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Midwives' Perspectives on Exclusive Breastfeeding Support in Umuahia North, Nigeria: A Qualitative Study


Authors : Martins-Okonji Nelly Chinemerem; Faith Diorgu; Bernice Amala Ogolo

Volume/Issue : Volume 11 - 2026, Issue 7 - July


Google Scholar : https://tinyurl.com/4busf5zf

Scribd : https://tinyurl.com/3pwyt2jd

DOI : https://doi.org/10.38124/ijisrt/26jul327

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Abstract : Background: Exclusive breastfeeding for the first six months of life lowers infant illness and death, yet uptake in Nigeria remains below global targets. Midwives are the health workers most consistently placed to counsel and support mothers on this practice, but their own perceptions and experiences of providing this support are rarely examined on their own terms, particularly across different tiers of care. This study explored how midwives working in primary and tertiary health facilities in Umuahia North Local Government Area, Abia State, perceive and experience their role in supporting exclusive breastfeeding.A qualitative descriptive design was used. Eight midwives working in antenatal, postnatal, immunisation and maternity units across two primary health centres and one tertiary hospital were purposively selected and interviewed using a semi-structured guide until no new information emerged. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Two broad themes emerged, comprising five barrier subthemes and four facilitator subthemes. Under barriers, midwives described pressure from family members and cultural custom, the pull of paid work on new mothers, the emotional strain mothers carry after delivery, maternal misconceptions about the adequacy of breast milk, and thin staffing with heavy caseloads. Under facilitators, midwives pointed to their own continuous reassurance and follow-up, stronger maternity-leave and workplace policies, structured antenatal and postnatal counselling, and encouragement from husbands and relatives. Midwives in this setting see themselves as central to exclusive breastfeeding promotion but describe their effectiveness as bounded by staffing levels, time, and the social pressures mothers face outside the clinic. Strengthening staffing, in-service training and family-inclusive counselling could improve breastfeeding support at both levels of care.

Keywords : Exclusive Breastfeeding; Midwives; Breastfeeding Support; Qualitative Study; Primary Health Care; Nigeria.

References :

  1. Adebayo, O. O., Omolade, D. G., Kehinde, A. C., Folashade, S. F., & Chiemeka, N. C. (2020). Knowledge, practice and challenges of exclusive breastfeeding among working mothers attending antenatal clinic in Lagos University Teaching Hospital, Idi-Araba. Scientific Research Journal, 3(2), 45–74.
  2. Adeyanju, C. A. (2023). Barriers and enablers to exclusive breastfeeding practices among women working in formal and informal sectors in Nigeria: A literature review [Master's thesis, Vrije Universiteit Amsterdam].
  3. Alabrah, J. A., Diorgu, F. C., & Onasoga, O. (2023). Maternal experiences and midwives' perspectives on breastfeeding support in a general hospital setting: A qualitative study. Journal of Public Health and Toxicological Research, 1(1), 24–29
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  5. Bäckström, C. A., Hertfelt Wahn, E. I., & Ekström, A. C. (2010). Two sides of breastfeeding support: Experiences of women and midwives. International Breastfeeding Journal, 5, 20. https://doi.org/10.1186/1746-4358-5-20
  6. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
  7. Dwiyanti, N. K. N., Sari, K. A. K., & Duarsa, D. P. (2019). Exclusive breastfeeding: The role of midwives at pregnancy, childbirth and postpartum. Public Health and Preventive Medicine Archive, 7(2), 127–134.
  8. Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82.
  9. Kinshella, M. O., Prasad, S., Hiwa, T., Vidler, M., Nyondo-Mipando, A. L., Dube, Q., Goldfarb, D., & Kawaza, K. (2021). Barriers and facilitators for early and exclusive breastfeeding in health facilities in Sub-Saharan Africa: A systematic review. Global Health Research and Policy, 6, 21.
  10. Malterud, K., Siersma, V. D., & Guassora, A. D. (2016). Sample size in qualitative interview studies: Guided by information power. Qualitative Health Research, 26(13), 1753–1760.
  11. National Population Commission (NPC) [Nigeria] & ICF. (2019). Nigeria demographic and health survey 2018. NPC and ICF.
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  13. Nwokoro, R. O., & Akunneh-Wariso, N. B. (2023). First time mothers' perception and experience about breastfeeding support received from nurses in health facilities in Aba. International Journal of Nursing, Midwife and Health Related Cases, 9(2), 16–28.
  14. Rollins, N. C., Piwoz, E. G., Baker, P., Kingston, G., Mabaso, K. M., McCoy, D., Neves, P. A. R., Pérez-Escamilla, R., Richter, L., Russ, K., Sen, G., Tomori, C., Victora, C. G., Zambrano, P., & Hastings, G. (2023). Marketing of commercial milk formula: A system to capture parents, communities, science, and policy. The Lancet, 401(10375), 486–502
  15. .Seabela, E. S., Modjadji, P., & Mokwena, K. E. (2023). Facilitators and barriers associated with breastfeeding among mothers attending primary healthcare facilities in Mpumalanga, South Africa. Frontiers in Nutrition, 10, 1062817.
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Background: Exclusive breastfeeding for the first six months of life lowers infant illness and death, yet uptake in Nigeria remains below global targets. Midwives are the health workers most consistently placed to counsel and support mothers on this practice, but their own perceptions and experiences of providing this support are rarely examined on their own terms, particularly across different tiers of care. This study explored how midwives working in primary and tertiary health facilities in Umuahia North Local Government Area, Abia State, perceive and experience their role in supporting exclusive breastfeeding.A qualitative descriptive design was used. Eight midwives working in antenatal, postnatal, immunisation and maternity units across two primary health centres and one tertiary hospital were purposively selected and interviewed using a semi-structured guide until no new information emerged. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Two broad themes emerged, comprising five barrier subthemes and four facilitator subthemes. Under barriers, midwives described pressure from family members and cultural custom, the pull of paid work on new mothers, the emotional strain mothers carry after delivery, maternal misconceptions about the adequacy of breast milk, and thin staffing with heavy caseloads. Under facilitators, midwives pointed to their own continuous reassurance and follow-up, stronger maternity-leave and workplace policies, structured antenatal and postnatal counselling, and encouragement from husbands and relatives. Midwives in this setting see themselves as central to exclusive breastfeeding promotion but describe their effectiveness as bounded by staffing levels, time, and the social pressures mothers face outside the clinic. Strengthening staffing, in-service training and family-inclusive counselling could improve breastfeeding support at both levels of care.

Keywords : Exclusive Breastfeeding; Midwives; Breastfeeding Support; Qualitative Study; Primary Health Care; Nigeria.

Paper Submission Last Date
31 - July - 2026

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