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Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Determinants of suboptimal breastfeeding practices in Nigeria: evidence from the 2008 demographic and health survey

Authors: Felix A Ogbo, Kingsley E Agho, Andrew Page

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

In Nigeria, suboptimal breastfeeding practices are contributing to the burden of childhood diseases and mortality. This study identified the determinants of key suboptimal breastfeeding practices among children 0–23 months in Nigeria.

Method

Data on 10,225 children under-24 months were obtained from the 2008 Nigeria Demographic and Health Survey (NDHS). Socio-economic, health service and individual factors associated with key breastfeeding indicators (early initiation of breastfeeding, exclusive breastfeeding, predominant breastfeeding and bottle feeding) were investigated using multiple logistic regression analyses.

Results

Among infants 0–5 months of age, 14% [95% confidence Interval (CI): 13%, 15%] were exclusively breastfed and 48% [95% CI: 46, 50%] were predominantly breastfed. Among children aged 0–23 months, 38% [95% CI 36, 39%] were breastfed within the first hour of birth, and 15% [95% CI: 14, 17%] were bottle-fed. Early initiation of breastfeeding was associated with higher maternal education, frequent antenatal care (ANC) visits and birth interval but deliveries at a health facility with caesarean section was associated with delayed initiation of breastfeeding. Educated mothers, older mothers and mothers from wealthier households exclusively breastfeed their babies. The risk for bottle feeding was higher among educated mothers and fathers, and women from wealthier households including mothers who made frequent ANC visits.

Conclusion

Socio-economic and health service factors were associated with suboptimal breastfeeding practices in Nigeria. To improve the current breastfeeding practices, breastfeeding initiatives should target all mothers – particularly low SES mothers – including, national and sub-national health policies that ensure improved access to maternal health services, and improvements to baby friendly hospital and community initiatives for mothers.
Appendix
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Literature
1.
Ladomenou F, Moschandreas J, Kafatos A, Tselentis Y, Galanakis E. Protective effect of exclusive breastfeeding against infections during infancy: a prospective study. Arch Dis Child. 2010;95(12):1004–8.CrossRefPubMed
2.
World Health Organization. WHO Collaborative study team on the role of breastfeeding on the prevention of infant mortality effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet. 2000;355(9202):451–5.CrossRef
3.
World Health Organisation. The global strategy for infant and young child feeding. Geneva: WHO; 2003.
4.
Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Rockville, MD: US Department of Health and Human Services; 2007.
5.
Dezoysa RM, Martines J. Why promote feeding in diarhhoea disease control programmes. Health Policy Plan. 1991;6:371–9.CrossRef
6.
World Health Organization. Indicators for accessing breastfeeding practices. In: WHO/CDD/SER/91.1, editor. 1991, Geneva: World Health Organization.
7.
8.
9.
Kramer MS, Kakuma R. The optimal duration of exclusive breastfeeding: a systematic review. Adv Exp Med Biol. 2004;554:63–77.CrossRefPubMed
10.
United Nations Children’s Fund (UNICEF). BREASTFEEDING ON THE WORLDWIDE AGENDA Findings from a landscape analysis on political commitment for programmes to protect, promote and support breastfeeding. NY USA: UNICEF; 2013.
11.
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.CrossRefPubMed
12.
Black R, Morris SS, Bryce J, The Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371:243–60.CrossRefPubMed
13.
Ogunlesi T, Dedeke O, Okeniyi J, Oyedeji G. Infant and toddler feeding practices in the Baby Friendly Initiative (BFI) Era In Ilesa, Nigeria. Int J Nutr Wellness. 2004;1:2.
14.
National Population Commission (NPC) [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey 2013. Calverton, Maryland, USA: National Population Commission and ICF Macro; 2013.
15.
Ogunlesi TA. Maternal socio-demographic factors influencing the initiation and exclusivity of breastfeeding in a Nigerian semi-urban setting. Matern Child Health J. 2010;14(3):459–65.CrossRefPubMed
16.
17.
Yahya BW, Adebayo BS. Modelling the trend and determinants of breastfeeding initiation in Nigeria. Child Dev Res. 2003;1:1–9.
18.
Center for Disease Control and Prevention. Breastfeeding Report Card 2012, United States: outcome indicators. Atlanta, USA: Center for Disease Control and Prevention; 2012.
19.
Victor R, Baines SK, Agho KE, Dibley MJ. Determinants of breastfeeding indicators among children less than 24 months of age in Tanzania: a secondary analysis of the 2010 Tanzania Demographic and Health Survey. BMJ Open. 2013;3(e001529):1.
20.
Kenya National Bureau of Statistics, MEASURE DHS, and ICF Macro. Kenya Demographic and Health Survey, 2008–09. Calverton, Maryland, USA: Kenya National Bureau of Statistics, Nairobi and ICF Macro; 2010.
21.
World Health Organization. Data bank on infant and young child feeding on Nigeria. Geneva, Switzerland: World Health Organisation; 2010.
22.
Salami L. Factors influencing breastfeeding practices in Edo state, Nigeria. Afr J Food Agric Nutr Dev. 2006;6(2):1–12.
23.
Ekure EN, Antia-Obong ON, Udo JJ, Edet EE. Maternal exclusive breastfeeding practice in Calabar Nigeira: some related social characteristics. Nigeria J Clin Pract. 2003;6(2):92–4.
24.
Maduforo AN, Ubah NC, Obiakor–okeke PN. The practice of exclusive breastfeeding by lactating women in Owerri metropolis, Imo State, Nigeria. Global Adv Res J Med Med Sci. 2013;2(1):13–9.
25.
Ukegbu AU, Ukegbu PO, Onyeonoro UU, Ubajaka CF. Determinants of breastfeeding patterns among mothers in Anambra State, Nigeria. South Afr J Child Health. 2011;5:4.
26.
Qureshi AM, Oche OM, Sadiq UA, Kabiru S. Using community volunteers to promote exclusive breastfeeding in Sokoto State, Nigeria. Pan Afr Med J. 2011;10:8.CrossRefPubMedPubMedCentral
27.
Agunbiade OM, Ogunleye OV. Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: implications for scaling up. Int Breastfeed J. 2012;7:5.CrossRefPubMedPubMedCentral
28.
Sadoh AE, Sadoh WE, Oniyelu P. Breast feeding practice among medical women in Nigeria. Nigeria Med J. 2011;52(1):7–12.
29.
National Population Commission (NPC) [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey 2008. Calverton, Maryland, USA: National Population Commission and ICF Macro; 2008.
30.
World Health Organisation. Indicators for assessing infant and young child feeding practices. Geneva, Switzerland: World Health Organisation; 2008.
31.
WHO, U., USAID, FANTA, AED, UC DAVIS, IFPRI. Indictors for assessing infant and young child feeding practices part III. Geneva, Switzerland: WHO; 2010.
32.
National Population Commission (NPC) [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey 1999. Calverton, Maryland, USA: National Population Commission and ICF Macro; 1999.
33.
National Population Commission (NPC) [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey 2003. Calverton, Maryland, USA: National Population Commission and ICF Macro; 2003.
34.
Filmer D, Pritchett LH. Estimating wealth effects without expenditure data—or tears: an application to educational enrollments in states of India. Demography. 2001;38(1):115–32.PubMed
35.
World Health Organization. Primary Health Care, Report of the International conference on primary health care, Alma-Ata, USSR, 6–12 September, 1978. Geneva, Switzerland: World Health Organisation; 1978.
36.
Khanal V, Sauer K, Zhao Y. Determinants of complementary feeding practices among Nepalese children aged 6–23 months: findings from demographic and health survey 2011. BMC Pediatr. 2013;13:131.CrossRefPubMedPubMedCentral
37.
Akram HT, Dure-Samin N, Yasir B, Kazmi N, Agho KE, Abbasi S, et al. Determinants of suboptimal breast-feeding practices in Pakistan. Public Health Nutr. 2013;16(04):659–72.CrossRefPubMed
38.
Tawiah-Agyemang C, Kirkwood BR, Edmond K, Bazzano A, Hill Z. Early initiation of breast-feeding in Ghana: barriers and facilitators. J Perinatol. 2008;28:46–52.CrossRef
39.
Edmond KM, Zandoh C, Quigley MA, Amenga-Etego S, Owusu-Agyei S, Kirkwood BR, et al. Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics. 2006;117(3):380–6.CrossRef
40.
Dubois L, Girard M. Social determinants of initiation, duration and exclusivity of breastfeeding at the population level: the results of the longitudinal study of child development in Quebec (ELDEQ 1998–2002). Can J Public Health. 2003;94:300–5.PubMed
41.
Kaunonen M, Hannula L, Tarkka MT. A systematic review of peer support interventions for breastfeeding. J Clin Nurs. 2012;21(13–14):1943–54.CrossRefPubMed
42.
Babalola S, Fatusi A. Determinants of use of maternal health services in Nigeria-looking beyond individual and household factors. BMC Pregnancy Childbirth. 2009;9(1):43.CrossRefPubMedPubMedCentral
43.
Simkhada B, Teijlingen ER, Porter M, Simkhada P. Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature. J Adv Nurs. 2008;61(3):244–60.CrossRefPubMed
44.
Gertler P, Rahman O, Feifer C, Ashley D. Determinants of pregnancy outcomes and targeting of maternal health services in Jamaica. Soc Sci Med. 1993;37(2):199–211.CrossRefPubMed
45.
Centers for Disease Control and Prevention (CDC). HIV/AIDS among US women: Minority and young women at continuing risk. Atlanta, GA: Centers for Disease Control and Prevention (2002).
46.
Ugboaja JO, Berthrand NO, Igwegbe OA, OBI-Nwosu AL. Barriers to postnatal care and exclusive breastfeeding among urbanwomen in southeastern Nigeria. Nigerian Med J. 2013;54(1):45–50.CrossRef
47.
Alutu ANG, Orubu OA. Barriers to successful exclusive breast-feeding practices among rural and urban nursing mothers in Edo State of Nigeria: Implications for education and counselling. Res Rev. 2005;21(2):27–35.
48.
Agbo HA, Envuladu EA, Adams HS, Inalegwu E, Okoh E, Agba A, et al. Barriers and facilitators to the practice of exclusive breast feeding among working class mothers: a study of female resident doctors in tertiary health institutions in Plateau State. J Med Res. 2013;2(1):112–6.
49.
50.
Aidam BA, Perez-Escamilla R, Lartey A, Aidam J. Factors associated with exclusive breastfeeding in Accra, Ghana. Eur J Clin Nutr. 2005;59:789–96.CrossRefPubMed
51.
World Health Organization, UNICEF, and University Of California. Complementary feeding of young children in developing countries: a review of current scientific knowledge. In: Brown K, Dewey K and Allen L, editors. 1998. Geneva: World Health Organization.
52.
Bezner KR, Dakishoni L, Shumba L, Msachi R, Chirwa M. “We grandmothers know plenty”: breastfeeding, complementary feeding and the multifaceted role of grandmothers in Malawi. Soc Sci Med. 2008;66(5):1095–105.CrossRef
53.
Grassley J, Eschiti V. Grandmother breastfeeding support: what do mothers need and want? Birth. 2008;35(4):329–35.CrossRefPubMed
54.
55.
Aghaji M. Exclusive breast-feeding practice and associated factors in Enugu, Nigeria. West Afr J Med. 2001;21(1):66–9.
56.
Maycock B, Binns CW, Dhaliwal S, Tohotoa J, Hauck Y, Burns S, et al. Education and support for fathers improves breastfeeding rates a randomized controlled trial. J Hum Lact. 2013;29(4):484–90.CrossRefPubMed
57.
Dearden K, Mekibib A, de Irma M, de Maritza O, Stone-Jimenez M, Morrow AL, et al. Determinants of optimal breast-feeding in peri-urban Guatemala City, Guatemala. Rev Panam Salud Publica. 2002;12(3):185–92.CrossRefPubMed
58.
Prior E, Santhakumaran S, Gale C, Philipps LH, Modi N, Hyde MJ. Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. Am J Clin Nutr. 2012;95(5):1113–35.CrossRefPubMed
59.
World Health Organisation, United Nation Childen Education Fund. Baby-friendly hospital initiative revised, updated and expanded for integrated care. Geneva, Switzerland: WHO Document Production Services; 2009.
60.
Akmam W. Women’s education and fertility rates in developing countries, with special reference to Bangladesh. Eubios J Asian Int Bioethics. 2002;12:138–43.
61.
62.
Van Der Meulen Rodgers Y. Maternal employment andchild health, Global issues and policy solutions. Cheltenham, UK: Edward Elgars Publishing Limited; 2011.CrossRef
63.
Patel A, Badhoniya N, Khadse S, Senarath U, Agho KE, Dibley M. 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 Nutri Bull. 2010;31(2):314–33.CrossRef
64.
Federal Government of Nigeria. Mellinium Development Goals Performance Tracking Survey 2012. In: National Bureau of Statistics, editor. 2013. Abuja, Nigeria: Federal Government of Nigeria.
65.
Metadata
Title
Determinants of suboptimal breastfeeding practices in Nigeria: evidence from the 2008 demographic and health survey
Authors
Felix A Ogbo
Kingsley E Agho
Andrew Page
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1595-7

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