Maternal education, breastfeeding behaviours and lactational amenorrhoea: studies among two ethnic communities in Ile Ife, Nigeria

Abstract

Breastfeeding is an important child survival strategy. This report aims to describe the unique contributions of education, ethnicity, and other variables to breastfeeding outcomes. The study was conducted among two groups of lactating mothers in Ile Ife, southwestern Nigeria, using structured questionnaires focusing on their breastfeeding history and current practice. Breastfeeding initiation was delayed in both groups, and primary education is the most significant predictor of initiation of breastfeeding within 6 hours of delivery (OR = 3.92, p = 0.0117). Breastfeeding duration (SD) was 13.7 (4.3) months for the Yorubas and 17.5 (3.4) for the Hausas. Its only significant predictors are education (p < = 0.0001), with an average decrease in breastfeeding duration of 3.2 and 6.6 months with mother's education to the primary and post-primary levels respectively, compared with mothers with no education. In turn, breastfeeding duration is the most significant predictor of the duration of lactational amenorrhoea (p = 0.0000). Mothers with some formal education are also more likely to start feeding human milk substitutes at 2 weeks (OR = 3.83, p = 0.024). The most important variable determining breastfeeding in this study is education. The educated mother is more likely to be involved in economic activity away from the home. To protect breastfeeding in these communities, there is a need for programmes to support the breastfeeding mother who works.

PIP: The contribution of maternal education to breast feeding behaviors among the two main ethnic groups, Yoruba and Hausa, in Ile Ife, Nigeria, was assessed through a random survey of lactating mothers who brought their infants to the Urban Comprehensive Health Center for first immunization. The 50 Yoruba mothers had significantly more years of education and fewer children than the 62 Hausa respondents. 87% of Hausa women compared to only 8% of Yorubas were full-time housewives; the proportions in polygamous unions were 66% and 26%, respectively. Primary education significantly increased the likelihood of breast feeding initiation within the first 6 hours of delivery (odds ratio, 3.92). The duration of breast feeding averaged 13.7 months among Yorubas and 17.5 months among Hausa mothers. This duration was significantly longer for full-time housewives (17.6 months) than women who worked away from home (14.1 months). There was an average decrease in breast feeding duration of 3.2 and 6.6 months with mother's education to the primary and secondary levels, respectively, compared with mothers with no education. At 15 months after delivery, 29% of Yorubas and 67% of Hausa mothers were still experiencing lactational amenorrhea. Belonging to the Hausa group contributed 4.4 additional months of postpartum amenorrhea. Hausa mothers were significantly less likely than Yorubas or mothers with some formal education to use human milk substitutes. To protect breast feeding in educated working women, measures such as child care centers at or near the workplace and promotion of the use of expressed breast milk are recommended.