Abstract
BackgroundExclusive breastfeeding (EBF) can prevent death and disease among young children. The proportion of EBF is low in Niger. This study aimed to identify the prevalence and correlates of exclusive breastfeeding.MethodsWe conducted a community-based cross-sectional study in urban and rural areas of Niger among mothers of infants under 7 months old. We used a structured questionnaire to investigate breastfeeding practices, sociodemographic factors, and health service use. We used multivariate analysis to explore the correlates of EBF since birth.ResultsThe study involved 234 urban and 283 rural mothers. Colostrum was almost universally given to newborns (98.7% [231/234] urban and 97.9% [277/283] rural) and many mothers started breastfeeding within an hour of giving birth (69.2% [162/234] and 90.5% [256/283]). The proportion of EBF since birth in urban and rural areas was 15.8% (37/234) and 54.4% (154/283), respectively. Among mothers who had ceased EBF, proportion of prelacteal feeding was 85.3% (168/197) in urban areas and 62.0% (80/129) in rural areas, while 93.4% (183/196) and 72.7% (88/121) had stopped EBF within 1 week after birth respectively. The median duration of EBF was 1 week in urban and 2 months in rural areas. In urban areas, EBF was more likely in mothers with infants 3 months old or younger (Adjusted Odds Ratio [AOR] 2.78; 95% Confidence Interval 95% [CI] 1.07, 7.21) and problems with delivery including Caesarean section (AOR 3.60; 95% CI 1.17, 11.01). In rural areas, lower socioeconomic status (AOR 1.89; 95% CI 1.12, 3.18), early initiation of breastfeeding (AOR 4.04; 95% CI 1.50, 10.83) and delivery assisted by a traditional birth attendant (AOR 3.49; 95% CI 1.37, 8.89) were correlated with exclusive breastfeeding.ConclusionsExclusive breastfeeding was uncommon. Most mothers ceased EBF within 1 week after birth. Adequate information about EBF by health professionals around delivery seems to encourage its use. To encourage EBF in Niger, it is important to educate health professionals, including traditional birth attendants, and enable them to discuss the practice with mothers through individual counselling or group education.
Highlights
Exclusive breastfeeding (EBF) can prevent death and disease among young children
The prevalence of EBF for 6 months remains low around the world, only 40% according to UNICEF figures [2]
The estimated population of Niger in 2012 was 16,274, 738, and more than 80% lived in rural areas, where the lifestyle is quite different from urban areas [17]
Summary
Exclusive breastfeeding (EBF) can prevent death and disease among young children. The proportion of EBF is low in Niger. Exclusive breastfeeding (EBF) for 6 months after birth has been predicted to prevent 823,000 deaths in children under 5 years of age annually, by decreasing the risks of infectious disease and malnutrition [1]. Exclusive breastfeeding is an effective way to save children’s lives in Niger, and a number of national and international programs have already been implemented [20, 21]. The prevalence of EBF until 6 months of age in Niger was reported to be 23.3% with its median duration being 1.1 months in 2012 [23] This prevalence was much lower than the national goal of 50% and that in some neighboring countries like Mali, Burkina Faso and Liberia (37.3, 50.1 and 54.6% respectively). It is important to revise strategies to fit local contexts and use targeted promotion activities
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