Journal of Public Health in Africa 2023; volume 14:2191

Factors affecting exclusive breastfeeding practices among working-class

women in Osun State, Nigeria
Olariike O. Kayode,1 Ayobami S. Oyedeji,2 Quadri K. Alabi3
1Department of Human Nutrition and Dietetics, Osun State University Osogbo, Osun State; 2Department of Public
Health, Achievers University Owo, Ondo State; 3Department of Physiology, Adeleke University Ede, Osun State,
Nigeria

edge of exclusive breastfeeding (EBF). Sixty-six percent (66.8%)

Abstract had good exclusive breastfeeding practices. The study showed that
Breastfeeding has been accepted as the most vital intervention there was a significant relationship between knowledge and prac-
for reducing infant mortality and ensuring optimal growth and tices of exclusive breastfeeding among the respondents (P<0.05).
Identified factors affecting exclusive breastfeeding among the
development of children. However, studies on the factors affecting
respondents are: duration of maternity leave, availability of crèche
exclusive breastfeeding, especially, among working-class women
near the place of work, breastfeeding break at work, husband and
are sparse. This study determined the factors affecting exclusive
family support, health conditions that could hinder EBF, and
breastfeeding among working-class women in Osun state. Multi- engagement in other activities with work. Breastfeeding breaks at
stage sampling was used to select a total of 316 respondents for work (AOR=4.717; P=0.000), husband and family support
this cross-sectional study and a pretested, interviewer-administered (AOR=2.944; P=0.000), and one-month maternal leave (P=0.000)

ly
questionnaire was used to elicit information. More than half were factors significantly associated with EBF practices. We con-
(57.6%) of the respondents were between the ages of 26-35 years.

on
clude that good knowledge and good practices of exclusive breast-
Ninety-eight percent (98.1%) of the respondents had good knowl- feeding were found among the study group. Improved policies
around maternity leave and the provision of breastfeeding friendly

e
work environment are needed to increase exclusive breastfeeding
practices. Husbands and family members should be educated on
us
Correspondence: Quadri K. Alabi, Department of Physiology, Faculty
of Basic Medical Sciences, Adeleke University, Ede, Osun State,
the need to provide support to breastfeeding mothers.
Nigeria.
al
E-mail: alabi.quadri@adelekeuniversity.edu.ng
Introduction
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Key words: exclusive breastfeeding, working-class women, KAP.

Breastfeeding has been recognized as the most essential inter-
er

Acknowledgments: the authors would like to thank all the mothers who vention for ensuring optimal growth, development of children and
participated in this study. decreasing infant mortality.1 It is essential for both the physiologi-
m

cal and psychological needs of an infant. World Health

Contributions: OO, intellectualized the knowledge, prepared the data,
Organization defines exclusive breastfeeding (EBF) as giving only
om

data analysis and wrote the draft of the manuscript; QK, AS, went
breast milk to infants for the first six months of life. It is estimated
through the theoretical basis, corrected and reviewed the results, and
contributed to writing and editing of the final version of the manuscript. that over two-thirds of deaths occurring globally in children under
the age of one are mostly linked to inappropriate feeding patterns,
-c

All the authors approved the final version to be published.

particularly due to poor EBF practices.2 EBF enhances optimum
on

Conflict of interest: the authors declare no potential conflict of interest. growth, development and health of the child. Infants should there-
after receive nutritionally adequate and safe complementary foods
Ethics approval and consent to participate: this study was conducted while continuing to breastfeed for up to two years or more.
N

according to the guidelines laid down in the Declaration of Helsinki and EBF has received attention as the recommended feeding prac-
all procedures involving human subjects were approved by the Ethic tice for newborns. It improves growth, health and survival status of
Review Board of Institute of Public Health, Adeleke University.
newborns and is one of the most natural and best forms of preven-
tive medicine.3,4 EBF plays a pivotal role in determining the opti-
Availability of data and materials: data and materials are available by
the authors. mal health and development of infants and is associated with a
decreased risk for many early-life diseases and conditions, includ-
Informed consent: written informed consent was obtained from all sub- ing otitis media, respiratory tract infection, diarrhea and early
jects. childhood obesity.5
Globally, about 35% of newborns are exclusively breastfed
Received for publication: 22 March 2022. during the first four months of life.6 Only 38% of infants under six
Accepted for publication: 16 May 2022. months of age in developing countries are exclusively breastfed,
and 21% in West Central Africa.7 Researchers have proposed that
This work is licensed under a Creative Commons Attribution
lack of suitable facilities outside of the home, inconvenience, con-
NonCommercial 4.0 License (CC BY-NC 4.0).
flicts at work, family pressure and ignorance adversely affect the
©Copyright: the Author(s),2023 willingness of women to practice EBF.8,9 The need to return to
Journal of Public Health in Africa 2023; 14:2191 work has also been implicated as a factor interfering with EBF.10
doi:10.4081/jphia.2023.2191 Studies have revealed that one of the barriers to exclusive
breastfeeding is work status.11,12 With enlarged urbanization and

[page 173] [Journal of Public Health in Africa 2023; 14:2191]

 Article

industrialization, more and more women have joined the work- ment. The questionnaires used to elicit information from the par-
force.13 The prevalence of exclusive breastfeeding has been stag- ticipants contained four sections which include: socio-demograph-
nant since about a decade ago at 17%.14 It increased to 25% in ic characteristics (age of mothers, age of the child in months, eth-
2017 according to the Federal Government of Nigeria by Prof nicity, marital status, religion, educational status, employment sta-
Isaac Adewole Federal Ministry of Health Abuja. A more detailed tus,), knowledge of EBF (meaning of EBF, EBF duration, benefits
understanding of the factors affecting exclusive breastfeeding of EBF), EBF practices (time of initiation of breastfeeding, time of
among working-class women is needed to develop effective inter- introducing complementary feeding), and factors affecting EBF
ventions to improve the prevalence of EBF and thus reduce infant practices (duration of maternity leave, availability of crèche at
mortality. This study aimed at identifying factors affecting exclu- place of work, breastfeeding break at work, family support). Prior
sive breastfeeding among working-class women in selected wards to administering the questionnaire, the purpose of the study was
in Egbedore Local Government Area, Osun state. explained to the participants and those who agreed to participate in
the study gave written consent.
Working-class women in this study were defined as mothers 0
to 12 months postpartum, working in the public sector including
Materials and Methods government hospitals, schools, colleges, and banks. Exclusive
Study design and study location breastfeeding was defined as giving only breastmilk to the infant
The study was a cross-sectional study and was conducted at without the addition of any other liquids or solids, except for drops
Egbedore Local Government using a quantitative method of data or syrups consisting of vitamins, mineral supplements, or medica-
collection. Egbedore Local Government Area is located in Osogbo tion (nothing else).4
at 7º 46 00N 402400E, it has an area of 270 km2 and a population
of 74,435 at the 2006 census. The local government is made up of Data analysis
10 wards and these wards have a total of 15 primary healthcare A statistical package for social sciences version 21.0 was used

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centers. for the analysis of data. Six items were used to assess the knowl-
edge of exclusive breastfeeding as shown in Table 1. Correct

on
Ethical approval answers were scored as “1” and incorrect answers as “0”. The
The research was approved by Adeleke University Ethics response to the 6 items was summed up to make the knowledge of
Research Committee (AUERC), Adeleke University, Ede, Osun the exclusive breastfeeding index. The knowledge of EBF was rep-

e
State, Nigeria. The Ethical reference number for the research is resented as poor knowledge (0-3) and good knowledge (4-6).
AUERC/FBMS/IND/02.
us Eight items were used to assess EBF practice. Six (6) of the
items’ correct answers were scored as “1” and the incorrect answer
as “0”. The item “do you lactate very well?” was scored as yes=2
Study population
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and no=1. A breastfeeding mother who does not lactate very well
The study enrolled working-class women with infants aged 0-
could be due to some physiological factors, therefore the answer
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12 months who were in full-time or part-time employment and

“no” may not be totally wrong. Those with less than 6 months of
who attended postnatal care at the selected wards in Egbedore local
EBF was scored as: no response=0; 1 month =1; 2 months =2; 3
er

government in Osun state. Women with infants aged 0-12 months

months =3; 4 months =4; 5 months =5. The response to the 8 items
were chosen for this study to avoid or reduce recall bias of exclu-
was summed up to make the exclusive breastfeeding practice index
m

sive breastfeeding practices.

which was presented as poor practice (0-5) and good practice (6-
Women were included if they had initiated breastfeeding, had
om

13). Descriptive statistics were used to summarize data. Inferential

single birth, and returned to work at the time of the interview.
statistics of Chi-Square was used to test the association between
Women were excluded if they had never breastfed, had multiple
categorical variables at P<0.05 and a confidence interval (95% CI)
births, or had an infant who experienced neonatal problems and
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was used where appropriate.

interfered with breastfeeding in the first days of life.
on

Sample size and sampling

The formula for precision by Leslie Kish was used to calculate Results
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the sample size. The alpha was set at 5%, power of 80% and EBF The socio-demographic characteristics of the respondents are
prevalence of 25% was used and the minimum sample required presented in Table 2. More than half (57.6%) of the respondents
was 288. The attrition rate of 10% was added making were between the ages of 26-35 years. Almost (94.9%) all of the
n=288+28=316.15 respondents were of tertiary education, respondents workplaces
A multi-stage sampling technique was used to select working- include: 38.6% worked in schools, 11.1% worked in Hospitals,
class women with infants aged 0-12 months. The first stage 14.9% worked in banks, 7.3% worked in hotels, 2.5%, worked in
involved a purposive selection of 5 wards out of 10 wards in bakeries, 5.1% works in Primary Health Care Centers, 13.6%
Egbedore Local Government Area. In the second stage, eight pri- works in a government office, 4.1% works in companies while
mary health centers were selected using simple random sampling 2.8% works at radio station. Higher percentage 87.7% were on
from a total of fifteen primary health centers in the selected wards. full-time jobs while 12.3% were on part-time jobs.
Then women who came for postnatal care at the selected primary The majority 97.8% of the respondents defined exclusive
health centers and who met the inclusion criteria were recruited for breastfeeding as giving baby breast milk only, 1.9% defined it as
the study. giving baby breast milk and water, while 0.3% of the respondents
defined it as giving breast milk and pap. Also, 98.7% reported that
Study procedures initiation of breastfeeding should be immediately after delivery,
This cross-sectional study was conducted over a period of 3 0.9% reported 2 days after delivery and 0.3% reported within the
months from January to April 2020. A 33-items pretested; inter- first month of delivery. Forty-nine percent (49.4%) reported the
viewer-administered questionnaire was used as the survey instru- importance of the first yellow breast milk to boost immunity and

[Journal of Public Health in Africa 2023; 14:2191] [page 174]

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57.9% reported giving baby breast milk only for the 6 months result shows the duration of maternity leave was: one month 38
helps to prevent the baby from getting an infection. The study (12.0%), two months 66 (20.9%), three months 125 (39.6%), four
revealed that 98.1% had good knowledge of EBF while 1.9% had months 58 (18.4%), five months 21 (6.6%) and six months 8
poor knowledge. (2.5%). More than half 176 (55.7%) of the respondents had crèche
EBF practices by the respondents are presented in Table 3. The near their place of work, 184 (58.2%) of the respondents had
majority 75.3% of the respondents initiated breastfeeding immedi- breastfeeding breaks at work, 255 (80.7%) reported that their hus-
ately after delivery, 18% after some days while 6.3% initiated bands and family support them to practice exclusive breastfeeding,
breastfeeding a few weeks after delivery and 0.3% reported after 64 (20.3%) had health conditions that could hinder exclusive
some months. More than half (66.1%) of the respondents reported breastfeeding and 142 (44.9%) engaged in other activities with
giving only breast milk to the child in the first six months, 1.9% work. Table 4 shows the relationship between knowledge and prac-
breastfed exclusively for 1 month, 5.7% breastfed exclusively for tice of exclusive breastfeeding. The result shows that there was a
2 months, 14.2% breastfed exclusively for 3 months, 8.9% breast- significant relationship between knowledge and practices of exclu-
fed exclusively for 4 months and 3.2% breastfed exclusively for 5 sively breastfeeding among working-class women in Egbedore
months. The majority (76.3%) of respondents breastfed their Local Government Area (P=0.013). Table 5 shows factors found to
babies’ colostrum and 66.1% of the respondents introduced com- be significantly associated with exclusive breastfeeding. They are:
plementary feeding at 6 months of age. The study revealed that duration of maternity leave, (X²= 161.233, P= 0.000); availability
66.8% of the respondents had good practice of exclusive breast- of crèche near place of work (X²= 196.687, P= 0.000); breastfeed-
feeding while 33.2%had poor practice. ing break at work (X²= 184.812, P=0.000); husband and family
Table 3 shows factors affecting exclusive breastfeeding. The support (X²= 86.472, P=0.000); morbidity that could hinder exclu-

Table 1. Knowledge of exclusive breastfeeding by respondents.

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Variable Frequency %

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Have you ever heard of exclusive breastfeeding?
Yes 316 100
No 0 0

e
Total 316 100
If yes, what is your sources of information?
Hospital
Friends
us 267
32
84.5
10.1
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Family members 6 1.9
Media 11 3.5
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Total 316 100

Exclusive breastfeeding is?
er

Giving baby breast milk only 309 97.8

Giving baby breast milk and water 6 1.9
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Giving breast milk and pap 1 0.3

Total 316 100
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WHO recommends that infants be exclusively breastfed for?

Three months 2 0.6
Four months 4 1.3
Six months 304 96.2
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Nine months 2 0.6

Not sure 4 1.3
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Total 316 100

Initiation of breastfeeding should be?
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Within the first one month 1 0.3

After 2 days 3 0.9
Immediately after delivery 312 98.7
Total 316 100
What should be given to babies immediately after safe delivery? 5 1.6
Water 308 97.5
Breast milk 3 0.9
Formula 316 100
Total
What is the importance of the first yellow breast milk?
To boost immunity 156 49.4
For speedy growth 91 28.8
Brain development 55 17.4
I don’t know 14 4.4
Total 316 100
Benefits of exclusive breastfeeding?
Giving baby breast milk only will not provide enough energy for the first 6 months of life 58 18.4
Giving baby breast milk only for the first 6 months helps to prevent the baby from getting infection 183 57.9
Giving baby breast milk only for the first 6 months helps to prevent diarrhea in babies 72 22.8
Exclusive breastfeeding delays the growth of the baby 3 9
Total 316 100

[page 175] [Journal of Public Health in Africa 2023; 14:2191]

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sive breastfeeding (X²= 39.937, P=0.01); engaging in other activi-

ties with work (X²= 128.331, P=0.01).
Table 3. Exclusive breastfeeding practices of the respondents.
Variable Frequency %
When did you initiate breastfeeding?

Discussion
After delivery 238 75.3
After some days 57 18.0

EBF provides infants with the nutrients and fluids required in

After some weeks 20 6.3
After some months 1 0.3
Total 316 100
Do you lactate very well?
Yes 232 73.4
Table 2. Socio-demographic characteristics of respondents. No 84 26.6
Total 316 100
Variable Frequency % Do you extract breast milk for your baby?
Yes 179 56.6
Age of mothers in years No 137 43.4
≤25 94 29.7 Total 316 100
26-35 182 57.6 Do you give only breast milk to your child for the first six months?
≥36 40 12.7 Yes 209 66.1
Total 316 100 No 107 33.9
Total 316 100
Age of child in months
0-3 171 54.1 If no, for how long did you practice exclusive breastfeeding?
No response 209 66.1
4-7 136 43.0 One month 6 1.9
8-12 9 2.8 Two months 18 5.7
Total 316 100 Three months 45 14.2

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Religion Four months 28 8.9
Five months 10 3.2
Christianity 174 55.1

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Total 316 100
Islam 141 44.6 At what month did you introduce complementary feeding?
Traditional 1 0.3 Within first month 16 5.1
Total 316 100 Second month 7 2.2

e
Ethnicity Third month 30 9.5
Fourth month 44 13.9
Yoruba
Igbo
Hausa
251
47
17
79.4
14.9
5.4
us
Fifth month
After sixth month
Total
10
209
316
3.2
66.1
100
Others 1 0.3
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Did you breastfeed your baby colostrum?
Total 316 100 Yes 241 76.3
No 75 23.7
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Marital status
Single 4 1.3 Total 316 100
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Married 295 93.4 How often do you breastfeed in a day?

Divorced 17 5.4 Whenever the baby wants it (on demand) 104 32.9
4-6 times a day 125 39.6
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Total 316 100 6 times and above 87 27.5

Number of children Total 316 100
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1 52 16.5
2 110 34.8 Factors affecting Exclusive Breastfeeding
3 105 33.2 Variable Frequency %
4 44 13.9
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Others 5 1.6 How long is your maternity leave?

Total 316 100 One month 38 12.0
on

Two month 66 20.9

Educational status Three month 125 39.6
Primary 0 0 Four month 58 18.4
Five month 21 6.6
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Secondary 16 5.1
Tertiary 300 94.9 Six month 8 2.5
Total 316 100
Total 316 100
Do you have crèche near your place of work?
Place of work Yes 176 55.7
School 122 38.6 No 140 44.3
Hospital 35 11.1 Total 316 100
Bank 47 14.7 If yes, do you have breastfeeding break at work?
Hotel 23 7.3 Yes 184 58.2
Bakery 8 2.5 No 132 41.8
PHC 16 5.1 Total 316 100
Radio station 9 2.8 Do your husband and family support you to exclusively breastfeed?
Government office 43 13.6 Yes 255 80.7
Company 13 4.1 No 61 19.3
Total 316 100
Total 316 100
Do you have any health condition that could hinder you from breastfeeding?
Employment status Yes 64 20.3
Full time 277 87.7 No 252 79.7
Part time 39 12.3 Total 316 100
Total 316 100 Do you engaging in other activities with your work?
Method of delivery Yes 142 44.9
Assisted virginal 203 64.2 No 174 55.1
Caesarean section 113 35.8 Total 316 100
Total 316 100

[Journal of Public Health in Africa 2023; 14:2191] [page 176]

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the first six months. Children who are exclusively breastfed have a study, more than half of the respondents (57.6%) were between the
lower risk of infections. EBF is the best and most effective way for ages of 26-35 years, the majority of the respondents and most
reducing infant morbidity and mortality. The findings of this study (64.2%) had been assisted vaginally. The delivery method of dis-
revealed a very good knowledge (98.1%) of EBF practices among tribution in this study is low compared to the result from a previous
the study group. This represented a high degree of literacy and study having 90.6% of vaginal-assisted delivery.16 The high vagi-
women’s empowerment. The majority (94.9%) of the respondents nal assisted delivery method could possibly be due to the differ-
had tertiary education. Breastfeeding mothers in this study have a ence in the study location. However, a study carried out in South-
higher level of education which is one of the most effective invest- East Nigeria showed vaginal (spontaneous or assisted) 80.0%.17
ments in strengthening the economy, self-reliant and healthy soci- Most of the respondents (96.2%) had good knowledge of
eties. With respect to the socio-demographic characteristics of this exclusive breastfeeding based on the WHO 6-month recommenda-

Table 4. Cross-tabulation of knowledge and exclusive breastfeeding practices of the respondents.

Practice of exclusive breastfeeding Total X2 P
Poor practice Good practice
Knowledge of exclusive breastfeeding Poor 0 12 12 6.207 0.013
Good 105 199 304
Total 105 211 316

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Cross tabulation of exclusive breastfeeding practices and factors affecting it practices

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s/n Items Option Good practice Poor practice Frequency X2 Df P
1 Duration of maternity One month 38 38 0 161.233 5 .000
Two month 66 66 0

e
Three month 89 125 36
Four month
Five month
Six month
8
2
8
us 58
21
8
50
19
0
Total 211 316 105
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2 Availability of crèche near the place of work Yes 176 176 0 197.687 1 .000
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No 35 140 105
Total 211 316 105
er

3 Breastfeeding break at work Yes 179 184 5 184.812 1 .000

No 32 132 100
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Total 286 316 105

4 Husband and family support Yes 201 255 54 86.472 1 .000
om

No 10 61 51
Total 211 316 105
5 Morbidity that could hinder breastfeeding Yes 64 64 0 39.937 1 0.01
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No 147 252 105

Total 211 316 105
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6 Engaging in other activities with work Yes 142 65 0

No 69 316 105 128.331 1 0.01
Total 211 316 105
N

Table 5. Binary logistics regression analysis of exclusive breastfeeding practices and factors affecting it practices.
Variables Odds ratio Df P-value 95% Confidence interval
Low Upper
Duration of maternity leave One month - 5 0.000 - -
Two month 0.000 1 1.000 .000 -
Three month 0.000 1 1.000 .000 -
Four month -20.298 1 0.999 .000 -
Five month -23.035 1 0.999 .000 -
Six month -23.454 1 0.999 .000 -
Availability of crèche near the place of work 22.302 1 0.994 .000 -
Breastfeeding break at work 4.717 1 0.000 42.251 296.232
Husband and family support 2.944 1 0.000 9.044 39.845
Health condition that could hinder breastfeeding 20.866 1 0.997 .000 -
Engaging in other activities with work 21.623 1 0.995 .000 -

[page 177] [Journal of Public Health in Africa 2023; 14:2191]

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tion for exclusive breastfeeding. The finding of this study is slight- practices include: duration of maternity leave for mothers (1 month
ly high compared to a study carried out by Ukegbu et al.18 who maternity=12%, 2 month=20.9%, 3 month=39.6%, 4
found that the majority 91.2% of the nursing mothers had a good month=18.4%, 5 month=6.6%, and 6 month=2.5%); availability of
knowledge of breastfeeding. This high percentage could be that crèche near the place of work (55.7%); breastfeeding break
this study was conducted in a health facility where most of the (58.2%), only (58.2%) of the respondents had breastfeeding break
respondents had received health education on EBF, and the present at work which implies that there is inadequate workplace-based
awareness of EBF now could be higher than when the study was support for exclusive breastfeeding in the populace. Osiyosola et
carried out. The majority of the respondents (84.5%) reported the al.15 highlighted the importance of workplace-based support for
hospital as their source of EBF information. This is supported by a mothers practicing exclusive breastfeeding. In Nigeria, the breast-
study carried out in the three regions of Nigeria with 84.5% in feeding facilities at the workplace were still low even though there
Ebonyin. The result of this study is lower compared to 90.5% is a national policy on infant and young child feeding and one of
reported in Ibadan and 92.2% reported in Zariah.19 the specific objectives is to protect, promote and support exclusive
The high percentage across the region could imply that health breastfeeding in the first six months of life. Breastfeeding is related
workers are doing well in the area of health education and health to privacy, hygiene, and discipline; without proper support, breast-
promotion. Ninety-eight percent (98.7%) had good knowledge feeding seems difficult. Husband and family support (80.7%), the
about the appropriate time to initiate breastfeeding (immediately result of this study is a little lower compared to a study done by
after delivery). This is high compared to a study done by Tadele Tilahun et al.18 that reported 87.8% of mothers were supported by
and Habta that found 73.3% of the mothers had good knowledge their husbands to feed their infants exclusively on breastmilk. For
about the initiation of breastfeeding.20 Also a study done by a breastfeeding mother to achieve a successful EBF practice there
Hadijah et al. that showed 52.8% of the mothers had good knowl- is a need for the husband and other family members’ support espe-
edge of when breastfeeding should be initiated.21 The high percent- cially in the area of feeding to consume foods rich in high nutrients
age of knowledge about the initiation of breastfeeding observed in (a balanced diet). Health conditions could hinder breastfeeding
(20.3%) and engage in other activities with work, which makes the

ly
this study could be attributed to the fact that the target population
is highly educated compared to their counterparts in the other breastfeeding mother have a very busy schedule (44.9%). The find-

on
study. Evidence from this survey showed high EBF practices ing is in contrast to Osiyosola et al.15 who reported 58.8% of busy
(66.8%), with sixty-six percent (66.1%) breastfed exclusively for 6 work schedules as one of the factors affecting EBF. This study
months. This is in contrast with the report of the Nigerian revealed the duration of maternity leave, availability of crèche near

e
Demographic and Health Survey,22 that reported only 17% of chil- the place of work, breastfeeding break at work, husband and fam-
dren under 6 months of age are exclusively breastfed. The finding
of this study is high compared to 37.3% reported in a study carried
us
ily support, morbidity that could hinder exclusive breastfeeding,
and engaging in other activities with work as factors significantly
out in Anambra State.23 And is slightly high compared to 66.2% associated with EBF practices. Finally, binary logistics regression
al
reported in a study by Aloysius and Nnoka in Enugu.24 The analysis showed breastfeeding break at work (AOR=4.717:
(66.1%) of 6 months of exclusively breastfeeding could be a result P=.000), Husband and family support (AOR=2.944, P=.000), and
ci

of the country’s adoption of the baby-friendly hospital initiative 1-month maternal leave (P=.000), as factors significantly associat-
(BFHI) program, before the adoption of the program, formula milk ed with EBF practices.
er

was freely advertised and used by nursing mothers. Most of the

respondents (76.3%) breastfed their baby colostrum, this is similar Limitation of the study
m

to findings from a previous study having a higher percentage Recall bias was a potential limitation due to the fact that infor-
om

79.8%.16 A lower percentage (33.9%) predominantly engaged in mation on EBF is based on recall since birth and some women
complimentary breastfeeding. These respondents did not give might not remember when they specifically introduced other liq-
“breast milk only” for the first six months. This corroborates with uids or solids. Hence the data gathered relied on women’s self-
-c

a study among breastfeeding mothers in Nnewi South-East Nigeria report. Also, this was a quantitative study and the study partici-
which reported 39% of complementary breastfeeding. Reasons for pants have no opportunity to express their opinions and concerns
on

this could be that some breastfeeding mothers believe that exclu- that are not catered for by the questionnaire. Further study should
sive breastfeeding for the first six months of birth delays comple- include a qualitative assessment probably focus group discussion
mentary feeding at six months as the baby might find it difficult to to add more information to this field of study.
N

accept other feeds than breastmilk. Therefore, some mothers prefer

complimentary breastfeeding in order to save them time to engage
in other activities. Another reason could be because in Yoruba and
Bini cultures, for example, EBF is considered to be harmful to the Conclusions
health of the newborn, who is thought to need water to satiate thirst This survey established a good knowledge and good practice
or halt hiccoughs.25 This study revealed that there was a significant of exclusive breastfeeding among working mothers in Egbedore
relationship between knowledge and the practice of exclusive Local Government Area in Osun State. Yet, it is important to
breastfeeding among the study group (χ2= 6.207, P=0.013). This is increase workplace-based support for exclusive breastfeeding
in contrast with Ukegbu et al.20 who found that there was no sig- among working-class mothers. There is a need to revise the post-
nificant association between EBF knowledge and its practices (χ2= partum maternity leave. Also, health workers, professional bodies
3.32, P=0.14). This implies that a breastfeeding mother could have and other stakeholders should advocate for a mandatory six
a good knowledge of EBF and yet not engage in EBF practices. months maternity leave for all working-class mothers.
According to Somerall,26 in predicting health behavior it is impor-
tant to consider individual characteristics (personal factors- biolog-
ical, psychological and sociocultural factors), as well situational
influences. This could be the reason for the insignificant relation- References
ship between knowledge and practices of exclusive breastfeeding 1. Gupta A, Arora V. The state of world’s breastfeeding -tracking
among the respondents. Factors affecting exclusive breastfeeding implementation of the global strategy for infant and young

[Journal of Public Health in Africa 2023; 14:2191] [page 178]

Article

child feeding. International Baby Food Action Network parative study of mothers in urban and rural communities in
(IBFAN), Asia Pacific. South Asia report 2007. Lagos, South West Nigeria. Niger Med J 2017;58:123-30.
2. World Health Organization. Exclusive Breastfeeding for Six 16. Tilahun T, Alemnesh M, Tenaw G, et al. Exclusive breastfeed-
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