Evidence from this study showed an average level of breastfeeding initiation immediately after childbirth (45%), and within the first two hours after birth (29%). The intention to breastfeed for up to 12 months was high among the respondents (73%). With the focus on mothers currently seeking postnatal care at a modern health facility that is baby friendly, there are likely chances that their awareness and dispositions towards exclusive breastfeeding could differ from the larger population of mothers. For instance, in Davies-Adetugbo's study on awareness and relevance of colostrum among nursing mothers in a rural Yoruba community in Nigeria, colostrum was perceived as milk that had stayed in the breast during the 9 months of pregnancy and thus become stale . While the relevance of colostrum had increased among the breastfeeding mothers in this study, traditional child feeding practices such as feeding infants with herbal concoction are still common among Yoruba people. This may be hinged on some cultural beliefs associated with child birth and rearing practices among the Yoruba people in southwest Nigeria [29, 36].
Breastfeeding culture is well enshrined in the various ethnic groups in Nigeria , but the low practice of exclusive breastfeeding persists. The Nigerian Demographic Health Survey in Nigeria, 2008 showed that only 13% of children below six months are exclusively breastfed while 87% of Nigerian infants below six months receive complementary liquids or foods. Only 19% (136) of the breastfeeding mothers whose infants were below or up to six months of age in this study practiced exclusive breastfeeding. There are variations in the exclusive breastfeeding rate found in this study compared with others [19, 37]. The variations in the prevalence rates may be due to the sample size and design adopted. However, the low practice of exclusive breastfeeding remains a concern, especially with the high level of awareness as revealed in the initiation rate and perceived benefits associated with breastfeeding.
In the Yoruba belief system, the breast is a symbolic part of the woman's body constructed as a vital source of nutrients and a medium of physical and spiritual bond sustenance between the mother and the child. From both the quantitative and qualitative findings, breastfeeding mothers are faced with personal and social constraints in practicing exclusive breastfeeding. Specific constraints identified include maternal health, breast and nipple problems, perceived milk insufficiency, and pressure from significant others. The qualitative findings also revealed that the good mother would struggle to appropriate the physical and spiritual bonds and benefits associated with exclusive breastfeeding. The mismatch between breastfeeding intention and the practice of exclusive breastfeeding indicates the existence of conflict revolving around intentions, normative expectations, and social pressures to practice exclusive breastfeeding among the breastfeeding mothers. These findings support the findings of Otoo, Lartey and Perez-Escamilla on perceived incentives and barriers to exclusive breastfeeding among peri-urban Ghanaian Women . Otoo et al. reported that there was widespread belief that exclusive breastfeeding was easier when breast milk began to flow soon after delivery . The main obstacles to exclusive breastfeeding identified were maternal employment, breast and nipple problems, perceived milk insufficiency, and pressure from family. With the available evidence portraying Nigeria as a challenging place for mothers , such conflicts could create additional psychosocial problems for younger mothers in particular, and older mothers who may lack access to adequate quality support networks. In addition, the practice of breastfeeding at night while both mother and child are asleep could create a level of discomfort for the mother and probable risk for the child as admitted in the findings.
In the Yoruba culture, significant others (grandmothers, mothers-in-law, and relations) are actively involved in the production of child health including the sustenance of breastfeeding culture . In this study, grandmothers and mother-in-laws played dual roles in the forms and prevailing breastfeeding practices reported among the respondents. For instance, some grandmothers felt that the early introduction of complementary feeding and herbal concoction would be better than breast milk only. From the participants' experiences and cultural expectations, grandmothers who did not practice exclusive breastfeeding are likely to exert pressure on younger mothers to discontinue exclusive breastfeeding, especially with the occurrence of lactation problems or pressing health challenges affecting either the mother or the child. This finding supports Grassley and Eschiti's position that grandmothers' own infant feeding experience and knowledge can influence mothers' decisions to initiate and continue breastfeeding or not . In Uchendu, Ikefuna and Emodi's study among breastfeeding mothers at the University of Nigeria Teaching hospital, 52% of women who had never practiced exclusive breastfeeding reported family opposition, especially grandmothers, and personal decision-making as major constraints . In spite of the structural constraints, breastfeeding experiences differ among the mothers. Those who practiced exclusive breastfeeding among them perceived the subjective norm of an exemplary mother, the joy attached to childbirth, personal resolutions, spouse, and mother-in-law's support as modifiers and insulators from social and psychological constraints in some respect. The family structure, in the form of extended families, was also considered as supportive in promoting the practice of breastfeeding, especially at the level of early initiation.
As revealed in this study, and similar to findings by Oweis, Tayem and Froelicher  and Otoo, Lartey, and Pérez-Escamilla , breastfeeding could be tiring, stressful or pleasurable to some mothers. Breastfeeding was described as stressful, painful, or pleasurable based on personal and prevailing circumstances around breastfeeding mothers. Some of the grandmothers and breastfeeding mothers described exclusive breastfeeding as an investment in a child's life. While a mother may intend to practice exclusive breastfeeding for the first six months and continue with breastfeeding for up to year, personal and socio-cultural factors could act as constraints. From the findings in this study, a number of the breastfeeding mothers were confronted with erroneous beliefs and child rearing practices that supported the introduction of herbs and solid food alongside breastfeeding. This is besides the normative responsibilities of motherhood and situational limitations such as poverty, high cost of living and the need to provide support for their household needs.
Similar to the above, and somewhat pressing, is the inadequate feeding among nursing mothers and its implications on the practice of exclusive breastfeeding. This latter constraint requires holistic measures such as empowering mothers economically. More so, the larger involvement of mothers in the provision of economic support of the household is also an indication of pressure on mothers and a possible source of disempowering women in the informal sector of the economy from practicing exclusive breastfeeding. There is an indication that a number of the breastfeeding mothers are undergoing strain as they struggle to engage in economic activities to support their husbands. At the moment, the high poverty level and costs of living in Nigeria expose a lot of households to malnutrition . Hence, we would suggest further investigation on motherhood and breastfeeding experiences of women, especially those with low-socioeconomic backgrounds. Findings from such studies may provide insight into the psychosocial consequences of conforming to cultural notions of motherhood and constraints associated with exclusive breastfeeding.
While counseling and proper education on desirable breastfeeding practices could be adopted to achieve a change in attitudes, perceptions, knowledge and practice of exclusive breastfeeding, the inadequate quality support from health care providers, as illustrated by the experiences of the nurses, could be a challenge. However, this is not peculiar to the provision of educational support on breastfeeding. Inadequate supply of health professionals and increasing health challenges is the bane of modern health delivery in developing nations. The migration of health care professionals and the poor working conditions prevailing in many sub-Saharan African countries has worsened the situation .
Hence, designing effective and prompt intervention initiatives that could promote the provision of quality support for nursing mothers' would require concrete efforts from all stakeholders, not just from the hospitals or healthcare system. Such efforts will go a long way in creating a sustainable exclusive breastfeeding culture and bridging the existing gaps in achieving millennium development goals four and five in Nigeria.
One of the limitations of this study is its focus on breastfeeding mothers at a modern health facility, which may have influenced the levels of breastfeeding initiation and practices. Another limitation is the sample design and the sample size selected. While a mixed method design was adopted to strengthen the findings, generalization of the findings is further limited with the existing cultural variations among the various ethnic groups in Nigeria.