title: A qualitative study of the promotion of exclusive breastfeeding by health professionals in Niamey, Niger.
abstract: BACKGROUND
  The practice of exclusive breastfeeding depends on various factors related to both mothers and their environment, including the services delivered by health professionals. It is known that support and counseling by health professionals can improve rates, early initiation and total duration of breastfeeding, particularly exclusive breastfeeding. Mothers' decisions are influenced by health professionals' advice. However, in Niger the practice of exclusive breastfeeding is almost non-existent.The purpose of this exploratory study, of which some results are presented here, was to document health professionals' attitudes and practices with regard to exclusive breastfeeding promotion in hospital settings in the urban community of Niamey, Niger.
  
  
  METHODS
  Fieldwork was conducted in Niamey, Niger. A qualitative approach was employed. Health professionals' practices were observed in a sample of frontline public healthcare facilities.
  
  
  RESULTS
  The field observation results presented here indicate that exclusive breastfeeding is not promoted in healthcare facilities because the health professionals do not encourage it and their practices are inappropriate. Some still have limited knowledge or are misinformed about this practice or do not believe in it. They do not systematically discuss exclusive breastfeeding with mothers, or they mention it only briefly and without giving any explanation. Worse still, some encourage the use of breast milk substitutes, which are frequently promoted in healthcare facilities. Thus mothers often receive contradictory messages.
  
  
  CONCLUSIONS
  The results suggest the need to train or retrain health professionals with regard to exclusive breastfeeding, and regularly supervise their activities.
authors.affiliation: Programme interfacultaire de doctorat en santé communautaire, Faculté des sciences infirmières et Faculté de médecine, Université Laval, Québec City, Canada. amalo96@yahoo.ca.
authors.forename: Aïssata
authors.initials: A
authors.lastname: Moussa Abba
authors.forename: Maria
authors.initials: M
authors.lastname: De Koninck
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hamelin