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Factors Influencing Exclusive Breastfeeding in Early Infancy: A Prospective Study in North Central Nigeria

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Abstract

Purpose

To determine the association between prenatal exclusive breastfeeding intentions and exclusive breastfeeding (EBF) and explore other factors associated with EBF until 3 months postpartum among mothers residing in suburban parts of the Federal Capital Territory, Abuja Nigeria.

Description

This longitudinal observational study involved the recruitment of 210 pregnant women who were prospectively followed until 3 months postpartum. Participants were recruited from antenatal clinics attached to four separate public secondary health facilities located in the suburban parts of Abuja. Cox regression hazards model was used to determine the risk of EBF cessation at 3 months postpartum.

Assessment

Over 70.0 % of women had strong intention to exclusively breastfeed. The risk of exclusive breastfeeding cessation was significantly lower in women with strong exclusive breastfeeding intentions (HR 0.87, 95 % CI 0.8–0.95). Other risk factors for cessation of exclusive breastfeeding were pre-lacteal feed administration (HR 2.93 95 % CI 1.49–5.77) and mode of delivery (HR 0.17 95 % CI 0.04–0.67). Higher maternal age (≥35 years), religion (Muslim) and having an unplanned pregnancy lowered the likelihood of having a strong intention to exclusively breastfeed an infant.

Conclusions

Prenatal exclusive breastfeeding intention was a strong predictor of exclusive breastfeeding. Intentions to EBF were further explained by maternal characteristics. Effective promotion of exclusive breastfeeding during prenatal period should also target factors influencing breastfeeding intentions. Additional research is warranted into the influence of maternal attitudes and self-efficacy about breastfeeding on breastfeeding intentions and practice.

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Acknowledgments

The current work received no specific grant from any funding agency, commercial or not-for-profit sectors. The authors thank the 268 mothers who volunteered to participate in this study and acknowledge the cooperation of the midwives, doctors and administrative staff in every setting as well as the research assistants who collected the data. O.O.B. and S.S. conceptualised the study. O.O.B., S.S., K.M.A. and E.O. designed the study. O.O.B. and S.K. were responsible for data collection and input. O.O.B. did the data analysis (with contribution from E.O., K.A. and S.S.) and wrote the first draft of the manuscript. S.K., K.M.A., E.O., K.A. and S.S. contributed to revising the manuscript. All procedures were approved by the Research Ethics Committee of the University of Tokyo [approval number: 3948-(1)], Ahmadu Bello University, Zaria and the Federal Capital Territory Authority Health and Human Service Secretariat, Abuja Nigeria (protocol approval number: FHREC/2013/01/05/05-03-13).

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Authors and Affiliations

  1. Department of Social and Preventive Epidemiology, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Olukunmi O. Balogun, Satomi Kobayashi & Satoshi Sasaki

  2. Integrated Health Risk Assessment Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan

    Satomi Kobayashi

  3. Department of Biochemistry, Faculty of Science, Ahmadu Bello University, Zaria, Nigeria

    Kola M. Anigo

  4. Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan

    Erika Ota

  5. Interfaculty Initiative in Information Studies, University of Tokyo, Tokyo, Japan

    Keiko Asakura

  6. Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan

    Keiko Asakura & Satoshi Sasaki

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  1. Olukunmi O. Balogun
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  2. Satomi Kobayashi
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  3. Kola M. Anigo
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  4. Erika Ota
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  5. Keiko Asakura
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Correspondence to Olukunmi O. Balogun.

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Appendix

Appendix

See Tables 4, 5 and 6.

Table 4 Reasons for non-participation in study
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Table 5 Definition of terms
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Table 6 Pre-lacteal feeds administered and reasons for giving such feeds
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Balogun, O.O., Kobayashi, S., Anigo, K.M. et al. Factors Influencing Exclusive Breastfeeding in Early Infancy: A Prospective Study in North Central Nigeria. Matern Child Health J 20, 363–375 (2016). https://doi.org/10.1007/s10995-015-1835-6

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