World Journal of Public Health

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Multiple Micronutrients Versus Iron Folic Acid on Neonatal Breastfeeding Intervals and Period in Kenya

Received: 06 July 2018    Accepted: 26 July 2018    Published: 19 October 2018
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Abstract

Exclusive breastfeeding within the first six months of life, provides sufficient infant nutrients, but remains a challenge for the postnatal women. Maternal pregnancy nutrient deficiency has long-term infant complications: heart disease; heart attacks; deaths; and irreversible cognitive challenges. Half of under five morbidity and mortality are associated with under nourishment. The study introduced multiple micronutrients to promote maternal nutrition to try and influence sustained exclusive breastfeeding to support neonatal and infant health. The study defined sub-populations at risk of nutritional deficiencies and provided opportunities for early intervention to support the known benefit of multiple micronutrients on breastfeeding outcomes up to six weeks (42 days) post delivery. The study determined variations on breastfeeding intervals and period among the Multiple Micronutrients (MMs) and Iron Folic Acid (IFA) groups. This was a Block Randomized Controlled study; treatment arm was administered with MMs while the control arm continued with the usual standard care of IFA. A structured Questionnaire with open and closed ended questions was employed to answer the research questions. Focus group discussions were conducted to collect qualitative data on impact of prenatal multiple micronutrients among the infants. The study demonstrated a significant difference in breast milk amounts and substitution between the treatment and control arm and assumed non-equal variances with a Levene’s test <0.10 (f=7.379, p=0.009): breast feeding was initiated immediately at 100% for MMs and 68.8% for IFA; breast milk was available within 30 minutes post delivery in 86.3% of MMs and 25% for IFA (t, -4.8 p =0.000); breast milk amount was sufficient at 100% for MMs and 60.7% for IFA (-3.697, p=0.001); and no breast milk substitution was effected at 100% for the MMs, while breast milk was substituted in 18.5% of the IFAs within 42 days post delivery (t,-2.190, p=0.033). The study demonstrated significant benefits in micronutrient supplementation to promote infant health compared to the Iron folic acid use by enhancing exclusive breastfeeding practice.

DOI 10.11648/j.wjph.20180304.11
Published in World Journal of Public Health (Volume 3, Issue 4, December 2018)
Page(s) 105-110
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Substitution, Infant Health, Nutrient Supplementation

References
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[2] Khanal V, Lee A H, Scott J A, Karkee R, Binns C W. Implications of methodological differences in measuring the rates of exclusive breastfeeding in Nepal: findings from literature review and cohort study. BMC Pregnancy and Childbirth (2016) 16:389 Doi.10.1186/s12884-016-1180-9
[3] Haroon S, Das J K, Salam R A, Imdad A, Bhutta Z A. Breasfeeding promotion Interventions and breastfeeding practices.; a systematic review. BMC Public Health 2013, 13(suppl 3): s20. http:l/www.biomed central.com/1471-2458/13/s3/s20
[4] Sonko A, Worku A. Prevalence and predictors of exclusive breastfeeding for the first six months of life among women in Halaba special Woreda, Southern National nationalities and people’s region/SNNPR/Ethiopia; a Community based cross-sectional study. Archives of Public Health (2015) 73:53. Doi 10.1186/s13690-015-00984
[5] Boccolini C S, Carvalho M L, De Oliveira M I C. Factors associated with exclusive breastfeeding in the first six months of life in Brazil. A systematic review. Rev Saude Publica 2015; 49-91.
[6] Lumbiganon P, Martis R, Laopaiboon M, Festin M R, Ho J J, Hakimi M. Antenatal breastfeeding education for increasing breastfeeding duration. Cochrane database Systematic Reviews (2011) Sept 12: CD006425.doi:10.1002/14651858.CD006425
[7] Renfew M J, McCormick F M, Wade A, Quinn B, Dowswell T. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database System Review; 5:CDoo1141.doi:10.1002/1461858.CD001141.pub4. Available in PMC 2014 March 26.
[8] Jiang B, Hua J, Wang Y, Fu Y, Zhuang Z, Zhu L. Evaluation of the impact of breast milk expression in early postpartum period on breastfeeding duration: a prospective cohort study. BMC Pregnancy and Childbirth. (2015) 15:268 Doi.10.1186/s12884-015-06986
[9] Hornel A, Lagstrom H, Lande B, Thorsdottir I. Breastffeeding, Introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendation Food and Nutrition Research 2013, 57:20823 http://dx.doiorg/10.3403/fnrv 5710.20823
[10] Dun-Deny E J, Laar A K. Exclusive breastfeeding among city dwelling professional working mothers in Ghana. International breastfeeding Journal (2016) 11:23 Doi 10.1186/s13006-016-0083-8
[11] Alzaheb R A. Factors influencing exclusive breastfeeding in Tabuk, Saudi Arabia. Clinical Medicine Insights 2017: Peadiatrics Volume 11:1-8 Doi.10.1177/117955-6517698136.
[12] Batool A H, Mohammad Y Y, Zulfiqar A B. Effects of multiple micronutrients supplementation during pregnancy on maternal and birth outcomes. BMC Public Health 2011.11(suppl):319
[13] UNICEF Annual Report: United Nations Children’s Fund (UNICEF), 2015 https://www.unicef.org/publications/files/UNICEF_Annual_Report_2015_En.pdf
[14] Kenya Demographic and Health Survey (KDHS), 2014. https://dhsprogram.com/pubs/pdf/fr308/fr308.pdf
[15] Kimani-Murage E W, Madise J N, Fotso J-C, Kyobutungi C, Mutua M K, Gitau T M, Yatich N. Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi, Kenya. BMC Public Health 2016. http:// www.biomedcentral.com/1471-2458/11/396
Author Information
  • Department of Public Health, School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya

  • Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya

  • Department of Food Science and Technology, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya

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  • APA Style

    Betsy Chebet Rono, Yeri Kombe, Anselimo Makokha. (2018). Multiple Micronutrients Versus Iron Folic Acid on Neonatal Breastfeeding Intervals and Period in Kenya. World Journal of Public Health, 3(4), 105-110. https://doi.org/10.11648/j.wjph.20180304.11

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    Betsy Chebet Rono; Yeri Kombe; Anselimo Makokha. Multiple Micronutrients Versus Iron Folic Acid on Neonatal Breastfeeding Intervals and Period in Kenya. World J. Public Health 2018, 3(4), 105-110. doi: 10.11648/j.wjph.20180304.11

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    AMA Style

    Betsy Chebet Rono, Yeri Kombe, Anselimo Makokha. Multiple Micronutrients Versus Iron Folic Acid on Neonatal Breastfeeding Intervals and Period in Kenya. World J Public Health. 2018;3(4):105-110. doi: 10.11648/j.wjph.20180304.11

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  • @article{10.11648/j.wjph.20180304.11,
      author = {Betsy Chebet Rono and Yeri Kombe and Anselimo Makokha},
      title = {Multiple Micronutrients Versus Iron Folic Acid on Neonatal Breastfeeding Intervals and Period in Kenya},
      journal = {World Journal of Public Health},
      volume = {3},
      number = {4},
      pages = {105-110},
      doi = {10.11648/j.wjph.20180304.11},
      url = {https://doi.org/10.11648/j.wjph.20180304.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.wjph.20180304.11},
      abstract = {Exclusive breastfeeding within the first six months of life, provides sufficient infant nutrients, but remains a challenge for the postnatal women. Maternal pregnancy nutrient deficiency has long-term infant complications: heart disease; heart attacks; deaths; and irreversible cognitive challenges. Half of under five morbidity and mortality are associated with under nourishment. The study introduced multiple micronutrients to promote maternal nutrition to try and influence sustained exclusive breastfeeding to support neonatal and infant health. The study defined sub-populations at risk of nutritional deficiencies and provided opportunities for early intervention to support the known benefit of multiple micronutrients on breastfeeding outcomes up to six weeks (42 days) post delivery. The study determined variations on breastfeeding intervals and period among the Multiple Micronutrients (MMs) and Iron Folic Acid (IFA) groups. This was a Block Randomized Controlled study; treatment arm was administered with MMs while the control arm continued with the usual standard care of IFA. A structured Questionnaire with open and closed ended questions was employed to answer the research questions. Focus group discussions were conducted to collect qualitative data on impact of prenatal multiple micronutrients among the infants. The study demonstrated a significant difference in breast milk amounts and substitution between the treatment and control arm and assumed non-equal variances with a Levene’s test <0.10 (f=7.379, p=0.009): breast feeding was initiated immediately at 100% for MMs and 68.8% for IFA; breast milk was available within 30 minutes post delivery in 86.3% of MMs and 25% for IFA (t, -4.8 p =0.000); breast milk amount was sufficient at 100% for MMs and 60.7% for IFA (-3.697, p=0.001); and no breast milk substitution was effected at 100% for the MMs, while breast milk was substituted in 18.5% of the IFAs within 42 days post delivery (t,-2.190, p=0.033). The study demonstrated significant benefits in micronutrient supplementation to promote infant health compared to the Iron folic acid use by enhancing exclusive breastfeeding practice.},
     year = {2018}
    }
    

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    AU  - Betsy Chebet Rono
    AU  - Yeri Kombe
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    JF  - World Journal of Public Health
    JO  - World Journal of Public Health
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    AB  - Exclusive breastfeeding within the first six months of life, provides sufficient infant nutrients, but remains a challenge for the postnatal women. Maternal pregnancy nutrient deficiency has long-term infant complications: heart disease; heart attacks; deaths; and irreversible cognitive challenges. Half of under five morbidity and mortality are associated with under nourishment. The study introduced multiple micronutrients to promote maternal nutrition to try and influence sustained exclusive breastfeeding to support neonatal and infant health. The study defined sub-populations at risk of nutritional deficiencies and provided opportunities for early intervention to support the known benefit of multiple micronutrients on breastfeeding outcomes up to six weeks (42 days) post delivery. The study determined variations on breastfeeding intervals and period among the Multiple Micronutrients (MMs) and Iron Folic Acid (IFA) groups. This was a Block Randomized Controlled study; treatment arm was administered with MMs while the control arm continued with the usual standard care of IFA. A structured Questionnaire with open and closed ended questions was employed to answer the research questions. Focus group discussions were conducted to collect qualitative data on impact of prenatal multiple micronutrients among the infants. The study demonstrated a significant difference in breast milk amounts and substitution between the treatment and control arm and assumed non-equal variances with a Levene’s test <0.10 (f=7.379, p=0.009): breast feeding was initiated immediately at 100% for MMs and 68.8% for IFA; breast milk was available within 30 minutes post delivery in 86.3% of MMs and 25% for IFA (t, -4.8 p =0.000); breast milk amount was sufficient at 100% for MMs and 60.7% for IFA (-3.697, p=0.001); and no breast milk substitution was effected at 100% for the MMs, while breast milk was substituted in 18.5% of the IFAs within 42 days post delivery (t,-2.190, p=0.033). The study demonstrated significant benefits in micronutrient supplementation to promote infant health compared to the Iron folic acid use by enhancing exclusive breastfeeding practice.
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