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

      research-article
      Author(s): , ,
      Publication date (Electronic):
      Journal: BMC Public Health
      Publisher: BioMed Central
      Keywords: Breastfeeding, Determinants, Mortality, Nigeria, Suboptimal

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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.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-015-1595-7) contains supplementary material, which is available to authorized users.

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          Most cited references70

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          Robert E Black, Cesar G Victora, Susan P. Walker … (2013)
          The Lancet, 382(9890), 427-451
          Article 0 comments Cited 2783 times – based on 0 reviews     Review now
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            Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India.

            Deon Filmer, Lant H. Pritchett (2001)
            Using data from India, we estimate the relationship between household wealth and children's school enrollment. We proxy wealth by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights. In Indian data this index is robust to the assets included, and produces internally coherent results. State-level results correspond well to independent data on per capita output and poverty. To validate the method and to show that the asset index predicts enrollments as accurately as expenditures, or more so, we use data sets from Indonesia, Pakistan, and Nepal that contain information on both expenditures and assets. The results show large, variable wealth gaps in children's enrollment across Indian states. On average a "rich" child is 31 percentage points more likely to be enrolled than a "poor" child, but this gap varies from only 4.6 percentage points in Kerala to 38.2 in Uttar Pradesh and 42.6 in Bihar.
            Article 0 comments Cited 1046 times – based on 0 reviews     Review now
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              Delayed breastfeeding initiation increases risk of neonatal mortality.

              Karen M. Edmond, Charles Zandoh, Maria A. Quigley … (2006)
              Breastfeeding promotion is a key child survival strategy. Although there is an extensive scientific basis for its impact on postneonatal mortality, evidence is sparse for its impact on neonatal mortality. We sought to assess the contribution of the timing of initiation of breastfeeding to any impact. This study took advantage of the 4-weekly surveillance system from a large ongoing maternal vitamin A supplementation trial in rural Ghana involving all women of childbearing age and their infants. It was designed to evaluate whether timing of initiation of breastfeeding and type (exclusive, predominant, or partial) are associated with risk of neonatal mortality. The analysis is based on 10,947 breastfed singleton infants born between July 2003 and June 2004 who survived to day 2 and whose mothers were visited in the neonatal period. Breastfeeding was initiated within the first day of birth in 71% of infants and by the end of day 3 in all but 1.3% of them; 70% were exclusively breastfed during the neonatal period. The risk of neonatal death was fourfold higher in children given milk-based fluids or solids in addition to breast milk. There was a marked dose response of increasing risk of neonatal mortality with increasing delay in initiation of breastfeeding from 1 hour to day 7; overall late initiation (after day 1) was associated with a 2.4-fold increase in risk. The size of this effect was similar when the model was refitted excluding infants at high risk of death (unwell on the day of birth, congenital abnormalities, premature, unwell at the time of interview) or when deaths during the first week (days 2-7) were excluded. Promotion of early initiation of breastfeeding has the potential to make a major contribution to the achievement of the child survival millennium development goal; 16% of neonatal deaths could be saved if all infants were breastfed from day 1 and 22% if breastfeeding started within the first hour. Breastfeeding-promotion programs should emphasize early initiation as well as exclusive breastfeeding. This has particular relevance for sub-Saharan Africa, where neonatal and infant mortality rates are high but most women already exclusively or predominantly breastfeed their infants.
              Article 0 comments Cited 285 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Felix A Ogbo: felgbo@yahoo.co.uk
                Kingsley E Agho: K.Agho@uws.edu.au
                Andrew Page: A.Page@uws.edu.au
                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2458
                Publication date (Electronic): 18 March 2015
                Publication date PMC-release: 18 March 2015
                Publication date Collection: 2015
                Volume: 15
                Electronic Location Identifier: 259
                Affiliations
                School of Science and Health, University of Western Sydney, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
                Article
                Publisher ID: 1595
                DOI: 10.1186/s12889-015-1595-7
                PMC ID: 4367831
                PubMed ID: 25849731
                SO-VID: a8eee322-3a86-4d1d-a83c-245757c3d9c6
                Copyright © © Ogbo et al.; licensee BioMed Central. 2015
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 18 May 2014
                Date accepted : 27 February 2015
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2015

                ScienceOpen disciplines: Public health
                Keywords: breastfeeding,determinants,mortality,nigeria,suboptimal
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: breastfeeding, determinants, mortality, nigeria, suboptimal

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