title: Infant feeding practices and maternal socio-demographic factors that influence practice of exclusive breastfeeding among mothers in Nnewi South-East Nigeria: a cross-sectional and analytical study.
abstract: BACKGROUND
  Malnutrition is an underlying factor in more than 50% of the major cause of infant mortality-Pneumonia, diarrhoeal disease and measles which account for 70% of infant mortality. Therefore, programs to promote adequate nutrition for age can help reduce mortality from these disease conditions and indispensible to achievement of MDG 4.
  
  
  OBJECTIVE
  To describe the feeding practices of infants below six months of age and determine maternal socio-demographic factors that influences the practice of exclusive breastfeeding (EBF) among mothers in Nnewi, south-east Nigeria.
  
  
  METHODS
  Four hundred mother-infant pairs attending the infant welfare clinic of the Nnamdi Azikiwe University teaching hospital (NAUTH) during 2012 were consecutively recruited after meeting the study inclusion criteria. Data on breastfeeding were based on infant feeding practice in the previous 24 hours. Exclusive breastfeeding was defined as infant feeding with only breast milk.
  
  
  RESULTS
  Awareness (95.3%) and knowledge (82.0%) of EBF was high among surveyed mother but the practice of EBF (33.5%) was very low. Positive attitude towards EBF practice was shown by many (71.0%) of surveyed mothers. EBF practice decreased with increasing infant age, OR 0.72 (95% CI 0.34, 1.51) for 1-2 months, OR 0.58 (95% CI 0.23, 1.44) for 3-4 months and OR 0.20 (95% CI 0.06, 0.73) for 5-6 months compared to infants < 1 month old. Maternal education, socioeconomic class, mode of delivery and infants first feed were retained as important maternal predictors of EBF practice after adjustment for confounders. Decreased likelihood of EBF practice was found among mothers of lower educational attainment, OR 0.33 (95% CI 0.13, 0.81), mothers who delivered through caesarean section, OR 0.38 (95% CI 0.18, 0.84), mothers of higher socio-economic status [(middle class, OR 0.46 (95% CI 0.22, 0.99) and upper class, OR 0.32 (95% CI 0.14, 0.74)] while increased likelihood of EBF practice was seen in mothers who gave their infants breast milk as their first feed, OR 3.36 (95% CI 1.75, 6.66).
  
  
  CONCLUSIONS
  Knowledge and awareness does not translate to practice of EBF. More effort by health workers and policy makers should be directed to mothers along the fault lines to encourage the practice of EBF.
authors.affiliation: Department of Paediatrics, Nnamdi Azikiwe University teaching Hospital, Nnewi, Anambra state, Nigeria.
authors.forename: Stanley
authors.initials: S
authors.lastname: Onah
authors.affiliation: Department of Paediatrics, Nnamdi Azikiwe University teaching Hospital, Nnewi, Anambra state, Nigeria ; Child Survival Unit, Medical Research Council Unit, Fajara, The Gambia.
authors.forename: Donatus Ignatius Chidiebere
authors.initials: DI
authors.lastname: Osuorah
authors.affiliation: Department of Paediatrics, Nnamdi Azikiwe University teaching Hospital, Nnewi, Anambra state, Nigeria.
authors.forename: Joy
authors.initials: J
authors.lastname: Ebenebe
authors.affiliation: Department of Paediatrics, Nnamdi Azikiwe University teaching Hospital, Nnewi, Anambra state, Nigeria.
authors.forename: Clement
authors.initials: C
authors.lastname: Ezechukwu
authors.affiliation: Department of Paediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria.
authors.forename: Uchenna
authors.initials: U
authors.lastname: Ekwochi
authors.affiliation: Department of Paediatrics, Nnamdi Azikiwe University teaching Hospital, Nnewi, Anambra state, Nigeria.
authors.forename: Ifeyinwa
authors.initials: I
authors.lastname: Ndukwu
keywords: Exclusive breastfeeding; Infant feeding practice