Background: Exclusive breastfeeding (EBF) for six months confers several benefits to
infants. It reduces infections and mortality and improves mental and motor development.
The prevalence of EBF in Ghana is far from optimal having reduced from 63% in 2008
to 46% in 2011. Poor feeding practices during early childhood have been shown to
contribute to stunting. The Upper East region of Ghana has 32% of its children under
five stunted.
Objective: To assess breastfeeding and complementary feeding practices and the
association between duration of EBF with the growth of infants at six months of age in
the Builsa district in the Upper East region.
Methodology: The study was conducted in two parts. The first was a qualitative study
utilizing focus group discussions (FGDs) with mothers with six months old infants
recruited from six communities in the Builsa district. The second was a cross-sectional
survey of 290 mother-child pairs recruited from six health facilities in the Builsa district.
Semi-structured questionnaires were used to collect data on socio-demographic
characteristics, infant and young child feeding practices, factors affecting feeding
practices and child morbidity. Data on infant nutritional status were obtained through
anthropometric measurements. Duration of EBF was collected through mothers’ recall.
Infants were grouped based on the duration of EBF; short (≤ 4 months) and long (5-6
months). Bivariate analyses were done to determine the relationship between the
duration of EBF and infant growth, breastfeeding and complementary feeding practices
and socio-demographic factors. Binary logistic regression was used to identify the
predictors of long duration of EBF.
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Results: Results showed that cultural beliefs underline most of the breastfeeding and
complementary feeding practices. Early and late introduction of complementary food,
water and traditional herbs/liquids to newborn babies are common. Grandmother’s
support for EBF, thickness of porridges and age of introduction of complementary food
were significantly associated with duration of EBF (p=0.007; p=0.004 and p<0.001,
respectively). Prevalence of underweight, stunting and wasting in the total sample was
26%, 27% and 37% respectively. Mean weight was significantly higher for infants in the
long duration than infants in the short duration of EBF (7.49 ± 1.00 Kg and 7.17 ± 0.90
Kg respectively) p=0.004. Mean WLZ was also significantly better for infants in the long
duration than those in the short duration of EBF (-0.50 ± 1.11 and -0.86 ± 0.98
respectively) p=0.004. Mean LAZ was significantly better for infants in the short
duration than those in the long duration of EBF (0.20 ± 1.04 and -0.13 ± 1.05
respectively) p=0.007. Duration of EBF was not associated with infant growth at 6
months of age. Predictors of long EBF were grandmother’s support for EBF (OR: 2.03;
95% CI, 1.16, 3.57), having at least primary/JHS/middle school education (OR: 2.32;
95% CI, 1.25, 4.31) and being a salaried worker (OR: 4.72; 95% CI, 1.10, 20.29).
Mothers who earned monthly incomes above GH¢100.00 were less likely to exclusively
breastfeed for long duration compared to mothers who did not earn any monthly income
(OR: 0.22; 95% CI, 0.06, 0.79).
Conclusion: There is the need to promote optimal feeding practices among mothers and
other persons involved in child feeding and education programs to increase knowledge in
nutrition so as to enhance good nutritional status of children.