Aim To report an analysis of the concept of exclusive breastfeeding (EBF) in African American women. Background EBF is the gold standard for infant nutrition from birth until 6 months. The rate of EBF in United States is low—26%, with African American women having the lowest rates. The low rates of EBF in this population are strongly attributed to bias, racism and generational trauma. Therefore, clarifying the concept of EBF with respect to these factors is important for promoting EBF rates of this population. Design Concept analysis. Data sources Search was conducted in four databases (CINAHL, PubMed, PsycINFO and Scopus) for articles published between 2001 and 2021. A total of 30 articles (20 quantitative, seven qualitative and three mixed methods) clarified the concept. Relevant literature emanated from diverse disciplines examining historical and present maternal and infant health. Methods Concept analysis using Rodger's evolutionary method. Results An operational definition of the concept of EBF in African American women was developed from the identified antecedents (modifiable and non‐modifiable), defining attributes and consequences of the concept. Access to breastfeeding resources, maternal (prenatal intention to breastfeed, smoking status, attitude towards breastfeeding), infant (skin‐to‐skin care, successful latching and weight) and contextual factors (socioeconomic, occupational and cultural) predict EBF. The primary attributes of EBF were physiological, physical, psychological and relational. Consequences of EBF were positive health outcomes for, and increased bonding between, mother and infant. Conclusion This concept analysis is the first identifying modifiable and non‐modifiable antecedents of EBF. The analysis provides an operational definition for EBF in African American women which is useful to promote understanding of breastfeeding. This new concept examines the historic societal trauma associated with wet nursing and reframes breastfeeding as a positive maternal and infant health behaviour.

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Background The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life and continued breastfeeding for 2 years. The global rate of exclusive breastfeeding is low at 33%. Thus, it is important to identify philosophical and theory-based strategies that can promote exclusive breastfeeding. The aim of the study was to identify philosophical schools of thought and theories used in research on promoting the practice of exclusive breastfeeding. Methods A scoping review using Arksey and O'Malley's framework explored the phenomenon of exclusive breastfeeding practice promotion. Searches were conducted using CINAHL Plus full-text, PubMed, APA PsycInfo, and Academic Search Premier. Search terms included theory, philosophy, framework, model, exclusive breastfeeding, promotion, support, English, and publication between 2001—2022. Results The online search yielded 1,682 articles, however, only 44 met the inclusion criteria for the scoping review. The articles promoting exclusive breastfeeding used pragmatism (n = 1) or phenomenology (n = 2) philosophies and theories of self-efficacy (n = 10), theory of planned behaviour (n = 13), social cognitive theories (n = 18) and represented 16 countries. Theories of self-efficacy and planned behaviour were the most used theories. Conclusions This review suggests that theories and models are increasingly being used to promote exclusive breastfeeding. Orienting exclusive breastfeeding programmes within theoretical frameworks is a step in the right direction because theories can sensitize researchers and practitioners to contextually relevant factors and processes appropriate for effective exclusive breastfeeding strategies. Future research should examine the efficacy and effectiveness of theory-informed exclusive breastfeeding programmes over time. Such information is important for designing cost-effective EBF programmes.

This observational study assessed the knowledge of pregnant women attending antenatal clinics at two selected hospitals in Abeokuta South, Nigeria on the causes and risk factors of maternal mortality, identifi ed barriers to knowledge acquisition, and examined the infl uence of parity of respondents on their knowledge of factors causing maternal mortality. Maternal mortality is extremely high in Nigeria, it is defi ned as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. Descriptive research design was used in this study and qualitative data from 136 respondents selected randomly, were obtained through a self-designed questionnaire that comprised three sections. Data were analyzed and indicated that parity of the pregnant women do not have an infl uence on their knowledge of factors responsible for maternal mortality. Findings revealed that majority (67.6%) of the respondents had high knowledge on the causes of maternal mortality-haemorrhage, sepsis, prolonged/obstructed labour, anaemia, unsafe abortion, infection, hypertensive disorders, care rendered by unskilled medical practitioners and its risk factors-parity, poverty, place of last delivery and low attendance at antenatal clinic. Educational background, marital status, irregular antenatal visits, socio-cultural practices and occupational status were identifi ed as barriers to knowledge acquisition. This paper concluded that pregnant women may have a high knowledge about the factors responsible for maternal mortality. This is probably due to the fact that all respondents had formal education and because they were interviewed on antenatal clinic days, which suggests that they might have heard about the causes and risk factors for maternal mortality during their visits. Authors recommended that government should employ qualifi ed health professionals and provide medical subsidy, it is hoped that this will ensure that pregnant women get quality care throughout the period of pregnancy and delivery.

Background: Some studies found that nurses are not actively involved in research. To address this issue, it is important to investigate the structure of training that nurses got while at school of nursing. To promote evidence-based practice, nursing and midwifery students must be actively involved in research. Several studies have reported on the attitude of nursing students towards research in different countries. However, no study has assessed attitude of both nursing and midwifery students towards research in Nigeria, using a valid and reliable measure- attitude towards research scale. Purpose: The aim of this study was to assess diploma nursing and midwifery students’ attitude towards research, and their participation in research-related activities. Methods: Descriptive cross-sectional design was used to conduct the study, where 91 nursing and midwifery students who were purposively selected, provided data for the study. Students in graduating classes were included in the study. Papanastasiou’s (2005) Attitude Towards Research scale questionnaire was adopted and used to collect data from participants. Ethical approvals were received from research ethics committee at School of Nursing Ilaro and research ethics committees at other participating institutions. Results: Majority of participants were females, and nursing students. Most participants agreed that research was useful in their career. However, they perceived research to be stressful, complicated, difficult and a complex subject. About 63% of participants had positive attitude towards research while 37% have negative attitude. Nonetheless, only 39% participated in research-related activities. Conclusions: Students’ participation in research-related activities was low. Nursing and midwifery faculties should adopt measures including research workshops, seminars, and conferences to improve student participation in research.