Family and community practices relating to infant feeding in central Togo: a study preceding implementation of the family and community component of the "Integrated Management of Childhood Illness" strategy (C-IMCI).

The aim of this study was to assess neonate and infant feeding practices in the central region of Togo before implementation of the community component of the «Integrated Management of Childhood Illness» (C-IMCI) strategy. It was a cross-sectional study from 29th March to 8th April 2004 and included a random sample of 983 households, 506 caretakers and 733 under-five children. Using the Epi-info and SPSS softwares, this study assessed mainly breast feeding, the use of breast milk substitutes and weaning practices. It was noted that out of the 733 children, 52% were males and 48% females, 27% less than one year and 21.6% between 12 and 23 months. After delivery, 29.3% of infants were breastfed within one hour, and 75.6% within the first 24 hours. Only 78.4% of the children received colostrum after birth. It was also noted insufficient breast milk flow in 53.1% of the mothers and water was the main substitute for breast milk in 21% of the children. If 57.7% of the children were exclusively breastfed for the first 6 months, only 9.5% of the infants were breastfed up to the 23rd month. Complementary foods were introduced at an average age of 6 months with water, pap, «diuri» (a plant decoction), and at an average age of 11 months with other family foods. Altogether, 65% of mothers stopped breastfeeding between 18 and 30 months for varying reasons : 7% because of pregnancy, 6% due to insufficient breast milk flow, 3% professional constraints and 3% death. From this study we recommend that sustained efforts have to be made on the sensitization of mothers during C-IMCI implementation on cultural practices that do not support optimal feeding of the neonate and young infant.