MOTHERS’ KNOWLEDGE AND PRACTICES OF KEY CLINICAL STEPS OF SUCCESSFUL BREASTFEEDING AT JARAMOGI OGINGA ODINGA TEACHING AND REFERRAL HOSPITAL, KENYA

Abstract

The Successful Breastfeeding steps of Baby Friendly Hospital Initiative (BFHI) is the model of the international standard of promoting breastfeeding rates. Nonetheless, sub-optimal breastfeeding is one of the greatest public health concerns that cause almost a half of all the deaths of children worldwide. The situation is especially acute in the area where this study was conducted; Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) that has reported the lowest rate of exclusive breastfeeding; only 50 per cent, which is way below the BFHI standard of 80 per cent. Although this is but one of the reported steps to successful breastfeeding (Exclusive breastfeeding), the gap points at key failures in implementing successful breastfeeding. Thus, this research was conducted to evaluate the knowledge of mothers and identify the practice of the key clinical steps of Successful Breastfeeding and establish the relationship between the knowledge and practice of these steps. The design used was a cross-sectional one and comprised of 79 breastfeeding mothers in JOOTRH selected by systematic sampling. A researcher-administered questionnaire and an observational checklist were used to collect data. The patterns of knowledge and practice were described by descriptive statistics (frequencies and percentages), whereas binary logistic regression was used to assess the correlation between knowledge and practice, with maternal age, education, and marital status as control variables. The results indicated a strong knowledge-practice gap. The knowledge of the mothers on most of the steps was according to the WHO/UNICEF requirements. These include step 3 (94.9%), step 6 (93.7%), step 7 (94.9%), step 8 (92.4%), and step 9 (81%), However, this success masked a severe deficit in actionable skills on step 3 (11.4%), step 4 (72.2%), step 5 (38%), and step 10 (21.5%). Furthermore, there was no statistically significant relationship between knowledge and corresponding practices for any of the steps (p > 0.05) according to the Logistic regression analysis results. However, negative directional associations were observed in step 3 (AOR =0.132) and step 6 (AOR =0.702) while other steps showed a while positive directional association (AOR > 1). The findings show that mothers’ knowledge was not sufficient to translate into skills to promote successful breastfeeding. Strengthening BFHI implementation should therefore prioritize hands-on, skill based coaching by nurses and integrate post-discharge breastfeeding support through Community Health Volunteer (CHV) programs to ensure sustained practice and improved child survival outcomes. There is a need for longitudinal studies to assess the sustainability of breastfeeding post-discharge.