PREVALENCE OF WEAVING DIARRHEA AMONG CHILDREN UNDER TWO YEARS OF AGE ATTENDING IN JIGA PRIMARY HEALTH CARE

THIS PROJECT IS SUBMITTED TO THE DEPARTMENT OF NUTRITION AND DIETETICS, KEBBI STATE COLLEGE OF HEALTH SCIENCES AND TECHNOLOGY, JEGA

FOR THE AWARD OF NATIONAL DIPLOMA IN NUTRITION AND DIETETICS

NOVEMBER 2019
DECLARATION
I hereby declare that this project work was carried out by me under the guidance of my supervisor Sani Usman of nutrition and dietetics Kebbi State College of Health Seience and Technelogy, Jega.
I have neither copied someone's work or nor has someone else done it for me. All references made in this work have been acknowledged.


NABILA UMAR
Student's Name                                                                         Signature





                                                       Date


APPROVAL PAGE
This is to certify that this project is an original work under taken by NABILA UMAR 17/ND/122. It has been prepare in accordance with the regulation governing the preparation and presentation in Kebbi State College of Health Science and Technology, Jega



SANI USMAN ALIERO
PROJECT SUPERVISOR                                                                            Date



MUSTAPA HAMIDU DANZARIA
HEAD OF DEPARTMENT                                                                         Date

             


EXTERNAL SUPERVISOR                                                                          Date



DEDICATION
I dedicate this project to almighty Allah who has given me the strength and ability to carry out this project work successfully. And to my lovely daddy Alh Muhammed Aliyu and my mummy Haj. Hadiza Abubakar and I will also not forget you my lovely Aunty Rashida Moh'd, you are always in my mind my Aunty and Uncle that I will never forget you Asma'u Muh'd and her lovely husband mind my Abubakar A. Abubakar Janga. Who encourage and showered their love on me during the cause of this work.














ACKNOWLEDGEMENTS
I appreciate the Almighty Allah who gives me the opportunity and strength to carry out this project work successfully. My thanks goes to my supervisor Sani Usman Aliero for his care, correction and encouragement to make the project a great success. My profound gratitude goes to my parent Alh. Muhammed Aliyu and my mummy Haj. Hadiza Abubakar also my aunty Rashida Mohammed for their encouragement, loves and support through this work, and also thanks to aunty Asmau and her husband Abubakar A. Abubakar .May almighty Allah continue to bless and keep them for me.
My thanks also goes to all members of staff of nutrition and dietetics Department
Kebbi State College of Health Science and Technology, Jega especially Mallam Aliyu, Mallam Bashir and Mr Sani Usman
I remain grateful to my brothers and sisters Bello, Muh'd, Biliyanminu, Rilwanu,
Abdulazak, Yahuza, Fatima, Salma, Rashida, Abdullahi, Aliyu for their support and contribution towards the success of this program. To my friends Amira Ibrahim and also not forget the family of Rilwanu Muh'd for their support thanks a lot.
I give thanks to Almighty Allah for seen me through my program.












ABSTRACT
Prevalence of weaning diarrhea among children in Jiga Birnin Primary Health Care Centre Aliero from the research obtained some patients suffered from weaning diarrhea which was more prevalent in infants weaned within the period of 4-6 months. These infants have a drastic change in weight loss due to improper weaning and lack of baby friendly practice among mothers. It is discovered that only 40% of the mothers do not practiced exclusive breastfeeding and also discovered that 60% of mothers do not practiced exclusive breastfeeding. Most of the children were malnourished and experience o lose in weight. Based on the research carried out weaning diarrhea could arise as a result of abrupt weaning. Early weaning period, unhygienic practice, ignorance and poverty. However, safe preparation and storage of food must be a priority during weaning.








TABLE OF CONTENTS
Title Page - - - - - - - - - - i
Declaration - - - - - - - - - - ii
Approval Page - - - - - - - - - iii
Dedication - - - - - - - - - - iv
Acknowledgement - - - - - - - - - v
Abstract - - - - - - - - - - vi
Table of Contents - - - - - - - - - vii
List of Tables - - - - - - - - - ix
CHAPTER ONE
1.0 Introduction - - - - - - - - - 1
1.1 Aims and Objectives - - - - - - - 2
CHAPTER TWO
2.0 Literature Review - - - - - - - - 3
2.1 Diarrhoea in fancy - - - - - - - - 3
2.2 Weaning - - - - - - - - - 3
2.3 Factors Influencing Weaning Practices - - - - 4
2.4 Weaning Diarrhoea - - - - - - - - 5
2.5 Causes of Weaning Diarrhoea - - - - - - 5
2.6 Signs and Symptoms of Diarrhoea - - - - - 6
2.7 Diarhoea Management - - - - - - - 7
2.8 Treatments for Diarrhoea - - - - - - - 7
2.9 Prevention of Diarrhoea - - - - - - - 7
2.10 Food use in Weaning - - - - - - - 8
CHAPTER THREE
3.0 Research Methodology - - - - - - - 11
3.1 Oral Questionnaire - - - - - - - - 11
3.2 Questionnaire Design - - - - - - - 11
3.3 Selection of Respondents - - - - - - - 12
CHAPTER FOUR
4.0 Result and Discussion - - - - - - - 13
4.1 Data Analysis - - - - - - - - 13
4.2 Discussion - - - - - - - - - 24
CHAPTER FIVE
5.0 Conclusion, Recommendation and Limitation - - - 27
5.1 Conclusion - - - - - - - - - 27
5.2 Recommendations - - - - - - - - 27
5.3 Limitations - - - - - - - - - 28
References - - - - - - - - - - 29
Questionnaire - - - - - - - - - 30




LIST OF TABLES
Table 1: Percentage Frequency Distribution of Infants Range - - 13
Table 2: Percentage Distribution of Infants Weight by Month
Classification - - - - - - - - - 14
Table 3: Percentage Frequency Distribution of Infants Weight
(6-12 Months) - - - - - - - - - 15
Table 4: Percentage Frequency of Infants Weight (12-18 months)- - 16
Table 5: Percentage Frequency Distribution of Fathers Education
Level - - - - - - - - - - - 17
Table 6: Percentage Frequency Distribution of Mothers Education
Level - - - - - - - - - - - 17
Table 7: Percentage Frequency Distribution Respondents Tribe - - 18
Table 8: Percentage Frequency Distribution of Mothers Education Level -19
Table 9: Percentage Frequency Distribution of Exclusive Breastfed
Infants with and without Diarrhoea - - - - - - 19
Table 10: Percentage Frequency Distribution of Weaning Period
by Month Classification - - - - - - - - 20
Table 1I: Percentage Frequency Distribution of Children who are
having or had Diarrhoea during Weaning - - - - - 21
Table 12: Percentage Frequency Distribution of Types of Utensil
in Feeding the Weaning Infants - - - - - - - 22
Table 13: Percentage Frequency Distribution of Infants Feeding
Pattern (Cup. Spoon and Bottled Ped) - - - - - - 22
Table 14: Percentage Frequency Distribution of the Type of Illness
Infani Suffered - - - - - - - - - 23










                                                     CHAPTER ONE
1.0 INTRODUCTION
Diarrhoea is the condition of having at least three loose or liquid boel movements each day it often lasts for few days and can result in dehydration due to fluid loss. (Dupont HL, 2014)
Diarrhoea may be contacted as a result of food poisoning eating contaminated food or drinking contaminated water. Especially in poor communities particularly in areas where there is much poverty overcrowding and unsanitary mode of living.
Diarrhoea that comes on suddenly and last for no longer than a couple of days is usually referred to as "acute Diarrhoea", most people with acute Diarrhoea recover on their own. Diarrhoea those last more than two weeks is thought of as "chronic Diarrhoea".(Whaley and Wong. 1994).
Typically, chronic Diarrhoea requires medical care to find the underlying causes and treat complication, such as dehydration while acute Diarrhoea occur throughout the world but it is a very serious problem in developing countries. It affects millions of children every year and many of these Whaley and Wong. 1994)
Weaning food should be introduced as from the age of six month because if introduced earlier an infant breast milk intake will be reduced and replace
With less suitable source of nutrients, on the other hand if complementary food is introduced too late the infants’ growth and development may be delayed (stunted growth).
A child's state of nutrition is reflected in the child's physical conclusion that is growth status of children as a measure of the health and well being of the child. In other words, the growth and weight child can be the best index for the health of the child. Children with Diarrhoea have poor nutritional status. As a result of this they have a low life expectancy increase disease rates, low physical and metal efficiency and other manifestation of ill health and thus growth and development is related (Whaley and Wong, 1994) Thirty percent (30%) of all Diarrhoea in developing countries is commonly found in children during weaning and is closely related of standards of hygiene 70% of all Diarrhoea episode are caused by germs
1.1 AIMS AND OBJECTIVES
To determine the effects of Diarrhoea on children's nutritional status
To find out why children are at risk of Diarrhoea during weaning.








                                                 CHAPTER TWO
2.0 LITERATURE REVIEW
2.1 DIARRHOEA IN INFANCY
Diarrhoea is the excessive loss of fluid and electrolyte in the stool. (Jolly1986). It is a symptom encountered most frequently, infact in children especially during weaning where by the Diarrhoea is often called weanling Diarrhoea or infantile Diarrhoea. Diarrhoea can be attributed to a large number of causes, however, some identified causes are organisms such as shigella, amoeba. Bacteria and virus etc, Bacteria such as Escherichia coli multiply and produce toxins which causes increased secretion into the gut and decrease food absorption especially in the under nourished (Jolly et al, 1986). Weaning Diarrhoea worsen as well as complicates malnutrition which is mostly common in under nourished children and more severe the under nutrition, the more persistent and serious the Diarrhoea (Jelliffe et al, 1981).
 2.2 WEANING
The process whereby the infant gradually becomes accustomed to the full adult or family diet is known as WEANING (Ebrahim, 1988).
Weaning is dangerous time for infant and young children, as there is higher rate of infection particularly of Diarrhoea diseases during than any other Weaning is dangerous time for infant and young children, as there is higher rate of infection particularly of Diarrhoea diseases during than any other period in life which is as a result of children being exposed to food borne germs for the first time in life as their diet changes from clean breast milk which contain anti-infective factors to food often stored and fed in only genic ways such as bottle feeding, hand feeding etc. if they are not  hygienically prepared they can be a major source of infection. Breast is the best and safest food for young babies. Older babies need extra food as well as breast milk. Babies can still receive an important amount of nourishment form breast milk (Holis, 1986)
2.3 FACTORS INFLUENCING WEANING PRACTICE
           Dietary pattern of the



                                     Family                                       Influence by village elders



         Geography Climate                    Previous Experience                    Tribal   
    Agriculture Food Crops                          of parents                            Influence
              (Ebrahim, 198)
                 
It can say that an infant is exposed to two major risks of infection during weaning that is Diarrhoea and childhood malnutrition. Weaning should be a very gradual process because it is a time of great change for both the mother and child. It should be made safe period so as to avoid infection (Ebrahim et al, 1981)

2.4 WEANING DIARRHOEA
Weaning Diarrhoea could arise as a result of abrupt weaning, early weaning period, unhygienic practices, ignorance and poverty. The introduction of weaning food increase the risks of Diarrhoea, this is because the frequency of Diarrhoea in infancy is closely related to the ingestion of contaminated weaning food and wrong weaning practice as well as over feeding and malabsorption Chronic Non Specific Diarrhoea (CNSD), sometimes called cause of persistent irritable bodwel syndrome, is the most common Diarrhoea in young children in which excess intake of fluid appears to have been associated with Chronic Non Specific Diarrhoea (Whaley and Wong 1994)
2.5 CAUSE OF WEANING DIARRIIOEA
Weaning Diarrhoea is caused by germs which could be food borne, water poor hygiene, overcrowding, bottle feeding. Dirty hands as well as dirty cooking, storage and heating utensils are factors or means which favour and breed these germs before they get into the body. The use of dirty water in preparing weaning foods, exposure of food to files and -other pests, improper food storage etc. Leads to bacterial contamination and eventually Diarrhoea when such foods are consumed. Diarrhoea is typically associated with abdominal cramps, the most common causes of Diarrhoea
Include:
Viruses
Bacteria
Parasites
Other causes include medications, such as antibiotics that disturb the natural balance of the bacteria in your intestines, artificial Sweeteners and lactose, which is a sugar found in milk. (Ebrahim, 1983)
2.6 SIGNS AND SYMPTOMS OF DIARRIIOEA
When treating Diarrhoea you should also look for other signs and symptoms. ORS and Zinc can be given if other signs and symptoms are present, but the Child may need additional medication for additional problems. Diarrhoea that persists for more than a couple of days is considered chronic and may be sign of an underlying condition, Such as inflammatory bowel disease or an infection. In these cases, Diarrlioea may lead to dehydration and requires the care of your doctor. Dehydration occurs when fluid and electrolytes, the salts potassium and sodium. The fluid and electrolytes last during Diarrhoea need to be replaced promptly because the body cannot function properly without them. Signs and symptoms associated with Diarrhoea may include:
Abdominal pain
Frequent loose, watery stools
Fever
Bleeding
Lightheadedness or dizziness from dehydration
Diarrhoea caused by a viral infection, such as a stomach virus or bacterial infection, also may cause vomiting. In addition, blood and mucus in the stools may appear with Diarrhoea caused by bacterial infections.


2.7 DIARRHOEA MANAGEMENT
Dietary Management, also known as food service management is the practice of providing nutritional options for individuals and groups with DIET concerns through supervision of food services Practitioners in dietary management, known as DIETARY MANAGERS; work in hospitals long-term care Facilities, restaurants. School and college, correctional facilities and other food service settings usually implementing meal plans established by a DIELUTIAN OR NUTRITIONIST. They are responsible for supervising the work of other Nutrition personal such as cooks and dietary aides.
2.8 TREATMENTS FOR DIARRHOEA
Mothers and other family member can often treat Diarrhoea themselves with Iluid and food that they have at home. The most important aspect of treating Diarrhoea involves avoiding dehydration replacing lost fluid. Because plain water foes not contain sugar, sodium or potassium, which are also lost in Diarrhoea, it is important to consume plenty of appropriated risks include water, prepared rehydration solutions, chicken or beef soup, fruit juice or Tizzy drinks can make Diarrhoea vorse in children.
2.9 PREVENTION OF DIARRHOEA
The most important way to avoid Diarrhoea is to avoid coming into contact with infectious agents that can cause it. This means that hygienic food preparation and storage techniques and good hand washing, especially when preparing food and after using the toilet are very important. If someone in your home has Diarrhoea takes precautions to stop it spreading
Don't share towels. Flannels, utensils with the person who is unwell
Disinfectant he toilet, handle and the seat after the person has used it each time.
Keep them at home until at least 48 hours after the last episode of Diarrhoea
2.10 FOOD USE IN WEANING
Weaning means introducing a variety of solid food gradually to your babies diet alongside their usual milk until they are eating the same healthy foods as the rest of the family. A thick creamy porridge made from the basic food of the community is a good weaning food for babies.
You can begin to introduce solids when your baby:
Can sit up
Begins to pick up food and put it in his/her mouth
Has better hand-eye coordination. Health experts now recommend that at round six months old most babies are ready for other foods in addition to milk, if your baby wins premature, ask your health visitor for advice on when to start weaning. For good oral health around weaning remember these two pointers:
No sugar or salt in any form should be added to weaning foods
Make your own home made weaning food as you can make sure that they are lower in Sugar
2.10.1 IDEAS FOR WEANING FOODS
Experiment with different foods to see what you will eat, try these suggestion for fist food.
MASHED FRUIT: Banana, Apple or Pear
COOKED VEGETABLES: Potato, Carrot parsnip, Turnip or Cauliflower
Baby Rice or other cereal mixed with their usual milk (expressed breast milk or formula) mixed in a bowl, not in a bottle. Start with a few teaspoon or well-mashed food for one meal a day, gradually increase the amount.
2.10.2 FOOD GIVEN DURING DIARRHOEA
Having Diarrhoea on occasion is nothing to worry about, Diarrhoea causes can range from a stomach FLU to meal or just an ingredient you ate that didn't agree with you, because certain food can Worsen symptoms, in order to start feeling better, you need to know what to eat, when you have Diarrhoea and what not to eat, you should eat plain, simple food for Diarrhoea, especially in the first 24 hours. It is thicker, bland foods including oatmeal, bananas, plain rice and applesauce. Other bland foods that you're likely to tolerate include:
Boiled potatoes
Toast
Plain crackers such as saltiness
Backed chicken without any skin or fat
Also, research shows that food with probiotics often called "Good" bacteria may shorten the duration, of about or Diarrhoea.  Probiotics have Become Very popular and can be found in a number of foods include yoghurt.
FOOD TO AVOID
As important as it is to know what to cat, when you have Diarrhoea, it is equally important to know what not to eat; certain food can travel through your intestines very fast and aggravate your condition or worsen Diarrhoea in other ways. Avoid these foods for Diarrhoea relief:
Fatty Foods: These include fried foods and foods that greasy or covered in gray which can make Diarrhoea worse.
Milk, Butter, Ice-cream and Cheese
Alcohol and Caffeine drinks: When you have Diarrhoea you have to avoid foods and beverages that cause you to lose fluids, alcohol can act as diuretics.
Sorbitol and other artificial sweeteners: Some people find that artificial Sweeteners have a laxative effect on their digestive system. If you have Diarrhoea it's best to avoid sugarless candy and gum; diet to avoid sugar Substitutes
Food that causes excess gas: It's important that you eat generous amounts of Fruits and vegetables every day. However, when Diarrhoea strikes you want to avoid choices that are likely to increase intestinal gas such as cabbages, beans and cauliflower until you are feeling better.
Foods that may be tainted: Stay away from food that may have been mishandled, including for too long or improperly stored. Raw meat or fish can be problematic, too follow the old expression, "When in doubt, throw it out" and you may save yourself from some stomach upset. "Other Diarrhoea strategies": One of the serious complications of Diarrhoea is dehydration, when you find out child with Diarrhoea for ray length of time take steps to avoid becoming dehydrated, look for liquids with sugar and salt. "Pediayte or full-salt soups work well. To stay hydrated you should consume enough liquid so that you make plenty of clear urine, "If your child urine is not clear or not making much urine then consume enough liquid to them.


CHAPTER THREE
3.0 RESEARCH METHODOLOGY
The questionnaire method was employed in carrying out this study. the state target group responses were obtained by the aid of:
1. Formal questionnaire
2. Oral questionnaire (Interview) method
3.1 ORAL QUESTIONNAIRE
This was a form of interview based on questions designed and spelt out in the formal questionnaire. In this method, personal interview was conducted which gave me the opportunity to clearly and correctly get necessary information. This was intended to enhance maximum objectivity and mother's co-operation in response or reaction to questions. Mother’s responses are quite impressive and encouraging through hectic as this method formed the basis for information obtained from a majority of respondents covered. However, responses were appropriately entered in the questionnaire form
3.2 QUESTIONNAIRE DESIGN
The questionnaire was basically divided into two main sections
Section for general information
Section for specific information
The arrangement provided a simple view in obtaining information relating to required factors. The section for general information served to give information on the parent's name, sex, age, weight, tribe and parent's educational level. The section for specific information was mainly concerned with the parent's health nutritional status dietary aspect as well as feeding pattern other necessary information.
3.3 SELECTION OF RESPONDENTS
The main sample unit was in Jiga Birni Primary Health Centre, Jiga Birni main Area, respondents were mostly mothers who are house wives and have babies with weaning age. The mothers were randomly selected and served with the interviewed














CHAPTER FOUR
4.0 RESULT AND DISCUSSION
4.1 DATA ANALYSIS
The percentage was used for the analysis of the total respondents covered in the hospital mentioned in the previous chapter. This statistical technique or method used was the mean percentage as follows:

N = The Total Number of Respondent
The Number of Respondents of a Particular Range
1: PERCENTAGE FREQUENCY DISTRIBUTION OF TABLE INFANTS AGE RANGE
AGE RANGE

NO. OF INFANTS
PERCENTAGE%


0-6 months
10

27.5%


6-12 months

7

17.5%


12- 18 months

17

42.5%


18-24 months

6

12.5%

Total
40
100%

This table shows the age range of infants which are between births to 24 months some of the infant affected by Diarrhoea had a drastic fall in their weight.
TABLE 2: PERCENTAGE DISTRIBUTION OF INFANTS WEIGHT
BY MONTH CLASSIFICATION
S/N

WEIGHT (KG)


1
4.2

2
4.4

3
4.6

4
4.4

5
4.8

6
5.2

7
5.3

8
5.6

9
5.5

10
5.2

Total
510 Kg


Table 2 shows a difference of 0.8 kg which is more or less of no significant important, the drop in weight may be as a result of unhygienic practice rather than weaning.


TABLE 3: PERCENTAGE FREQUENCY DISTRIBUTION OF INFANTS WEIGHT (6-12 MONTHS)
S/N

WEIGHT (KG) 6-12 MONTHS


1
4.5

2
5.9

3
6.0

4
7.0

5
6.0

6
6.2

7
6.0

8
5.8

9
6.2

10
5.8

11
5.9

12
6.0

13
4.6

14
7.0

15
7.5

16
6.0

17
5.9

Total
102.3 Kg


Table 3 had a difference of 1.85 kg which is of significant importance; his is the critical period which mother start introducing complementary feeds to their babies.
TABLE 4: PERCENTAGE FREQUENCY OF INFANTS WEICHT (12 - 18 MONTHS)
S/N

WEIGHT (KG) (12-18 MONTHS)


1
11.0

2
11.0

3
9.6

4
7.5

5
9.5

Total
50.6 Kg


Infants falling within the age range of 12-18 months as shows in table 5 drop in weight since the result shows a were not so much affected by Difference of0.5Kg, this could be as a result of mother awareness on proper earning period and practice.


TABLE 5: PERCENTAGE FREQUENCY DISTRIBUTION OF FATHERS EDUCATION LEVEL
EDUCATIONAL LEVEL
NO. OF RESPONDENTS

PERCENTAGE %

Primary

10

25%

Secondary

10

25%

Tertiary

16

40%

Others

4
10%

Total

40
100%

Table 5 shows that 40% of tertiary levels are highly educated.
TABLE 6: PERCENTAGE FREQUENCY DISTRIBUTION OF 3OTHERS EDUCATION LEVEL
EDUCATIONAL LEVEL

NO. OF RESPONDENTS

PERCENTAGE %

Primary

7
17.5%

Secondary

10

45%

Tertiary

12

10.5%

Others

11
27.5%

Total

40
100%

Table 6 shows that only 10% of mothers had tertiary education while the rest 90% had little or no education, such mothers are not aware o proper weaning practice as well as the nutritional needs of their babies.
TABLE 7 PERCENTAGE FREQUENCY DISTRIBUTION
TRIBE
NO. OF RESPONDENTS

PERCENTAGE %

Hausa
25

62.5%

Yoruba

6

15%

Igbo

3

7.5%

Others

6
15%

Total

40
100%


Table 7 shows the percentage frequency distribution of respondent of 62.5% of respondents are Hausas, this may be due to their culture, Traditional belief and family pattern.


TABLE 8: PERCENTACE FREQUENCY DISTRIBUTION MOTHERS EDUCATIONAL 1EVEL
EXCLUSIVE OF NON-
EXCLUSIVE BREAST
FED

NO. OF RESPONDENTS
PERCENTAGE%


Exclusive

25

62.5%

Non-exclusive
15

37.5%

Total
40

IO0%

Table 8 shows that 62.5% of infant were exclusively breast fed while 37.5% Were not
TABLE 9: PERCENTAGE FREQUENCY DISTRIBUTION OF EXCLUSIVIE BREASTFED INFANTS WITH AND WITHOUT DIARRIHOEA
WITH DIARRIHOEA

WITHHOUT DIARRIIOEA



No. of infants

Percentage %
No. of infants

Percentage %
Difference


Exclusive
Breast fed

12
38.7%
8
89%
4

Non-exclusive
Breast fed

19
61.3
1
11%
18

Total
31
I00%
9
100%



Table 9 indicate that out of 100 of infant 61.3% of non-exclusive breast fed infant had Diarrhoea while 11% of non-exclusive breastfed infants had no Diarrhoea whereas 38.7% of exclusive breastfed infant had Diarrhoea, while 89% had no Diarrhoea, this shows the lack of baby friendly practice can because exclusive breastfeeding provide affect infant anti-infective properties.
TABLE 10:    PERCENTACE FREQUENCY DISTRIBUTION OF WEANING PERIOD BY MONTH CLASSIFICATION
AGE
NO. OF RESPONDENTS

PERCENTAGE %


3 months
15
37.5%

4 months
9
22.5%

5 months
5
2.5%

6 months
11
27.5%

Total
40
100%


Table 10 shows that 37.5% of infant are weaned at the age of 3 months which is very early and hence the infant is at risk of Diarrhoea


TABLE 11: PERCENTAGE FREQUENCY DISTRIBUTION OF CHILDREN WHO ARE HAVING OR HAD DIARRIHOEA DURING WEANING
DIARRHOEA PRESENT

NO. OF RESPONDENTS

PERCENTAGE %

Yes
25
70%


No
15
30%


Total
40
100%



Table 11 shows that 70% of infant had Diarrhoea, during weaning, this is as a result of early weaning.



TABLE 12: PERCENTAGE FREQUENCY DISTRIBUTION OF TYPES OF UTENSIL USED IN FEEDING THE WEANING INFANTS
TYPES OF UTENSIL

NO. OF RESPONDENTS

PERCENTAGE%

Cups and Spoons

25
37.5%


Feeding Bottle

10
37.5%


Hand Feeding

5
25%


Total
40
I00%


TABLE 13: PERCENTAGE FREQUENCY DISTRIBUTION OF INFANTS FEEDING PATTERN (CUP, SPOON AND BOTTLED FED)

No. of Infant

Percentage %


No. of Infant

Percentage %


Bottle
 Feeding
15
50%
Cup and Spoon
15
50%

Diarrhoea
Present

10
33.33%
Diarrhoea
Present

13
43.33%

Diarrhoea
Absent
5
16.7%
Diarrhoea
Absent

2
6.66%

Total
30
100%
Total
30
100%



Table 13 shows that 43.33% of infant fed with cup and spoon had Diarrhoea, of bottle fed infant had Diarrhoea that cause of Diarrhoea in while 33.33% the case should be inadequate preparation of food and poor feeding time
TABLE 14: PERCENTAGE FREQUENCY DISTRIBUTION OF THE TYPE OF ILLNESS INFANT SUFFERED
ILLNESS

NO. OF INFANTS

PERCENTAGE%


Fever

20

50%

Measles

10
25%

Other
10
25%

Total
40

100%



Table 14 shows that 50% of infants sulfured from fever, 25% from measles and 25% from others types of illness.






4.2 DISCUSSION
Table 1 show the age of infants which are between 024 months some of the infants affected by Diarrhoea had a drastic fall in their weight
Table 2 shows a difference of 0.8 Kg. which is more or less no of significant importance. The drop in weight may be as a result of unhygienic practices rather than weaning subsequently
Table 3 had a difference of 1.85 Kg which is of significant importance. This is the critical period during which mother start introducing complementary Feed to their babies.
Table 4 in which the infants felling within the age range of 12-18 months were not so much affected by drop in weight since the result shows difference of 0.05 Kg. this could be as a result of mother awareness on proper weaning period and practice. Though the infants may have Diarhoea, this is because it is not may stage they move around putting things in there and are likely to come in Contact with germs. However, they are already accustomed to the weaning food are at less risk of Diarrhoea.
Table 5 show the percentage distribution of respondents tribe 62.5 respondents re hausas, This may be due to the culture traditional beliefs and family pattern. For instance most of them practice polygamy where the father is entitling to four wives and probably a low income earner. In this kind of family adequate nutrition and care is not provided for children. As mothers use foods prepared from family pots for weaning, rather than preparing waning foods separated from family foods, such foods are not usually nutritious also it is a tradition in the Hausa society to keep a child away from his mother during weaning. The child is left with his grandmother or other relations who have title or no idea of weaning proper practice. Other reasons are divorce, food taboos etc.
Table 6 shows that 40% of fathers are highly educated (Tertiary education). However, the fathers do not stay at home with their children and have little or no time for their babies. The sole responsibility is for the mothers and only 10% of mothers had a tertiary education. While the rest 90% had little or no education is shows in table 7 such mothers are not aware of proper weaning practice, as well as the nutritional needs of their babies. Also, the uneducated mothers are not aware of the importance of exclusive breastfeeding and thus do not practice it. Table 8 shows that 62.5% of infant wore exclusively breast fed while 37.5% Ore not Table 9 indicates that out of 100 of infants 61.3% of nonexclusive breastfed infants had Diarrhoea (with Diarrhoea), while 11% of non-exclusive breastfeed infants had Diarrhoea and 89% had no Diarrhoea. This shows that lack of baby friendly practice can affect infants because exclusive breastfeeding provides anti-infective properties nourishment, and can delay the weaning period which is from six months. The major contributing factor of Diarrhoea is early weaning.
Table 10 shows that 37.5% of infant are weaned at the age of 3 months which is very early and hence the infant is at risk of Diarrhoea. This also shows that some mothers were not sincere in answering the question as 62.5% of mother claim to practice exclusive breastfeeding which shows that the response from (table 9 is inappropriate/adequate.
Table 11 shows that 75% of infants had Diarrhoea during weaning, with reference to table 10, one of the reasons for this is early weaning, as only 27.5% begin weaning at the age of six months. Other reasons are unhygienic practice, Abrupt weaning introducing too much food at a time, under nutrition, poor methods of food preparation and feeding pattern as well as her illness such as fever, measles, etc, as shown in table 11
Table 12 shows that 37.5% infants are bottle fed while 25% practice hand feeding this is also another cause of Diarrhoea in infants. Also 37.5% infants are fed with cup and spoon improper washing and contamination of this utensil by germs may give rise to Diarrhoea. Another cause of Diarrhoea is the improper cooking of gruel on fire before feeding the baby with it.
Table 13 shows that 43.33% of infants fed with cup and spoon had Diarrhoea, while 33.33% of bottle fed infants had Diarrhoea. The cause of Diarrhoea in this case could be adequate preparation of food, ignorance and poor feeding timing etc.
Table 14 shows that 50% of infant suffered from fever, 25% from measles and 25% from other types of illness such as anemia, pneumonia Stomachache. This Diarrhoea is a symptom of disease and not a disease on its own as such the Diarrhoea may have arisen as a result of illness. Other reasons include improper weaning practices abrupt weaning, poor which timing, unhygienic handling of utensils, ignorance as well as poverty, result in weaning Diarrhoea drop in weight and hence affect nutritional status.






CHAPTER FIVE
5.0 CONCLUSON, RECOMMENDATION AND LIMITATION
5.1 CONCLUSION
Based on the study carried out in Jiga Birni Primary Health Care Centre Aliero, Kebbi State, it is observed that the cause of weaning Diarrhoea include, improper weaning, ignorance, unhygienic practice in the preparation of foods, poverty as well as failure to comply with the campaign on baby friendly i.e. exclusive breast feeding. Another cause of weaning Diarrhoea is poor immunization of children against measles, whooping cough etc. however, children are at high risk of Diarrhoea during weaning as 31 out of 40 children Suffer from Diarrhoea from the study carried out. This is because they are exposed to food born germs from the first time in life. It has become a major health problem that needs to be arrested because it results to malnutrition retardation of growth and development and eventually poor nutritional status which leads to a low life expectancy and other manifestation of ill health. However, possible ways of arresting the situation as well as preventive measure have been outlined
5.2 RECOMMENDATIONS
Government should support ante-natal clinic in hospitals by helping in supply of vaccines for immunization.
Advice mother of the baby to increase fluid and continue feeding during failure episode Provide children with 20 Mg. per day of zinc supplementation for 10-14 days (10mg per day for infants under six month old).
Health care work should emphasize continues feeding or increased breast feeding during and increased feeding after the Diarrhoea episode.
Mothers and care givers should recognize the signs of dehydration and take the child to a heath care provider for ORS or intravenous electrolyte solution or zinc as well as familiarize themselves with other symptoms requiring medical treatment (e.g. bloody Diarrhoea).
5.3 LIMITATIONS
Most of the respondents were not willing to comply and were very hostile towards some of the questions asked, while some refuse to answer some questions












REFERENCES
Ebrahim G.J. (1981) Pediatric Practice in Developing Countries, Macmillan Press
Publisher, London and Basing Stock pp. 45 49 and 53-57
Ebrahim G.J. (1983) Nutrition in Mother and Child Health Macmillan
http://www.weaningsupplementonline.com
Hoise C.C. (1986) Using Communication to Solve Nutrition Problems (INCS)
International Communication Services Nutritionhttp://www.weaning.supplementonline.com
Jellife B & Stanfiled P.J. (1981) Discase of Children in the Shutrap ICS & 3'
Edition pg. 511 - 514 Published by English Language by Tropic English Language Book Society & Edward Arnold Ltd.
Jolly I.T. & Levene 1.M. (1986) Food Nutrition and Diet Therapy Seventh Edition.
 W.B. Senders Company Philadelphia pp. 412 -414
Wholey F.H& Wong L.D (1994) Nursing Care of Infants and Young Children.
 Third Edition. Fabor Publisher, London pp. 1 188 - 1193
Holis C.(1986) using communication to solve Nutrition problems (INCS) service
Nutrition communication international http://www. nngsuplementonline.com
Dupont HL. (2014) acute infectious diarrhea in immunocometent adult he new
 hngland Journal of Medicine. 370 (16): 1532-40.

QUESTIONNAIRE
Questions are on the Prevalence of Weaning Diarrhoea among Children under 2 years of Age attending in Jiga Birni Primary Health Care Centre
GENERAL INFORMATION
Please tick (  ) appropriately
1a. Name
1b. Sex
2a Age
2b Weight
2c. Height
3. Father Educational Level
a. None (    ) b. Primary (     ) c. Secondary (      ) d. Tertiary (     ) e. other (  )
Specify
4. Tribe
a. Hausa (        ) b. Yoruba (  ) c. Igbo (    ) d. Others ( )
5. Mothers Educational Level
a. None ( ) b Primary (         ) e. Secondary ( ) e. Others specify ( )
6. Mothers Occupation
a. House wife (      ) b. Business woman (      ) c. Civil servant ( )
SPECIFIC INFORMATION
7a. Do you Practice exclusive breastfeeding
a. Yes ( ) b. No ( )
b. Yes, How Long
a.1 - 3 months ( ) b.1- 4 months ( ) c.1- 5 months ( ) d. 1-6 moths ( )
8a. Have you Started introducing Complementary Food for your Child?
a. Yes ( ) b. No ( )
b. If Yes. What kind of food?
9. How many times do you feed your child per day?
a. 2 times (   ) b. 3 times (      ) c.4 times ( ) d. other specify (      )
10. What kind utensils do you use in feeding your Child?
a. Cup and Spoon (        ) b. feeding bottle (    ) c. Hand (     )
11. Is your child presently having Diarrhoea?

12. How frequent is/was the Diarrhoea?

13. Did you any changes in weight of the Child?
a. Yes (     ) b. No (      )
14. Is your Child suffering from any illness?
a. Measles (     ) b. Fever (     ) c. Other Specify (     )