Determinants of early initiation of breastfeeding in Ethiopia: a population-based study using the 2016 demographic and health survey data

Abstract

BackgroundTimely breastfeeding initiation is a simple but important measure that has protective effects on infants and mothers. This study aims to determine the predictors of early breastfeeding initiation among mothers residing in Ethiopia.MethodsThis study employed the 2016 Ethiopian Demographic and Health Survey data. A total of 5546 children born during the last 24 months at the time of survey were included for analysis from nine regional states and two city administration areas. Socio-demographic and socio-economic factors including individual, household and community-level factors were examined of their significance against the outcome variable of early initiation of breastfeeding using a mixed-effect logistic regression model.ResultsThe proportion of infants who had timely initiation of breastfeeding was 74.3% (n = 3064). In the multivariate logistic regression analysis, mothers who delivered with assistance of one or more health professionals had 68% (AOR 1.68; 95% CI: 1.23, 2.29) higher odds of initiating timely breastfeeding. In addition, mothers delivering by a caesarean section had 86% reduced odds of early breastfeeding initiation (AOR 0.14; 95% CI: 0.09, 0.22) when compared to mothers who had vaginal delivery. In terms of socio-demographic factors, the odds of early breastfeeding initiation were more than two and half times higher particularly for mothers residing particularly in Oromiya (AOR 2.58; 95% CI: 1.84, 3.63) and Southern Nations Nationalities and Peoples (SNNP) (AOR 2.75; 95% CI: 1.86, 4.05). In addition, timely breastfeeding initiation was also significantly associated with wealth index with wealthier mothers having 43% higher odds compared to mothers of poorest households (AOR 1.43; 95% CI: 1.07, 1.92). Other factors such as age, gender and birth order of the infant also had significant associations with early breastfeeding initiation.ConclusionEarly breastfeeding initiation in Ethiopia is inextricably associated with various socio-demographic, biomedical, and socio-economic factors. The study findings can potentially inform mothers and the wider community on the benefits of timely breastfeeding initiation and policymakers and community leaders to target health promotional interventions and resources where needed.

Three-fourth of children is received early initiation of Breastfeeding in West Belessa District

“…The current study finding revealed that early initiation of breastfeeding in West Belessa district was 77.7% (95%CI, 74.3-81.0). This finding is similar to the study Debre Tabor which is 76.8%(26), Motta 78.8% (27), Dembecha District 73.1% (28), and EDHS 2016 74.3% (18). The possible correspondence might be most of the previous and current studies might similar study settings and target populations.…”

“…Reports showed that residence (15,16), place of delivery (15), Postnatal care (17), maternal educational status (16)(17)(18)(19), maternal age (17), wealth index (18,20), age of the infants (18), gender and birth order of the infant (18,20), delivery mode (16,19) were significantly associated with early initiation of breastfeeding.…”

Socio-Economic Differences in Early Initiation of Breastfeeding Among Children in a Ugandan Cross-Sectional Study

“…This poor -rich differences in EIB among children might be linked to issues of access to maternal antenatal and delivery services [43], given that pregnant mothers in affluent families might be more likely to deliver in health facilities because they have financial capacity to access maternal healthcare services regardless of where they live in the country as opposed to their counterparts in poorer and poorest households that might have financial challenges limiting their access to antenatal care and health facility based deliveries that supervised by trained healthcare professionals. Our findings are consistent with the results of a Nigerian cross-sectional study which showed an increasing trend in EIB with increasing household socio-economic status [42], however they are not consistent with the results of an Ethiopian cross-sectional study that found no association between household socio-economic status and EIB [20]. This difference to a large extend reflect variations in confounding variables adjusted for in both studies and the references categories for the variable household wealth index employed for comparability of the effect measure for EIB among children.…”

“…Observational studies conducted in sub-Saharan Africa have shown the existence of socio-economic inequalities in EIB. A cross-sectional study conducted in Ethiopia found a positive association between maternal education, unemployment and EIB respectively and no association between household wealth status and EIB among children less than 24 months of age [20]. On the same note, another cross-sectional study conducted in a semi-urban area in Nigeria, found lower likelihood of EIB among mothers with no formal or primary level education compared to those that had attained tertiary level education [21].…”

“…Of interest to mention among others are those factors that are positively associated with EIB, which include but not limited to maternal-newborn skin-to-skin contact after birth, health facility based deliveries that are supervised by skilled attendants, maternal age above 30 years and normal vaginal delivery. Factors that are negatively associated with EIB include maternal multiparity and living in rural areas [20].…”