Flax Valerie L, Fagbemi Mariam, Ngongo Carrie, Edwards Susan, Dharod Jigna M, Ogbodo Victor
RTI International, Durham, North Carolina, United States of America.
Yucca Consulting, Lagos, Nigeria.
PLOS Glob Public Health. 2025 Jun 27;5(6):e0004753. doi: 10.1371/journal.pgph.0004753. eCollection 2025.
Early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), and minimum dietary diversity (MDD) are recommended infant and young child feeding (IYCF) practices. Subnational analyses of predictors of these practices are rare but can contribute to programmatic and policy decisions. The aim of this study was to assess predictors of EIBF, EBF, and MDD in Kaduna and Lagos States, Nigeria. This analysis of the population-based data from the Alive & Thrive impact evaluation [Kaduna (N = 4,702), Lagos (N = 1,563)] used chi-square automatic interaction detection to select variables related to EIBF, EBF, and MDD with P < 0.20. Final logistic regression models retained predictors associated with each outcome at P < 0.05. Positive predictors of EIBF were woman-headed household (both states), contact with a health worker (both), EIBF knowledge (both), EIBF awareness (Lagos), EIBF beliefs (both), EIBF self-efficacy (Kaduna), maternal education (Kaduna), household food security (Kaduna), delivery at health facility (Kaduna), counseling on EIBF (Lagos), and vaginal birth (Lagos). Maternal employment was negatively associated with EIBF (Kaduna). Positive predictors of EBF were EBF knowledge (both), EBF awareness (Kaduna), EBF beliefs (Kaduna), EBF self-efficacy (both), postpartum practices such as checking to see if the baby was sucking well (Kaduna), maternal education (Kaduna), household food security (Kaduna), and EBF norms (Lagos). The child having fever in the last 2 weeks was negatively associated with EBF (Kaduna). Positive predictors of MDD were child's age (both), socioeconomic status (both), four or more antenatal care visits (Kaduna), child still breastfed (Kaduna), complementary feeding awareness (Kaduna), complementary feeding beliefs (Kaduna), help from husband or mother/mother-in-law (Kaduna), contact with a health worker (Lagos), complementary feeding knowledge (Lagos), and complementary feeding self-efficacy (Lagos). Maternal education (Kaduna) and household food security (Lagos) were negatively associated with MDD. This study reveals that different combinations of behavioral factors and maternal and household characteristics are critical predictors of IYCF in Nigeria, though variations exist between Kaduna and Lagos. These insights can inform tailored state-specific IYCF interventions and policies to improve IYCF practices in Nigeria.
早期开始母乳喂养（EIBF）、纯母乳喂养（EBF）和最低饮食多样性（MDD）是推荐的婴幼儿喂养（IYCF）方式。对这些喂养方式预测因素的次国家级分析很少见，但可为项目和政策决策提供参考。本研究的目的是评估尼日利亚卡杜纳州和拉各斯州EIBF、EBF和MDD的预测因素。这项基于“活力与繁荣”影响评估中的人口数据进行的分析（卡杜纳州N = 4702，拉各斯州N = 1563）使用卡方自动交互检测来选择与EIBF、EBF和MDD相关且P < 0.20的变量。最终的逻辑回归模型保留了与每个结果相关且P < 0.05的预测因素。EIBF的正向预测因素有女性为户主的家庭（两个州均是）、与卫生工作者接触（两个州均是）、EIBF知识（两个州均是）、EIBF意识（拉各斯州）、EIBF信念（两个州均是）以及EIBF自我效能感（卡杜纳州）、母亲教育程度（卡杜纳州）、家庭粮食安全（卡杜纳州）、在医疗机构分娩（卡杜纳州）、关于EIBF的咨询（拉各斯州）以及顺产（拉各斯州）。母亲就业与EIBF呈负相关（卡杜纳州）。EBF的正向预测因素有EBF知识（两个州均是）、EBF意识（卡杜纳州）、EBF信念（卡杜纳州）、EBF自我效能感（两个州均是）、产后行为如检查婴儿吸吮情况是否良好（卡杜纳州）、母亲教育程度（卡杜纳州）、家庭粮食安全（卡杜纳州）以及EBF规范（拉各斯州）。过去两周内孩子发烧与EBF呈负相关（卡杜纳州）。MDD的正向预测因素有孩子年龄（两个州均是）、社会经济地位（两个州均是）、四次或更多次产前检查（卡杜纳州）、孩子仍在母乳喂养（卡杜纳州）、辅食添加意识（卡杜纳州）、辅食添加信念（卡杜纳州）、丈夫或母亲/岳母提供的帮助（卡杜纳州）、与卫生工作者接触（拉各斯州）、辅食添加知识（拉各斯州）以及辅食添加自我效能感（拉各斯州）。母亲教育程度（卡杜纳州）和家庭粮食安全（拉各斯州）与MDD呈负相关。本研究表明，行为因素以及母亲和家庭特征的不同组合是尼日利亚婴幼儿喂养方式的关键预测因素，尽管卡杜纳州和拉各斯州存在差异。这些见解可为制定针对特定州的婴幼儿喂养干预措施和政策提供参考，以改善尼日利亚的婴幼儿喂养方式。
