Breastfeeding support among healthcare workers in Nigeria

The exclusive breastfeeding rate in Sub-Saharan Africa is abysmally low, and based on current trends, achieving the World Health Organization's (WHO) global nutrition goal of a 50% exclusive breastfeeding rate by 2025 will require an additional three decades.

This is a cross-sectional study involving healthcare workers (HCWs) providing direct care to breastfeeding mothers in six geopolitical zones in Nigeria. HCWs were recruited using a stratified random sampling method, with a minimum sample size of 1537. Data was collected through validated-interviewer-administered-questionnaires.

The mean age of the 1294 respondents was 35.2 ± 10.0 years, with a male-to-female ratio of 1:3. Overall, breastfeeding knowledge was subsufficient (41.2% across three domains), with specific knowledge gaps observed in breastfeeding for mothers with breast cancer (13.4%) and hepatitis B (59.4%). Only 18.9% correctly identified laid-back and cross-cradle breastfeeding positions. High school and tertiary education were significantly associated with sufficient breastfeeding knowledge (AOR: 2.2, 95% CI 1.299–3.738; AOR: 2.0, 95% CI 1.234–3.205). Negative attitudes toward breastfeeding support were associated with being female (AOR: 1.5, 95% CI 1.094–1.957), while being a doctor was linked to the lowest instructional support (AOR: 0.3, 95% CI 0.118–0.661). Positive attitudes toward breastfeeding support were significantly associated with sufficient knowledge (AOR: 2.4, 95% CI 1.833–3.161; p < 0.001), but not with technical knowledge (AOR: 0.8, 95% CI 0.629–0.993).

Healthcare workers showed subsufficient overall breastfeeding knowledge, especially regarding breastfeeding in maternal illnesses and positioning. Targeted programs are needed to improve breastfeeding support knowledge, instructional support and attitudes, especially among female HCWs and physicians.