Knowledge, attitude, and practice of exclusive breastfeeding among post-natal women in Kwara State, Nigeria: a descriptive cross-sectional study

Abstract

BACKGROUND: Exclusive breastfeeding (EBF) is essential for optimal infant nutrition and health, yet its uptake remains suboptimal in Nigeria. Although the Accelerating Nutrition Results in Nigeria (ANRiN) project delivers community-based nutritional interventions, there is limited evidence on how access to the intervention influenced mothers' knowledge, attitudes, and practices (KAP) regarding EBF, particularly in Kwara State. OBJECTIVES: This study assessed the KAP of EBF among mothers of infants aged 0-6 months in Kwara State and identified the sociodemographic predictors associated with these outcomes with access to ANRiN intervention as a comparator. METHODS: A descriptive cross-sectional study was conducted among 582 mothers of infants aged 0-6 months (with access to ANRiN intervention as a comparator into beneficiaries and non-beneficiaries), recruited using multistage sampling. Data were collected with a structured questionnaire and analyzed using chi-square tests, t-tests, and logistic regression. RESULTS: Beneficiaries demonstrated significantly higher knowledge (10.65 ± 2.49 vs. 8.98 ± 2.69, p < 0.001) and attitude scores (5.52 ± 0.91 vs. 5.32 ± 1.13, p = 0.024) than non-beneficiaries. The prevalence of breastfeeding in the previous 24 h was also higher among beneficiaries (56.6%) compared to non-beneficiaries (43.4%, p = 0.012), though this does not necessarily reflect sustained EBF for six months. Predictors of good knowledge and attitudes differed between groups: for non-beneficiaries, partner education (p = 0.013, p = 0.009), higher income (p = 0.010), and healthcare provider information (p = 0.002) were significant, whereas among beneficiaries, urban residence (p = 0.002), self-employment (p = 0.023), and healthcare provider information (p < 0.001) were strongest. Improved practices among beneficiaries were associated with higher partner education (p = 0.048) and employment (p = 0.001, p = 0.015). CONCLUSIONS: The findings show that nutritional interventions such as ANRiN not only enhance mothers' EBF knowledge and attitudes but also shape distinct predictors of practice compared to non-beneficiaries. Tailored strategies that consider these differential predictors, such as targeting rural, less-educated households for non-beneficiaries and addressing urban-rural disparities among beneficiaries, may strengthen the effectiveness of EBF promotion programs in Nigeria.