Effect of Father-Targeted Nutrition Education on Feeding Practices, Nutritional Status and Morbidity among Infants in Kisumu East, Kenya

Abstract

Fathers play a very important role in infant feeding, however, most interventions on behavior change around infant feeding target mothers with little attention to the fathers. Many of the studies about engaging men in breastfeeding promotion and support are in higher-income countries and are thus of unknown relevance to low and middle income countries. The main objective of this study was to determine the effect of father targeted nutrition education on feeding practices, nutritional status and morbidity among infants in Kisumu East Sub County, Kisumu County. A randomized control trial was conducted on 290 father-mother pairs who were split into an intervention (145 pairs) and a control group (145 pairs). The intervention group received nutrition education on breastfeeding and complementary feeding, while the control group did not receive any intervention during the nine month research period. Quantitative and qualitative data were collected on breastfeeding knowledge of the father and mother, father support in infant feeding practices, infant feeding practices (early initiation of breastfeeding, exclusive breastfeeding, timely introduction of complementary foods, meal frequency and dietary diversity), nutritional status of the infant (wasting, stunting, underweight) and morbidity among the infants born. Descriptive data analysis was done for the variables as well as relationships assessed using chi-square test, independent t-test, odds ratio and multiple linear regression. Baseline and end line assessment were done and the results showed the homogeneity of the intervention and control group. Parity which was the only significantly different variable between the intervention and control group at baseline (t=3.82; p=0.003) and at end line (t=3.86; p=0.004) had no impact to the regression models when assessing relationship of significant variables on exclusive breastfeeding (t=-0.24; p=0.61) and minimum acceptable diet (t=-0.29; p=0.72). The initiation of breastfeeding within an hour of birth, was at 97.1% in the intervention group versus 52.1% in the control group, the difference was significant (X2=74.18, p <0.001); infants exclusively breastfed for the first 6 months of life were 77.7% in the intervention group versus 45.1% in the control group, the difference was significant (X2=9.58, p=0.001). There were significantly more infants receiving the minimum acceptable diet at 9 months of age, in the intervention group compared to the control group, (X2=2.18; p<0.001). There were significantly more children at 9 months of age wasted (X2=2.08; p=0.015) and underweight (X2 =2.08; p=0.010) in the control group than the intervention group. There were significantly more children with diarrhea (X2=6.12; p=0.015), acute respiratory infections (X2=8.11; p=0.05) and fever (X2=1.09; p=0.03) in the intervention group at 6 months than in the control group. Post-intervention, fathers in the intervention group were 1.6 times more likely to be knowledgeable that breastfeeding should be initiated within an hour of birth (OR = 1.61; % CI: 1.07 – 2.42; p=0.02), and were twice likely to be more knowledgeable on exclusive breastfeeding (OR = 2.01; % CI: 1.27 – 3.19; p<0.01). There were significantly more fathers providing support in terms of providing encouragement and motivation on following the recommended breastfeeding practice (X2=19.71; p<0.001). Therefore, providing nutrition education to fathers during the antenatal period improved their knowledge and subsequently support towards infant feeding. Hence, fathers should be included in education sessions on infant feeding at the health facility and community levels, all of which may be an important step in the survival and development of the child.