“I am a baby-friendly doctor, but…”

Abstract This paper investigates instances of narrativised health advice exchanges between Nigerian doctors and laypersons on X/Twitter, Naija . Based on 144 story tweets, the analysis focuses on how advice exchanges manifest as acts of narrative identity positioning. With Bamberg’s (1997) three-level model of positioning, interactional pragmatics, and membership categorisation analysis, the study examines the emergence and co-construction of tale-world, interactional, and ideological dimensions of identity in the context of health communication. The findings reveal that advice-giving interactions, as acts of identity positioning, manifest as cautionary tales, the evaluated biographical selves of storytellers, the management of institutional roles, and as a concession to oppositional pressures, acquiescence to, or mostly resistance to, hegemonic subject positions. The paper concludes that health advice-giving practices should be understood as discursive sites where power and identity are negotiated. Therefore, practitioners should aim to co-construct advice interactions that minimise asymmetry and foster collaborative meaning-making rather than reproducing hierarchical relations.