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Motivators and disincentives to exclusive breastfeeding among mothers in Zaria, Northwestern Nigeria

Background: Human milk remains the best food for infant optimal nutrition, growth, and development. Breastfeeding among mothers however remains challenging with an increasingly less proportion of mothers′ breastfeeding their babies and even far less practicing exclusive breastfeeding (EBF). Bearing in mind the complexities in deciding infant nutrition in our communities, the study explored the motivators and disincentives to EBF among mothers and assessed mothers′ perception of key stakeholders in influencing infant nutrition decision-making. Objective: To evaluate factors that motivate/deter mothers from exclusively breastfeeding their babies in Zaria. Methods: The study was a cross-sectional study of mothers in Zaria as part of a national multicenter breastfeeding survey. Information was obtained using a specifically designed structured interviewer-administered questionnaire on mothers′ knowledge and practices of breastfeeding and their perception of the attitude of significant others to EBF. Focus-group discussions were held with groups of predefined significant others (fathers and grandmothers), and in-depth interviews were also conducted. Results: Ninety-seven percent of mothers have heard of EBF while 68% had a correct perception of the concept. The percentage of those that ever breastfed was 98.1% while only 2% practiced EBF. Motivation to EBF appeared to be the conviction on the benefits of EBF. Reasons for not supporting EBF were mainly surrounding the perceptions that babies like adults must drink water even if once a day and the inadequacy of human milk as sole infant nutrition within the first 6 months of life. Mothers perceived mainly health workers as promoters and supportive of EBF and breastfeeding in general while religious leaders and relatives, particularly fathers and grandmothers, though aware of EBF, were least supportive. Conclusion: Almost all mothers were aware of EBF; however, only a few (2%) exclusively breastfed their babies. Incentives to EBF appear to go beyond information and knowledge of breastfeeding. More needs to be done to understand other factors which influence mothers will to exclusively breastfeed.