Formula feeding practice and associated factors among mothers with infants 0–6 months of age in Addis Ababa, Ethiopia: a community-based cross-sectional study

Abstract

Background Lack of exclusive breastfeeding during the first half-year of life is an important risk factor for childhood morbidity and mortality. Despite this, less than 40% of infants below 6 months are exclusively breastfed worldwide. This is because breastfeeding is declining and being replaced by formula feeding. Nowaday, formula feeding has become a more common practice in urban communities of developing countries. However, relatively little information is available regarding formula feeding practice and its associated factors in Ethiopia, particularly in Addis Ababa. Hence, this study was aimed at assessing the prevalence of formula feeding practice and its associated factors among mothers of an infant aged 0–6 months in Addis Ababa, Ethiopia. Methods A community-based cross-sectional study was conducted from April-1 to May 30/2020 among 494 mothers with infants 0–6 months of age. Data were collected using a pre-tested structured questionnaire. Data were entered and cleaned by using Epi data version 3.1 and analysed by SPSS software version 25. Then data were processed by using descriptive analysis, including frequency distribution, and summary measures. The degree of association was assessed using binary logistic regression analysis. P-value < 0.05 was considered statistically significant. Result The prevalence of formula feeding and pre-lacteal feeding practice was 46.2 and 34.4%, respectively. Educational status with a diploma and above (AOR = 3.09, 95%CI: 1.56–6.14), delivery by cesarean section (AOR = 6.13, 95%CI: 4.01–9.37), pre-lacteal feeding practice (AOR = 7.61, 95%CI: 4.11–11.06), and delayed initiation of breastfeeding (after 1 h to 1 day (AOR = 3.43, 95% CI: 1.59–7.40), after 1 day to 3 days (AOR = 3.71, 95% CI: 1.51–9.41), and after 3 days (AOR = 5.41, 95% CI: 2.15–13.60)) were significantly associated with formula feeding practice. Conclusions Nearly half of the participants were practiced formula-feeding for their infant. Educational status of mothers, the timing of initiation of breastfeeding, delivery by cesarean section, and pre-lacteal feeding practice were significantly associated with formula feeding practice. Therefore, early initiation of breastfeeding, educating mothers about the risks associated with pre-lacteal feeding, and supporting mothers who gave birth by cesarean section for exclusive breastfeeding should be encouraged at the community and institutional levels.

Infant and Young Child Feeding Practice in Ethiopia and the Cost of Not Breastfeeding: Review

“…According to the findings of a study done in Addis Ababa, hospital care and early commencement of breast milk expression are important to a mother's ability to produce breast milk for her preterm infant at discharge. Exclusive breastfeeding was linked with ANC follow-up, PNC attendance, counseling, and pregnancy intention [14,26,27]. In Gondar, maternal age was less than 19 years, mothers were civil servants, husbands were illiterate, it was the first pregnancy, there was no postnatal follow up, and women had little awareness of the benefits of nursing and the composition of breastmilk [21].…”

Relationship between feeding development and alterations in orofacial motor skills

“…During natural lactation, some masticatory muscles begin their maturation and positioning, such as the temporalis (activated in mandibular retrusion) (9), the lateral pterygoid (necessary during propulsion), the mylohyoid (mainly responsible for swallowing), and the masseters (activated in sucking mechanics) (10), the mylohyoid (mainly responsible for swallowing) and the masseters (activated in sucking mechanics) (10), while the orbicularis oris of the upper and lower lips guide the growth and development of the anterior region of the stomatognathic system (11), being responsible for the maturation of the masticatory muscles (12). The upper and lower orbicular orbicular orbicular orbicularis oculi are responsible for stimulating the development of the jaws and differentiating the temporomandibular joints, which helps to prevent the development of parafunctional oral habits and malocclusions (13).…”

“…In 2016, the United Nations (UN) Office of the High Commissioner for Human Rights stated that breastfeeding is a human rights issue for both mothers and children and should be protected and promoted for the benefit of both. The introduction of local nutrient-rich complementary foods is recommended thereafter with continued breastfeed-ing for 2 years of age and beyond (9)…”

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“…Most organizations recommend breastfeeding for at least one year, and the WHO recommends a minimum of 2 years, but less than 40% of infants below the 6 months are exclusively breastfeeding worldwide [ 186 , 187 ]. Multiple investigations have demonstrated that breast feeding not only reduces the risk of death and disease in early life but has lasting health benefits through adult life [ 188 , 189 ]. Taye et al [ 189 ] assessed the Authors found that the educational status of mothers, timing of initiation breastfeeding, pre-lactal feeding, and delivery by cesarean section were significantly associated with formula feeding practice.…”

“…Multiple investigations have demonstrated that breast feeding not only reduces the risk of death and disease in early life but has lasting health benefits through adult life [ 188 , 189 ]. Taye et al [ 189 ] assessed the Authors found that the educational status of mothers, timing of initiation breastfeeding, pre-lactal feeding, and delivery by cesarean section were significantly associated with formula feeding practice. Therefore, early initiation of breastfeeding, educating mothers about the risks associated with pre-lacteal feeding and supporting mothers who gave birth by cesarean section for exclusive breastfeeding should be encouraged at the community and institutional levels.…”