Approaches and attitudes of mothers about complementary feeding

Introduction and objective: Nutrition is one of the main factors for a child to grow and develop in a healthy way. The negative effects of wrong and unconscious implementations made in this issue can be seen not only in childhood but also in all periods of life. World Health Organization (WHO) and American academy of Pediatrics (AAP) advise that infants should be fed only on breast milk in 0-6 months, supplementary food should be started in the 6th month and breastfeeding should be sustained for 2 years. According to Turkey Population Health Research, early starting the supplementary food is a very common practice and supplementary food has also been determined not to be given in accordance with its month. This study aims to determine how long mothers feed babies only on breast milk, when they start supplementary food, and the factors affecting the decision to start supplementary food, and also aims to detect the solution ways of mistakes in infant nutrition. Materials and method: The children between 12-36 months were included in the study, who applied well child follow-up polyclinics, General Pediatrics Polyclinic and other sub-branch polyclinics of Pediatrics Department, Medical School of Aegean University and who followed up in service as in-patients. The parents of children were informed before the questionnaire and written approval form of information was taken. Questionnaires were made one by one and face to face by the researcher. On the questionnaire form, questions were asked such as general features of children, socio-demographic features of families, nutritional condition of children, whether the children took breast milk in the first 24 hours or not, the duration of nutrition only with breast milk, the manner of nutrition in the first 6 months, when they started supplementary food, why mothers, having started supplementary food before the first 6 months, started supplementary food, the reason why the infants did not get breast milk who had never gotten breast milk, total duration of getting breast milk, who were involved in the care of the children in the first 1 year, from which source they got information about supplementary food, and the usage of salt and sugar in the first 1 year. The data obtained from the research were analyzed in SPSS statistics 22 program. Descriptive statistics were performed primarily for all variables. Chi square test was applied for the difference between categorical variables and Spearman's correlation analysis was performed for the relationship between numeric variables. If there were two independent groups in comparing the data statistically, Mann Whitney U test was applied, if there were more than two groups, Kruskal Wallis test was applied. It was accepted to be statistically significant when p < 0.05. Results: A total of 300 children aged between 12-36 months were included in our study. The average age of children was 22.5±7.8 months. 293 of the cases (97.7%) got breast milk within the first 24 hours after birth, yet those having taken only breast milk was 78.3% (n=235). 19.7% (n=58) of those having taken breast milk in the first 24 hours after birth were given formula together with breast milk. The duration of nutrition only with breast milk was 4±2.5 months. The rate of nutrition only with breast milk in the first 6 months was 47.7%. Total period of taking breast milk was 14±7.8. The average age of starting supplementary food was 5.6±1.2 months and 88% of the cases started supplementary food before the 6th month. When the mothers were asked why they started supplementary food before the 6th month, the most common answer was "to have them taste" (37.5%). No relationship was found between the nutrition of children included in the study with breast milk in the first 6 months, total period of taking breast milk, time of starting supplementary food and the gender of the child, the birth order of the child, age of the mother, mother-father education, mother's working or not, economic level of the family, caretaker (p>0.05) Conclusion: Mothers have high tendency of giving breast milk in the first 24 hours, while the rate of giving only breast milk is not at sufficient level; formula has been observed to be given at a high level at birth in addition to breast milk. The rate of early starting supplementary food was found to be high in comparison to Turkey average and there are deficiencies in the matter of nutrition with proper supplementary food at the proper time. Although health officials seem to be effective in informing about nutrition, it does not seem to be reflecting on families' behavior. Society needs more training about the nutrition of infants. Significant relationship was not found in our study in evaluating the factors affecting the nutrition only with breast milk in the first 6 months, time of starting supplementary food, total duration of taking breast milk. More widespread studies are needed on this issue with more cases.