(P24-020-24) Factors Associated With Infant and Young Child Feeding Practices in Kaduna and Lagos States, Nigeria

Objectives: This study examined factors associated with early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), and minimum dietary diversity (MDD) in Kaduna and Lagos States, Nigeria.

Methods: We used baseline population-based survey data from the Alive & Thrive Nigeria impact evaluation (total N=6,008) to assess correlations of factors selected for each outcome (EIBF, EBF, MDD). We then used backward stepwise regression to fit the models by state. We built composite scores for maternal breastfeeding and complementary feeding knowledge, awareness, beliefs, and self-efficacy and used principal components analysis for assets.

Results: Maternal knowledge, awareness, beliefs, perceptions of positive social norms, and self-efficacy were positively associated with EIBF, EBF, and MDD in both states. Breastfeeding counseling and contact with a community health worker were positively associated with EIBF and EBF in Kaduna and with EIBF and MDD in Lagos. In Kaduna, antenatal care attendance was negatively associated with EIBF and EBF, but positively associated with MDD. Facility birth and vaginal delivery were positively associated with EIBF in both states. The child having diarrhea or fever was negatively associated with EBF in Kaduna and Lagos, respectively. Maternal education was positively associated with all three outcomes in Kaduna, though not in Lagos. Maternal-headed household was positively associated with EIBF in both states, but negatively associated with both EBF and MDD in Kaduna. In Kaduna, wealth, approximated by assets, was associated with MDD but not EIBF or EBF. Support from husbands and mothers/mothers-in-law was positively associated with MDD in Kaduna but was either not predictive or negatively associated with breastfeeding behaviors.

Conclusions: These findings point to modifiable factors, such as maternal awareness, beliefs, and self-efficacy, that could be addressed by nutrition programs implemented by the government of Nigeria and its partners. Community health workers offer important support for breastfeeding, which could potentially be better reinforced by other sources (antenatal care, husbands, mothers-in-law).

Funding Sources: This analysis was funded RTI International. Data collection was funded by the Bill & Melinda Gates Foundation through FHI360.