Background
Theoretical framework
Methods
Setting
Study design
Population
Sampling and sample size
Data collection
Data analyses
Results
Socio-demographic characteristic of participants
Variable | Frequency (N) (N = 30) | Percentage (%) |
---|---|---|
Age (In completed years) | ||
16 | 3 | 10.0 |
17 | 6 | 20.0 |
18 | 8 | 26.7 |
19 | 13 | 43.3 |
Level of Education | ||
Primary | 9 | 30.0 |
JHS | 18 | 60.0 |
SHS | 3 | 10.0 |
Marital Status | ||
Never married | 19 | 63.3 |
Married | 3 | 10.0 |
Cohabiting | 8 | 26.7 |
Religion | ||
Christian | 27 | 90.0 |
Islamic | 3 | 10.0 |
Occupation | ||
Not working | 15 | 50.0 |
Petty trading | 6 | 20.0 |
Seamstress | 4 | 13.3 |
Hairdresser | 3 | 10.0 |
Mobile banking/Transfer | 2 | 6.7 |
Childcare practices of teenage mothers
Baby’s positioning and attachment practices
However, we found that this healthy practice required time for some teenage mothers to master. A teenage mother with a 3 months-old male child who during the first few days following delivery struggled to position her baby when breastfeeding had this to say:Yes! I sit down and put my baby on my lap and support the head like the one showing in the pictorial guide [picture 2] and I hold the breast in the mouth of my baby. This helps the baby to suck or feed well because if I don’t do it this way the breast milk can pass through the baby’s nose. ¬R 1, 17 years with a male child.
Yes! But when I started breastfeeding my baby, hmm!, It was very difficult for me because at a point in time I had to use one hand to hold her neck side and use the other hand to control my breast to ensure that I breastfeed the baby well... In my usual ways, I put my baby on my lap and raise his head a bit. [But now], I hold my baby the same way it is shown in the book. [Referring to pictorial guide; picture 2] ¬R 13, 18 years with 3months male child.
Exclusive breastfeeding practices
Yes, I breastfeed my baby all the time, I know the breast milk has all the nutrients my child needs and it is safe and natural. God specifically made it for me to be given to my baby so I have to give the breast milk to my child anytime my child needs it, either in the morning, afternoon, evening and even at dawn to help my baby grow well and get stronger ¬R 20, 18 years with 3 months female child.
Benefits of exclusive breastfeeding
This was corroborated by a 19-year-old mother with a baby aged 4 months old.I know that breast milk is the only food for my baby at this time, so I breastfeed her because I know my baby can become strong and healthy when I breastfeed her from now till the time I have to stop breastfeeding. ¬R 3, 18 years with a female child.
… It helps my baby to grow well and protect my baby against any infections and makes my baby strong and healthy. ¬R11, 19 years with 4 months child.
Knowledge of exclusive breastfeeding: the micro-level influence
Another teenage mother who was practising exclusive breastfeeding based on what the nurse told her when she gave birth at the facility had this to say:My mother supports me and educates me on the kind of food items which, when eaten can increase milk supply [breast milk] and shows me how to position the baby for optimal and successful feeding. ¬R 2, 19 years with 3 weeks child.
When I gave birth, the nurse educated me that I should breastfeed my baby for six months before I can give my baby any food so I am just doing that. ¬R 27, 18 years with a female child.
Complementary feeding practices
Oooh yes, sometimes I give my baby Cerelac [a canned baby food] and porridge [koko] but I prepare the ‘Koko’ at home; I don’t buy it outside … Yes, I use the same position as in the book [pointing at picture #3 in the pictorial guide] when feeding my baby. I know when I give other food to my baby, it also makes my baby healthy and stronger. ¬R 9, 19 years with 7months child.
… I give my baby porridge, cowbell mix and water for now because the breast milk is not sufficient for her so I have even decided that when she is one-year-old I will stop breastfeeding and give her other heavy food like mashed kenkey, rice, [...] Yes, I put my baby on my lap like it is shown in the pictorial guide number three when I am feeding her. ¬R 17, 19 years, 10 months female child.
Challenges associated with breastfeeding practices
This was further corroborated by a teenage mother aged 18 years with a female childI felt some pain from my stomach/abdomen as my baby suckled, and this continued for a while so I went to the hospital and the midwife told me my womb is getting back to its shape and the doctor prescribed medicine for me but it was still unbearable. ¬R 22, 17 years, with a female child.
A participant whose husband liked to suck the breast had this say:I nearly stopped because I did not like putting the breast into my baby’s mouth because it tickles and I feel pain and there was a little [insufficient] breast milk too but I don’t have money to buy those ‘s3’ [like] NAN 1 or ‘s3’ [like] NAN 2 [ … ] I don’t even know how to mention it hm! [She giggled]. ¬R3, 18 years with a female child.
Hmm [ … ] initially, the moment I put the breast into my baby’s mouth and if he starts sucking, I begin to feel for sex but now I am used to it. [She giggled and related that … ] my husband likes to suck my breast ‘paaa’ [a lot] ... ¬R 28, 19 years with 4 months male child.
Baby care: signs of hunger and satisfaction
With regards to the child’s satisfaction, some participants revealed that they usually pick up signals or sound that their babies usually make when they are satisfied with breast milk. The following are some statements made by one of the teenage mothers:… my child sometimes cries hard ¬R7; 18 years, with 3 months old child.
When my baby is satisfied, she would reject the breast when I give it to her. When I see that I turn her back against my lap and tap her at the back lightly [ … ] this act of tapping the baby’s back gently is called ‘abatan bo’, the baby will belch. That tells she is full and satisfied [ She giggled]. ¬R 5; 18 years with 5months female child.
Baby bathing practices
It emerged from the data analysis that bathing children come with challenges for several teenage mothers. Teenage mothers acknowledged that bathing children, especially in the early days of the child require a lot of skills which they lacked. Participants conveyed feelings of fear, lacking in confidence and skills, especially when it comes to cleaning some parts of the body. One participant had this to say:For the first three months, I had to observe my mother doing it because I did not have the courage to it so she asked me to look carefully anytime she was bathing the baby. After sometimes, my mother helped me to do it. But, nowadays I do it by myself. I even bath my baby twice in a day, one in the morning, one in the evening and I do it very well. Yes, I gently place the baby in the rubber bowl like the one in picture 4 [in pictorial guide] ¬R29; 19 years with 15 months child.
Concerning child bathing and cleaning practices, teenage mothers were asked to provide a narrative of how they clean their baby’s umbilical cord. Almost all the participants mentioned that their guardian, parents, mother-in-law or traditional birth attendants (TBAs) assist them at the initial stage. Teenage mothers mentioned they have been using substances such as methylated spirit and cotton wool, capsules mixed with powder, palm kernel oil, and shea butter to the cord stump while others put a wet towel on a hot stone to make it warm and then put the warm towel on the umbilical cord. One participant had this to say:I think the little problem I faced when bathing my baby is when I want to clean her vagina. It is very difficult for me because I’m not too sure whether her vagina is clean or not ¬R 7; 18 years with 3 months child.
This was further corroborated by another teenage motherWhen I returned from the hospital my mother was the one bathing and cleaning my baby’s umbilical cord for me. She sometimes uses palm kernel oil mixed with some medicine like ash and black colour [herbs]...I don’t know the name and she rubs it around the chord. She said it relieves the pains and help the wound to heal fast. ¬R12; 18 years with 2 weeks child.
I did not clean it myself, the woman [TBA] who helped me to give birth did it for my baby. She puts a stone in a fire and after removing it, she put a wet cloth/towel on the hot stone to make bit warm and apply it on the cord/stump. ¬R 14; 17 years with a female child.
Sleeping practices and arrangements
To corroborate this statement, another teenage mother mentioned;Hmm, that wooden structure [pointing at it] I have a mat [pointed at picture 6 in pictorial guide] that I and my baby sleep together on … sometimes, I feel pains when I wake up but I am used to it. Besides, I don’t have any option. ¬R 10; 19 years with 20 months old child.
Another teenage mother aged 18 with a baby aged 5 months who sleeps in an old metal container and wanted to prevent malaria had this to say:I was living with my friend at “Esuakyire” [one of the suburbs of Elmina] but when I gave birth I decided to come home and stay with my mum. We all sleep in a single room. I have a mat [pointed at picture 6 in pictorial guide] that I and my baby sleep together on it. I put rubber under the baby’s cloth to avoid urine penetrating the mat when the baby urinates on it … I will say it is ok for me and my baby, but I wish we sleep on a good bed and under an insecticide-treated bed net. ¬R 21; 19 years with 22 months child.
Hmm! Where I stay, there are a lot of mosquitoes because of the big gutter there. So, I always put my baby under a mosquito net. I sleep under it too. Oh yes, like picture 7 in the pictorial guide. I know it’s good to sleep under an insecticide-treated bed net. ¬R 6; 18 years with 5months child.