Skin-to-skin contact and breastfeeding practices in Nigeria: a study of socioeconomic inequalities

Amit Arora,Michael Ekholuenetale,Amadou Barrow

doi:10.1186/s13006-021-00444-7

Abstract

BackgroundThe effects of breastfeeding practices on children’s health are undoubtedly of great interest. However, inequalities in breastfeeding practices and mother and newborn skin-to-skin contact (SSC) exist in many resource-constrained settings. This study examined the regional prevalence and socioeconomic inequalities in exclusive breastfeeding (EBF), early initiation of breastfeeding and SSC in Nigeria.MethodsData on 2936 infants under six months were extracted from the 2018 Nigeria Demographic and Health Survey (NDHS) to determine EBF. In addition, data on 21,569 children were analysed for early initiation of breastfeeding and SSC. Concentration index and curves were used to measure socioeconomic inequalities in EBF, early initiation of breastfeeding and SSC.ResultsThe prevalence of EBF, early initiation of breastfeeding and SSC were 31.8, 44.2 and 12.1% respectively. Furthermore, Ogun state had the highest prevalence of EBF (71.4%); while Bayelsa state had the highest prevalence of SSC (67.8%) and early initiation of breastfeeding (96.2%) respectively. Urban dwellers had higher prevalence of EBF, SSC and early initiation of breastfeeding across household wealth quintile and by levels of mothers’ education in contrast to their rural counterparts. We quantified inequalities in early initiation of breastfeeding, EBF, and SSC according to household wealth and maternal education. The study outcomes had greater coverage in higher household wealth, in contrast to the lower household wealth groups; early initiation of breastfeeding (concentration index = 0.103; p = 0.002), EBF (concentration index = 0.118; p < 0.001), and SSC (concentration index = 0.152; p < 0.001) respectively. Furthermore, early initiation of breastfeeding (concentration index = 0.091; p < 0.001), EBF (concentration index = 0.157; p < 0.001) and SSC (concentration index = 0.156; p < 0.001) had greater coverage among mothers with higher educational attainment.ConclusionLow prevalence and socioeconomic inequalities in early initiation of breastfeeding, EBF and SSC were identified. We recommend that health promotion programs targeted and co-designed with disadvantaged mothers are critical to meet global breastfeeding targets. Also, future researchers should conduct further studies especially clinical control trials and qualitative studies to unravel the possible reasons for differences in the indicators.

Highlights

The effects of breastfeeding practices on children’s health are undoubtedly of great interest
The findings from a previous intervention study led to the development of guidelines that allowed early initiation of breastfeeding and skin-to-skin contact (SSC) be included in the policy of newborn care [7]
We estimated the prevalence of exclusive breastfeeding (EBF) (31.8%), early initiation of breastfeeding (44.2%) and SSC (12.1%) respectively

Summary

Introduction

The effects of breastfeeding practices on children’s health are undoubtedly of great interest. Inequalities in breastfeeding practices and mother and newborn skin-to-skin contact (SSC) exist in many resource-constrained settings. World Health Organization (WHO) recommends early initiation of breastfeeding for newborn within the first hour of birth [3]. This is referred to as timely breastfeeding. Exclusive breastfeeding (EBF) is the practice whereby an infant receives only breast milk for the first six months, with no other liquids or solid food, except oral rehydration solutions, drops and syrups [3, 4]. Initiation of breastfeeding is associated with mother and newborn skin-to-skin contact (SSC), which reduces the risk of hypothermia [5], and strengthens maternal bonding with the infant [6]. There has been an increased attention on infant and young child feeding pattern to ascertain optimal breastfeeding practices [2]

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