One of the inborn characteristics of mammals is to breastfeed their young after delivery using their natural breast milk that is highly required for growth and development especially within the first six months of life. Beyond the six months, the infant requires vitamins, iron and extra energy for growth and sustenance of life through the introduction of weaning diet [1].

Weaning is the gradual process of introducing an infant to food while still breastfeeding till he/she can handle adult food physiological. It is the method of gradual introduction of solid food to under-one year child’s feeding schedule with the aim of replacing breast or bottle feeds with adult diet. To support this, adequate and proper infant weaning practices adopted by nursing mother are very crucial to achieve stipulated growth [1].

In May 2014, the federal ministry of health introduced the Health sectors components of national food and nutrition policy and the national strategic plan of action for nutrition (2014-2019). They goal of these initiative is to improve the nutrition status of Nigerian people throughout their life cycle, with particular focus on vulnerable groups such as women of reproductive age and children under-five (Federal Ministry of Health, 2014).

After the first 6months, breast milk alone is no longer sufficient to meet the nutritional need of an infant. After 6month, appropriate complementary foods should be introduced while breastfeeding is continued until age 2 or older. The transition from exclusive breastfeeding to complementary feeding with family foods is when children are most vulnerable to becoming under nourished and during this time it is important that they received solid, semi solid or soft foods. Appropriate complementary feeding should include feeding children a variety of foods to ensure those nutrients requirements are met. Fruit and vegetables rich in vitamin A should be consumed daily. Eating a range of fruit and vegetables, in addition to those rich in Vitamin A, is also important studies have shown that plant -based complementary foods by themselves are insufficient to meet the needs for certain micronutrients. Therefore it has been recommended that meat, poultry, fish, or egg be part of the daily diet or eaten as often as possible (World Health Organization, 2003).

Weaning practices are all activities carried out by nursing mothers during the process of weaning. The practice involves what weaning diet means to the mothers, type of food substance used as well as food mixed utilize. There is a particular food substance or formula to use. The approach differs from country to country and from one community to another. Some is guided by culture, individual, beliefs customs, attitude, values, the types of local food substance available, level of education, the stage of development and technology the particular community has attained. The type of weaning food the mother gives varies in communities. In Nigeria, Enugu State especially grain processed in sort of gruel usually mentioned as pap (Akamu in Igbo language, Ogi in Yoruba language) are used. It is obvious that babies experience rapid climb during this stage of development. To support this proper weaning practices are very crucial. Any deviation from normal weaning diet leads to growth retardation and complication [1].

The prevalence of stunting, wasting and underweight is almost twice as high among children in rural areas (45% and 27% respectively). In urban areas (27%, 5% and 15% respectively), (Nigeria Demographic and Health Survey, 2018). Globally, only 64.5%of infant 6-8months aged are fed solid, semi solid, or soft foods (for the sake of brevity, solid, semi solid or soft foods are going to be mentioned as “solid foods” throughout the rest of this paper), with the lowest rates in SA at 53.5,% and highest in Latin America and the Caribbean (LAC), at 83.1%. Global rates of Minimum Meal Frequency (MMF) and Minimum Meal Dietary (MMD) were both low at 52.2% and 29.4%, respectively. In West and Central Africa (WCA), East and South Africa (ESA) and South Africa (SA) the rates of Minimum Meal Frequency (MMF) are less than 50% and Minimum Dietary Diversity (MDD) less than 25%. Rates for both indicators are highest in East Asia and Pacific (EAP) and Latin America and the Caribbean (LAC) where about three in four children are getting Minimum Meal Frequency (MMF) and Minimum Meal Dietary (MMD).Rates for Minimum Acceptable Diet (MAD) are low across all regions with available data. Rates are highest in East Asia and Pacific (EAP) and 41% and lowest in West and Central Africa (WCA) at 8.6%, East and South Africa (ESA) at 9.8% and SA at 13.0%. Rates for all complementary feeding indicators are lowest in West and Central Africa (WCA), East and South Africa (ESA), and South Africa (SA), whereas rate of continued breastfeeding at 1and 2 years are highest in these regions (United Nations Children’s Funds, 2016).

According to the available statistics from Nigeria, infant mortality is responsible for almost 50% of all deaths in children up to 14years of age and under 5 mortality accounts for 93% of these deaths, 70% which are attributed to preventable diseases (Nigeria Demographic and Health Survey, 2018). 

An earlier Demographic and Health Survey (DHS) survey of children aged 6-36 months in Ondo State, Nigeria, found 28% prevalence for underweight, 32% for stunting, and 7% for wasting. It is therefore clear that during the period of weaning, children in West Africa are very vulnerable to malnutrition, and one of the major factors that causes stunting or what makes some children appear stunted can be traced to inadequate food intake.

Weaning diet has been suggested to be responsible for about one-third of all deaths occurring in children less than 1year of age in developing countries. During my visit to the health facility in Oda, it was observed that 30% of the nursing mothers who came for routine immunization had little knowledge to weaning diet composition. Therefore, there is the need to research into this problem among the nursing mothers in Oda.

The aim of the study is to investigate the perception of nursing mothers to weaning diet for under-one year children in Oda, Akure South Local Government, Ondo State, Nigeria. The objectives are:

• To investigate the level of understanding of nursing mothers on weaning diet for under-one year children in Oda

• To find out the practice of nursing mothers regarding weaning diet for under-one year children in Oda

• The find out local food sources for weaning in Oda

Research Design

Descriptive survey design was used in this study. McCombes [2] stated that descriptive research aimed to accurately and systematically describe a population, situation or phenomenon. Descriptive research is an appropriate choice when the research aim is to identify characteristics, frequencies, trends, and categories. It could answer what, where, when and how questions, but not why questions.

This research was to describe and interpret relevant facts and information in order to understand the perception of nursing mothers to weaning diet for under-one year children in Oda Community.

Study Area

This research was conducted in Oda Community in Akure South Local Government, Ondo State, Nigeria. According to Ige [3] Oda is a town in the South-Eastern part of Akure, the Ondo State capital. It is about ten kilometres away from the State capital. It shares boundaries with Idanre and Owo local government areas. The study area lies on latitude 7º 10’ 31”N of the equator and longitude 5º 14’ 9”E of the Greenwich meridian [4]. Oda is about two hundred and fifty (250) metres above sea level and the land towards Idanre local government is hilly and subdued with large granite formation acclaimed to be of volcanic origin. The study area enjoys abundant rainfall of over 1.5 mm annually. The South-West wind blows for a considerable part of the year in Oda. During the months of December to February, the cooler day continental air from the North-East prevails. The rainy season in Oda usually lasts from March to October [3].

It consisted predominantly of the Yorubas but there are also few Igbos, Hausas and other tribes. Most of the inhabitants are Christian and few of them are of Islamic religion while some are traditional worshippers. There are both Primary and Secondary Schools owned by the Government with other Private Schools. A Basic Health Centre exists to render primary health care (PHC) services with few private clinics. The major occupations in Oda are farming, hunting, trading, tailoring, hairdressing and civil service.

Study Population

The population for this study are nursing mothers in Oda community, Akure South Local Government, Ondo State, Nigeria.

Sample Size Determination

The sample size used for the study was determined using the formula by Cochran [5] for a single population proportion:

nₒ = t²pq

d²

Where:

• nₒ = the sample size

• t = the confidence level of 1.96,

• d = the desired level of precision (i.e. the margin of error, which is 0.05),

• p = the (estimated) proportion of the population of nursing mothers (which is 0.5), and

• q = 1-p

Hence,

nₒ = (1.96)² x 0.5 x (1-0.5)

(0.05)²

nₒ = 3.8416 x 0.5 x 0.5

0.0025

nₒ = 0.9604

0.0025

Therefore, nₒ = 384.16.

Additional 10% allowance (non-response) for absenteeism, refusal to participate or incomplete data in the study was considered. Thus, 423 nursing mothers were questioned, using a structured questionnaire.

Sampling Technique

The sampling technique used during this research work was simple random sampling technique. According to Corporate Finance Institute (CFI) [6] simple random sampling is the randomised selection of a small segment of members from a whole population. It provides each individual with an equal and fair probability of being selected. The CFI added that this sampling method is the most convenient and simple sample selection technique.

Study Instrument

This study adopted a structured type of questionnaire to carry out the main aim of the research. The questions were written in English for easy understanding of the respondents. The questionnaire comprised two sections (Section A and B). Section A described the socio-demographic characteristics of the respondents while section B described the variables of the objectives highlighted in the Introduction. Cheung [7] stated that the use of structured questionnaire has a close link with quantitative analysis. It is a document that consists of a set of quality and standardized questions with a fixed scheme, which specifies the exact wording and order of the questions, for gathering information from the study population.

Reliability and Validity of the Instrument

The quality of data was assured by properly designing and pre-testing of the questionnaire. The questionnaire was reviewed every day and checked for completeness by the researcher, and the necessary feedback was given to data collectors in the next morning before data collection. 

The questionnaire was pre-tested in Ilekun, Akure South Local Government Area, Ondo State, Nigeria other than the selected study area (in Oda town), but has similar socio-demographic characteristics with the study population. Accordingly, it was carried out among 5% of the total sample size and necessary adjustments were made to the questionnaire before the actual data collection. Middletown [8] stated that reliabilty and validity are concepts used to examine the quality of research. They indicate how good a method, technique or test measures something. Reliability is about the consistency of a measure while validity is about the accuracy of a measure.

Data Collection

The data was collected through the use of a structured questionnaire. The questionnaire was administered to nursing mothers in the study area and was retrieved after it had been duly responded to. The data was sorted out and was in analysed on International Business Machines Corporation Statistical Package for Social Sciences (IBM SPSS Statistics v.27.0.1.0), using simple percentage with frequency table.

Data Analysis

Data entry and statistical analysis was done using International Business Machines Corporation Statistical Package for Social Sciences (IBM SPSS Statistics) version 27.0.1.0 (IBM Armonk, New York). The data collected using the above mentioned measures were analysed, using frequencies and percentages.

Ethical Consideration

Ethical clearance was carried out in strict compliance with the guidelines specified by the State Ethics Committee. Informed consent was made through the head of Oda town as well as the respondents. Utmost care was taken to protect the privacy of the respondents. Adequate confidentiality of the information provided by the respondents was observed.

This chapter deals with the presentation and analysis of the findings on the perception of nursing mothers to weaning diet among under-one year old children in Oda town, Akure South Local Government Area, Ondo State, Nigeria. Four hundred and twenty-three (423) questionnaires were distributed to nursing mothers but three hundred and ninety-three questionnaires were retrieved for analysis. Thirty (30) questionnaires were not completely or correctly filled by the respondents; hence they were not entered for analysis.

The data presentation is divided into two (2) sections: Section A shows the socio-demographic data of the respondents while Section B depicts the analysis of data collected on the objectives of the study, using frequency tables and simple percentage.

Section A: Socio-Demographic Data of the Respondents

The Table 1 reveals that 52 respondents (13.23%) are within the age range of 15-24years; 169 respondents (43%) are between 25-34years; 144 respondents (36.6%) are between 35-44years while 28 respondents (7.13%) are between 45years and above.

Table 1: Age of the Respondents

 Source: Researcher’s Field Survey, 2021.

The above table reveals that 186 respondents (47.33%) said the age range of their children is between 0-6months while 207 respondents (52.67%) said the age range of their children is between 7-12months.

The Table 2,3 reveals that 49 respondent (12.5%) are single; 270 respondents (68.8%) are married; 28 respondents (7.1%) are divorced; 18 respondents (4.6%) are widow, while 28 respondents (7.1%) are separated.

Table 2: Child’s Age

Source: Researcher’s Field Survey, 2021.

Table 3: Marital Status of the Respondents

Source: Researcher’s Field Survey, 2021.

The Table 4 reveals that 267 respondents (68%) are Christian; 105 respondents (26.7%) are Muslim while 21 respondents (5.3%) are traditional worshippers.

Table 4: The Religion of the Respondents

Source: Researcher’s Field Survey, 2021.

The Table 5 reveals that 126 respondents (32.06%) are traders; 84 respondents (21.4%) are civil servants; 57 respondents (14.5%) are artisan; 63 respondents (16%) are unemployed while 63 respondents (16%) are farmers.

Table 5: Occupation of the Respondents

Source: Researcher’s Field Survey, 2021.

The Table 6 reveals that 109 respondent (27.7%) earned N10, 000 and below income monthly; 235 respondents (59.8%) earned between N10, 000 – N50, 000 monthly income while 49 respondents (12.5%) earned between N50, 000 and above monthly income.

Table 6: Average Income per Month of the Respondents

Source: Researcher’s Field Survey, 2021.

Section B: Perception of Nursing Mothers to Weaning Diet

The Table 7 reveals that 386 respondent (98.2%) have heard about weaning diet while 7 respondents (1.8%) have not heard about it.

Table 7: Have you heard about Weaning Diet Before?

Source: Researcher’s Field Survey, 2021.

The Table 8 reveals that 221 respondents (56.2%) received information about weaning from health facility; 60 respondents (15.3%) received information about weaning from their mother-in-law; 49 respondents (12.5%) received information from media while 63 respondents (16%) received information about weaning from friends.

Table 8: Where did you Receive Information about Weaning From?

Source: Researcher’s Field Survey, 2021.

The Table 9 reveals that 197 respondents (50.13%) start to wean their babies between the age of 0-6months while 196 respondents (49.87%) start to wean their babies between the age of 7-12months.

Table 9: At What Age did you Start Weaning your Baby?

Source: Researcher’s Field Survey, 2021.

The Table 10 reveals that 316 respondents (80.4%) give their baby local foods while 77 respondents (19.6%) give baby formula.

Table 10: Which Weaning Food are you giving your Baby?

Source: Researcher’s Field Survey, 2021.

The Table 11 reveals that 361 respondents (91.9%) have heard about exclusive breastfeeding while 32 respondents (8.1%) said they have not heard about exclusive breastfeeding.

Table 11: Have you heard about Exclusive Breastfeeding Before?

Source: Researcher’s Field Survey, 2021.

The Table 12 reveals that 253 respondents (64.3%) bottle fed their babies while 140 respondents (35.6%) did not bottle fed their babies.

Table 12: Is your Baby Being Bottle Fed?

Source: Researcher’s Field Survey, 2021.

The Table 13 reveals that 137 babies (34.9%) refuse weaning diet; 88 babies (22.4%) had diarrhoea; 98 babies (24.9%) react to weaning diet by vomiting while 70 babies (17.8%) react to weaning diet by having constipation.

Table 13: How does your Baby React to Weaning Diet?

Source: Researcher’s Field Survey, 2021.

The Table 14 reveals that 84 respondents (21 .4%) are afraid of using baby formula for weaning their baby while 309 respondents (78.6%) are not.

Table 14: Are you Afraid of Using Baby Formula for Weaning your Baby?

Source: Researcher’s Field Survey, 2021.

The Table 15 reveals that 386 respondents (98.2%) say adequate nutrition helps the growth and development of a baby while 7 respondents (1.8%) say adequate nutrition does not help the growth and development of a baby. 

Table 15:   Does Adequate Nutrition Help the Growth and Development of a Baby?

Source: Researcher’s Field Survey, 2021.

The Table 16 reveals that 98 respondents (24.9%) combine pap and peanut; 134 respondents (34.1%) combine pap and soybean; 147 respondents (37.4%) combine pap and cow-pea while 14 respondents (3.6%) combine pap and melon seed for their baby’s food.

Table 16: How do you combine your Baby’s Food?

Source: Researcher’s Field Survey, 2021.

The Table 17 reveals that 108 respondents (27.5%) give weaning food in liquid form to their babies; 267 respondents (67.9%) give weaning food in semi-solid form to their babies while 18 respondents (4.6%) give weaning food in solid form to their babies.

Table 17: What Form of Weaning Food do you give your Baby?

Source: Researcher’s Field Survey, 2021.

The Table 18 reveals that 175 respondents (44.5%) believe that early weaning (that is between 4-6months) affects the growth of a baby while 218 respondents (55.5%) said early weaning (that is between 4-6months) does not affect the growth of a baby.

Table 18: Does Early Weaning (That Is between 4-6months) Affect the Growth of a Baby?

Source: Researcher’s Field Survey, 2021.

The Table 19 reveals that 375 respondents (95.4%) agreed that adequate nutrition prevents baby from falling sick while 18 respondents (4.6%) disagreed.

Table 19: Do you Agree that Adequate Nutrition Prevents Baby from Falling Sick?

Source: Researcher’s Field Survey, 2021

The purpose of this study was to investigate the perception of nursing mothers to weaning diet among under-one year children in Oda town, Akure South Local Government Area, Ondo State, Nigeria. It further identified local food combination for weaning with the view to bringing a positive behavioural changes in nursing mothers in Oda town.

The study revealed the age of nursing mothers between 15 and 49 years, with the highest between 25-34yeras which was 43% followed by 35-44years (36.6%). This is in consonance with FMOH (2014) that stated that the goal of this initiate is to improve the nutrition status of Nigeria people throughout their life cycle, with particular focus on vulnerable groups such as women of reproductive age and children under the age of five years old. 

The findings also shows the age of children, that is less than six months (47.33%) and age between 7-12 months (52.67%). This supports the assumption of Ezenduka et al. [1] that beyond the six months, the infant requires vitamins, iron and extra energy for growth, development and substance of life through the introduction of weaning diet. 

The study shows that 98.2% (386 nursing mothers) have heard about weaning diet before while 1.8% (7 nursing mothers) have not heard about weaning diet before. It was further revealed that 56.2% (221 nursing mothers) got the information about weaning diet from the health facility during their visit. Kent State University [9] applauded the roles of health information dissemination in the health facility where health educators educate patients about medical procedures, operations, services and therapeutic regimens; educate individuals to protect, promote or maintain their health and reduce risky behaviours. Akpor et al. [10] recommended that complementary feeding education that would involve various media most especially primary health facilities is paramount for the optimal health of infants.

Also, the study shows that 91.9% (361 nursing mothers) had heard about exclusive breastfeeding before while 8.1% (32 nursing mothers) have not heard it before. These findings are in agreement with WHO [11] who stated that early initiation of breastfeeding within one hour of birth; exclusive breastfeeding for the first 6 months of life and introduction of nutritionally adequate and safe complementary (solid) foods at 6 months together with continued breastfeeding up to 2 years of age or beyond would enhance child’s survival, growth and development.

This survey further reveals how baby react to weaning diet, this include; refusal (34.9%), diarrhoea (22.4%), vomiting (24.9%) and constipation (17.8%). These findings are in agreement with the study of Choudhurg [12] that identified the following as the problems of weaning: diarrhoea, obesity, underweight, allergy, refusal to take the new food, choking, regurgitation and vomiting, constipation, and colic. 

However, the study reveals that 64.4% (253 nursing mothers) are still bottle-feeding their babies while 35.6% (140 nursing mothers) are not involved in the practice of bottle-feeding. The research further shows that 78.6% (309 nursing mothers) are not afraid to use baby formula in weaning their infants while 21.4% (84 nursing mothers) are afraid to use baby formula; though 98.2% (386 nursing mothers) agreed that adequate nutrition helps the growth and development of the infant. Swati (2014) reported that weaning was often advantageous in reducing early infant mortality. Akpor et al. [10] opined that an adequate diet is necessary in the growth and health status of children especially in their first two years of life. The findings of their study revealed that nursing mothers practice abrupt weaning which is harmful to infant. They added that most of the nursing mothers had good knowledge of feeding, weaning and the benefits of exclusive breastfeeding, it was only few of them that practice exclusive breastfeeding.

The study also shows how nursing mothers combine the local food sources to make their baby’s food as follows: pap and peanut (22.9%), pap and soybean (34.1%), pap and cow-pea (37.4%), and pap and melon seed (3.6%). These findings are in agreement with what Akeredolu [13] reported that a mixture of cow-pea, melon, soybean and pap was found to be superior to any single protein source in protein efficiency ratio, net protein retention, biological value and net protein utilization. 

The research further reveals the weaning food being introduced to infants as: liquid (27.5%), semisolid (67.9%), and solid (4.6%). However, 55.5% (218 nursing mothers) disagreed that early weaning between 4-6 months affect the growth of the infant while 44.5% (175 nursing mothers) agreed that early weaning does affect the growth and development of the infant. Murray [14] reported that an infant might suffer from the following if weaned early: decline of immunity, which could result into ear infections, diarrhoea and upper respiratory infections; sudden infant death syndrome (SIDS); digestive issues; development of health problems like eczema and certain cancers; childhood obesity, heart disease, diabetes, and high blood pressure. Her study recommended that the nursing mother should wait until her clinician recommends adding weaning or complimentary diet at approximately six months, and begin to add them slowly. The study added that weaning before the nursing mother was ready could be disappointing and stressful, hence nursing mothers should wait for the right time for their infants.

Finally, the study shows that 95.4% (375 nursing mothers) agreed that adequate nutrition prevents an infant from falling ill while 4.6% (18 nursing mothers) disagreed. This is in agreement with Akpor et al. [10] that asserted that an appropriate or adequate nutrition is necessary in the growth and health status of children especially in the first two years of their life.

Based on the findings from the study, it is concluded that nursing mothers needed to be health educated to bring about a positive behavioural change towards weaning diet composition for their infants.

The study showed that most of the nursing mothers use local available foods to wean their babies which is creditable but early weaning of infants should be stopped. The study also revealed how infants react to weaning diet as follows: diarrhoea, refusal, vomiting and constipation.

In addition, the study revealed how nursing mothers combine local food sources as follows: pap and peanut, pap and soybean, pap and cow-pea and pap and melon seed.

The study has found that still there are mothers who are unaware about the healthy weaning practices and composition hence, it is important to provide health education regarding weaning in order to reduce infant morbidity and mortality rate. Infant nutritional status should be promoted by all nursing mothers.

Recommendations

The following recommendations are made:

• All those entrusted with infant care are encouraged to pull their ideas together and create awareness in the community about weaning diet to infants

• Food demonstration should be re-activated in all the health facilities by the health workers

• Nursing mothers should be properly health educated on weaning diet by the health workers

• All health workers should undergo more seminars/workshop on child survival strategies, so as to mobilize the nursing mothers in the community on weaning diet

• Nursing mothers should allow gradual weaning of their infants and stop the practice of early weaning

• If there is no contra-indication to exclusive breatsfeeding, bottle-feeding should be discouraged by the nursing mothers, so as to prevent diarrhoeal diseases and sudden infant death syndrome (SIDS)

• Baby-Friendly Hospital Initiative (BFHI) should be re-activated in all the health facilities in order to promote exclusive breastfeeding among the nursing mothers

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