Breastfeeding is a major factor in child growth and very effective as a birth-spacing method, yet its use is still low in developing countries. This study examined the impact of socio-demographic factors on the reported low usage of breastfeeding as a child-spacing method. The study utilized the combination of Max Weber's Social Action Theory and Ajzen and Fishbien's Theory of Reasoned Action as its theoretical framework. Three hundred and thirty-eight copies of a structured questionnaire were administered to nursing mothers. Additional data were collected through qualitative method, such as in-depth interview. A total of 71.4% of the nursing mothers who had post-secondary education had a higher knowledge of exclusive breastfeeding (EBF) as a contraceptive, while 68.8% of the women with lower income would likely use EBF as a contraceptive. A total of 45.4% of the nursing mothers were using EBF as contraceptive, while 31.5% were complementing it with other family planning methods. Socio-demographic factors such as age, income, education and ethnic membership affected the use of EBF as a contraceptive. Suggestions for intervention include health education, especially during antenatal/postnatal sessions and aggressive advocacy on the effectiveness of EBF.


Birth-spacing, Breastfeeding, Contraceptive, Nursing mothers

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Agho, K. E.; Dibley, M.J.; Odiase, J.I. and Ogbonmwan, S.M. 2011. Determinants of exclusive breastfeeding in Nigeria. BMC Pregnancy Childbirth. Volume. 11, No. 2: Pp. 1-4.

Agunbiade, O. M. and Ogunleye, O. V. 2012. Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: implications for scaling up. International Breastfeeding Journal, 7: 5. Pp. 1-10.

Ajzen, I. & Fishbein, M. 1980. Understanding attitudes and predicting social behaviour. Englewood Cliffs, NJ: Prentice-Hall.

Ayoade, A. R. & Adeola, R. G. 2012. Effects of poverty on Rural Household Welfare in Oyo State, Nigeria. Global Journal of Science Frontier Research Agriculture & Biology Volume 12, Issue 4:Pp. 1-9.

Al-Binali, A. M. 2012. Breastfeeding knowledge, attitude and practice among school teachers in Abha female educational district, southwestern Saudi Arabia. International Breastfeeding Journal, vol. 7:10. Pp. 1-3.

Sapna, S.P.; Ameya, A.H.; Rooma, S.P.; Aarti, P.; Rashid, A.K. and Narayan, K.A. 2009. Prevalence of exclusive breastfeeding and its correlates in an urban slum in western India. International Journal of Science Medicine & Education, 3(2):14–18.

Al-Sahab, B.; Lanes, A.; Feldman, M. and Tamim, H. 2010. Prevalence and predictors of 6 - months exclusive breastfeeding among Canadian women: a national survey. BMC Pediatr. 2010, vol. 10, No. 20: Pp. 1-7.

Caldwell, J.C. 1979. Education as a factor in mortality decline: An examination of Nigerian data. Population Studies, (November) 33: 395-413.

Caleb, L.M. and Townsend, J.W. 1996. lactational amenorrhoea method for birth spacing in Uttar Pradesh, India: Population Council, Operations Research and Technical Assistance Project.

Central Statistical Agency [Ethiopia] and ICF International, 2012. Ethiopia demographic and health survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012.

Cochrane, S.H. 1979. Fertility and education: What do we really know? Baltimore: Johns Hopkins University Press.

Dada, O.A.; Akesode, F.A.; Olanrewaju, D.M.O.A.; Sule-odu, O.; Fakoya, T.A.; Oluwole, F.A.; Odunlami, B.V. and W.H.O. 2002. Infant feeding and lactational amennorrhea in Sagamu, Nigeria. Africa Journal of Reproductive Health vol. 6: Pp. 39-50.

Dyson, T. & Moore, M. 1983.On kinship structure, female autonomy and demographic behavior in India. Population and Development Review (March) 9: 35-60.

Egata, G.; Berhane, Y. and Worku, A. 2013. Predictors of non-exclusive breastfeeding at 6 months among rural mothers in east Ethiopia: a community-based analytical cross-sectional study. International Breastfeeding Journal vol. 8, No. 8: Pp. 1-16.

Family Health International (FHI). 1998 or 1988. Breastfeeding as a family planning method. Lancet, Nov.19, Pp. 1204-1205.

Gomes, G.P. and Gubert, M. 2012. Breastfeeding in children under 2 years old and household food and nutrition security status. Journal de Pediatric, 2012, vol. 88(3): Pp. 279–282.

Institute of Advanced Medical Research and Training (IMRAT) 2011. Notice of full approval after full committee review UI/EC/11/0042. College of Medicine, University of Ibadan, Ibadan, Nigeria.

James, D. C. S. and Lessen, R. 2009. Position of America Dietetic Association: promoting and supporting breastfeeding. Journal of American Dietary Association., 109 (11): Pp. 1926-1942.

Jones, G.; Steketee, R. W.; Black, R. E.; Bhutta, Z. A.; Morris, S. S. 2003. Bellagio Child Survival Study Group: How many child deaths can prevent this year? Lancet, vol. 362: Pp. 65-71.

Kennedy, K. et al. 1989. Consensus Statement on the use of breast-feeding as a family planning method. Contraception, 39: 477-496.

Kennedy, K.I. and Kotelchuck, M. 1998. Policy Considerations for the introduction and promotion of the lactational amenorrhea method: advantages and disadvantages of LAM”. Journal of Human Lactation. vol. 14: Pp. 191-203.

Kennedy, K.I.; Rivera, R. and McNeilly S. 1989.Consensus statement on the use of breastfeeding as a family planning method. Contraception 39(5): Pp. 477-496.

Kimani-Murage, E.W.; Madise, N.J.; Fotso, J.C.; Kyobutungi, C.; Mutua, M.K.; Gitau, T.M. and Yatich N. 2011. Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health, vol. 11: p. 396.

Koosha, A.; Hashemifesharaki, R. and Mousavinasab, N. 2008. Breastfeeding patterns and factors determining exclusive breast-feeding. Singapore Medical Journal, vol. 49(12): Pp. 1002–1006.

Kramer, M. S. and Kakuma, R. 2002. The optimal duration of exclusive breastfeeding: a systematic review. Department of Nutrition for Health and Development & Department of Child and Adolescent Health Organization. Accessed on October 20, 2013 from

Labbok, M.H.; Perez, A.; Valdes, V.; Sevilla, F.; Wade, K.; Lukaran, V.H. et al. 1994. The lactational amenorrhea method (LAM): a postpartum introductory family planning method with policy and program implications. Advances in Contraception vol. 10: Pp. 93-109. [CrossRef] [Medline] [Web of Science].

Lemeshow, S.; Hosmer, D.W.; Klar, J. and Lwanga, S.K. 1990. Adequacy of sample size in health studies. Geneva: World Health Organization.

Mihrshahi, S.; Ichikawa, N.; Shuaib, M.; Oddy, W.; Ampon, R.; Dibley, M.J.; Kabir, A.K.M.L. and Peat, J.K. 2007. Prevalence of exclusive breastfeeding in Bangladesh and its association with diarrhoea and acute respiratory infection: results of the multiple indicator cluster survey 2003. Journal of Health Population Nutrition, 25(2): Pp. 195–204.

Nabulsi, N. 2009. Why are breastfeeding rates low in Lebanon? A qualitative study. BMC Pediatric, 11: 75.

National Bureau of Statistics (NBS) and Multiple Indicator Cluster Survey (MICS), 2011. Monitoring the situation of children and women. Multiple Indicator Cluster Survey Nigeria; Main Report, April 2013: Pp. 1- 420.

Multiple Indicator Cluster Survey 2011. National Bureau Statistics (NBS), United Nations Children's Fund (UNICEF), United Nations Population Fund (UNFPA); Multiple Indicator Cluster Survey Nigeria, 2011; Main Report, April 2013: Pp. 1- 420.

Nigeria Demographic and Health Survey 2008. National Population Commission (NPC) [Nigeria] and ICF Macro, 2009. National Population Commission and ICF Macro, Abuja, Nigeria: National Population Commission and ICF Macro.

National Population Commission (NPC) [Nigeria] and ICF Macro, 2009. Nigeria Demographic and Health Survey 2008. National Population Commission and ICF Macro, Abuja, Nigeria: National Population Commission and ICF Macro.

Qiu, L.; Zhao, Y.; Binns, C.W.; Lee, A.H. and Xie, X. 2009. Initiation of breastfeeding and prevalence of exclusive breastfeeding at hospital discharge in urban, suburban, and rural areas of Zhejiang China. International Breastfeeding Journal 2009, vol. 4, No. 1: Pp. 1-5.

Saha, K.K.; Frongillo, E.A.; Alam, D.S.; Arifeen, S.E.; Persson, L.A.; Rasmusse, K.M. 2008. Household food security is associated with infant feeding practices in rural Bangladesh. Journal of Nutrition, vol. 138: Pp.1383–1390.

Senaiumhe, A.E. and Oviawe, O. 1996. The changing pattern of post partum sexual abstinence in a Nigerian Rural Community Social Science Medical; 23(7): Pp. 683-686.

Shi, L.; Zhang, J.; Wang, Y. and Guyer, B. 2008. Breastfeeding in rural China: association between knowledge, attitudes, and practices. J Hum Lact 2008, vol. 24: Pp. 377–385.

Tan, K. L. 2011. Factors associated with exclusive breastfeeding among infants under-six months of age in peninsular Malaysia. International Breastfeeding Journal, 2011, vol. 6, No. 2: Pp. 1-5.

Tan, K.L. 2009. Factors associated with non-exclusive breastfeeding among 4-week post-partum mothers in Klang district, Peninsular Malaysia. Malaysian Journal of Nutrition, vol. 15(1): Pp. 11–18.

Thulier, D. and Mercer, J. 2009. Variables associated with breastfeeding duration. J Obstet Gynaecol Neonatal Nurs 2009, 38 (3): Pp. 259-268.

Ulak, M.; Chandyo, R. K.; Mellander, L.; Shrestha, P.S. and Strand, T.A. 2012. Infant feeding practices in Bhaktapur, Nepal: a cross-sectional, health facility based survey. International Breastfeeding Journal, vol. 7, No.1: Pp. 1-6.

United States Agency for International Development (USAID), 2013. ADS Chapter 212- Breastfeeding Promotion. Functional Series 200- Programming Policy. Pp. 1-10.

Venancio, S.I. and Monteiro, C.A. 2005. Individual and contextual determinants of exclusive breastfeeding in Sa˜o Paulo, Brazil: a multilevel analysis. Public Health Nutr 2005, vol. 9: Pp.40–46.

Weber, M. 1978. Economy and society: an outline of interpretive Sociology, USA: University of California Press.

Weber, M. & Secher, H.P. 1962. Basic concepts in Sociology. Contributions: Max Weber and H.P. Secher: the citadel press, New York.

Winikoff, B.; Semeraro, P. and Zimmerman, M. 1988. Contraception during breastfeeding: a clinician’s source book. New York: The Population Council.

World Health Organization (WHO), 2002. Global strategy for infant and young child feeding [Internet]. Geneva, Switzerland: World Health Organization; [updated 2002 May 18]. AccessedonNovember1,2013from,pdf.

Wade, K.; Sevilla, F. & Labbok, M. 1994.Integrating the lactational amenorrhea method into family planning program in Ecuador. Studies in Family Planning 25(3): 162-175.

Kazi, A.; Kennedy, K.I.; Visness, C.M. & Khan, T. 1995.Effectiveness of the lactational amenorrhea method in Pakistan. Fertility and Sterility. 64:717-723.

Cooney, K.A.; Nyuirabukeye, T.; Labbok, M.H.; Hoser, P.H. & Balard, E. 1996.An assessment of the nine-month lactational amenorrhea method (MAMA-9) in Rwanda. Study Family Planning 27:162-171.

Oyedokun, A.O. 2004. Domestic violence and contraceptive use in Ife-North Local Government Area of Osun State, Nigeria. Unpublished M.Sc. thesis submitted to the Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.169.

Population Reports 1999. Ending Violence against Women. Series L, Number 11. Volume XXVII, No. 4, December 1999.

World Health Organization (WHO), 2003. Global strategy for infant and young child feeding. Geneva: World Health Organization, 2003.


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