Trends of breastfeeding in "Laini-Saba" (Kibera) and their relationship to child health

Abstract

This study was carried out in "Laini-Saba" village of the Kibera slum area in Nairobi. It examined the prevalence of breast feeding among mothers resident in such an urban slum setting, and also attempted to understand the relationship between such factors as employment or educational level of a mother and her ability to breastfeed successfully. In the same vein, the study looked into the various reasons which slum dwelling mothers may have for discontinuing breastfeeding and introducing other foods into their babies' diets. Having achieved the foregoing, the study attempted to establish how residence in a slum community affects the health of slum children vis-a-vis the nature of the diseases that usually ail them and how relevant breastfeeding is to the overall health of such children. The study population consisted of mothers residing in "Laini-Saba" village of Kibera who had children below two years of age during the research period. They were randomly selected using the door-to-door enumeration process based on the principle of "snow-balling" and the system of statistical random numbers. Such selection was also guided by the mothers' willingness to participate in the interview process whose main tool was the questionnaire. The mothers were the study's respondents while the children and the residential units (houses) were the units of analysis. One hundred respondents were interviewed, fifty-eight of whom were breastfeeding during the research period and forty two of whom had breast fed sometime hitherto but had now ceased doing so. Various hypotheses were tested during data analysis and this led to certain salient findings. The study confirmed that a mother's ability to carry her breastfeeding child to her workplace, and hence to be able to breast feed without any hitches even after resumption of work depends, to a large extent, on the nature of her occupation. Those engaged in self-employment (such as hawking or market. trading) may for example, be in a better position to carry their children to work than their counterparts who are employed in the formal sector. The study also established that the decision to breast feed a child depends partly on the mother's level of education since the level of education she attains may be the crucial determinant of what kind of employment she engages in, or her level of awareness of the basic requirements of successful child care such as breastfeeding. Regarding the health of the children, the study revealed that the health status of the slum-dwelling children is not determined by the period during which such children were exclusively breast fed. Similarly.! it was confirmed that the nature of the disease these children usually suffer from is not determined by whether they were breast fed or not. Following such findings as the foregoing, it has been concluded that for the slum-dwelling mothers, breast feeding may not be feasible, considering their occupational categories and that the extent to which such mothers practise breastfeeding is not really very important in improving the health of their children, considering the squalid conditions in which such children are born. It was further concluded that level of education plays a relatively insignificant role in the promotion of awareness of breast feeding requirements as contrasted to word of mouth from neighbours, friends and midwives. For that reason, the failure of slum-dwelling mothers to breast feed consistently for lengthy periods of time was found to lie more with other factors such as nature of employment or various problems including breast infections and the child's rejection of breast milk. In a slum village such as "Laini-Saba", therefore,it became apparent from the study that hardly any significant relationship seemed to exist between breast-feeding and child health. Rather, the state of the slum child's health is determined more by the environment in which he grows up and his mother's ability to provide good care even as she pursues economic-oriented goals which are supposed to improve this ability. The study's recommendations mainly revolve around the need for action by the government towards improving living conditions in slum areas such as "Laini-Saba" in Kibera. These include improving the water supply, garbage collection services and health services. Only then can the chances of improving the child's overall health status and of undertaking breast-feeding successfully be enhanced in such communities.