Practice and Determinants of Exclusive Breastfeeding: A Cross-Sectional Study in Ondo, South-Western Nigeria
Keywords:
Continuous breastfeeding, Determinant, Exclusive breastfeeding, Knowledge, Practice, Sociodemographic, Timely complementary feedingAbstract
Exclusive breastfeeding (EBF) offers enormous benefits for both babies and mothers, but it is often not practiced in most developing countries. This study evaluated breastfeeding practices, and determined the sociodemographic characteristics that influenced EBF among mothers attending infant welfare clinic (IWC) in University of Medical Sciences Teaching Hospital (UNIMEDTH), Ondo Nigeria. This study adopted a cross-sectional study design with structured questionnaires to collect data from 170 mothers with children aged 0–18months. Mothers attending IWC from January 2025 to June 2025 were selected through simple random sampling. Breastfeeding practices in the last 24hours prior to this study were assessed based on the definition by the World Health Organization. Sociodemographic characteristics, level of knowledge and practices of EBF were obtained from eligible mothers. There was a universal awareness and high level of knowledge of EBF among mothers, but the level of practice low (28.2%, n=48/170). Mothers aged <25years [aOR4.54; 95% (CI) 0.63, 1.83], aged 26-30 years [aOR4.01; 95%CI 0.76, 2.01], who had tertiary education [aOR5.56; 95%CI 0.84, 2.56], who are civil servants [aOR4.54; 95%CI 0.43, 1.23], and who had spontaneous vagina delivery [aOR6.51; 95%CI 2.13, 3.0] were more likely to breastfeed their infants exclusively. EBF and timely complementary feeding practices are suboptimal. Age, educational status, occupation, and mode of delivery of mothers strongly predicted maternal practice of EBF. Interventions emphasizing on practical education should therefore be targeted at addressing these factors.
References
1. Adebayo A, Oluwaseyi O. Breastfeeding practices among mothers in Southwest Nigeria. Ethiop J Health Sci. 2020;30:697.
2. Afolabi OJ, Akinneye JO, Igiekhume AMA. Identification, abundance, and diversity of mosquitoed in Akure South Local government Area, Ondo State, Nigeria. JoBAZ. 2019.80;39.
3. Agho KE, Dibley MJ, Odiase JI, Ogbonmwan SM. Determinants of exclusive breastfeeding in Nigeria. BMC Pregnancy Childbirth. 2011;11:2.
4. Agunbiade OM, Ogunleye OW. Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: Implications for scaling up. Int Breastfeed J. 2012;7:5.
5. Ahmad MM, Sani UM, Abolodje E, Isah BA, Mohammed BA, Garba BI. Mothers' attitude and practices on breast feeding in Sokoto, North-Western Nigeria. Int J Health Sci Res. 2017;7:20–4.
6. Aidam BA, Perez-Escamilla R, Lartey A, Aidam J. Factors associated with exclusive breastfeeding in Accra, Ghana. Eur J ClinNutr. 2005;59:789–96.
7. Aidam BA, Perez-Escamilla R, Lartey A, Aidam J. Factors associated with exclusive breastfeeding in Accra, Ghana Eur J ClinNutr. 2005;59:789–96.
8. Akinyinka MR, Olatona FA, Oluwole EO. Breastfeeding knowledge and practices among mothers of children under 2 years of age living in a military barrack in Southwest Nigeria. Int J MCH AIDS. 2016;5:1–13.
9. Aladeniyi I, Adeniyi OV, Fawole O. Pattern and correlates of obesity among public service workers in Ondo State, Nigeria: a cross-sectional study. S Afr Fam Pract. 2017;1(1):1-6.
10. Alemayehu T, Haidar J, Habte D. Determinants of exclusive breastfeeding practices in Ethiopia. Ethiop J Health Dev. 2009;23:1.
11. Araoye M.O. Sample size determination in: Research Methodology with Statistics for health and social sciences. Nathadex Publishers Saw- mill Ilorin. 2003:115–21.
12. Asemahagn MA. Determinants of exclusive breastfeeding practices among mothers in Azezo district, Northwest Ethiopia. Int Breastfeed J. 2016;11:22.
13. Babakazo P, Donnen P, Akilimali P, Ali NMM, Okitolonda E. Predictors of discontinuing exclusive breastfeeding before six months among mothers in Kinshasa: a prospective study. Int Breastfeed J. 2015;10:19.
14. Cai X, Wardlaw T, Brown DW. Global trends in exclusive breastfeeding. Int Breastfeed J. 2012;7:12.
15. Casmir Ebirim CI, Dozie UW, Akor W, Dozie IJ, Ashiegbu OA. Exclusive breastfeeding practice and associated maternal socio-demographic factors among mothers attending Imo State Specialist Hospital, Owerri, South-Eastern Nigeria. Arch Community Med Public Health. 2016;2:27–31.
16. Danso J. Examining the practice of exclusive breastfeeding among professional working mothers in Kumasi metropolis of Ghana. Int J Nurs. 2014;1:1.
17. Dibley MJ, Roy SK, Senarath U, Patel A, Tiwari K, Agho KE, Mihrshahi S. Across-country comparisons of selected infant and young child feeding indicators and associated factors in four south Asian countries. Food Nutr Bull. 2010;31:2.
18. Ekanem IA, Ekanem AP, Asuquo A, Eyo VO. Attitude of working mothers to exclusive breastfeeding in Calabar, Municipality, Cross River State. Nig J Food Res. 2012;1:71–5.
19. Erkkola M, Salmenhaara M, Kronberg-Kippila C, Ahonen S, Arkkola T, Uusitalo L. Determinants of breast-feeding in a Finnish birth cohort. Public Health Nutr. 2010;13:4.
20. Fosu-Brefo R, Arthur E. Effect of timely initiation of breastfeeding on child health in Ghana. Health Econ Rev. 2015;5:8.
21. Friday J, Jane E. A qualitative exploration of the sociocultural determinants of exclusive breastfeeding practices among rural mothers, North-West Nigeria. EarlandInt Breastfeeding J. 2019;14:38.
22. Issaka AI, Agho KE, Burns P, Page A, Dibley MJ. Determinants of inadequate complementary feeding practices among children aged 6–23 months in Ghana. Public Health Nutr. 2014;18:4.
23. Jacdonmi I, Suhainizam MS, Suriani IB, Zoakah AI, Jacdonmi GR. Determinants of Exclusive breastfeeding continuity among mothers of infants under six months in Plateau State, Nigeria. Int J Health Sci Res. 2016;6:4.
24. Jino GB, Munyanshongore C, Birungi F. Knowledge, attitudes and practices of exclusive breastfeeding of infants aged 0–6 months by urban refugee women in Kigali Rwanda Med J. 2013;70:7–10.
25. Kabir I, Khanam M, Agho KE, Mihrshahi S, Dibley MJ, Swapan K, Royet SK. Determinants of inappropriate complementary feeding practices in infant and young children in Bangladesh: secondary data analysis of demographic health survey 2007. Matern Child Nutr. 2012;8:11–27.
26. Katsinde SM, Srinivas SC. Breast feeding and the sustainable development agenda. Indian J Pharm Prac. 2016;9:144–6.
27. Kimani-Murage EW, Madise NJ, Fotso JC, Kyobutungi C, Mutua MK, Gitau TM, Yatich N. Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health. 2011;11:396.
28. Mbada CE, Olowookere AE, Faronbi JO, Oyinlola-Aromolaran FC, Faremi FA, Ogundele AO. Knowledge, attitude and techniques of breastfeeding among Nigerian mothers from a semi-urban community. BMC Res Notes. 2013;6:552.
29. Mekuria G, Edris M. Exclusive breastfeeding and associated factors among mothers in Debre Markos, Northwest Ethiopia: a cross-sectional study. Int Breastfeed J. 2015;10:1.
30. Oche MO, Umar AS, Ahmed H. Knowledge and Practice of exclusive breastfeeding in Kware, Nigeria. Afr Health Sci. 2011;11:3.
31. Oche MO, Umar AS. Breastfeeding practices of mothers in a rural community of Sokoto, Nigeria. Nig Postgraduate J. 2008;15:101–4.
32. Ogbo FA, Agho KE, Page A. Determinants of suboptimal breastfeeding practices in Nigeria: evidence from the 2008 demographic and health survey. BMC Public Health. 2015;15:259.
33. Ogunlesi TA. Maternal socio-demographic factors influencing the initiation and exclusivity of breastfeeding in a Nigerian semi-urban setting. Maternal Child Health J. 2010;14:3.
34. Okafor IP, Olatona FA, Olufemi OA. Breastfeeding practices of mothers of young children in Lagos, Nigeria. Niger J Paed. 2014;41:43–7.
35. Oliemen P, Onyaye EK, Chika OD. Knowledge and practice of exclusive breast feeding among mothers in Gbarantoru community, Bayelsa State, Nigeria. IOSR J Dental Med Sci. 2013;1:34–40.
36. Onah S, Osuarah DIC, Ebenebe J, Ezechukwu C, Ekwochi U, Ndukwu I. Infant feeding practices and maternal socio-demographic factors that influence practice of exclusive breastfeeding among mothers in Nnewi south- East Nigeria: a cross-sectional and analytical study. Int Breastfeed J. 2014;9:6.
37. Patel A, Badhoniya N, Khadse S, Senarath U, Agho KE, Dible MJ. Infant and young child feeding indicators and determinants of poor feeding practices in India: secondary data analysis of National Family Health Survey 2005–06. Food Nutr Bull. 2010;31:2.
38. Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387:491–504.
39. Safari JG, Kimambo SC, Lwelamira JE. Feeding practices and nutritional status of infants in Morogoro municipality, Tanzaniea. Tanzania J Health Res. 2013;15:3.
40. Salami LI. Factors Influencing Breastfeeding Practices in Edo state, Nigeria. AJFAND. 2006;6(2):1–12.
41. Sanusi RA, Leshi OO, Agada UN. Mother's knowledge and practice of breastfeeding and complementary feeding in Enugu State, Nigeria. J Res Nur Midwifery. 2016;5:21–9.
42. Seid AM, Yesuf ME, Koye DN. Prevalence of exclusive breastfeeding practices and associated factors among mothers in Bahir Dar City, Northwest Ethiopia: a community based cross-sectional study. Int Breastfeed J. 2013;8:14.
43. Semahegn A, Tesfaye G, Bogale A. Complementary feeding practice of mothers and associated factors in HiwotFana specialized hospital, eastern Ethiopia. Pan African Med J. 2014;18:143.
44. Senarath U, Dibley MJ, Agho KE. Breastfeeding practices and associated factors among children under 24 months of age in Timor-Leste. Eur J ClinNutr. 2007; 61: 387–10.
45. Setegn T, Belachew T, Gerbaba M, Debribe K, Deribew A, Biadgilign S. Factors associated with exclusive breastfeeding practices among mothers in Goba district, South East Ethiopia: a cross-sectional study. Int Breastfeed J. 2012;7:17.
46. Setegn T, Gerbaba M, Belachew T. Determinants of timely initiation of breastfeeding among mothers in GobaWoreda, south East Ethiopia: a cross sectional study. BMC Public Health. 2011;11:217.
47. Shifraw T, Worku A, Berhane Y. Factors associated exclusive breastfeeding practices of urban women in Addis Ababa public health centers, Ethiopia: a cross sectional study. Int Breastfeed J. 2015;10:22.
48. Tampah-Naah AM, Kumi-Kyereme A. Determinants of exclusive breastfeeding among mothers in Ghana: a cross-sectional study. Int Breastfeed J. 2013;8:13.
49. Tan KL. Factors associated with exclusive breastfeeding among infants under six months of age in peninsular Malaysia. Int Breastfeed J. 2011;6:2.
50. Tawiah-Agyemang C, Kirkwood BR, Edmond K, Bazzano A, Hill Z. Early initiation of breast-feeding in Ghana: barriers and facilitators. J Perinatol. 2008;28:S46–52.
51. Ulak M, Chandyo RK, Mellander L, Shrestha PS, Strand TA. Infant feeding practices in Bhaktapur, Nepal: across-sectional, health facility based survey. Int Breastfeed J. 2012;7:1.
52. Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387:475–90.
53. Vieira TO, Veiria GO, de Oliveira NF, Mendes MC, Giuglinia ER, Silva LR. Duration of exclusive breastfeeding in Brazilian population: a new determinant in a cohort study. BMC Pregnancy Childhealth. 2014;14:175.
54. Wanjohi M, Griffiths P, Wekesah F, Muriuki P, Muhia N, Musoke RN. Sociocultural factors influencing breastfeeding practices in two slums in Nairobi, Kenya. Int Breastfeeding J. 2016;12:5.
55. World Health Organization. Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6–8 November 2007 in Washington D.C., USA. Geneva: World Health Organization; 2008.