Exclusive Breastfeeding Practices and Challenges in Nigeria, Sub-saharan Africa: An Integrative Review

Background: Exclusive breastfeeding (EBF) remains a key public health strategy for improving infant and maternal outcomes. In Nigeria, despite policy commitments, EBF practice rates remain inconsistent and highly context-dependent. Objectives: This integrative review assesses the prevalence and patterns of EBF in Nigeria, examines the socio-demographic and systemic factors influencing practice, identifies barriers and enablers, and evaluates existing interventions to promote EBF. Methods: Nineteen peer-reviewed primary studies, published between 2013 and 2024, were systematically identified across six geopolitical zones. Data extraction and synthesis followed a deductive coding framework, drawing on qualitative and quantitative findings, and guided by socio-ecological and capability-oriented perspectives. Results: EBF prevalence varied significantly across regions and contexts (12.5%–73.8%). Key themes emerged around socio-demographic variability, contextual factors, cultural practices, and structural barriers. Despite high knowledge levels, systemic and relational constraints limited the sustained implementation of EBF practice. The review also identified gaps in research, including the limited inclusion of fathers, informal caregivers, and mothers in displaced or rural communities. Conclusion: This review advances the literature by offering a context-sensitive, multi-dimensional interpretation of EBF practices in Nigeria. It highlights the need for equity-focused policies and interventions that move beyond individual awareness to address structural enablers of maternal capabilities.