What Are the Individual, Household, and Community Factors Associated With Optimal Breastfeeding Practices in Three Selected West African Countries?

Optimal breastfeeding is rarely practiced among mothers across the three studied countries: Guinea, Nigeria, and Sierra Leone. The methodological approach used in this study is the first of its kind in the study area. It provides answers to the statistical association between individual, household, and community factors and optimal breastfeeding practices. The study adopted a cross-sectional research design. It employed secondary data. The study data were extracted from the Demographic Health Surveys in Guinea (2012 GDHS), Nigeria (2013 NDHS), and Sierra Leone (2013 SLDHS). Information was extracted from mothers (20–49 years) who had at least one child before the surveys. Optimal breastfeeding was coded into “1” if adhered to and “0” if otherwise. Multilevel mixed-effect logistic regression was used. It was found that optimal breastfeeding was infrequently practiced in Guinea (5.3%), Nigeria (8.6%), and Sierra Leone (14.0%). The fixed-effects results showed that optimal breastfeeding was significantly associated with individual, household, and community-level factors (p < .05). The random effect results showed that community factors accounted for 40.4%, 20.3%, and 20.7% variation in adherence to optimal breastfeeding for mothers in Guinea, Nigeria, and Sierra Leone, respectively. The study concluded that mothers in the study area rarely practice optimal breastfeeding.