 2018
Nutritional Status and Weaning Practices of Infants in Ogun State, Nigeria
Ngozi Elizabeth O1*, Taylor Ore-Oluwa A2, Kehinde Tolulope A3, Adeoye Bolade K4, Akinlade Ademola R5, Ojo Mariam I6 and Ajuzie Nneoma C7
1,2,3,4,5,7Department of Nutrition and Dietetics, Babcock University, Ilisan-Remo, 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
Abstract
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
Introduction
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.
  1. Currently breastfeeding at the time of the investigation.
  2. Age, weaning started between 3 and 7 months.
  3. Mode of preparation of weaning foods; home prepared, commercially (factory) products and combination of both home and factory made foods
  4. 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.
  5. Length of food storage ranging from 1-2 to 5-6 h.
  6. Mode of feeding: Involved feeding food to the infant on demand, scheduled timing and forced feeding at the demand of the mother
  7. Frequency of feeding per day. Varied from twice daily, thrice daily, four time daily and other frequencies of feeding in the day.
  8. 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.
  9. Types of root and tubers used as weaning meals – included yams, cocoyam, Gari and starch.
  10. Protein sources used for weaning infants. Four (4) main sources of proteins commonly used are fish, meat, egg and chicken
  11. Vegetable protein sources used for weaning infants. These are beans, Akara and Moinmoin.
  12. 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.
Results
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%).
Characteristics Frequency Percentage
Age of Mothers (Years)    
<20 36 18.0
21-25 53 26.5
26-30 63 31.5
31-35 27 13.5
36-40 15 7.5
41-45 6 3.0
Religion    
Christian 128 64.0
Muslim 45 22.5
Traditional 27 13.5
Occupation    
Farmer 39 19.5
Trader 84 42.0
Teacher 37 18.5
Others 40 20.0
Marital Status    
Married 151 75.5
Single 25 12.5
Divorced 15 7.5
Widowed 9 4.5
Educational Level    
Secondary 77 38.5
Tertiary 73 36.5
Primary 24 12.0
No formal education 26 13.0
Household Size    
<4 48 24.0
4-7 125 62.5
>7 27 13.5
Table 1a: Demographic characteristics of mother-infant pairs.
Characteristics Frequency Percentage
No of the Children    
1-4 170 85.0
5-6 15 7.5
>6 15 7.5
Infants Age (Month)    
<6 67 33.5
6-12 81 40.5
13-18 45 22.5
>18 7 3.5
Sex of Infants    
Female 110 55
Male 90 45
Weight of Infants (Kg)    
2.0–4.0 37 18.5
4.1–6.0 29 14.5
6.1–8.0 56 28
8.1–10.0 36 18
10.1–12.0 42 21
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%).
Weaning practices Frequency Percentage
Still Breastfeeding    
Yes 110 55.0
No 90 45.0
Introduction of Complementary Foods (Age)    
3 Months 34 17.0
4 Months 39 19.0
5 Months 36 18.0
6 Months 64 32.5
7 Months 27 13.5
Mode of Preparation    
Home prepared 102 51.0
Commercially prepared 36 18.0
Combination 62 31.0
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    
1-4 hours 145 72.5
> 5 hours 55 27.5
Length of Feeding    
Feeding on demand 137 68.5
Scheduled 39 19.5
Forced feeding 24 12.0
Frequency of Feeding Per Day    
Twice/day 6 3.0
Three times/day 42 21.0
Four times/day 89 44.5
More than four times 63 31.5
Cereal Groups    
Corn Pap 128 64.0
Agidi 6 3.0
Custard 9 4.5
Cerelac 24 12.0
Nutrend 15 7.5
Rice 3 1.5
Noodles 15 7.5
Rootss and Tubers    
Yam 79 39.5
Cocoyam 70 35.0
Garri 39 19.5
Starch 12 6.0
Meat and Fish    
Fish 134 67.0
Meat 12 6.0
Egg 28 14.0
Chickens 26 13.0
Legumes    
Beans 52 26.0
Akara 75 37.5
Moinmoin 73 36.5
Fruits and Vegetables    
Orange 21 10.5
Pawpaw 12 6.0
Banana 121 60.5
Watermelon 24 12.0
Plantain 22 11.0
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
Okra Family taboo 3 1.5
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
Normal 138 69
Moderately malnourished 20 10
Severely malnourished 42 21
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
Scheduled feeding 39 32 82.0 4 10.3 3 7.7
Forced Feeding 24 18 75.0 2 8.3 4 16.7
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
Home prepared 102 67 65.7 11 10.8 23.5
Commercially prepared 36 13 36.1 8 22.2 41.7
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 (%)
3rd Month 34 27 79.4 1 2.9 6 17.7
4th Month 39 29 74.4 3 7.7 7 17.9
5th Month 36 30 83.3 1 2.8 5 13.9
6th Month 64 35 54.7 9 14.0 20 31.3
7th Month 27 17 63 6 22.2 4 14.8
Table 7: Relationship between Age of Introduction of Solid/Semi-Solid Food and the Nutritional Status of the Infants Using Weight for Age.
Conclusion
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:
  1. Majority of the infants (69%) seen in this study had normal nutritional status although at a lower level to W.H.O standard.
  2. Infants exposed to poor weaning practices (31%) were moderately to severely malnourished.
  3. The introduction of timely, adequate, balanced and hygienically prepared complementary or weaning foods suffered little or no malnutrition.
  4. 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.