Although breastfeeding is widely practiced across all subgroups of women, the timing of initial breastfeeding varies by background characteristics. WHO recommends early (i.e. within one hour of giving birth) initiation of breastfeeding. According to NDHS (2008), the proportion of children breastfed within one hour of delivery is slightly higher in urban areas (41 %) than in rural areas (38 %). With respect to states, North Central has the highest proportion (61 %) of children breastfed within one hour of birth, while the North East has the lowest proportion (25 %), which is surprising given that they are contiguous states. Children born to mothers with at least primary education are more likely to be breastfed within one hour of birth than those born to mothers with no education (NDHS, 2008).
Prelacteal feeding is widely practiced in Nigeria. More than half (56 %) of last-born children received a prelacteal feed. There are no marked differences in the proportions of children, who received a prelacteal feed by sex of the child.
There are substantial variations by residence, assistance at delivery, and place of delivery. Prelacteal feeding is most widely practiced in North East (79 %) and North West states (68 %), and is least common in South West (31 %). Children whose mothers have more than secondary education (33 %) are less likely to receive prelacteal feeds than children whose mothers have no education (68 %). Likewise, children born to mothers in the highest wealth quintile (39 %) are less likely to receive a prelacteal feed than children born to mothers in the lowest wealth quintile (71 %) (NDHS, 2008).
According to the NDHS 2008, the median duration of any breastfeeding in Nigeria is 18.1 months with the mean duration of 17.9 months. The median duration does not vary much by sex of the child. Rural children are breastfed for a longer duration (19 months) than urban children (16.2 months). Children in households in the highest wealth quintile are breastfed for the shortest duration (14.6 months) while other children are breastfed for 17-21 months. The NW and NE states have the highest median duration of breastfeeding in the whole of Nigeria (20 months and 20.7 months respectively).
The median duration of completely exclusive breastfeeding at national level is less than one month and in the NW is less than half a month (0.4). The NW and NE states have the highest incidence of âpredominantly breastfedâ, which is defined as either exclusively breastfed or received breast milk and plain water, and/or non-milk liquids only, at 4.6 months. This duration is almost twice as long as other Nigerian states, and still falls some way short of both the recommended practise and duration.
The NDHS surveys of 2003 and 2008 show no change in the prevalence of exclusive breastfeeding in the NW states, being less than half a month (0.4) on both occasions. The MICS (2007) survey shows that the exclusive breast feeding rate (6 months) was 11.75% nationally, while the percentage of children 0-5 months in the five Programme states exclusively breast fed varied from 1.3% in Yobe to 4.7% in Kebbi; this is among the lowest in the country.
A study of 256 caregivers and 704 children age 6-24 months, based in the three NW states of Kaduna, Kebbi and Niger, found on average over 70% of mothers were still breastfeeding at the time of the survey (Matthew et al, 2009). The duration of breastfeeding was between 13-24 months (73.4%). Only 54.3% of mothers in NW practiced exclusive breastfeeding for the first six months but practices of exclusive breast feeding were not in compliance with international standards as over three-quarters of caregivers also gave plain water. About one fifth of caregivers (19%) reported always sterilizing bottle feeds. Complementary foods were introduced to the majority of the children much earlier than the sixth month recommended, at third month (41.2%), and for the first 1-2 months for 17.8%. This study also revealed that on the average, 31.7% of the children sampled were severely stunted which was lower than the national average.
A study in Ondo State found that a high proportion of the nursing mothers used local ingredients to formulate weaning foods for their babies (Ijarotimi et al, 2006). The nutritional composition of these foods is of high quality and they are suitable as weaning foods, particularly for infants of low-income parents who do not have access to commercial weaning foods.