Paradox of health promoters: optimal breastfeeding practices and obstacles among health workers at Treichville University Hospital, Abidjan, Ivory Coast

Optimal breastfeeding is crucial for infant health, but its prevalence remains low in Sub-Saharan Africa. Health workers play a central role in its promotion, but their own ability to follow the recommendations they provide, particularly in the face of professional constraints, is poorly documented in the Ivory Coast. The objective of this study was to assess the knowledge, personal breastfeeding practices, and professional barriers among healthcare workers at a university hospital. A cross-sectional study was conducted in August 2022 at the Treichville University Hospital in Abidjan (Ivory Coast). Sixty-one healthcare workers (physicians, midwives, nurses, and nursing assistants) from the pediatrics and obstetrics/gynecology departments completed a structured questionnaire. The data were analyzed using SPSS v20. The mean age was 34±5.7 years. Although 98.4% were aware of its benefits, only 39.3% understood the World Health Organization (WHO) definition of exclusive breastfeeding. Regarding practices, 96.7% had breastfed, but only 50% had initiated breastfeeding within the first hour after delivery, 36% had practiced exclusive breastfeeding for 6 months, and only 5% had breastfed until 24 months. The major obstacle was returning to work (85.2%), combined with the lack of a dedicated breastfeeding room. No significant association was found between continuing education and the practice of exclusive breastfeeding. A significant gap exists between healthcare workers’ theoretical knowledge and breastfeeding practices, primarily hindered by systemic professional constraints. Institutional interventions targeting the work environment are needed to support healthcare workers in their dual role as mothers and breastfeeding promoters.