Social and Bio-Medical Predictors of Exclusive Breastfeeding Among Nursing Mothers in Lagos and Taraba States, Nigeria.

Purpose: Although exclusive breastfeeding (EBF) is known to have positive consequences for mothers and infants, EBF rate in Nigeria is <25%. This study investigated if social factors were stronger predictors of EBF than bio-medical factors in the metropolitan areas of Lagos and Taraba States. Social factors included mother's education, infant sex, place of birth, and nature of mother's employment, while bio-medical factors included nature of birth (whether vaginal or caesarean section), problems with breast/nipple, breast milk insufficiency, and mother's age.

Design And Methods: The study adopted a cross-sectional survey design and mixed method of data collection. From the two states, 500 mothers with babies between 7 and 12 months of age completed a structured questionnaire. Twenty respondents from each state were interviewed using an in-depth interview guide.

Results: Education (β = 1.743; p < 0.001), infant sex (β = -0.454; p < 0.05), and place of delivery (β = -1.552; p < 0.001) were significant social predictors. Breast milk insufficiency (β = -1.851; p < 0.001) and mother's age (β = 0.064; p < 0.001) were significant bio-medical predictors. When all the eight factors were considered, only two of the three social factors, namely, education and infants' sex, remained significant, while three bio-medical factors, namely, breast milk insufficiency, mother's age, and nature of delivery, were significant.

Conclusions: Social and bio-medical factors co-determine the practice of EBF and must not be considered dichotomous.

Practical Implications: Interventions to encourage EBF among Nigerian mothers must focus on education regarding its benefits and correction of misconceptions that breast milk alone is insufficient as an infant's diet.