Predictors of breastfeeding practices among mothers in a developing African country – A tertiary facility based study in Calabar, Nigeria

Abstract

Introduction: Breastfeeding is essential for optimum childhood development. Although there is an increased awareness of the importance of breast milk, the Nigerian Demographic and Health Survey of 2018 showed that less than one-third (29%) of mothers in Nigeria practice exclusive breastfeeding. This may be attributed to several factors, hence the need for this study to assess the indicators and predictors of breastfeeding practices among mothers in a tertiary facility in Calabar, Cross River State. Methods: This cross-sectional study was conducted in the University of Calabar Teaching Hospital, Calabar, Nigeria. Consenting mothers of children aged six weeks to two years were sequentially recruited into the study using an interviewer-administered questionnaire. A test of association of categorical variables was done using Chi square test and pvalue was set at 0.05. Results: One hundred and twenty one children and their mothers were surveyed. Mean age of children was 6.2±3.8months and mothers was 28±25years. Exclusive breastfeeding rate for six months was 67.8%.Timely breastfeeding within one hour of life was 44.6%,ever breastfed rate was 86%. Practice of giving water alongside breast milk and use of breast milk substitute was 18.2% and 14.0% respectively. Mothers age was significantly associated with practice of exclusive breastfeeding (p=0.014) and giving water alongside breast milk (p=0.005) while birth order was associated with timely commencement of breastfeeding within one hour of life (p=0.022). Conclusion: The ever breastfed and exclusive breastfeeding rates were fairly high. However, the timely first suckling rate, increased use of breast milk substitute and giving of water alongside breast milk in the first six months of life were low. There is the need for continuous health education of mothers.

Assessment of the Baby‐Friendly Hospital Initiative showed suboptimal knowledge and a low exclusive breastfeeding rate in Ogun State, Nigeria

“…Less than half (45.5%) of the mothers in this study put their babies to breast within 1 h after delivery. This is similar to the average national rate of 42.1% reported in the Nigeria Demographic and Health Survey 7 as well as another report from South–south Nigeria (44.6%), 21 but lower than the rates observed in Ghana (63.4%), Bangladesh (67%) and Uganda (68%) 22–24 . The differences noted may be related to the practices of the healthcare workers at the delivery centres, in addition to other factors such as neonatal and maternal health status 24 …”

“…Less than half (47.3%) of the mothers in this study practised exclusive breastfeeding for 6 months. This exclusive breastfeeding rate is higher than the 29% reported by the Nigeria Demographic and Health Survey 7 but lower than some other Nigerian reports 21,25 . The observed rate is also at variance with other African, Asian and European studies which mostly reported lower rates 26–28 .…”

“…This exclusive breastfeeding rate is higher than the 29% reported by the Nigeria Demographic and Health Survey 7 but lower than some other Nigerian reports. 21,25 The observed rate is also at variance with other African, Asian and European studies which mostly reported lower rates. [26][27][28] Sociocultural factors, beliefs, work demands and family support systems may be contributory factors to the differences observed.…”

Complementary Feeding in Western Cape, South Africa: Identifying Suboptimal Practices and Potential Targets for Intervention

“…Early initiation of breastfeeding within one hour of birth in this study was observed in 72.4% of infants. This rate is higher than the United Nations Children’s Fund (UNICEF) global database rate of 45% [ 11 ], the South African rate of 63% based on the 2015 UNICEF data [ 10 ], and the rate of 44.6% in Calabar, Nigeria [ 12 ]. This high rate shows that there is an increase in the awareness and importance of breastfeeding among mothers of infants studied.…”

“…Kruger et al [ 8 ] and MacIntyre et al [ 13 ] documented the commencement of complementary food as early as one month and six weeks of life, respectively, in South Africa. Ikobah et al [ 12 ] documented an early commencement of complementary food at one month of life in Calabar, Nigeria. Studies in Tanzania [ 14 ], Kenya [ 15 ], and Malawi [ 16 ] have shown early commencement of complementary feed at ages 2-3 months of life.…”