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1 Komponen
2 Judul artikel

Knowledge and practice of exclusive breastfeeding in

Kware, Nigeria
Judul menarik dan tidak terlalu panjang dalam penulisan

3 Pengarang Dan Institusi MO Oche,1 AS Umar,1 and H Ahmed2

nama 2 pengarang sudah ditulis kan sesuai dengan aturan jurnal
4 Abstrak Pada komponen ini Terdiri dari 1 paragrap terstruktus
Pada IMRAD Tidak ada komponen introduction
Pada penyususnan kata tidak lebih dari 250 kata yaitu 205
kata
Background
For almost all infants, breastfeeding remains the simplest,
healthiest and least expensive feeding method that fulfils the
infants' needs. Despite strong evidence in support of
Exclusive breast feding (EBF) for the first six months of life,
its prevalence has remained low worldwide.
Methodology
This was a cross-sectional descriptive study involving women
of child bearing age in Kware town of Sokoto State. One in
eight samples of 179 mother-child pairs were selected and
information regarding their knowledge and practice of
exclusive breastfeeding obtained using a set of structured
interviewer administered questionnaires.

Results

A total of 54(31%) of the mothers had adequate knowledge of

exclusive breastfeeding with 94(53%) of them initiating
breastfeeding immediately after birth. Only 55(31%) of the
mothers practiced exclusive breastfeeding. Out of the 53
 mothers that stopped breastfeeding, 85% of them did so
between 16–20months.

Conclusion

Although breastfeeding was universal in this community, the

knowledge and practice of EBF was low. There is a need to
institute interventions aimed at early initiation of
breastfeeding and improving the knowledge and practice of
EBF towards achieving the goals of MDG-4 in the study
community.

Keywords: Mothers, breastfeeding, knowledge & practice,

Kware
Abstrak terdiri dari

5 Pendahuluan pada pendahuluan memiliki 4 paragraf

Introduction
For almost all infants, breastfeeding remains the simplest,
healthiest and least expensive feeding method that fulfils the
infants' needs.1 The numerous benefits of breast-feeding are of
public health relevance for developing countries as well as for
industrialized nations.

Exclusive breastfeeding, which giving breast milk only and no

other liquids, except drops or syrups with vitamins, mineral
supplements or medicines, is superior to non-exclusive
breastfeeding with a protective effect against both morbidity
and mortality 2, 3. Exclusive breast-feeding provides low cost,
complete nutrition for the infant, protects him/ her against
infections including infant diarrhea, and prolongs lactation
amenorrhea, thereby increasing birth spacing4, 5.

Despite strong evidences in support of EBF for the first six

months of life, its prevalence has remained low worldwide6,7.
In Nigeria, breastfeeding is universal with almost all babies
being breastfed. However, the practice of EBF is rare with
only 17% of children younger than six months being
exclusively breastfed. 8

The need to protect, promote and support breastfeeding in our

communities has been widely recognised. It is in realisation of
this noble objective that the Federal Ministry of Health and
Social Services in conjunction with UNICEF and WHO
launched the Baby Friendly Hospital Initiative (BFHI) to
protect, promote and support breastfeeding in Nigeria. To
achieve this objective, a number of Teaching and Specialist
hospitals were designated as baby friendly hospitals following
the “Innocenti declaration”. The Innocenti Declaration has as
its main objectives the promotion of early initiation of
breastfeeding (within 30minutes of delivery), EBF for the first
six months of life, breastfeeding on demand and continuing
breastfeeding with complementary feeds into the second year
9, 10
of life . Although several studies have been reported from
our study area, these studies however did not assess the
knowledge of the mothers with regards to exclusive
breastfeeding 11, 12, 13.
Translate
pengantar
Untuk hampir semua bayi, menyusui tetap merupakan
metode pemberian makan yang paling sederhana, sehat
dan tidak mahal yang memenuhi kebutuhan bayi.
Banyak manfaat menyusui adalah relevansi kesehatan
masyarakat untuk negara berkembang dan juga bagi
negara-negara industry
Pada bagian pertama menjelaskan tentang penting
nya menelitiiti

Pemberian ASI eksklusif, yang hanya memberikan ASI

dan tidak ada cairan lain, kecuali tetes atau sirup
dengan vitamin, suplemen mineral atau obat-obatan,
lebih unggul daripada ASI non-eksklusif dengan efek
perlindungan terhadap morbiditas dan mortalitas 2, 3.
Pemberian ASI eksklusif biaya rendah, nutrisi lengkap
untuk bayi, melindungi mereka terhadap infeksi
termasuk diare bayi, dan memperpanjang laktasi
amenore, sehingga meningkatkan jarak kelahiran4, 5.
Meskipun bukti kuat dalam mendukung EBF untuk
enam bulan pertama kehidupan, prevalensinya tetap
rendah di seluruh dunia 6,7. Di Nigeria, menyusui
bersifat universal dengan hampir semua bayi disusui.
Namun, praktek EBF jarang dengan hanya 17% anak-
anak yang lebih muda dari enam bulan secara eksklusif
disusui. 8
Kebutuhan untuk melindungi, mempromosikan, dan
mendukung pemberian ASI di komunitas kami telah
diakui secara luas. Ini adalah realisasi dari tujuan mulia
ini bahwa Kementerian Kesehatan dan Layanan Sosial
Federal dalam hubungannya dengan UNICEF dan
WHO meluncurkan Inisiatif Rumah Sakit Ramah Bayi
(BFHI) untuk melindungi, mempromosikan dan
mendukung menyusui di Nigeria. Untuk mencapai
tujuan ini, sejumlah rumah sakit Pengajaran dan
Spesialis ditetapkan sebagai rumah sakit ramah bayi
mengikuti "deklarasi Innocenti". Deklarasi Innocenti
memiliki tujuan utama promosi inisiasi menyusui dini
(dalam 30 menit persalinan), EBF untuk enam bulan
pertama kehidupan, menyusui sesuai permintaan dan
 terus menyusui dengan makanan pendamping ke dalam
tahun kedua kehidupan 9, 10. Meskipun beberapa
penelitian telah dilaporkan dari daerah penelitian kami,
namun penelitian ini tidak menilai pengetahuan ibu
tentang pemberian ASI eksklusif
Pada bagian ke dua hanya menjalaskan peting nya
asi

Metode Method
This was a cross sectional descriptive study involving women
of child bearing age who were currently breastfeeding at the
time of the study or who had stopped breastfeeding not later
than two years before (inclusion criterion)while mothers who
never breastfed or were temporary visitors to the town were
excluded from the study (exclusion criteria).

The study took place in Kware town, a semi urban local

government area of Sokoto State with 1,350 women of child
bearing age.14 The town is served by Comprehensive and
Primary health centres in addition to the Federal Neuro-
Psychiatric Hospital. The vegetation in Kware town is the
guinea Savannah type with an annual rainfall of about 550mm
which peaks in August. Dry season sets in first with cold
harmattan from October to March and a hot period from April
to the end of May when temperature reaches 38°C during the
day. The main indigenous tribe in the area is Hausa/Fulani
with Islam as the main religion. There are other ethnic groups
like Ibos, Yoruba, Idomas etc. Farming is the main pre-
occupation of the people producing food crops like millet,
corn, ground nuts, sorghum and cotton. Animal husbandry is
also common among the Fulanis.

A sample size of 179 was determined using the formula for

cross-sectional studies and a prevalence of EBF of 13%8.

A day was set aside for house numbering and using a

systematic sampling method, the first of every eight houses
was selected from which 179 mother-child pairs were enrolled
into the study. Six Community health workers residing in the
community were recruited to act as research assistants (RAs).
They were trained on the general principles of the research
and the study instruments.

Data was collected using a comprehensive, pre-tested and

structured interviewer-administered questionnaire which
sought such information as age, educational status,
occupation, initiation of breastfeeding, prelacteal feeding and
knowledge and practice of exclusive breastfeeding. Exclusive
breastfeeding in this study refers to the practice of giving the
infant only breast milk for six months without any fluids
except liquid medicines. Knowledge of EBF was assessed
through such questions as duration of EBF, feeding the infant
with only breast milk for six months; EBF protects the infant
against infections etc. The questionnaires were manually
sorted out for completeness and accuracy a day after the
collection of the data and where there were any omissions; the
respondents were traced using the house identification
numbers. Data processing and analysis were done using EPI-
Info version 3.4.1 computer soft ware programme and
Microsoft Office Excel 2003. An author devised scoring and
grading system for knowledge was used with each correct
answer attracting a mark. A score ≥50% was graded as
adequate knowledge of EBF. Cross tabulation of variables
was done where feasible and level of statistical significance
was set at 95% confidence interval

metode
Ini adalah penelitian deskriptif cross sectional yang
melibatkan wanita usia subur yang saat ini menyusui
pada saat penelitian atau yang telah berhenti menyusui
tidak lebih dari dua tahun sebelumnya (kriteria inklusi)
sementara ibu yang tidak pernah menyusui atau
pengunjung sementara ke kota dikeluarkan dari
penelitian (kriteria eksklusi).
Penelitian berlangsung di kota Kware, daerah
pemerintah daerah semi urban di Negara Bagian
Sokoto dengan 1.350 wanita usia subur.14 Kota ini
dilayani oleh Pusat Kesehatan Komprehensif dan
Utama di samping Rumah Sakit Neuro-Psikiatri
Federal. Vegetasi di kota Kware adalah jenis guinea
Savannah dengan curah hujan tahunan sekitar 550mm
yang memuncak pada bulan Agustus. Musim kemarau
dimulai pertama dengan cold harmattan dari Oktober
hingga Maret dan periode panas dari April hingga
akhir Mei ketika suhu mencapai 38 ° C pada siang hari.
Suku pribumi utama di daerah tersebut adalah Hausa /
Fulani dengan Islam sebagai agama utama. Ada
kelompok etnis lain seperti Ibos, Yoruba, Idomas, dll.
Pertanian adalah pekerjaan utama orang-orang yang
memproduksi tanaman pangan seperti millet, jagung,
kacang tanah, sorgum dan kapas. Peternakan juga
umum di kalangan Fulanis.
Ukuran sampel 179 ditentukan dengan menggunakan
rumus untuk studi cross-sectional dan prevalensi EBF
13% 8.
Satu hari disisihkan untuk penomoran rumah dan
menggunakan metode sampling sistematis, yang
pertama dari setiap delapan rumah dipilih dari 179
pasangan ibu-anak yang terdaftar dalam penelitian.
Enam petugas kesehatan masyarakat yang tinggal di
masyarakat direkrut untuk bertindak sebagai asisten
peneliti (RAs). Mereka dilatih tentang prinsip-prinsip
umum penelitian dan instrumen penelitian.
Data dikumpulkan menggunakan kuesioner yang
dikelola secara komprehensif, pre-teruji dan terstruktur
yang dikelola oleh pewawancara yang mencari
informasi seperti usia, status pendidikan, pekerjaan,
inisiasi menyusui, makan dan pengetahuan pralaktasi
dan praktik pemberian ASI eksklusif. ASI eksklusif
dalam penelitian ini mengacu pada praktik pemberian
ASI saja selama enam bulan tanpa cairan apa pun
kecuali obat-obatan cair. Pengetahuan tentang EBF
dinilai melalui pertanyaan seperti durasi EBF,
menyusui bayi hanya dengan ASI selama enam bulan;
EBF melindungi bayi terhadap infeksi dll. Kuesioner
secara manual disortir untuk kelengkapan dan akurasi
sehari setelah pengumpulan data dan di mana ada
kelalaian; responden dilacak menggunakan nomor
identifikasi rumah. Pengolahan dan analisis data
dilakukan dengan menggunakan program soft ware
komputer EPI-Info versi 3.4.1 dan Microsoft Office
Excel 2003. Seorang penulis yang merancang sistem
penilaian dan penilaian untuk pengetahuan digunakan
dengan setiap jawaban yang benar yang menarik tanda.
Skor ≥50% dinilai sebagai pengetahuan EBF yang
memadai. Tabulasi silang variabel dilakukan di mana
layak dan tingkat signifikansi statistik ditetapkan pada
95% interval kepercayaan
 Pada metode yang di gunakan yaitu studi
diskriptif
  Dan pada metode ini tidak di sebtkan jenis
peneliianya
Hasil Results

A total of 84 (47%) of the respondents were between the ages

of 23–32years while only 29(16%) were above 38 years of
age with a mean age of 29.8 ±10.3years. Only 62 (34%), of
the study subjects had formal education made up of 33 (18%)
Primary, 20 (11%) secondary and 9 (5%) tertiary. All the
respondents were married with majority, 109(61%) being
fulltime house wives while only 21(12%) of the respondents
were civil servants. A total of 143(79.9%) of the women were
of the Hausa tribe, with Fulanis constituting 14.5% (table 1).

Tabel 1

Socio-demographic characteristics of the respondents (n=179)

Age (years) No. (%)

13–17 17 (10)
18–22 22 (12)
23–27 43 (24)
28–32 41 (23)
33–37 27 (15)
≥38 29 (16)

Educational level
None 60 (34)
Quaranic only 57 (32)
Primary 33 (18)
Secondary 20 (11)
Tertiary 9 (5)

Occupation
Full time housewife 109 (61)
Civil Servant 21 (12)
Trading/business 49 (27)

Religion
Islam 174 (97.2)
Christianity 5 (2.8)

Tribe
Hausa 143(79.9)
Fulani 26(14.5)
Others 10(5.6)

Sixty percent of the mothers were aware of exclusive

breastfeeding (EBF) but only 30% of them had adequate
knowledge of EBF having scored 50% or more in the
assessment of knowledge of EBF. Main Sources of
information on EBF were mothers of respondents and health
workers.

Concerning the breastfeeding practices of the mothers, more

than half, 94(53%) initiated breastfeeding immediately
(<30minutes) after delivery, while 85(47%) did so long after
30 minutes. Reasons adduced for delayed initiation of
breastfeeding among eighty five mothers include colostrum
being dirty and thought to be harmful to the child, lack of
breast milk and mother or child illness (table 2). For the
women who considered colostrum dirty, while awaiting the
coming of the clean milk, they gave boiled water, honey,
animal milk and washouts from writings of the Quran on
slates.

Table 2

Reasons for late Initiation of breastfeeding

Reasons No. (%)

Colostrum dirty 122 (68.1)
No breast milk 25(13.8)
Mother sick 15 (8.6)
Child sick 10 (5.7)
No reasons 7 (3.8)
Total 179 (100)

A total of fifty-three mothers had stopped breastfeeding at the

time of the survey, out of which only one mother stopped
breastfeeding before six months due to onset of a new
pregnancy, while 45(85%) did so between sixteen to twenty
months (Table 3). Other reasons for stopping breastfeeding
include child old enough to eat family adult food and mother
or child's illness

Table 3

Age child stopped breastfeeding

Age (months) No. (%)

0–5 1 (0.6)
6–10 2 (1.1)
11–15 5 (2.8)
16–20 45 (25.1)
21–24 126 (70.4)
Total 179 (100)

Out of the 179 mothers, only 55(31%) practiced exclusive

breastfeeding. The ages, education and occupation of the
respondents were found not to have influenced the practice of
EBF (tables 4).

Table 4

Relationship between some variables and the practice of

exclusive breastfeeding

Variable Practice of Test statistics

exclusive
breastfeeding
Educational Yes No Xc2=0.00029, df=1,
status =0.986(not significant)
Formal 19 43
Non formal 36 81
Age(yrs)
<30 26 76 X2=2.51, df=1,
=0.113(not significant)
>30 29 48
Occupation
Full time house 39 70 X2=2.77, df=1,
wife =0.996(not significant)
Civil 16 54
servant/business

Discussion

In a recent evaluation of the Millennium Development Goals

(MDGs), exclusive breastfeeding (EBF) for six months was
considered as one of the most effective interventions to
achieve MDG-415.

In our study, only 54(30%) of the mothers had adequate

knowledge of EBF. This is comparable to the study in Gwale,
Kano with similar socio-cultural background as the study
area, where 31% of the mothers had good knowledge of
EBF16. However, the figure obtained in this study is low when
compared to the 55% obtained in the study by Freed and his
colleagues17 and 98% observed in a similar study in Accra
Ghana18.

The Baby friendly hospital Initiative (BFHI) was designed to

promote early initiation of breastfeeding, preferably
immediately after birth. This study observed that 94 (53%) of
the mothers initiated breastfeeding immediately after birth.
This is higher than 26% and 31% obtained in the studies from
Kano and Sokoto respectively16, 19. The study from Western
Nepal, India, obtained a higher rate (72.2%) of breastfeeding
initiation20. Findings from recent studies have stressed the risk
of delayed onset of breastfeeding on neonatal mortality in
sub-Saharan Africa and showed that neonatal mortality could
be significantly reduced by 16% if the mothers started
breastfeeding at day one and 22% when breastfeeding was
commenced within the first hour. 21 The major reason for late
initiation of breastfeeding in most (47%) of the respondents
was colostrum not pure thus supporting the general perception
in the study area that in the first three days, the mother's milk
is not pure and therefore could harm the infant. This finding is
in consonance with that of Onayande and others in Ile-Ife22
even though the study areas have varying socio-cultural
characteristics. While starving the child for the period of not
giving colostrum, the child is also denied the benefits of the
immunological constituents of colostrum and subsequently
delays the proper establishment of lactation later. 23 While
awaiting the establishment of the “clean milk”, the mothers
gave prelacteals in form of boiled water, honey and animal
milk. This is in consonance with findings from similar
studies16, 19, 21. The introduction and use of prelacteal feeds
have found a common place among African mothers24, 25.

In the study community, even though breastfeeding has found

universal acceptability with all the mothers' breastfeeding
their infants, the exclusive breastfeeding (EBF) rate was
found to be only 31%. The EBF rate obtained in this study
was however high compared to 17% reported for Nigeria in
the Nigerian Demographic and Health survey8 and equally
higher than figures obtained in other studies16, 26, 27, 28. In
contrast to the EBF rate obtained in this study, Oche19, in a
separate study in the same zone as the study area, obtained an
EBF rate of 79%.The high rate obtained in his study may not
be unconnected with the fact that all his subjects were full
time house wives and therefore had enough time to carry on
breastfeeding for longer periods.

Maternal education is related to knowledge of good child care

practice and to household wealth. Female education has
severally been described as one of the strongest determinants
of the practice of EBF29. In our study, education of the
respondents had no influence on the practice of EBF as there
was no statistically significant difference between those with
formal education and informal education with regards to the
practice of EBF (p=0.986). Although, 39 housewives
compared to 19 civil servants practiced EBF, this was found
not to be statistically significant (p=0.096). This is in contrast
to another study in the same study area where the authors
opined that the high rate of EBF by the mothers could be
attributed to their being full time housewives and therefore
they had enough time to practice EBF19.

Only 1(2%) subject stopped breastfeeding before six months

which is in consonance with the study from Kano, where
2.4% of the respondents stopped breastfeeding before the age
16
of six months. The only mother that stopped breastfeeding
before six months did so because of the onset of a new
pregnancy. In the study area, the widely held cultural belief is
that the new pregnancy produces milk that is contaminated
and thus harmful to the child hence the need to put the child
off the breast. This practice has far reaching implications for
the growing children as they are exposed to malnutrition and
denied all the benefits of breastfeeding. The commonest
reason for stoppage of breastfeeding in this study was that the
child was old enough and could eat solid foods. This is in
consonance with the findings from another study in Sokoto
Hasil
Sebanyak 84 (47%) dari responden adalah antara usia
23-32 tahun sementara hanya 29 (16%) berada di atas
38 tahun dengan usia rata-rata 29,8 ± 10,3 tahun.
Hanya 62 (34%), dari subyek penelitian memiliki
pendidikan formal yang terdiri dari 33 (18%) Primer,
20 (11%) sekunder dan 9 (5%) tersier. Semua
responden menikah dengan mayoritas, 109 (61%)
adalah istri rumah fulltime sementara hanya 21 (12%)
dari responden adalah pegawai negeri sipil. Sebanyak
143 (79,9%) dari perempuan adalah dari suku Hausa,
dengan Fulanis merupakan 14,5% (tabel 1).
Tabel 1
Karakteristik sosio-demografi responden (n = 179)
Usia (tahun) No. (%)
13-17 17 (10)
18-22 22 (12)
23-27 43 (24)
28–32 41 (23)
33–37 27 (15)
≥38 29 (16)

Tingkat pendidikan
Tidak ada 60 (34)
Quaranic only 57 (32)
Primer 33 (18)
Secondary 20 (11)
Tersier 9 (5)

Pendudukan
Penuh waktu ibu rumah tangga 109 (61)
Pegawai Negeri Sipil 21 (12)
Perdagangan / bisnis 49 (27)

Agama
Islam 174 (97.2)
Agama Kristen 5 (2.8)

Suku
Hausa 143 (79,9)
Fulani 26 (14,5)
Lainnya 10 (5,6)

Enam puluh persen dari ibu-ibu menyadari pemberian

ASI eksklusif (EBF) tetapi hanya 30% dari mereka
yang memiliki pengetahuan EBF yang memadai yang
memiliki skor 50% atau lebih dalam penilaian
pengetahuan EBF. Sumber utama informasi tentang
EBF adalah ibu dari responden dan pekerja kesehatan.
Mengenai praktik menyusui para ibu, lebih dari
separuh, 94 (53%) memulai menyusui segera (<30
menit) setelah melahirkan, sementara 85 (47%)
melakukannya begitu lama setelah 30 menit. Alasan
yang dikemukakan untuk menunda inisiasi menyusui
di antara delapan puluh lima ibu termasuk kolostrum
yang kotor dan dianggap berbahaya bagi anak,
kekurangan ASI dan ibu atau anak yang sakit (tabel 2).
Bagi wanita yang menganggap kolostrum kotor, sambil
menunggu datangnya susu bersih, mereka memberikan
air matang, madu, susu hewan, dan pencucian dari
tulisan Al-Quran di papan tulis.

Table 2
Alasan terlambat Inisiasi menyusui
Alasan Tidak (%)
Kolostrum kotor 122 (68,1)
Tidak ada ASI 25 (13,8)
Ibu sakit 15 (8.6)
Anak sakit 10 (5.7)
Tanpa alasan 7 (3.8)
Total 179 (100)
Sebanyak lima puluh tiga ibu telah berhenti menyusui
pada saat survei, dari yang hanya satu ibu berhenti
menyusui sebelum enam bulan karena timbulnya
kehamilan baru, sementara 45 (85%) melakukannya
antara enam belas sampai dua puluh bulan ( Tabel 3).
Alasan lain untuk berhenti menyusui termasuk anak
yang cukup tua untuk makan makanan keluarga
dewasa dan ibu atau penyakit anak
Tabel 3
Usia anak berhenti menyusui
Usia (bulan) No. (%)
0–5 1 (0,6)
6–10 2 (1.1)
11-15 5 (2.8)
16-20 (25,1)
21–24 126 (70,4)
Total 179 (100)
Dari 179 ibu, hanya 55 (31%) yang melakukan ASI
eksklusif. Usia, pendidikan dan pekerjaan dari
responden ditemukan tidak mempengaruhi praktek
EBF (tabel 4).
Tabel 4
Hubungan antara beberapa variabel dan praktik
pemberian ASI eksklusif
Praktek Variabel eksklusif
statistik tes menyusui
Status pendidikan Ya Tidak Xc2 = 0,00029, df = 1, =
0,986 (tidak signifikan)
Formal 19 43
Non formal 36 81
Umur (yrs)
<30 26 76 X2 = 2,51, df = 1, = 0,113 (tidak signifikan)
> 30 29 48
Pendudukan
Istri rumah penuh waktu 39 70 X2 = 2,77, df = 1, =
0,996 (tidak signifikan)
Pegawai negeri / bisnis 16 54
Diskusi
Dalam evaluasi terbaru Tujuan Pembangunan
Milenium (MDGs), pemberian ASI eksklusif (EBF)
selama enam bulan dianggap sebagai salah satu
intervensi paling efektif untuk mencapai MDG-415.
Dalam penelitian kami, hanya 54 (30%) dari ibu
memiliki pengetahuan EBF yang memadai. Hal ini
sebanding dengan penelitian di Gwale, Kano dengan
latar belakang sosial budaya yang sama sebagai daerah
penelitian, di mana 31% dari para ibu memiliki
pengetahuan yang baik tentang EBF16. Namun, angka
yang diperoleh dalam penelitian ini rendah bila
dibandingkan dengan 55% yang diperoleh dalam studi
oleh Freed dan rekan-rekannya17 dan 98% diamati
dalam penelitian serupa di Accra Ghana18.
Inisiatif Rumah Sakit Ramah Bayi (BFHI) dirancang
untuk mempromosikan inisiasi dini menyusui,
sebaiknya segera setelah lahir. Penelitian ini
mengamati bahwa 94 (53%) dari ibu memulai
menyusui segera setelah lahir. Ini lebih tinggi dari 26%
dan 31% diperoleh dalam studi dari Kano dan Sokoto
masing-masing16,19. Penelitian dari Nepal Barat,
India, memperoleh tingkat yang lebih tinggi (72,2%)
dari inisiasi menyusui20. Temuan dari penelitian baru-
baru ini telah menekankan risiko penundaan kelahiran
menyusui pada kematian neonatal di Afrika sub-Sahara
dan menunjukkan bahwa kematian neonatal dapat
dikurangi secara signifikan sebesar 16% jika ibu mulai
 menyusui pada hari pertama dan 22% ketika menyusui
dimulai dalam jam pertama. Alasan utama untuk
terlambat inisiasi menyusui di sebagian besar (47%)
dari responden adalah kolostrum tidak murni sehingga
mendukung persepsi umum di daerah penelitian bahwa
dalam tiga hari pertama, ASI tidak murni dan
karenanya dapat membahayakan bayi. . Temuan ini
sesuai dengan Onayande dan lainnya di Ile-Ife22
meskipun wilayah penelitian memiliki karakteristik
sosio-budaya yang bervariasi. Saat kelaparan

 Tabel ditulis dengan benar

 Ilustrasi tabel informative
 Ilustrasi tabel diperlukan
 Semua hasil sudah disebutkan dan dijelaskan
 Analisis dilakukan dengan uji yang sesuai
 Disertakan hasil uji statistic
 Hasil disertai dengan komentar dan pendapat

Diskusi Keterbatasan

Studi ini tidak mengeksplorasi faktor penentu budaya lain dari

menyusui yang mungkin memiliki pengaruh pada EBF.

Kesimpulan

Meskipun menyusui telah menemukan penerimaan universal

di wilayah studi sebagaimana dibuktikan oleh fakta bahwa
semua anak disusui, pengetahuan dan praktik EBF sangat
rendah. Untuk mencapai tujuan MDG-4, ada kebutuhan untuk
menetapkan langkah-langkah intervensi yang ditujukan untuk
meningkatkan tingkat EBF di komunitas penelitian.
Pendidikan yang sesuai diarahkan pada inisiasi menyusui dini,
 peningkatan pengetahuan EBF dan penggunaan kolostrum

diperlukan untuk meningkatkan EBF dan durasi menyusui.

Pada komponen diskusi tidak ada

Akhir Ucapan terima kasih

Kami ingin mengucapkan terima kasih kepada Hajia Hauwa,

Maryam dan Saratu untuk pengumpulan data. Penghargaan
kami diberikan kepada Departemen Perawatan Kesehatan
Primer dari area pemerintah daerah Kware karena memberi
kami izin untuk melakukan penelitian dan juga ibu-ibu kota
kware untuk setuju untuk berpartisipasi dalam penelitian ini.

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