Breastfeeding among working mothers in Nairobi

Breastfeeding is the best food source for the nutritional and health needs of young children. However when a mother returns to work, breastfeeding may be discontinued prematurely. The purpose of this study was to study infant feeding practices used by working mothers in Nairobi. Mothers attending clinics at two hospitals, one a private hospital serving higher socioeconomic groups and the other a public hospital represented the low socioeconomic groups, were interviewed. A structured interview was held with 444 mothers (200 from the low socioeconomic group and 244 from the high socioeconomic group) between January 5th and February 11th 2000. All mothers with infants aged 16-48 weeks who were willing to participate were interviewed. The prevalence of breastfeeding at the time of the study was found to be 94.1%. The low socioeconomic group exhibited a higher prevalence of breastfeeding (99%) with a 10% difference between the low and high socioeconomic groups. The prevalence of exclusive breastfeeding was 13.3% at three months. Early introduction of other feeding methods was high, with 46.4% of the mothers introducing other feeding methods before one month. Multivariate logistic regression was used to determine factors that were associated with exclusive breastfeeding using two separate models for exclusive breastfeeding at one month and two months. The mode of work (fixed working hours as opposed to shift work) was associated with exclusive breastfeeding for at least month (OR=0.45) and two months (OR=0.39). Insufficient milk and return to work were the main reasons cited for cessation of exclusive breastfeeding.Multiple linear regression was used to find out whether growth rates differed between feeding methods and types of foods for complementary feeding. Bottle-feeding had a significant negative association (-0.240, p=0.018) with baby weight and a downward trend was evident in baby Z-score for age exhibiting a risk of growth faltering in all infants. The results of this study indicate that the prevalence of breastfeeding in Nairobi Kenya has remained considerably high. Working mothers are still committed to breastfeeding despite the long working hours of separation (mean 46.23 hours). However exclusive breastfeeding is low, recommendations are made for interventions to promote exclusive breastfeeding and policies with strategies to enable working mothers to exclusively breastfeed for at least four months