The Impact of Urbanization on Infant Feeding Practices in Nigeria
Rosemary C. Anyanwu and Cyril O. Enwonwu School of Nature Sciences, Fudan University
Email: 15307110377@fudan.edu.cn
ABSTRACT:
Breast-feeding, a traditional infant-feeding practice in Nigeria, has undergone a serious decline recently. In order to explore the factors responsible for the negative change and offer some suggestions based on the result, a survey was conducted among Nigerian women resident in Surulere. The feeding practice and attitudes of 558 mothers were examined via questionnaires and personal interview. The result showed that despite the women’s awareness of the importance of breast-feeding practice which should continue for up to one year (38 %) according to their
expressed opinion, only about 24.6 % of the mothers practiced breast-feeding for that long and 81 % used supplementary foods for infants from birth to three months. It is suggested that economic and social pressures were responsible for the change in traditional infant feeding practices. Hence unless the poverty of urban women was solved any nutrition education program was meaningless. Key words: urbanization, infant feeding practices, Nieria
INTRODUCTION
Breast-feeding is currently a subject of immense health and nutritional interest all over the world. In 1983, the World Health Organization called attention to the world-wide decline in the prevalence and duration of breast-feeding, and underscored the urgent need for more definitive data on present-day infant-feeding practices and trends, as well as information on the key factors influencing women's decisions on how to feed their babies. Breast-feeding has been the traditional infant-feeding practice in the developing world, but recent extensive reports strongly suggest that this is rapidly giving way to the \pert-urban areas and in the poverty pockets of urbanized population groups (Darwish,1983). The dimensions of this rapid, pervasive socio-cultural transformation, often erroneously regarded as a symbol of modernity, as well as the forces underlying the disturbing negative change, are not yet clearly defined.
This report attempts to evaluate current maternal perceptions of infant-feeding among different ethnic, religious, cultural, and socio-economic groups in Nigeria, with the primary objective of assessing the extent of decline in breast-feeding as well as the major factors
responsible for the negative change, and how best to institute corrective educational measures. For this particular study, Surulere, a suburb of metropolitan Lagos that is heterogeneous in its ethnic and socio-economic composition, was selected as a pretest area for the widely assumed negative effects of urbanization and modernization on infant-feeding practices and the traditional African image of mothering.
MATERIALS AND METHODS
The study sample comprised 558 randomly selected Nigerian women resident in Surulere. An interview was conducted at the Gbaja and Randle Health Centres located in the area, using a standard questionnaire to obtain information on the following: - ethnic origin of mother, - level of education,
- mother's occupation and age, - total income of the family,
- number of children born alive to mother,
- type of infant feeding preferred by mother and factors influencing the decision, - age at which breast-feeding was supplemented with other foods, - specific types of supplementary foods preferred by the mothers, - duration of breast-feeding,
- influence of hospitals/clinics and advertisers of baby foods on choice of infant-feeding practice.
Most of the women interviewed (71 %) were 21-30 years old, while those 16-20 years and 31-35 years accounted for 11 and 12 per cent respectively of the sample. Four mothers were under 16 years, and the rest were over 36 years of age. Twenty-four per cent of the women interviewed described themselves as full-time housewives with no readily visible occupation outside their homes, while 48 % were traders The rest were teachers, civil servants, nurses, seamstresses, hairdressers, and full-time students.
The women's educational qualifications were assessed by grouping them into the following major categories: no formal schooling of any type, completion of primary school education lasting about six years, completion of secondary school or its equivalent, including modern school, and graduates of university or post-secondary professional programs. Only 12 per cent of the women belonged to the last group, while 15 % had had no formal schooling. The highest proportion of the sample (44 %) had completed primary school. TABLE 1. Family Income Status of Study Sample Monthly Income(Naira)* <200 200-399 400-599 600-799 800-999 >=1,000 Does not know/did not state Number of Mothers Responding Percentage 160 154 36 17 8 8 157 29 28 7 3 1 1 31 *Combined monthly income of father and mother. TABLE 2. Number of Children Born Alive to Mother Number of Children Number Percentage of Mothers 1 2 3 4 5 6 7 8-10 >10 TABLE 3. Mother's Expressed Opinion on Ideal Duration of Breast-feeding Duration (months) No breast-feeding <1 1 2-3 4-6 7-9 10-12 >12 Does not know TABLE 4. Actual Duration of Breast-feeding Practised by the Mothers Duration (months) Never breast-fed <1 Number of Mothers Percentage - 3 - <1 Number of Mothers Percentage - - 3 8 50 156 210 67 64 - - <1 2 9 28 38 12 11 6 10 3 1 2 <1 170 134 108 54 41 32 31 24 19 10 7 6 1 2-3 4-6 7-9 10-12 >12 Not applicable* 3 22 80 146 137 73 94 <1 4 14 26 25 13 17 *Women who were still breast-feeding at the time of the interview. RESULTS
Table 1 shows that the estimated total monthly income per family was less than N 400 (1 naira = US$1.30) for about 56 % of the study sample. No fewer than 29 % of the families had monthly incomes below N 200, well below the subsistence level in a city rated among the most expensive in the world in terms of housing and general cost of living. The number of children born alive to most of the women (74 %) varied from one to three, while 16 % of the women had five or more children born alive (table 2).
In the opinion of most of the mothers, breast-feeding should be practiced for as long as 7 to 12 months, while a relatively small number (less than 12 %) believed that breast-feeding should be restricted to only the first six months of life (table 3). Contrary to the belief of the mothers (38 %) that breast-feeding should continue for up to one year of life, only about 24.6 % of the mothers practiced breast-feeding for that long (table 4). While none of the 558 mothers interviewed was of the opinion that breast-feeding should stop before the first month, three mothers actually breast-fed their infants for less than this. As many as 64 women interviewed (about 11 %) admitted that they did not know how long breast-feeding should last, while a comparatively similar number (about 17 %) were still breast-feeding their babies at the time of the study. Table 5 summarizes the opinions of the women regarding the appropriate age for introduction of supplementary foods. Only 4 per cent of the mothers believed that breast feeding should be supplemented for infants under one month of age. Forty-four per cent of the women suggested one to three months as the best age for introducing supplementary feeding, while about 28% believed that breast-feeding should remain unsupplemented for as long as six to nine months. In marked contrast to their expressed beliefs, 43 % of these mothers actually introduced supplementary feeding to their infants before one month, and as many as 81 % used supplementary foods for infants from birth to three months (table 6). Only about 2 % of the women waited until their infants were six months and older before initiating supplementary feeding, an observation markedly different from their expressed opinions. In effect, these mothers did not practice their beliefs about infant feeding. The commonest reasons advanced by the women for early introduction of supplementary feeding included the following:
- the nature of work outside the home militates against prolonged breast-feeding; - insufficient breast milk;
- supplementary feeding promotes faster growth of the baby; - others do so.
The preferred supplementary foods used by the mothers studied included imported powdered milk or milk-based products, various locally available as well as imported canned cereals, animal proteins, and mashed beans and yams (table 7).
TABLE 5. Mothers' Opinion as to Age at Which Supplementary Feeding Should Be Introduced
Age of Infant (months) <1 1 2 3 4 5 6 6-9 >9 No opinion TABLE 6. Youngest Age at which Supplementary Feeding Was Actually Introduced Age (months) <1 1 2 3 4 5 6 Number of Mothers 241 91 85 37 15 7 3 Percentage 43 16 15 7 3 1 <1 Number of Mothers 24 39 101 105 16 8 54 79 80 52 Percentage 4 7 18 19 3 2 10 14 14 9
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