Title: Investigating factors that influence the practice of exclusive breastfeeding among mothers
in an urban general hospital in Ghana: A cross-sectional study
Version: 1 Date: 28 Sep 2022
Reviewer's report:
Thank you for the opportunity to review the manuscript entitled; Investigating factors that
influence the practice of exclusive breastfeeding among mothers in a peri-urban general hospital
in Ghana. This paper requires significant revision so at this time I am suggesting that the authors
carefully proofread and review the paper addressing the comments. Please pay close attention to
the Methods section as this underpins the study. At present quite a lot of important information
is missing from this section making it difficult to assess the results and discussion sections.
I have included a link to the STROBE checklist for reporting observational studies to support
you to include relevant information.
I wish the authors all the best.
Title: please consider adding the words cross-sectional study.
Abstract:
Background; state the country, please
Line 37. Consider replacing the word ‘about’ with the exact proportion.
Line 39. Confidence intervals (CI) are not reported correctly – please include the range and
reframe from using abbreviations where possible.
Consider reporting the COR to one decimal place or reporting this as a risk ration
Introduction
Avoid subjective language please such as delete ‘enormous’ ‘huge’and replace it with evidence
and examples of the benefits
A citation is needed at the end of the first sentence, please.
Line 75- error in a citation here repeat use of  (4)
Line 78 grammatical errors here – “we need…”
Line 85- I suggest the authors delete ‘achieve that by finding out the’ and state this study aims
to …
You will contribute but it is ambitious to think that one study will achieve all of the above.
Line 87 State the country where Tema General Hospital is located, please
Methods
Please start this section with the study design and why that was chosen. This section needs to be
edited as there is not enough information here and reordered and use headings to break up the
text. Study design, Setting, Sample, Recruitment and Participants, Variables, and Data analysis.
Please use the STOBE checklist to review the content in this section this is available here https://
www.strobe-statement.org/checklists/
Line 116- questions -please include variables and justify why these were used. Please define
exclusive breastfeeding and other infant feeding variables- with a citation to support
Was the data gathered retrospectively or prospectively?
Statistical analysis
What type of analysis was undertaken and why? Please include a citation to support this. Include
how the analysis was undertaken, including control for confounding, how potential bias was
addressed, missing data
Then describe the process in a systematic manner so that someone else might be able to repeat
your study.
Results
Line 171. No need to repeat the N
How was knowledge defined and measured? Include this in the methods section please 177-
remove the words ‘According to the statistics
182. the authors have not described how exclusive breastfeeding and initiation were measured
–and defined/collected. Please address this in the methods section as it is difficult to assess the
results without this.
I suggest combining tables 1 and 2 together and tables 4 and 5 together
Line 197- is unclear please review
Line 200 Attitudes – again is it hard to assess this because the variables gathered have not been
defined or included in the Methods section. What do you mean by ‘good’ attitudes
Line 204- Please write out x2. in words and always report CI (the range) with P values
Discussion and interpretation
Please consider combining these. Currently, the discussion section is a repeat of the Results
section. This is your opportunity to critically discuss your results.