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      Time to breastfeeding cessation and its predictors among mothers who have children aged two to three years in Gozamin district, Northwest Ethiopia: A retrospective follow-up study

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          Abstract

          Introduction

          Globally, breastfeeding duration is below the recommended level. In Ethiopia, more than 24% of mothers ceased breastfeeding before 24 months of age of a child which caused 14,000 preventable childhood deaths annually. To tackle this problem, current and up-to-date information regarding the time to breastfeeding cessation and its predictors is essential. Therefore, this study aims to determine the time to breastfeeding cessation and its predictors among mothers who have children aged two to three years in Gozamin district, Northwest Ethiopia.

          Methods

          A community-based retrospective follow-up study was used among 502 mothers who have children aged two to three years in the Gozamin district from October 1, 2017, up to September 30, 2020. Interviewer-administered structured questionnaires were used. Cox proportional hazard model was applied after its assumptions and model fitness were checked, to identify predictors for time to breastfeeding cessation.

          Results

          The overall mean time to breastfeeding cessation was 22.56 (95%CI: 22.21, 22.91) months, and the cumulative survival probability on breastfeeding up to 24 months was 82.5% (95%CI:78.85, 85.53). The overall incidence of early breastfeeding cessation was 7.77 (95%CI:6.31, 9.58) per 1000 person-month observations. Having no antenatal care follow up (AHR:2.15, 95%CI:1.19, 3.89), having ≥4 number of children (AHR:1.76, 95%CI:1.10, 2.80), < 24 months breastfeeding experience (AHR:1.77, 95%CI:1.14, 2.75), and presence of cow milk in the household (AHR:3.01, 95%CI:1.89, 4.78) were significant predictors for time to breastfeeding cessation.

          Conclusion

          The time to breastfeeding cessation is below the recommendation and therefore, strengthening breastfeeding education and related counseling at the community level is better.

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          Most cited references35

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          Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect.

          The importance of breastfeeding in low-income and middle-income countries is well recognised, but less consensus exists about its importance in high-income countries. In low-income and middle-income countries, only 37% of children younger than 6 months of age are exclusively breastfed. With few exceptions, breastfeeding duration is shorter in high-income countries than in those that are resource-poor. Our meta-analyses indicate protection against child infections and malocclusion, increases in intelligence, and probable reductions in overweight and diabetes. We did not find associations with allergic disorders such as asthma or with blood pressure or cholesterol, and we noted an increase in tooth decay with longer periods of breastfeeding. For nursing women, breastfeeding gave protection against breast cancer and it improved birth spacing, and it might also protect against ovarian cancer and type 2 diabetes. The scaling up of breastfeeding to a near universal level could prevent 823,000 annual deaths in children younger than 5 years and 20,000 annual deaths from breast cancer. Recent epidemiological and biological findings from during the past decade expand on the known benefits of breastfeeding for women and children, whether they are rich or poor.
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            Optimal breastfeeding practices and infant and child mortality: a systematic review and meta-analysis.

            To synthesise the evidence for effects of optimal breastfeeding on all-cause and infection-related mortality in infants and children aged 0-23 months.
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              Reasons for earlier than desired cessation of breastfeeding.

              To describe the prevalence and factors associated with not meeting desired breastfeeding duration. Data were analyzed from 1177 mothers aged ≥18 years who responded to monthly surveys from pregnancy until their child was 1 year old. When breastfeeding stopped, mothers were asked whether they breastfed as long as they wanted (yes or no) and to rate the importance of 32 reasons for stopping on a 4-point Likert scale. Multiple logistic regressions were used to examine the association between the importance of each reason and the likelihood of mothers not meeting their desired breastfeeding duration. Approximately 60% of mothers who stopped breastfeeding did so earlier than desired. Early termination was positively associated with mothers' concerns regarding: (1) difficulties with lactation; (2) infant nutrition and weight; (3) illness or need to take medicine; and (4) the effort associated with pumping milk. Our findings indicate that the major reasons why mothers stop breastfeeding before they desire include concerns about maternal or child health (infant nutrition, maternal illness or the need for medicine, and infant illness) and processes associated with breastfeeding (lactation and milk-pumping problems). Continued professional support may be necessary to address these challenges and help mothers meet their desired breastfeeding duration.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – original draft
                Role: ConceptualizationRole: Data curationRole: MethodologyRole: SoftwareRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: MethodologyRole: SoftwareRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                21 January 2022
                2022
                : 17
                : 1
                : e0262583
                Affiliations
                [1 ] Epidemiology Unit, Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
                [2 ] Department of Reproductive Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
                [3 ] Department of Human Nutrition, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
                Flinders University, AUSTRALIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-2388-3171
                Article
                PONE-D-21-09209
                10.1371/journal.pone.0262583
                8782324
                35061816
                0eaa8ccf-d42a-4a6a-90c6-13b0078751d8
                © 2022 Tsega et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 20 March 2021
                : 30 December 2021
                Page count
                Figures: 5, Tables: 4, Pages: 16
                Funding
                The author(s) received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Breast Feeding
                Medicine and Health Sciences
                Pediatrics
                Neonatology
                Breast Feeding
                People and Places
                Population Groupings
                Families
                Mothers
                Biology and Life Sciences
                Nutrition
                Diet
                Beverages
                Milk
                Breast Milk
                Medicine and Health Sciences
                Nutrition
                Diet
                Beverages
                Milk
                Breast Milk
                Biology and Life Sciences
                Anatomy
                Body Fluids
                Milk
                Breast Milk
                Medicine and Health Sciences
                Anatomy
                Body Fluids
                Milk
                Breast Milk
                Biology and Life Sciences
                Physiology
                Body Fluids
                Milk
                Breast Milk
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Antenatal Care
                People and Places
                Population Groupings
                Age Groups
                Children
                People and Places
                Population Groupings
                Families
                Children
                People and Places
                Geographical Locations
                Africa
                Ethiopia
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Forecasting
                Physical Sciences
                Mathematics
                Statistics
                Statistical Methods
                Forecasting
                Medicine and Health Sciences
                Epidemiology
                Custom metadata
                All relevant data are within the manuscript and its Supporting Information files.

                Uncategorized
                Uncategorized

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