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      Prevalence of Exclusive Breastfeeding Practices and associated factors among mothers in Bahir Dar city, Northwest Ethiopia: a community based cross-sectional study

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          Abstract

          Background

          Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants. World Health Organization (WHO) recommend exclusive breastfeeding (EBF) for six months which has a great contribution in reducing under five mortality, which otherwise leads to death of 88/1000 live birth yearly in Ethiopia. Hence, this study aimed to assess prevalence of EBF and associated factors in mothers in the city of Bahir Dar, Northwest Ethiopia.

          Methods

          A community-based cross-sectional study was conducted from 10 to 25 June 2012 among mothers who delivered 12 months earlier in Bahir Dar city, Northwest Ethiopia. A cluster sampling technique was used to select a sample of 819 participants. Data were collected using a structured and pre-tested questionnaire by face-to-face interview technique. Bivariate and multivariate analyses were performed to check associations and control confounding.

          Results

          Of 819 mother-infant pairs sampled, the overall age appropriate rate of EBF practice was found to be 50.3%. Having a young infant aged 0-1 month (AOR = 3.77, 95% CI = 1.54, 9.24) and 2-3 months (AOR = 2.80, 95% CI = 1.71, 4.58), being a housewife (AOR = 2.16, 95% CI = 1.48, 3.16), having prenatal EBF plan (AOR = 3.75, 95% CI = 2.21, 6.37), delivering at a health facility (AOR = 3.02, 95% CI = 1.55, 5.89), giving birth vaginally (AOR = 2.33, 95% CI = 1.40, 3.87) and receiving infant feeding counseling/advice (AOR = 5.20, 95% CI = 2.13, 12.68) were found to be significantly associated with EBF practice.

          Conclusion

          Prevalence of exclusive breastfeeding was low in Bahir Dar. Strengthening infant feeding advice/counseling both at the community and institutional levels, promoting institutional delivery, providing adequate pain relief and early assistance for mothers who gave birth by caesarean section, and enabling every mother a prenatal EBF plan during antenatal care were recommended in order to increase the proportion of women practicing EBF.

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          Most cited references13

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          Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya

          Background The World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. Methods Data from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods. Results There was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence). Conclusions The study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning.
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            Determinants of exclusive breastfeeding in Nigeria

            Background Exclusive breast feeding (EBF) has important protective effects on the survival of infants and decreases risk for many early-life diseases. The purpose of this study was to assess the factors associated with EBF in Nigeria. Methods Data on 658 children less than 6 months of age were obtained from the Nigeria Demographic and Health Survey (NDHS) 2003. The 2003 NDHS was a multi-stage cluster sample survey of 7864 households. EBF rates were examined against a set of individual, household and community level variables using a backward stepwise multilevel logistic regression method. Results The average EBF rate among infants younger than 6 months of age was 16.4% (95%CI: 12.6%-21.1%) but was only 7.1% in infants in their fifth month of age. After adjusting for potential confounders, multivariate analyses revealed that the odds of EBF were higher in rich (Adjusted Odds Ratios (AOR) = 1.15, CI = 0.28-6.69) and middle level (AOR = 2.45, CI = 1.06-5.68) households than poor households. Increasing infant age was associated with significantly less EBF (AOR = 0.65, 95%CI: 0.51-0.82). Mothers who had four or more antenatal visits were significantly more likely to engage in EBF (AOR = 2.70, 95%CI = 1.04-7.01). Female infants were more likely to be exclusively breastfed than male infants (AOR = 2.13, 95%CI = 1.03-4.39). Mothers who lived in the North Central geopolitical region were significantly more likely to exclusively breastfeed their babies than those mothers who lived in other geopolitical regions. Conclusions The EBF rate in Nigeria is low and falls well short of the expected levels needed to achieve a substantial reduction in child mortality. Antenatal care was strongly associated with an increased rate of EBF. Appropriate infant feeding practises are needed if Nigeria is to reach the child survival Millennium Development Goal of reducing infant mortality from about 100 deaths per 1000 live births to a target of 35 deaths per 1000 live births by the year 2015.
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              Prevalence and predictors of 6-month exclusive breastfeeding among Canadian women: a national survey

              Background In spite of the evidence supporting the importance of breastfeeding during the first year of life, data on breastfeeding practices remain limited in Canada. The study aimed to examine the prevalence and predictors of 6-month exclusive breastfeeding among Canadian women. Methods The analysis was based on the Maternity Experience Survey targeting women aged ≥ 15 years who had singleton live births between February 2006 - May 2006 in the Canadian provinces and November 2005 - February 2006 in the territories. The main outcome was exclusive breastfeeding based on the World Health Organization definition. Socioeconomic, demographic, maternal, pregnancy and delivery related variables were considered for a multivariate logistic regression using stepwise modeling. Bootstrapping was performed to account for the complex sampling design. Results The sample size in this study was 5,615 weighted to represent 66,810 Canadian women. While ever breastfeeding was 90.3%, the 6-month exclusive breastfeeding rate was 13.8%. Based on the regression model, having higher years of education, residing in the Northern territories and Western provinces, living with a partner, having had previous pregnancies, having lower pre-pregnancy body mass index and giving birth at older age were associated with increased likelihood of 6-month exclusive breastfeeding. Moreover, smoking during pregnancy, Caesarean birth, infant's admission to the intensive care unit and maternal employment status before 6 months of infant's age were negatively associated with exclusive breastfeeding. Mothers choosing to deliver at home were more likely to remain exclusively breastfeeding for 6 months (Odds Ratio: 5.29, 95% Confidence Interval: 2.95-9.46). Conclusions The 6-month exclusive breastfeeding rate is low in Canada. The study results constitute the basis for designing interventions that aim to bridge the gap between the current practices of breastfeeding and the World Health Organization recommendation.
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                Author and article information

                Contributors
                Journal
                Int Breastfeed J
                Int Breastfeed J
                International Breastfeeding Journal
                BioMed Central
                1746-4358
                2013
                23 October 2013
                : 8
                : 14
                Affiliations
                [1 ]Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
                [2 ]Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
                [3 ]Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
                Article
                1746-4358-8-14
                10.1186/1746-4358-8-14
                3815630
                24152996
                bdf91164-a221-43b1-8319-df3fab2fc9da
                Copyright ©2013 Seid et al.; licensee BioMed Central Ltd.

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 January 2013
                : 20 October 2013
                Categories
                Research

                Obstetrics & Gynecology
                prevalence,exclusive breastfeeding,associated factors,northwest ethiopia

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