EFFECT OF PEER SUPPORT GROUP COUNSELLING ON INFANT FEEDING PRACTICES OF MOTHERS IN SELECTED RURAL AREAS IN IBADAN, OYO STATE, NIGERIA

Abstract

Poor Infant and Young Child Feeding (IYCF) practices contribute to high burden of child malnutrition in Nigeria. Community-based support group intervention has the potential to improve IYCF coverage and reach the rural population; however, its effects on infant feeding practices of mothers in Nigeria remain unexplored. This study was therefore conducted to determine the effects of peer support group counselling on infant feeding practices of mothers in selected rural areas of Ido and Oluyole Local Government Areas in Ibadan, Nigeria.

This quasi experimental design study involved systematic random sampling of 240 non-primigravid pregnant women (26-34 weeks). Respondents were assigned into Experimental Group (EG) (Ido) and Control Group (CG) (Oluyole) of 120 each based on area of residence. Baseline and endline data were collected using a semi-structured, interviewer-administered questionnaire comprising socio-demographic characteristics, 21-point knowledge, 17-point attitude and 36-point practice scales on infant feeding. All respondents were exposed to conventional antenatal nutrition education. Respondents in experimental group were followed up with 15-months peer support counselling including action-oriented group discussion, use of pictorial counselling booklet and home visits. Complementary feeding practice indicators were assessed using multiple pass 24-hour dietary recall. Weight and length of index children were measured at age 12 months using standard procedure and analysed for anthropometric characteristics using WHO Anthro software. Factors influencing IYCF practices and mothers’ strategies for responsive feeding were determined using Focus Group Discussions and analysed thematically. Quantitative data were analysed using descriptive statistics and students’t-test at α0.05. Age of Mothers was 28.7±5.1 years, 98.8% were married, 97.1% were Yoruba and 60.8% had secondary education. Mothers’ infant feeding knowledge significantly increased from 12.0±4.6 at baseline to 20.7±2.0 in EG and 16.9±3.1 to 18.9±3.2 in CG. Mothers’ attitude to breastfeeding significantly increased from 7.5±2.7at baseline to 15.2±2.1in EG and 11.0±2.5 to 13.6±3.4 in CG.Mothers’ attitude to complementary feeding significantly increased from 4.3±1.6 at baseline to 9.0±0.1in EG and 7.7±1.3 to 8.1±1.8 in CG. Mothers’ practice of IYCF improved significantly from 16.6±2.9 at baseline to 18.1±2.8 in EG with no significant improvement among the CG (16.6±3.2 at baseline to 16.4±2.6). Early initiation (57.5%; 42.2%), exclusive breastfeeding (61.3%; 33.9%),), timely introduction of complementary feeding (62.2%; 39.4%), and children that met minimum dietary diversity (64.2%; 30.6%) were higher in EG than CG, respectively. At age 12 months, prevalence of wasting (24.8%; 17.4%); stunting (11.0%; 2.8%), underweight (18.3%; 1.8%) and overweight (6.4%; 2.8%) was significantly higher among index children in CG compared to EG, respectively. Decision of mothers on IYCF practices was solely personal but the practice was influenced by the introduction of pre-lacteal foods, mainly water and local concoctions by extended family members. Responsive feeding was practised by mothers mainly in form of singing and praising to encourage child’s cooperation during feeding. Peer support group counselling increased infant feeding knowledge, attitude and practice among women in rural areas of Ibadan with good nutrition outcomes among infants. Efforts to promote infant feeding practices and reduce child malnutrition could therefore include the use of peer support groups.