University of Medical

Sciences and Technology

College of Nursing Sciences

Assessment of Nursing Student’s Knowledge

Regarding Breastfeeding Weaning. In
University of Medical Sciences and Technology,
Khartoum State, Sudan from December 2022 -
February 2023

Thesis Submitted in Partial Fulfillment of the

Requirements of Bachelor’s Degree in Nursing
Sciences

Submitted By:
Abeer Ali Hussein

Supervised by:
Dr. Nadia Hamad
I
 Dedication
I dedicate this research to my family,

My father and mother

My brothers and sisters

To my friends and colleagues

I
 Acknowledgment
I would like to acknowledge and give my warmed thanks to my thesis
supervisor Dr. Nadia Hamad who made this work possible. Her guidance and
advice carried me through all the stages of writing my thesis.

I would like to give special thanks to my parents and my family as a whole for
their continued support and understanding when undertaking my research and
writing my thesis. Your prayers for me were what sustained me this far.

Finally special thanks to my colleagues for their participation in this study.

II
 Abstract
Background: Breastfeeding is widely recognized as the optimal way to nourish
infants and provides numerous benefits for both the mother and child. The
World Health Organization (WHO) recommends exclusive breastfeeding for the
first six months of life, followed by the introduction of complementary foods
while continuing to breastfeed for up to two years or beyond. While
breastfeeding is a natural and instinctual process, it can sometimes be
challenging, and mothers may encounter difficulties in maintaining exclusive
breastfeeding for the recommended period.

Objectives: The study aimed to assess nursing student’s knowledge regarding

breastfeeding weaning

Results: The study showed that the sample showed good knowledge (78.92%)
regarding knowledge about the process of breastfeeding weaning, moderate
knowledge (63.9%) regarding the ideal time of breastfeeding weaning, good
knowledge (73.85%) regarding specific foods to be offered for infants during
the process of breastfeeding weaning, good knowledge (84.53%) regarding
complications that may occur from process of weaning and good knowledge
(83.8%) regarding the role of nurses in the process of weaning.

Conclusion: The study concluded that the sample showed good knowledge
regarding the process of breastfeeding weaning.

III
 ‫مستخلص الدراسة‬

‫الخلفية‪ :‬من المع ترف ب ه على نط اق واس ع أن الرض اعة الطبيعي ة هي الطريق ة المثلى لتغذي ة الرض ع‬

‫وتوفر فوائد عديدة لكل من األم والطفل‪ .‬توصي منظمة الصحة العالمية (‪ )WHO‬بالرضاعة الطبيعية‬

‫الحصرية لألشهر الستة األولى من العمر‪ ،‬يليها إدخال األطعمة التكميلية مع االستمرار في الرضاعة‬

‫الطبيعية لمدة تصل إلى عامين أو أكثر‪ .‬في حين أن الرضاعة الطبيعية هي عملية طبيعية وغريزية‪،‬‬

‫إال أنه ا ق د تك ون ص عبة في بعض األحي ان‪ ،‬وق د تواج ه األمه ات ص عوبات في الحفاظ على الرض اعة‬

‫الطبيعية الحصرية للفترة الموصى بها‪.‬‬

‫األهداف‪ :‬هدفت الدراسة إلى تقييم معرفة طلبة التمريض فيما يتعلق بالفطام عن الرضاعة الطبيعية‬

‫النت ائج‪ :‬أظه رت الدراس ة أن العين ة أظه رت معرف ة جي دة (‪ )٪78.92‬بمعرف ة عملي ة فط ام الرض اعة‬

‫الطبيعي ة‪ ،‬ومعرف ة متوس طة (‪ )٪63.9‬ب الوقت المث الي لفط ام الرض اعة الطبيعي ة‪ ،‬ومعرف ة جي دة (‬

‫‪ )٪73.85‬بأطعم ة معين ة س يتم تق ديمها‪ .‬بالنس بة للرض ع أثن اء عملي ة فط ام الرض اعة‪ ،‬معرف ة جي دة (‬

‫‪ )٪84.53‬بالمض اعفات ال تي ق د تح دث من عملي ة الفط ام ومعرف ة جي دة ( ‪ )٪83.8‬فيم ا يتعل ق ب دور‬

‫الممرضات في عملية الفطام‪.‬‬

‫الخالصة ‪ :‬خلصت الدراسة إلى أن أفراد العينة أظهروا معرفة جيدة بعملية فطام الرضاعة الطبيعية‬

‫‪IV‬‬
 Table of Contents
No. Content Page No.
- Dedication I
- Acknowledgment II
- Abstract III
- ‫مستخلص الدراسة‬ IV
- Table of contents V
- List of Tables VII
- List of figures VIII
Chapter One
Introduction
1.1 Background 1
1.2 Problem Statement 3
1.3 Justification 4
1.4 Objectives 4
Chapter Two
Literature Review
2.1 Process of weaning 5
2.2 Specific foods to be offered to infants during process 6
of weaning
2.3 Complication that may occurs from wrong process of 7
weaning
2.4 Ideal time of breastfeed weaning 10
2.5 Role of nurses in weaning instructions 10
2.6 Previous Studies 12

Chapter Three

V
 Materials and Methods
3.1 Study design 14
3.2 Study duration 14
3.3 Study area 14
3.4 Study population 14
3.5 Study variables 15
3.6 Data collection tools and technique 15
3.7 Plan of analysis 15
3.8 Ethical consideration 15
Chapter Four
Results
4.1 Socio-demographic data 17
4.2 Knowledge regarding weaning 20
4.3 Total nursing students’ knowledge regarding 22
breastfeeding weaning according to scoring system
Chapter Five
Discussion, Conclusion and Recommendations
5.1 Discussion 23
5.2 Conclusion 25
5.3 Recommendations 26
- References 27
Appendices
- Appendix 1: Questionnaire used in the study 30

VI
 List of Tables
Table Table Description Page
No. No.
4.1 Age 17
4.2 Gender 18
4.3 Marital Status 19
4.4 distribution of nursing students’ specific knowledge regarding 20
breastfeeding weaning at the University of Science and
Technology
4.5 Total nursing students’ knowledge regarding breastfeeding 22
weaning according to scoring system

VII
 List of Figures
Figur Figure Description Pag
e No. e
No.
4.1 Age 17
4.2 Gender 18
4.3 Marital Status 19

VIII
Chapter One
Introduction

0
 Chapter One

Introduction

1.1 Background

Breastfeeding should continue past the first or second year of life as long as a
family deems it appropriate, according to recommendations from the American
Academy of Pediatrics and the World Health Organization (WHO) [1].

Breastfeeding is widely recognized as the optimal source of nutrition for infants,

with numerous health benefits for both mother and baby. The World Health
Organization (WHO) recommends exclusive breastfeeding for the first six
months of life, with continued breastfeeding along with appropriate
complementary foods for up to two years or beyond. While many nursing
students may receive some education on the importance of breastfeeding, the
topic of breastfeeding weaning may not always be covered in depth.

Breastfeeding weaning, the process of gradually decreasing a child's

dependence on breastfeeding, can be a challenging time for both mothers and
babies. It involves the introduction of complementary foods and the eventual
cessation of breastfeeding. Mothers may experience physical discomfort and
emotional distress during this time, while infants may have difficulty adjusting
to new foods and routines.

Given the importance of breastfeeding and the challenges associated with

weaning, it is crucial for nursing students to have a solid understanding of the
process. This includes knowledge of the recommended timeline for weaning,
strategies for managing common challenges, and resources for supporting
mothers and infants throughout the process. By assessing nursing students'
knowledge regarding breastfeeding weaning, we can identify potential gaps in

1
education and develop strategies for improving the support provided to mothers
and infants during this important transition.

Breastfeeding weaning can be influenced by a range of factors, including

cultural practices, social norms, and individual preferences. For example, some
cultures may encourage extended breastfeeding, while others may emphasize
early weaning. Additionally, mothers may have different reasons for choosing
to wean their babies, such as returning to work, medical issues, or personal
preferences.

While there is a wealth of information available on breastfeeding and weaning,

not all sources may be reliable or evidence-based. Nursing students should be
equipped with the skills to critically evaluate information and make
recommendations based on current research and guidelines.

The role of healthcare providers in supporting breastfeeding and weaning is

critical, as they can play a key role in educating and empowering mothers to
make informed decisions. However, healthcare providers may also have their
own biases or preferences that can influence their recommendations. It is
important for nursing students to be aware of potential biases and provide non-
judgmental support to mothers during the weaning process.

Breastfeeding weaning is not always a linear process and may involve setbacks
or challenges. Nursing students should be prepared to provide support and
guidance to mothers during these times, such as through the use of
breastfeeding aids or referral to lactation consultants.

While breastfeeding weaning is an important topic for nursing students, it is

also relevant for a range of healthcare professionals who work with mothers and
infants, such as pediatricians, obstetricians, and midwives. Collaboration
between healthcare providers can help ensure that mothers receive
comprehensive and consistent support throughout the weaning process.

2
Both immediately and later on, breastfeeding has many positive health effects
on both mother and child. By preventing the infant from contracting infectious
and chronic diseases and fostering his sensory and cognitive growth, exclusive
breastfeeding lowers the risk of infant mortality [2].

The term "weaning" refers to the protracted process of transitioning a child from
total reliance on breast milk to a complete cessation of milk feeding [3,4].

Weaning thus begins with the introduction of any food other than breast milk
and concludes with the last milk feeding of the infant. Between these two
milestones is the complementary feeding period, during which other foods are
combined with milk [5].

1.2 Problem Statement

Despite the well-documented benefits of breastfeeding and the role of nurses in

promoting and supporting it, a significant proportion of mothers choose to wean
their infants before the recommended age of 2 years. This decision can be
influenced by various factors, including lack of knowledge and support. Nursing
students play a crucial role in educating and supporting mothers in their
breastfeeding journey, yet it is not clear how well equipped they are to provide
this support. The purpose of this study is to assess the level of knowledge that
nursing students have regarding breastfeeding weaning and identify any gaps in
their education. The results of this study will provide insight into the need for
additional breastfeeding education for nursing students and inform the
development of targeted educational interventions to improve the support
provided to breastfeeding mothers

3
1.3 Justification

Nursing students' knowledge regarding breastfeeding weaning is vital to

ensuring that mothers are able to successfully breastfeed their babies. There are
a number of factors that can contribute to successful breastfeeding, and weaning
is one of them. It is important for nursing students to be familiar with the
process of weaning so that they can support mothers who are going through it.

1.4 Objectives

1.4.1 General Objective

Assessment of nursing student’s knowledge regarding breastfeeding weaning

1.4.2 Specific Objectives:

- To assess nursing student knowledge about process of weaning

- To identify nurses student knowledge about ideal time of weaning
- To identify nurses student knowledge regarding specific food to be offered
for infant during process of weaning
- To assess nursing student knowledge about complication that may occurs
from wrong process of weaning
- To assess nursing student knowledge about role of the nurses regarding
process of weaning

4
 Chapter Two

Literature Review

4
 Chapter Two

Literature Review

2.1 Process of weaning

2.1.1 Natural Weaning

Natural weaning happens as the newborn starts to accept more supplemental

feedings, both in terms of quantity and variety, while still being breastfed on
demand. Complete weaning often occurs between the ages of two and four
when natural weaning is used [6]. This method of weaning is still mostly
tolerated in western countries, and many mothers who breastfeed older infants
and children end up becoming "closet nursers." Closet nursing involves nursing
covertly at home and spreads misinformation about the length of time that
should be spent breastfeeding [7].

2.1.2 Planned weaning

When a mother decides to wean without waiting for her child to give her signs
that he is ready to stop nursing, this is known as planned weaning. Weaning is
frequently planned for a variety of reasons, such as insufficient milk production,
worries about the baby's development, uncomfortable feedings or mastitis,
returning to work, a new pregnancy, the desire for the partner or another
caregiver to be able to provide feedings, or the baby's teeth starting to erupt [8].

Despite the mother's initial intention to continue breastfeeding, certain

circumstances may lead to early full weaning. Regardless of whether the woman
wants to continue breastfeeding, it is appropriate for the doctor to inform and
encourage her. A referral to a nursing expert should be taken into consideration
if the doctor is unsure how to offer this kind of help [9].

5
2.2 Specific foods to be offered to infants during process of
weaning

Some babies adapt to solids more easily than others do. Therefore, it is worth
considering the following advice [10]:

- Start by offering just a few tablespoons of food, once a day

- Heat food thoroughly, allow it to cool and test it before offering it to the
baby

- Throw away any food the baby hasn’t eaten – do not reheat it

- Feed at the baby’s pace and allow the baby to get used to different tastes
and consistencies

- Stay with the baby when they are eating to make sure they don’t choke

- Don’t worry if the baby refuses to take food, they know when they have
had enough

- Involve the baby in the process by encouraging them to use their fingers
or a spoon to feed themselves

- Use mashed up family food when possible – it will get the baby used to
eating what is eaten at home

- Make sure everything used for feeding your baby is really clean

- Never add any food to the baby’s bottle (this includes rusks) as this can
damage teeth and cause choking

2.2.1 Foods to avoid

It’s a good idea to try to introduce the baby to a variety of tastes at an early age.
However, there are certain foods that should not be included in their diet.

These include [11]:

6
 - salty foods such as meat or sausages – Salt should not be added to food as
a baby’s kidneys are not fully developed and cannot cope with it

- sugary foods – don’t add sugar to any foods or drinks

- honey – this is also a sugar and shouldn’t be given to babies under one
year old

- nuts – whole nuts should not be given to children under five years old as
these can cause choking

2.2.2 Weaning before six months

Weaning before six months is not recommended. If a mother weans her baby
before six months, there are certain foods to avoid as these can cause allergies.
A mother should never wean her baby before they are four months old (17
weeks).

If a mother weans her baby before they are six months old, she should avoid the
following, as they can cause an allergic reaction or contain harmful bacteria
[12]:

- wheat based foods containing gluten (wheat flour, bread, breakfast

cereals, rusks)

- nuts and seeds, including ground nuts

- fish and shellfish

- soft and unpasteurized cheeses

2.3 Complication that may occurs from wrong process of weaning

There are definitely circumstances that require sudden weaning, such as medical
emergencies. However, in many situations, sudden weaning can be avoided.
Some reasons for sudden weaning include [13]:

7
- A new medication: There are certain prescription drugs that a mother
cannot take while she is breastfeeding. If a mother’s doctor prescribes a
new drug that's not compatible with breastfeeding, she should ask if
there's an alternative that is safe. Of course, if the mother’s health
depends on a medication that is not compatible with breastfeeding, such
as chemotherapy drugs to fight cancer, then she will have no choice but to
wean.

- Illness, hospitalization, or surgery: If a mother gets sick with a mild

illness, such as a cold or a stomach bug, she can continue to breastfeed.
But if she has a serious illness, she has to be hospitalized, or she needs
surgery, the mother may have to stop breastfeeding abruptly. If it's her
baby who is sick, breast milk can be very helpful. If possible, the mother
should continue to breastfeed or pump for her baby.

- Separation from a child: When a mother has to be away from her baby for
an extended period, such as for a military deployment, the mother won't
be able to breastfeed. If she plans to breastfeed when she returns home,
the mother should pump to maintain her supply. The mother can even
send her breast milk home to her baby. Of course, this can be challenging
and time-consuming, so many people choose to stop breastfeeding
instead.

- Pressure from others: Criticism and pressure from a partner, family,

friends, or even a health care provider who doesn't support or understand
breastfeeding can cause a parent to decide to wean suddenly, especially if
the child is a little older.

- A new pregnancy: It is not always necessary to stop breastfeeding

because of a new pregnancy. But since breastfeeding can cause uterine

8
 contractions, if a mother is at a high risk of miscarriage or premature
birth, weaning may be the safer option.

Weaning has physical, hormonal, and emotional effects on the breastfeeding

parent. When a mother weans gradually, she can prepare and adjust to the
changes over time. But when weaning is sudden, it can have a greater impact on
the mother and her body, with effects such as:

- Painful breast engorgement

- Breast infection, plugged milk ducts, or a breast abscess due to

engorgement

- Milk fever, a flu-like condition with symptoms such as fever, chills, and
muscle weakness

- Leaky breasts (it could take many months for milk to dry up completely)

- Return of period and fertility

Gradual weaning allows a child to slowly adjust to a new source of food and the
loss of the comfort and security that breastfeeding provides. So when
breastfeeding ends quickly, it can affect the baby in many ways [14]:

Babies may refuse to take a bottle, especially if their breastfeeding parent is the
one trying to give it to them. They may have a difficult time giving up
breastfeeding and understanding that breastfeeding has to end. They may be
fussy, sad, or even angry at the parent for not letting them breastfeed.

Babies may be more likely to get sick. Breastfeeding helps to prevent some
common childhood illnesses, so the sudden weaning of a newborn or young
infant can put them at greater risk for ear infections and respiratory infections.

9
2.4 Ideal time of breastfeed weaning

The American Academy of Pediatrics recommends exclusive breast-feeding for

the first six months after birth — and breast-feeding in combination with solids
foods until at least age 1. Breast-feeding is recommended as long as the mother
and the baby wish to continue.

When to start weaning a child is a personal decision. It is often easiest to begin

weaning when the baby starts the process. Changes in breast-feeding patterns
leading to eventual weaning often begin naturally at age 6 months, when solid
foods are typically introduced. Some children begin to seek other forms of
nutrition and comfort at around age one. By this age, children typically eat a
variety of solid foods and are able to drink from a cup. Other children might not
initiate weaning until they become toddlers, when they are less willing to sit still
during breast-feeding [15].

Mothers might also decide when to start the weaning process by themselves.
This might be more difficult than following the child's lead — but can be done
with extra care and sensitivity.

Whenever weaning a baby from the breast, the mother should focus on her
child's needs as well as her own. A mother should resist comparing her situation
with that of other families, and consider rethinking any deadlines; she might
have set for weaning when she was pregnant or when her baby was a newborn
[14,15].

25 Role of nurses in weaning instructions

It is important to note that nurses play a critical role in providing important

information and support to mothers who are breastfeeding and weaning their
infants. Studies have shown that nurses' knowledge and attitudes toward

10
breastfeeding weaning can be a major factor in successful breastfeeding
outcomes.

A study by SC Shaw in 2018, found that the knowledge of doctors and nurses
regarding breast feeding practices needed improvement particularly for proper
weaning after 6 months [16]. Similarly, a descriptive study conducted in 2022
found that assessment of nurses' knowledge regarding weaning among nursing
mothers revealed gaps and deficiencies in knowledge and understanding [17].

Nurses need to have a thorough understanding of the weaning process,

including the appropriate timing, methods, and safety considerations for
weaning. The American Academy of Pediatrics recommends that infants should
receive exclusive breastfeeding for the first 6 months of life, with continued
breastfeeding for at least 1 year and beyond, if mutually desired by the mother
and baby. Therefore, nurses need to be well informed and knowledgeable about
the process of weaning and be prepared to provide mothers with the necessary
advice and support [18].

Nurses should be familiar with the signs and symptoms of weaning, such as
decreased milk production, changes in the baby's feeding pattern and behavior,
and signs of discomfort or distress. They should also be able to recognize when
a mother is having difficulty with weaning and recommend appropriate
resources or support. Nurses should also be knowledgeable about the various
methods of weaning, such as the slow, gradual method, which is often
recommended for the best success rate, or the abrupt weaning method, which is
typically used when a mother needs to wean urgently [19].

Finally, nurses should be knowledgeable about the safety considerations for

weaning, such as the potential for dehydration or malnutrition in infants, or the
increased risk of infection for mothers who are breastfeeding for a prolonged
period of time. They should be able to provide advice on the risks and benefits

11
of weaning, as well as providing resources for mothers who may be struggling
with the weaning process.

2.6 Previous Studies

"Assessment of nursing students' knowledge, attitude and practice regarding

breastfeeding" (2018) - The study found that nursing students had moderate
knowledge about breastfeeding, with a mean score of 12.04 out of 20. However,
they had positive attitudes towards breastfeeding and acknowledged its
importance. On the other hand, their practical skills related to breastfeeding,
such as positioning and attachment of the baby, were inadequate [20].

"Knowledge of breastfeeding among nursing students: A descriptive study"

(2020) - The study found that nursing students had good overall knowledge of
breastfeeding, with a mean score of 11.2 out of 14. However, there were some
knowledge gaps in areas such as milk production, latching, and common
breastfeeding problems [21].

"Assessment of nursing students' knowledge and practice of breastfeeding in

Saudi Arabia" (2019) - The study found that nursing students had good
knowledge about breastfeeding, with a mean score of 9.8 out of 12. However,
their practical skills were inadequate, especially in the areas of positioning and
attachment, and breastfeeding problem management [22].

"Assessment of nursing students' knowledge, attitude and practice towards

infant feeding" (2017) - The study found that nursing students had good overall
knowledge about breastfeeding, with a mean score of 11.48 out of 20. They also
had positive attitudes towards breastfeeding and acknowledged its benefits.
However, their practical skills related to breastfeeding were lacking, with only
29.2% of students demonstrating proper breastfeeding techniques [23].

12
"Assessment of nursing students' knowledge, attitude and practice regarding
complementary feeding" (2019) - The study found that nursing students had
moderate knowledge and positive attitudes towards complementary feeding,
with a mean score of 63.2% and 77.2%, respectively. However, their practical
skills were inadequate, especially in the areas of introducing complementary
foods and monitoring the baby's growth and development [24]

13
 Chapter Three

Materials and Methods

14
 Chapter Three
Materials and Methods

3.1 Study Design

A descriptive cross-sectional institutional-based study

3.2 Study Duration

The study was conducted within a period of three months from December 2022
to February 2023.

3.3 Study area

University of Science and Technology lies in Khartoum Locality, Khartoum

State – Sudan. It lies East of Khartoum International Airport, South West of
Makkah Eye Hospital (Riyadh Branch), West of Ebed Khatim Street and North
of Mecca Street, North of Forensic Evidence Laboratory.

3.4. Study Population

Final year nursing students of University of Medical Science a006Ed

Technology

3.4.1 Sample size

The sample consisted of 50 student nurses

3.4.2 Inclusion Criteria

- Final year nurses student of the faculty of nursing in the University of

Science and Technology willing to participate in this study
3.4.3 Exclusion Criteria

- Nurses who refused to participate in the study

- Nurses who were unavailable during conducting study

14
 - Other levels of the students
3.4.4 Sampling and Sampling technique

Total coverage of final year nursing students.

3.5 Study variables

3.5.1 Independent variables

Demographic data: Age, gender, marital status

3.5.2 Dependent variables

- Knowledge of nursing students regarding breastfeeding weaning

3.6 Data Collection tools and technique

Data will be collected through a self-retained questionnaire that will be

distributed to the study participants by the researcher. The questionnaire was
fully completed by the participants and was checked by the researchers for
completion after a thorough explanation of the aims and objectives of the
research and thorough explanation of confidentiality and privacy.

3.7 Plan of Analysis

The Statistical Package for Social Sciences (SPSS) version 26 was used to
analyze the data and calculate the frequency. Tables and figures were used to
display the results.

3.8 Ethical Consideration

Written permission to conducting scientific research will be obtained from the

University of Medical Sciences and Technology. In addition, an informed
consent will be taken from respondents. Research purpose and objectives will
be explained to the participants in clear and simple words. Participants have the
right to voluntary informed consent. Participants have the right to no harm

15
(privacy and confidentiality by using coded questionnaire). Participants have the
right to benefit from the researchers’ knowledge and skills. The participants will
receive investigation results immediately. Questionnaire will be filled with the
participants willingly and without disturbance in their free time without any
interruptions to their work.

16
Chapter Four

Results

16
 Chapter Four

Results

4.1 Socio-demographic data

Table 4.1 Age

Variables Frequency Percentage

20-24 years 5 13.5%
25-29 years 19 51.4%
30-34 years 13 35.1%
Total 37 100%

Age
60.00%
51.40%
50.00%

40.00% 35.10%

30.00%

20.00%
13.50%
10.00%

0.00%
20-24 years 25-29 years 30-34 years

Percentage

Figure 4.1 Age

From the table and figure above, the distribution of the sample according to age
is depicted. 13.5% of the sample were between the ages of 20-24 years, 51.4%
of the sample were between 25-29 years and 35.1% of the sample were between
the ages of 30-34 years.

17
Table 4.2 Gender
Variables Frequency Percentage
Female 30 81.1%
Male 7 18.9%
Total 37 100%

Gender

18.90%

81.10%

Female Male

Figure 4.2 Gender

From the table and figure above, the distribution of the sample according to
gender is depicted. 81.1% of the sample stated they were females and 18.9%
stated they were male.

18
Table 4.3 Marital Status
Variables Frequency Percentage
Single 18 48.6%
Married 17 45.9%
Divorced 1 2.7%
Widowed 1 2.7%
Total 37 100%

60.00%

50.00% 48.60%
45.90%

40.00%

30.00%

20.00%

10.00%
2.70% 2.70%
0.00%
Single Married Divorced Widowed

Percentage

Figure 4.3 Marital status

From the table and figure above, the distribution of the sample according to
marital status is depicted. 48.6% of the sample stated they were single, 45.9% of
the sample stated they were married, 2.7% of the sample stated they were
divorced and widowed respectively.

19
 4.2 Knowledge regarding weaning
Table 4.4 distribution of nursing students’ specific knowledge regarding
breastfeeding weaning at the University of Science and Technology (n = 37)
Items Frequency(n) Percentage
(%)
4. Weaning is the process of gradually introducing solid
foods to an infant's diet:
a. True 25 64.9%
b. False 7 24.3%
c. I don’t know 4 10.8%
5- The World Health Organization recommends starting
weaning when an infant is around 6 months old.
a. True 23 63.9%
b. False 12 33.3%
c. I don’t know 1 2.8%
6- Breast milk continues to provide important nutrients to
an infant during the weaning process
a. True 31 83.3%
b. False 2 5.4%
c. I don’t know 4 10.8%
7- It is recommended to avoid cow's milk as a main drink
for an infant under 12 months old, but it can be used in
cooking and mixed with other foods.
a. True 23 63.9%
b. False 5 13.9%
c. I don’t know 8 22.2%
8- Weaning an infant from breastfeeding too quickly can
increase the risk of breast engorgement, mastitis, and
emotional distress for both the mother and infant.
a. True 30 81.1%
b. False 1 2.7%
c. I don’t know 6 16.2%
9- Introducing one new food at a time during weaning can
help identify any potential allergies or intolerances
a. True 31 86.1%
b. False 3 8.3%
a. I don’t know 2 5.6%

20
10. The introduction of solid foods during weaning can
sometimes cause constipation in infants, but offering plenty of
fluids and high-fiber foods can help prevent it.
a. True 34 91.9%
b. False 2 5.4%
c. I don’t know 1 2.7%
11. It is recommended to avoid giving honey to an infant
under one year old due to the risk of infant botulism.
d. True 31 83.8%
e. False 3 8.1%
f. I don’t know 3 8.1%
12. It is common for infants to start to refuse breast milk or
formula during weaning as they become more interested in
solid foods, but it is important to continue offering it to ensure
they are getting enough nutrition.
a. True 29 80.6%
b. False 2 5.6%
c. I don’t know 5 13.9%
13. Breast milk or formula should continue to be the main
source of nutrition for an infant during the weaning process,
even as solid foods are introduced.
a. True 30 81.1%
b. False 4 10.8%
c. I don’t know 3 8.1%
14. Incorrect weaning from breastfeeding negatively affect a
child's immune system and increase their risk of illness?
a. True 31 83.8%
b. False 1 2.7%
c. I don’t know 5 13.5%

21
4.3 Total nursing students’ knowledge regarding breastfeeding weaning
according to scoring system
Table 4.5 Total nursing students’ knowledge regarding breastfeeding weaning
according to scoring system
Items Percentage Scoring
system

- Knowledge about process of weaning 78.92% Good

- Ideal time of weaning 63.9% Moderate
- Specific food to be offered for infant during process 73.85% Good
of weaning
- Complication that may occurs from wrong process of 84.53% Good
weaning
- Role of the nurses regarding process of weaning 83.8% Good
Total 77% Good

22
 Chapter Five
Discussion, Conclusion and
Recommendations

16
 Chapter Five
Discussion, Conclusion and Recommendations
5.1 Discussion

This was a descriptive cross sectional study that took place at the University of
Science and Technology that included a sample size of 37 nursing students and
aimed to assess the level of knowledge of student nurses regarding
breastfeeding weaning.

The study found that the student nurses have a good knowledge regarding
breastfeeding weaning with the majority of the sample scoring 77% across all
knowledge questions. There were several knowledge regarding specific food to
be offered to infants during the process of breastfeeding weaning which is
similar to the study by Ogbolu, Y (2020) that showed there were some
knowledge gaps in areas such as milk production, latching, and common
breastfeeding problems.

One possible explanation for the knowledge gap regarding weaning time is that
it may not be emphasized enough in nursing education programs. This study
highlights the need for nursing education programs to place greater emphasis on
breastfeeding weaning, including the ideal time for weaning and the different
methods of weaning.

Another possible explanation for the knowledge gap is that student nurses may
not have had sufficient exposure to breastfeeding mothers who are weaning
their children. It is important for student nurses to have opportunities to observe
and participate in the care of breastfeeding mothers who are weaning their
children, in order to gain practical experience and knowledge about the weaning
process.

23
The findings of this study have important implications for nursing education
and practice. Nursing education programs should consider including
comprehensive training on breastfeeding weaning, in order to better equip
student nurses with the knowledge and skills necessary to support breastfeeding
mothers. Healthcare institutions should also consider developing clinical
practice guidelines that provide evidence-based recommendations for
breastfeeding weaning.

The majority of the participants acknowledged the importance of breastfeeding

weaning properly and showed good knowledge (84.53%) regarding the
complications that may occur from the wrong process of weaning.

Participants also showed good knowledge (83.8%) about the role of nurses
regarding the process of weaning and good knowledge (73.85%) regarding
specific foods to be offered to infants during the process of breastfeeding
weaning.

24
5.2 Conclusion

The study concluded that the sample showed good knowledge regarding the
process of breastfeeding weaning.

25
5.3 Recommendations

The researcher recommends the following:

- Education and training programs: Develop education and training

programs for student nurses that focus specifically on breastfeeding
weaning. The program should cover the ideal time for weaning, different
weaning methods, and the benefits of weaning for both the mother and
the child.
- Clinical practice guidelines: Develop clinical practice guidelines for
healthcare professionals, including student nurses, to help them manage
breastfeeding weaning. The guidelines should be evidence-based and
cover the ideal time for weaning, the different methods of weaning, and
the management of weaning-related problems.
- Continuing education: Provide continuing education opportunities for
student nurses and other healthcare professionals to keep them up to date
on the latest research and best practices related to breastfeeding weaning.
- Collaboration with lactation consultants: Encourage collaboration
between student nurses and lactation consultants to enhance their
knowledge and skills in managing breastfeeding weaning. This
collaboration will also ensure that breastfeeding mothers receive
comprehensive care that includes weaning support.
- Research: Conduct further research to explore the reasons for the
knowledge gaps identified in your study and to develop effective
strategies for improving knowledge and practices related to breastfeeding
weaning among healthcare professionals, including student nurses.

26
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weaning.html
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29
Appendices

17
 Appendices
- Appendix 1: Questionnaire used in the study

Questionnaire

This questionnaire is designed to assess the knowledge of student nurses

regarding breastfeeding weaning.

Part One: Demographic Data

1. Age years

20-24 years 25-29 years 30-34 years

2. Gender

Male Female

3. Marital status

Single Married Divorced Widowed

4. Residence
Khartoum Omdurman Bahri
Part Two: Knowledge Assessment on breastfeeding weaning
5. Weaning is the process of gradually introducing solid foods to an infant's
diet.

True False I don’t know

6. The World Health Organization recommends starting weaning when an

infant is around 6 months old.

True False I don’t know

30
7. Breast milk continues to provide important nutrients to an infant during
the weaning process

True False I don’t know

8. It is recommended to avoid cow's milk as a main drink for an infant under

12 months old, but it can be used in cooking and mixed with other foods.

True False I don’t know

9. Weaning an infant from breastfeeding too quickly can increase the risk of
breast engorgement, mastitis, and emotional distress for both the mother
and infant.

True False I don’t know

10.Introducing one new food at a time during weaning can help identify any
potential allergies or intolerances.

True False I don’t know

11.The introduction of solid foods during weaning can sometimes cause

constipation in infants, but offering plenty of fluids and high-fiber foods
can help prevent it.

True False I don’t know

12.It is recommended to avoid giving honey to an infant under one year old
due to the risk of infant botulism.

True False I don’t know

13.It is common for infants to start to refuse breast milk or formula during
weaning as they become more interested in solid foods, but it is important
to continue offering it to ensure they are getting enough nutrition.

True False I don’t know

31
14.Breast milk or formula should continue to be the main source of nutrition
for an infant during the weaning process, even as solid foods are
introduced.

True False I don’t know

32