BackgroundProvision of mother’s breast milk to infants within one hour of birth is referred to as Early Initiation of Breast Feeding (EIBF) which is an important strategy to reduce perinatal and infant morbidities and mortality. This study aimed to use recent nationally representative survey data to identify individual, household and community level factors associated with EIBF and to update on previous knowlegde with regards to EIBF in Nigeria.MethodsWe used cross-sectional data from the 2013 Nigerian Demographic and Health Survey (NDHS). Chi-square tests and binary logistic regression were used to test for association between EIBF and individual, household and community level factors.ResultThe proportion of infants who initiated breastfeeding within 1 h of birth was 34.7 % (95 % Confidence Interval (CI): 33.9–35.6). In the multivariate analysis, mothers who delivered in a health facility were more likely to initiate breastfeeding early as compared to mothers who delivered at home (Adjusted Odds Ratio (AOR) =1.40, 95 % CI = 1.22–1.60). The odds of EIBF was three times higher for mothers who had vaginal delivery as compared to mothers who had caesarean section (AOR = 3.08, 95 % CI = 2.14–4.46). Other factors that were significantly associated with increased likelihood of EIBF were; multiparity, large sized infant at birth, not working mothers as compared to mothers working in sales and other sectors, wealthier household index and urban residence. Mothers in the South West were less likely to inititiate breastfeeding within 1 h of birth as compared to the North West, however, the following geopolitical zones; North East, North Central, and South South had higher likelihood of EIBF when compared to the North West geopolitical zone.ConclusionEIBF in Nigeria is not optimal with just about 34.7 % of children initiating breastfeeding within one hour of birth, the results suggest that breastfeeding programmes and policies should give special attention to “rural mothers, working mothers, primiparous mothers, mothers with ceasarean deliveries, home deliveries and poor mothers” and this intervention should cut across geopolitical zones with more emphasis to zones with lower rates of EIBF.

To achieve a substantial increase in EBF rates in SSA, breast-feeding interventions and policies should target all women but with more emphasis to mothers with younger age, low educational status, urban residence, poor status, multiple births, and male infants. In addition, there is a need to promote antenatal care utilisation, hospital deliveries, and EIBF.

To achieve optimal breast-feeding, there is a need to discourage breast-feeding practices such as PLF. Breast-feeding promotion programmes should target the at-risk sub-population groups discovered in our study.

BackgroundPrelacteal feeding (PLF) is a barrier to exclusive breast feeding.ObjectiveTo determine factors associated with PLF in rural and urban Nigeria.MethodsWe utilized data from the 2013 Nigerian Demographic and Health Survey. Bivariate and multivariate analyses were used to test for association between PLF and related factors.ResultsPrevalence of PLF in urban Nigeria was 49.8%, while in rural Nigeria it was 66.4%. Sugar or glucose water was given more in urban Nigeria (9.7% vs 2.9%), plain water was given more in rural Nigeria (59.9% vs 40.8%). The multivariate analysis revealed that urban and rural Nigeria shared similarities with respect to factors like mother's education, place of delivery, and size of child at birth being significant predictors of PLF. Mode of delivery and type of birth were significant predictors of PLF only in urban Nigeria, whereas, mother's age at birth was a significant predictor of PLF only in rural Nigeria. Zones also showed variations in the odds of PLF according to place of residence.ConclusionInterventions aimed at decreasing PLF rate should be through a tailored approach, and should target at risk sub-groups based on place of residence.

ObjectiveThe present study aimed to give an overall view of the pattern of high-dose vitamin A supplementation (VAS) coverage in twenty-three sub-Saharan African countries and factors associated with receipt of VAS among children aged 6–59 months.DesignCross-sectional data from the twenty-three Demographic and Health Surveys conducted from 2011 to 2015 in twenty-three sub-Saharan African countries were pooled. A multilevel logistic regression model was used to explore factors associated with VAS.SettingTwenty-three sub-Saharan African countries.ParticipantsChildren (n 215 511) aged 6–59 months.ResultsThe overall coverage of VAS among children aged 6–59 months for the surveys included was 59·4 %. In the multivariable analysis, children whose mothers had primary (adjusted OR (aOR)=1·43; 95 % CI 1·39, 1·47) or secondary or above (aOR=1·72; 95 % CI 1·67, 1·77) educational status were more likely to receive VAS than children whose mothers had no formal education. Other factors associated with significantly increased likelihood of VAS were: living in urban areas; children of working mothers; children whose mothers had higher media exposure; children of older mothers v. children of mothers aged 15–19 years; and older children v. children aged 6–11 months. At the country level, lower media exposure was significant and negatively associated with VAS.ConclusionsBroader VAS coverage is needed according to our data. More efforts are needed to scale up coverage, focusing mostly on groups at risk of non-receipt of vitamin A.