Background: Exclusive Breastfeeding (EBF) refers to the practice of feeding breast milk only, (including expressed breast milk) to infants; and
excluding water, other liquids, breast milk substitutes, and solid foods. Inadequately breastfed infants are likely to be undernourished and have
childhood infections. EBF knowledge and infant feeding practices have not been studied sufficiently in Sokoto State, Nigeria. We describe the
results of a randomized community trial to promote Exclusive Breastfeeding (EBF) in two local government areas Kware and Bodinga selected as
intervention and control groups respectively. Methods: During advocacy meetings with community leaders, a Committee was formed. Members of
the Committee were consulted for informed consent and selection of ten female volunteers who would educate mothers about breastfeeding
during home visits. Participants comprised mothers of infants who were breastfeeding at the time of the study. A total of 179 mothers were
recruited through systematic random sampling from each community. Volunteers conducted in-person interviews using a structured questionnaire
and counseled mothers in the intervention group only. Results: At baseline, intervention and control groups differed significantly regarding
maternal occupation (P=0.07), and age of the index child (P=0.07). 42% of infants in the intervention group were up to 6 months old and about
30% of them were exclusively breastfed. Intention to EBF was significantly associated with maternal age (P=0.01), education (P=0.00) and
women who were exclusively breastfeeding (P=0.00). After counseling, all infants up to 6 months of age were exclusively breastfed. The
proportion of mothers with intention to EBF increased significantly with maternal age (P=0.00), occupation (P=0.00) and women who were
exclusively breastfeeding (P=0.01). Post-intervention surveys showed that source of information and late initiation of breastfeeding was not
significantly associated with intention to EBF. Mothers who reported practicing EBF for 6 months, were older (P=0.00) multi-parous (P=0.05) and
more educated (P=0.00) compared to those who did not practice EBF. Among them, significantly increased proportion of women agreed that EBF
should be continued during the night (P=0.03), infant should be fed on demand (P=0.05), sick child could be given medication (P=0.02), EBF
offered protection against childhood diarrhea (P=0.01), and helped mothers with birth spacing (P=0.00). Conclusion: This study shows that there
is a need for reaching women with reliable information about infant nutrition in Sokoto State. The results show decreased EBF practice among
working mothers, young women, mothers with poor education and fewer than five children. Counseling is a useful strategy for promoting the
duration of EBF for six months and for developing support systems for nursing mothers. Working mothers may need additional resources in this
setting to enable them to practice EBF.