Factors associated with nutritional status among lactating mothers at Shashemene Woreda, West Arsi Zone, Oromia, Ethiopia: A comparative cross-sectional study

Abstract

Inadequate nutritional intake prior to pregnancy, during pregnancy and lactation process increases postnatal nutritional stresses and health risk of the mother resulting in a high maternal mortality. The aim of this study was to compare nutritional status and associated factors of urban and rural lactating women from Shashemene Woreda, West Arsi Zone of Oromia, Ethiopia. A community based comparative cross-sectional study was conducted among 484 randomly selected lactating mothers from six kebeles. Anthropometric measurements were taken from each mother using calibrated equipment and standardized techniques. A 24 hr dietary intake was also collected from randomly selected sub sample (n=48) of mothers. The energy and nutrient content of foods consumed by the mothers was calculated using Ethiopian food composition and world food tables. Logistic regression model, independent t-test analyses and chi-square test were used to see the mean difference in nutrient intake and nutritional status among lactating mothers. Variables with a p-value less than 0.05 on multiple variable logistic regressions were taken as significant variables. The prevalence of under-nutrition (MUAC<23 cm) among lactating mothers was higher in rural than urban communities with observed statistical significant difference (X 2 =12.5, p ≤ 0.001), but they are comparable in other indices. Residence of lactating women [AOR=2.54, 95% CI (1.5, 4.31)] and age of breast fed child [AOR=0.46, 95% CI (0.28, 0.78)] were significantly associated with nutritional status of lactating mothers. Having breast feeding child was significantly associated with nutritional status (BMI) of lactating mothers [AOR=0.37, 95% CI (0.17, 0.81)]. Feeding practices in urban study subjects had better feeding practices than that of rural areas (X 2 = 25.0, p-value ≤ 0.001). It was not sufficient to attain their increased energy and nutrient requirements, w h i c h is worse among rural than urban study subject. Therefore, improvements of health and nutrition are recommended to lactating mother on increased food intake, proper dietary practices, and dietary diversity during lactation.

Dietary diversity and practice of pregnant and lactating women in Ethiopia: A systematic review and meta‐analysis

“…Regarding the meal frequency of pregnant and lactating women in Ethiopia, it was reported by 23 studies (Abriha et al, 2014;Alemayehu & Tesema, 2015;Aliwo et al, 2019;Boke & Geremew, 2018;Kobiro et al, 2020;Demilew et al, 2020;Desalegn et al, 2018;Desta et al, 2019;Diddana, 2019;Duko et al, 2018;Engidaw et al, 2019;Eramo, 2018;Gizahewu et al, 2019;Haileslassie et al, 2013;Hailu & Woldemichael, 2019;Jemal & Awol, 2019;Kumera et al, 2015;Nigatu et al, 2018;Sitotaw et al, 2017;Sonko, 2016;Tikuye et al, 2019;Weldehaweria et al, 2016) with a total of 9,447 study subjects. Of the total study subjects, 7,554 (80%) of pregnant and lactating women ate ≤3 times per day, whereas 1854 (20%) of them ate ≥4 times per day (Table 1).…”

A Narrative Review of Nutritional Malpractices, Motivational Drivers, and Consequences in Pregnant Women: Evidence from Recent Literature and Program Implications in Ethiopia

“…The consequences of poor nutrition to both baby and mother are not recognized by women and indicate the degree of women's awareness about diet, which is not adequate [ 8 ]. Understanding regarding the need for improved nutritional intake of lactating women was reported by most participants in West Arsi Zone, Oromia, Ethiopia [ 45 ]. It is an imperative drift as women's nutrition during the pregnancy period is significant to reduce complications related to pregnancy such as morbidity/morbidity to mothers and infants.…”

“…It also reported that most women in Ethiopia did not follow a healthy eating style and knew major food groups during the pregnancy period. About 71.2%, 68.6%, and 39.3% of lactating women were not eating meals additionally [ 37 , 45 , 47 ], respectively. This dietary behavior of pregnant and lactating women was also common and further supported by the formative finding of [ 48 ].…”

“…In another study, limited numbers of women (33.2%) had a change of dieting trends such as increasing frequency of feeding and taking of foods containing extra carbohydrates [ 30 ]. According to a study from the northern part of Ethiopia, changes in food intake during lactation were not practiced by most of the lactating mothers [ 26 , 47 ] but it was better in the study in [ 45 ]. Some women are practicing decreasing their dietary intake because of two reasons: the experience of aversion and nausea to different foods in the first three months [ 48 ] and the fact that, in the later periods of pregnancy, women deliberately lowered their dietary intakes to have a little fetus and minimize delivery difficulty [ 32 , 48 ].…”

“…The advantages and disadvantages of nonfood cravings have been widely studied, and an additional questioning type of desire is pica , consumption of nonfood substances, observed worldwide and posited to be somewhat biologically adaptive and culturally supported [ 35 , 36 , 42 – 44 ]. In most cases, their reasons are not supported scientifically and it seems to prevent complications related to pregnancy [ 26 , 29 – 32 , 37 , 45 – 48 ]. Furthermore, the [ 39 ] funding concluded that food cravings are intended and consumed by women's beliefs to make certain about baby health status.…”