CHAPTER TWO   LITERATURE REVIEW

Concept of Complementary Feeding

Complementary feeding is the process where solid, semi-solid and soft foods are supplemented with breast milk when breast milk alone can no longer meet the nutritional requirements of the infant. World health organization recommends that complementary feeding is introduced at six months and continue up to two years or more of age. Complementary feeding is very necessary for health and mental well-being of infants and children. Complicated issues like the time to start feeding, the diversity of foods offered, the number of meals per day, management of foods and hygiene during feeding are the different aspects of complementary feeding. The consequence of inappropriate complementary feeding are under nutrition infection growth retardation and mental retardation. All these go to underscore the importance of educating nursing mothers on infant feeding practices. In many developing nations such as Nigeria, inappropriate complementary feeding poses a significant health challenge. Inappropriate complementary feeding results from various reasons, such as cultural practices, poverty, poor maternal education, and inadequate health information. Maternal education via antenatal and postnatal clinics has been recommended by some researchers as a way of improving complementary feeding and preventing childhood malnutrition. Knowledge of Complementary Feeding Among Nursing Mothers

Complementary feeding knowledge refers to the knowledge nursing mothers have for the "appropriate" feeding of infants that is, the time to start complementary feeds, the nutritional requirements of infants, food preparation and how often they should be fed. The mothers' knowledge is important because it influences the manner in which they feed their infants..

Mothers who are given health education during post natal care visits have good complementary feeding practices. Bello and Yusuf (2025) found that educated mothers and mothers with health information from health workers, knew more about the feeding and nutrition of their infants. The study show that health workers are important sources of health education on exclusive breastfeeding and complementary feeding practices;.

In a similar study, Okeke et al. (2025) established that although most nursing mothers in Nigeria have moderate knowledge on complementary feeding, they do not understand the concepts of dietary diversity and food hygiene. Inadequate maternal knowledge was found to be associated with improper infant feeding and malnutrition. The Ojimaojo Clinic offers chances for health education through postnatal visits. Counseling and nutrition education will help nursing mothers to understand the nutritional requirements of their babies as well as the need for timely introduction of complementary foods.   Attitude of Nursing Mothers Toward Complementary Feeding

Attitude encompasses the beliefs, sentiments, and perceptions that determine the actions of individuals towards a specific practice. The attitude of nursing mothers towards complementary feeding plays a significant role in determining infant nutrition and feeding practices. Positive attitude promotes good feeding practices, whereas negative attitude can result in poor nutrition and poor feeding practices.

Some nursing mothers have the notion that breast milk alone is inadequate before six months hence the need for introducing water and solid foods earlier than required. Some nursing mothers delay introducing complementary feeding due to fears of diarrhea or other cultural reasons. Ibrahim & Lawal (2025) noted that cultural beliefs and family influences still shape the attitude of mothers towards infant feeding in Nigeria. It has also been found that mothers who regularly attend postnatal clinics tend to have better attitudes towards appropriate feeding practices due to constant health education and counseling by health care professionals. Better attitudes towards hygiene, balance diet, and nutritional variety will lead to healthier children.

Socioeconomic status and educational level affect the attitudes of mothers towards complementary feeding practices. Educated mothers tend to be aware of the significance of balanced nutrition and feeding practices. It is therefore vital to change the attitudes of mothers through health education.

Practice of Complementary Feeding Among Nursing Mothers

Actual implementation of recommended feeding practices by nursing mothers, which include the age at which complementary foods are introduced frequency quality of foods, variety of foods included in the diet and hygiene during food preparation and feeding. Proper complementary feeding practices are required to prevent childhood malnutrition and provide adequate growth and development.

Yet, research findings carried out in Nigeria revealed that some mothers have not succeeded in practicing the recommended guidelines. Adeyemi et al, (2025) found that a considerable proportion of nursing mothers introduced complementary foods too early or too late which resulted in adverse effects on the health and nutrition of children.

And, economic instability might deprive mothers from giving healthy and balanced diet to children. Some mothers are giving mainly foods rich in carbohydrate and lack of proteins, vitamins and minerals. This type of feeding behavior mostly results in under nutrition, low immune status and deterioration in cognitive development of children.

Musa and Abdullahi (2025) conducted a study and revealed that most mothers had knowledge of complementary feeding recommendations but refused to follow them as there was little beneficial feeding practices that is, feeding frequency, dietary diversity and so on as most responses were not good enough. Time, money and family support were some of the limiting factors. Postnatal clinics can provide a good opportunity for promotion of good feeding practices for mothers.

Healthy teachings, demonstration on food preparation and SSS (Schedule of sick visits) for infant feeding are given at postnatal visits in the facility such as Ojimaojo Clinic. These education can help in improving maternal practices and nutritional status of children..

  Empirical Review Several researchers have investigated knowledge, attitude, and practice of complementary feeding among nursing mothers. For instance, Bello and Yusuf (2025) revealed that maternal literacy and healthcare access play a key role in improving the practice of complementary feeding among nursing mothers visiting primary healthcare centers in Nigeria. The importance of continuous nutritional education was underscored in post-natal care. Okeke et al. (2025) also showed that mothers who make regular postnatal clinic visits possessed more knowledge about and practiced good feeding than those who were not able to easily access health facilities. They suggested reinforcement of public health campaigns on infant feeding. Once again, the importance of cultural belief and poverty on attitudes and feeding practices of nursing mothers in northern Nigeria has been confirmed by Ibrahim and Lawal (2025). The continuing prevalence of poor dietary diversity as one of the major problems encountered by nursing mothers has been observed by Adeyemi et al. (2025) even with the growing awareness of complementary feeding. Summary of Literature Review

The literature reviewed has shown the importance of complementary feeding for growth and development of infants and the crucial role played by knowledge, attitude and practice of feeding practices of nursing mothers to health and nutritional status of their children. Evidence from various studies indicate that health education at postnatal visitation had improved mothers knowledge and use of recommended infant feeding practices. Yet, various related factors such as poverty, low educational attainment and cultural beliefs still influence practices of complementary feeding among nursing mothers. This study is So aimed at studying the knowledge, attitude and practice of complementary feeding among nursing mothers attending postnatal visitation at Ojimaojo Clinic.

Free tips on when to Use T-test

The t-test is an inferential statistical technique utilized to test for the presence of a significant difference between the means of two groups. This technique is often employed where a researcher wants to make a comparison of the results obtained and establish if any differences noted occurred due to chance or due to some actual cause. For a t-test to work effectively, the variables have to be numeric, the sample sizes small, and the data normally distributed. T-tests are employed in many fields including education, psychology, medicine, business, and social sciences.. For instance, a teacher can apply t-test when comparing the mean scores of the learners who were taught using two different techniques. Likewise, a health care expert may wish to compare the blood pressure values of the patients before and after administering some treatments. Various types of t-tests exist based on the nature of the design applied. Independent t-test involves comparison between two unrelated groups. Paired t-test is used for the comparison of related variables like repeated measures from the same subjects. One sample t-test applies in the comparison between the sample mean and a particular known value. The right t-test is important in making correct conclusions.