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[86

CHAPTER THREE
RESEARCH METHODOLOGY

3.0 INTRODUCTION

This chapter comprised of the research design, location of the study,target

population,sampling procedure and sampling size, research instruments, pilot study, data
collection technique,method of data analysis.

3.1RESEARCH DESIGN

The research design refers to the overall structure and strategy of the research study Coolian
(2009).The research design that was adopted for this study was descriptive survey design used
to carefully examine challenges of exclusive breastfeeding among working class women in
Karshi,FCT.

3.2 RESEARCH SETTING

The research setting selected for this study was Karshi General Hospital.Karshi General
Hospital is located in the Federal Capital Territory,Opposite NYSC Zonal Headquarters,
Karshi,Abuja FCT, is a satellite town situated in Abuja Municipal Area Council in Nigeria. Its
geographical coordinates are 8° 49' 40" North, 7° 33' 0" East. Karshi is about 38 km to Federal
capital city of Abuja and 41 km from Karshi to Apo.

Karshi General Hospital is an accredited hospital with license and offers medical services
such as; all medical care, surgery,maternal care,ambulance,mortuary,laboratory,diagnosis
centre,online operators and pharmacy.
The Antenatal clinic in Karshi General Hospital is an active clinic that runs fromn Monday
to Friday of every week (excluding Wednesday) between 7am-Ipm. The activities of the clinic
include booking visits for new pregnant women and routine antenatal visit for booked clients.
[85K/s

This study will be conducted among working mothers attending antenatal clinic in Karshi
General Hospital Abuja,between 4t and 18th October, 2021. The clinic attends to an average
of 40 clients on clinicdays,that is, 160 clients every week,however, the population was studied
for two (2)weeks which made a total of 320.

3.4 SAMPLE SIZE

According to Osuala (2007), a sample is a subject of a population, a proportion chosen

to stand in for the entirety of all the subjects or observation under consideration. To be
effectively used to draw inferences about population, a sample size must be representative of
the population.A representative sample is one that has all the characteristics of the
population from where it has been chosen.Sampling size is the total number of elements in
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the sample. It is normally denoted by 'n' the total number of the population elements is often
designated as 'N'

To calculate the sample size required, the Yamane's formula was used

Where n is the sample size

N is the number of working mothers registered to attend antenatal clinic in Karshi
General Hospital,betweenand18th October,2021 e is the level of precision which is
0.05.

n=

A10%allowance for unusable data and incomplete questionnaires was added.

Thus,sample size rn=196

3.5 SAMPLING TECHNIQUE

This is a procedure of sampling in which the choice of a particular element does not
jeopardize the chance of other element being selected into the sample. It is a method of
sampling done in such a way that every possible sample of size 'n' out of a population size N
has equal

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[85K/s

This study will be conducted among working mothers attending antenatal clinic in Karshi
General Hospital Abuja,between 4t and 18th October, 2021. The clinic attends to an average
of 40 clients on clinicdays,that is, 160 clients every week,however, the population was studied
for two (2)weeks which made a total of 320.

3.4 SAMPLE SIZE

According to Osuala (2007), a sample is a subject of a population, a proportion chosen

to stand in for the entirety of all the subjects or observation under consideration. To be
effectively used to draw inferences about population, a sample size must be representative of
the population.A representative sample is one that has all the characteristics of the
population from where it has been chosen.Sampling size is the total number of elements in
the sample. It is normally denoted by 'n' the total number of the population elements is often
designated as 'N'

To calculate the sample size required, the Yamane's formula was used

Where n is the sample size

N is the number of working mothers registered to attend antenatal clinic in Karshi
General Hospital,betweenand18th October,2021 e is the level of precision which is
0.05.

n=

A10%allowance for unusable data and incomplete questionnaires was added.

Thus,sample size rn=196

3.5 SAMPLING TECHNIQUE

This is a procedure of sampling in which the choice of a particular element does not
jeopardize the chance of other element being selected into the sample. It is a method of
sampling done in such a way that every possible sample of size 'n' out of a population size N
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has equal

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chance of being chosen in other words, in a simple random sample, each unit of the population has
exactly the same chance as any other of being included on the sample. This research adopted simple
random sampling technique to select the population of thestudy.One of the advantages of random
sampling technique is that it is a reliable procedure for the choice of random samples.

3.6 METHOD OF DATA COLLECTION

Data will be collected using a structured questionnaire which contain the following sections:

SECTION A:Socio-demographic data/information of the respondents

SECTION B: The knowledge of exclusive breastfeeding
SECTION C: The influence of organization culture on exclusive breastfeeding
SECTION D: The challenges of exclusive breastfeeding on working class mothers.

3.7 VALIDITY OF INSTRUMENT

The instrument will be validated through review by the researcher's supervisor to ascertain face and
content validity, and also to check for any unclear and ambiguous question for modification.

3.8 ETHICAL CONSIDERATION

The ethical clearance will be obtained from the ethical committee of Karshi General Hospital.

Abuja through a letter of permission. Also informed consent of participants will be requested.

3.9 METHOD OF DATA COLLECTION

Data will be collected through face to face administration of the copies of the questionnaire from
respondents.Data was collected by the researcher and a research assistant during the antenatal days
from Monday It to Monday 18th October,2021.

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chance of being chosen in other words, in a simple random sample, each unit of the population has
exactly the same chance as any other of being included on the sample. This research adopted simple
random sampling technique to select the population of thestudy.One of the advantages of random
sampling technique is that it is a reliable procedure for the choice of random samples.

3.6 METHOD OF DATA COLLECTION

Data will be collected using a structured questionnaire which contain the following sections:

SECTION A:Socio-demographic data/information of the respondents

SECTION B: The knowledge of exclusive breastfeeding
SECTION C: The influence of organization culture on exclusive breastfeeding
SECTION D: The challenges of exclusive breastfeeding on working class mothers.

3.7 VALIDITY OF INSTRUMENT

The instrument will be validated through review by the researcher's supervisor to ascertain face and
content validity, and also to check for any unclear and ambiguous question for modification.

3.8 ETHICAL CONSIDERATION

The ethical clearance will be obtained from the ethical committee of Karshi General Hospital.

Abuja through a letter of permission. Also informed consent of participants will be requested.

3.9 METHOD OF DATA COLLECTION

Data will be collected through face to face administration of the copies of the questionnaire from
respondents.Data was collected by the researcher and a research assistant during the antenatal days
from Monday It to Monday 18th October,2021.

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CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS

4.0 Introduction

This chapter presented and analysed the data collected on the Challenges of Exclusive
Breastfeeding among Working Class women in Karshi, Abuja. A total of 196 questionnaires were
distributed with 100% return rate.

4.1.DATA PRESENTATION AND ANALYSIS

Table 1:socio-demographic characteristics of the women

Variables Frequency Percentage%
Age(years)
18-22 6 3
23-27 23 12
28-32 40 21
33-37 101 53
38-45 18 9
43-47 8 4

Total 196 100

Marital status

Single 19 10
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Married 179 90
Total 196 100

Religion

Christianity 130 66
Islam 66 34
Total 196 100.0

Educational qualification

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None 10 5

Primary 23 12

Secondary 118 60

Tertiary 45 23

Total 196 100

Occupation

Civil servant 113 58

Self-employed 83 42

Total 196 100

Ethnicity
Yoruba 111 57

Igbo 44 22
Hausa 34 17

others 7 4

Total 196 100

Number of children
1 33 17

2 69 35

3 58 30
4 18 9

5 18 9

Total 196 100

Income status

<40,000/month 80 41

41,000-70,000 94 48

71,000-100,000 22 11

Total 196 100.0

From the table above,majority of the respondents 101 (53%) are within the age range of 33-37,

while 179(90%) were married,130(66%) were Christians,however,118(60%)had secondary

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school education,while 113(58%)were civil servants, 111(57%) were from

the Yoruba ethnic group,notwithstanding 58(30%) has had 2 children while
94(48%) income status ranges from 41,000-70,000
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Table 2: Knowledge ofWomen on Breastfeeding

Variables Frequency Percentage %
Have you heard about Exclusive breastfeeding?
Yes 185 94
No 7 6
Total 196 100.0
Were you at any time educated on exclusive breastfeeding?
Yes 195 98
No 4 2
Total 196 100.0
What is the source of your information?
Media 21 10
Hospital 119 61
Friends/relations 56 29
Total 196 100
How long should your baby be exclusively breastfed for?
6months 125 64
lyear 41 21
3months 26 13
I don't know 4 2
Total 196 100
Breastfeeding should be continued for up to 2 years of life
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Yes 81 41
No 94 48
I don't know 21 11
Total 196 100
You are allowed to give your baby vitamins and supplements while
breastfeeding your baby
Yes 64 33
No 110 56
I don't know 22 11
Total 196 100

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Giving water is encouraged to the baby after every breastfeeding

Yes 93 47
No 103 53
Total 196 100
Supplementing breast milk with formula during the first week of life is good
Yes 25 13
No 171 87
Total 196 100
Exclusive breastfeeding can be used as a family planning method
Yes 141 72
No 55 28
Total 196 100
Yes 129 66

No 67 34
Total 196 100
Exclusive breastfeeding helps in weight loss
Yes 167 85
No 26 13
Total 196 100
Complementary feeds can be introduced after 6 months of life
Yes 174 89
No 22 11
Total 196 100
Exclusive breastfeeding helps in protecting the baby from illness and allergies
Yes 180 92
No 16 8
Total 196 100

Table 2 above focusses on the knowledge of women towards EBS, from the table,it was

revealed that 185(94%) have heard about exclusive breastfeeding, 195(98%) have been
educated at some point about exclusive breastfeeding, 119(61%) said their source of
information was from
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the hospital.Nevertheless, 125(64%) said baby should be exclusive breastfed upto six month while

81 (41%) said breastfeeding should be continued till 2years while 94(48%) said no.However, 64(33%)

said yes to being allowed to give vitamins and supplements while 110(56%)said no.

Also,93(47%) said yes to giving baby water after every breastfeeding while 103(53%) said No,that

water is not allowed after every breastfeeding.Nevertheless,25(13%) said no while 11(87%) to

supplementing breast milk with formula during the first week of life is good.

Moreover,141(72%)were of the opinion that exclusive breastfeeding can be used as a family

planning method while 55(28%) were on the contrary. Also, 129(72%) opined that a woman who is

exclusively breastfeeding is less likely to get pregnant while 67 (34%) said no to the assertion.Also,

167(85%) said yes to exclusivebreastfeeding helping them to lose weight while a minority of 67(34%)

objected. Nevertheless, 174(89%) said complementary feeds can be introduced after 6 months of

life while 22(11%) were of a contradictory opinion. Moreso, 180(92%)said exclusive breastfeeding

helps in protecting the baby from illness and allergies while 16(8%) said no.

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Table 4: Practice of Breastfeeding among Women

Variables Frequency Percentage %

How often should a baby breastfeed?
On demand 117 60
By routine 55 28
I dont know 24 12
Total 196 100.0
How often does your baby breastfeed?
5-6times/day 13 7
7-8times/day 83 42
More than 9 times/day 31 16
Total 196 100.0
How soon after delivery did your baby breastfeed?
Immediately 120 61
Before the end of the day 59 30
After 24 hours 17 9
Total 196 100.0
Do you intend to give your baby formula milk in the first six months of life
Yes 82 42
No 114 58
Total 196 100.0
Do you give your baby any artificial food?
Yes 117 60
No 79 40
Total 196 100.0
If your answer is yes, which type of artificial food
Pap/gruel 23 20
Water 47 40
Custard 20 17
Goldenmorn 14 12

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Fiso gold 13 11
Total 117 100
Breastfeeding should be continued up to 2 years of life even though the baby
has received solid food
Yes 125 64
No 71 36
Total 196 100
Should baby be given water after breastfeeding?
Yes 62 32
No 134 68
Total 196 100.0
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Have you tried exclusive breastfeeding as a family planning method before?
Yes 70 36
No 126 64
Total 196 100.0

Table 4 reveals the practice of breastfeeding among women, from the table it was shown that
117(60%) which represented a majority wereof the opinion that babies should be breastfed on
demand,55(28%) were of the opinion that babies should be breastfeed by routine,also 83(42%)of
the respondents indicated that babies are breastfeed 7-8times a day,31(16%) indicated that they
are breastfed more than 9 times a day while a minority 13(7%) indicated 5-6times a
day.However,120(61%) indicated that they breastfeed their babies immediately after delivery
while 59(30%) indicated they breastfeed before the end of the day whereas a minority
representing 17(9%) indicated they breastfeed after 24 hours.Nevertheless, a strong majority
representing 114(58%) said they did not intend to give their babies formula milk in the first six
months of life whereas 82(42%) were of the contrary opinion. Also 117(70%) opined that they
give their babies artificial food with 47(40%) indicating water as a type of artificial food given
followed by pap/gruel with 23(20%)

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Nevertheless, 125(64%) of the respondents indicated that breastfeeding should be continued upto
2 years of life even though the baby has received solid food,whereas, 71(36%) were of the contrary
view. Moreso, 62(32%) of the respondents admitted to giving their babies water after breastfeedng
whereas 134(68%) disagreed. Nevertheless,70(36%) admitted to trying exclusive breastfeeding as a
family planning method before while 126(64%) said they haven't tried it before.
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Items Strongly Agreed Strongly
Table 5:Challenges of Exclusive Breastfeeding
Agreed among(%) disagreed
working class women Disagree
(%) (%) d
(%)
Husband does not support 12(6)
Exclusive breastfeeding 85(43) 74(38) 25(13)
Cracked,sore nipples 74(38) 70(36) 42(21) 10(5)

Health condition of the mother 111(57) 62(31) 16(8) 7(4)

Health condition of the baby 106(54) 12(6) 14(7)

64(32)
Work schedule 109(56) 55(28) 28(14) 4(2)
Number of children 17(9) 16(8) 131(67) 32(16)
Maternity leave of 3 months
is not long enough for 125(64) 38(19) 20(10) 13(7)
successful breastfeeding
Selected places to
breastfeed at the workplace 84(43) 57(29) 34(17) 21(11)
Feeling shy of breastfeeding
150(77) 16(8) 10(5) 20(10)
in public
Sociocultural pressure 99(51) 64(33) 19(10) 14(7)
Inadequate production of milk 75(38) 74(38) 41(21) 6(3)
Table 5 revealed the challenges of exclusive breastfeeding among working class women,from
the table it was revealed that 85(43%) of the respondents strongly agreed that husband does
not support exclusive breastfeeding, 74(38%) strongly agreed that cracked/sore nipples was a
challenge to exclusive breastfeeding closely followed by 70(36%) who also agreed whereas
42(21%) strongly disagreed. Nevertheless, health condition of the baby was considered a great
factor as seen by 111(57%) who strongly agreed with 62(31%) who also agreed while
16(8%)strongly disagreed and 7(4%6)disagreed. Also,health condition of the baby was also a
factor that affects exclusive breastfeeding as 106(54%) strongly agreed and 64(32%) agreed
while 12(6%)

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strongly disagreed and 14(7%) disagreed. Nevertheless, work schedule of the mother was a
major challenge as 109 (56%) strongly agreed closely followed by 55(28%) agreed meanwhile
28(14%) strongly disagreed and 4(2%) disagreed. Nevertheless, 17(9%) strongly agreed that
number of children was a challenge to exclusive breastfeeding and 16(8%) also agreed but
131(67%) strongly disagreed and 32(16%) disagreed that number of children does not affect
exclusive breastfeeding. However, 125(64%) strongly agreed and was followed by 38
(19%)agreed that maternity leave of 3 months is not long enough for successful breastfeeding
while 20(10%)strongly disagreed and 13(7%) strongly disagreed that maternity leave of 3month
is sufficient enough for exclusive breastfeeding. Notwithstanding, 84(43%) strongly agreed and
57(29%) agreed that selected places to breastfeed at workplace was a challenge.
Moreso,150(77%) strongly agreed and 16(8%) agreed that feeling shy of breastfeeding in public
was a challenge while 10(5%) strongly agreed and 20(10%) disagreed that they don't feel shy
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breastfeeding in public. Furthermore, 99(51%) strongly agreed with 64(33%) agreed that
sociocultural pressure was a challenge while 19(10%) and 14(7%) strongly disagreed that
sociocultural pressure is not a challenge. Nevertheless, 75(38%) strongly agreed and
74(38%)agreed that inadequate production of milk was one of the challenges to exclusive
breastfeeding while 41(21%) strongly disagreed and 6(3%) disagreed that to the assertion.

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CHAPTER FIVE

DISCUSSION OF FINDINGS,SUMMARY,CONCLUSIONS, RECOMMENDATIONS,

AND SUGGESTIONS FOR FURTHER STUDIES

5.0 INTRODUCTION

The chapter dwells on discussion of findings and results, conclusion, nursing implication of
the work,recommendations and suggestions for further studies.

5.1 DISCUSSION OF FINDINGS

The result of this study showed that more than half of the respondents are within the age

range 31-40years and a strong majority of the respondents were married with a good knowledge of

exclusive breastfeeding. Majority of the respondents' are educated with qualification all level of

education. Majority of the respondents were both working classed and self-employed with an

average income status. This result is similar to the result of the study conducted by Nankumbi and

Muliira (2015) observed that challenges in relation to appropriate infant and young child-feeding

practices are mothers' knowledge about complimentary feeding, influence of culture custodians on

mothers, and patterns and burden of other responsibilities the mothers have in the household.

The result from this current study revealed that majority of the respondents said babies

should be exclusively breastfed for 6mnonths. All the respondents had heard about exclusive

breastfeeding and that they have been educated on exclusive breastfeeding. Most of the

respondents' source of information is the hospital. This finding is similar to a study carried out by

Mulugeta, Netsanet, Nigusie and Selam (2018), which reported that the major source of information

of majority of the women was health institutions.

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The findings from this study showed that majority of the respondents have good practice
of exclusive breastfeeding. This is consistent with a study carried out by Onah,Osuorah and
Ndukwu (2014) which also revealed that the practice of EBF is fair. Meanwhile, the result from
this current study disagree with a study carried out by Agbo et al.,(2013),which revealed that the
practice of EBF was done by only minority of the women.
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5.2 SUMMARY

The purpose of this study was to assess the challenges of exclusive breastfeeding among
working class women in Karshi, FCT.The researcher conducted an extensive literature review to
gain information on previous related studies done in order to get an in-depth understanding of
the topic. The researcher used a structured questionnaire to collect data, which was analyzed
and revealed that the knowledge of exclusive breastfeeding was 70%, the practice of exclusive
breastfeeding was 30%. Some of the challenges of exclusive breastfeeding identified were time
consuming and sometimes these women have sore/painful nipples.

5.3 IMPLICATION TO NURSING

Nurses/midwives are burdened with the task to safeguard mothers attending Antenatal
clinic as well as the public are knowledgeable about appropriate way of breastfeeding
Nurses/Midwives having knowledge of Exclusive Breast Feeding should teach women the
importance of exclusive breastfeeding to both mothers and baby, as this will help inform mothers
and the community at large on the effect the practice of non-exclusive breastfeeding will have on
both mother and baby which will improve the overall practice of exclusive breastfeeding and also
improve the child's well-being. Nurses and midwives in various health care facilities are to
partake in the formulation of policies that will enhance the practice of exclusive breastfeeding.

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This study has shown that the women have good knowledge and practice of exclusive
breastfeeding as well as good practice of breastfeeding. The most challenging factors of breastfeeding
identify in this study were condition of the sore nipples, inadequate production of milk and work
schedule.

5.5 RECOMMENDATIONS

Based on the findings of this study the following were recommended:

i. The government should formulate policies that will be generally accepted by the public on
exclusive breastfeeding.

ii. The community and the government should work together to ensure that every girl-
child is educated, and guarantee that workplace is free of harassment and discrimination
against women who prefer to breastfeed their babies through appropriate mechanisms.

iii. Health sector should mandate that proper health education is carried out in hospitals
for pregnant women receiving antenatal care in their facilities.
iv. The midwife should ensure the mother and the baby are prevented or treated for any
disease that may hinder breastfeeding

V. Professional working mothers must initiate and arrange childcare for the infants close
to the mother's work place to enable their babies to be brought to the workplace or
breastfeeding mothers to go to the child care facility at breastfeeding period.

vi. This study demonstrates the need to educate women on early treatment of any post-
partum morbidity in order to ensure proper EBF practices.
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5.6 SUGGESTIONS FOR FURTHER STUDIES

Further studies should be conducted with a larger sample and in a different geographical
region in order to ascertain the findings of this study. Studies should also explore policies

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842 12:23

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ensuring and guaranteeing breaks from work for working mothers to breastfeed babies particularly
during the time frame for exclusive breastfeeding.

REFERENCES

Agbo HA,Envuladu EA,Adams HS, Inalegwu E, Oko E, et al.(2013) Barriers and facilitators to
the practice of exclusive breastfeeding among working class mothers: A study of female
resident doctors in tertiary health institutions in Plateau state. Journal of Medical Research
2:0112-0116.

Agu M,Agu MC (2011)Knowledge and practice of exclusive breastfeeding among mothers in a

rural population in Southeastern Nigeria.Tropical Journal of Medical Research 15:2.

Akinyinka M,Olatona F,Oluwole E(2016)Breastfeeding knowledge and practices among

mothers of children under 2 years of age living in a military barrack in southwest
Nigeria.International Journal of MCH and AIDS5:1-13.

American Pregnancy Association (2015)from What's in Breast Milk?

http://americanpregnancy.org?first-year-oflife?whats-in-breastmilk/.
Bhadra K (2012) Advantages and Disadvantages of Exclusive Breastfeeding.from UNICEF
Neonatal Care:http://www.babycare.onlymyhealth.com?advantages-
disadvantagesexclusive-breastfeeding-1338206371.

Bjarnadottir A (2017)11 Benefits of breastfeeding for both mom and baby.

Caesar GV.(2015,April). Association between breastfeeding and intelligence,educational

attainment, and income at 30 years of age: a prospectiv birth chort study from
Brazil.Science Direct 3:e199-e205.

Caesar GV(2016)Breasfeeding in the 21st Century:epidemiology,mechanisms and

lifelong effects 387:475-490.

CBHS Health Fund Blog (2018) The advantages of breastfeeding,from

http://www.cbhs.com.au/health-wellbeing-blo/blog-article/2014/11/24/the-advantages-
ofbreastfeeding.

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