title: Determinants of early initiation of breastfeeding in Nigeria: a population-based study using the 2013 demograhic and health survey data.
abstract: BACKGROUND
  Provision of mother's breast milk to infants within one hour of birth is referred to as Early Initiation of Breast Feeding (EIBF) which is an important strategy to reduce perinatal and infant morbidities and mortality. This study aimed to use recent nationally representative survey data to identify individual, household and community level factors associated with EIBF and to update on previous knowlegde with regards to EIBF in Nigeria.
  
  
  METHODS
  We used cross-sectional data from the 2013 Nigerian Demographic and Health Survey (NDHS). Chi-square tests and binary logistic regression were used to test for association between EIBF and individual, household and community level factors.
  
  
  RESULTS
  The proportion of infants who initiated breastfeeding within 1 h of birth was 34.7% (95% Confidence Interval (CI): 33.9-35.6). In the multivariate analysis, mothers who delivered in a health facility were more likely to initiate breastfeeding early as compared to mothers who delivered at home (Adjusted Odds Ratio (AOR) =1.40, 95% CI = 1.22-1.60). The odds of EIBF was three times higher for mothers who had vaginal delivery as compared to mothers who had caesarean section (AOR = 3.08, 95% CI = 2.14-4.46). Other factors that were significantly associated with increased likelihood of EIBF were; multiparity, large sized infant at birth, not working mothers as compared to mothers working in sales and other sectors, wealthier household index and urban residence. Mothers in the South West were less likely to inititiate breastfeeding within 1 h of birth as compared to the North West, however, the following geopolitical zones; North East, North Central, and South South had higher likelihood of EIBF when compared to the North West geopolitical zone.
  
  
  CONCLUSIONS
  EIBF in Nigeria is not optimal with just about 34.7% of children initiating breastfeeding within one hour of birth, the results suggest that breastfeeding programmes and policies should give special attention to "rural mothers, working mothers, primiparous mothers, mothers with ceasarean deliveries, home deliveries and poor mothers" and this intervention should cut across geopolitical zones with more emphasis to zones with lower rates of EIBF.
authors: Institute of Public Health, Hacettepe University, Ankara, Turkey. anselm.berde@hacettepe.edu.tr.
authors: Anselm S
authors: AS
authors: Berde
authors: Department of Social Peadiatrics, Hacettepe University, Ankara, Turkey.
authors: Siddika Songül
authors: SS
authors: Yalcin
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D004651:Employment; D005260:Female; D062306:Geography, Medical; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D009549:Nigeria / Q000453:epidemiology; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult