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      Factors associated with exclusive breastfeeding practices in Debre Berhan District, Central Ethiopia: a cross sectional community based study

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      International Breastfeeding Journal
      BioMed Central

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          Abstract

          Background

          Globally, an estimated 6.3 million children under-five years of age died in the year 2013. To reduce the burden of morbidity and mortality of infants, Ethiopia adopted the World Health Organization (WHO) recommendation of exclusive breastfeeding (EBF) for the first six months of life. The objective of this study was to assess factors associated with EBF practices among mothers who have an infant aged below 12 months in Debre Berhan District, Ethiopia.

          Methods

          In this study we employed a cross sectional community based quantitative survey method, and data were collected from January through April 2014. Univariate statistical analysis was used to describe variables using frequencies and percentages. Multivariable logistic regression model was developed; the factors associated with EBF practice were identified.

          Result

          We enrolled 634 mothers with their index infant aged under 12 months. Four hundred thirty five (68.6 %; 95 % CI: 64.9 %, 72.2 %) mothers practiced EBF to six months. In this study 83.4 % of mothers were knowledgeable with the recommended duration of EBF. About 97.5 % of mothers had a positive attitude towards EBF practice. Mothers from rural places were 4.54 times likely to EBF than mothers residing in urban areas Adjusted Odds Ratio (AOR 4.54; 95 % CI: 2.64, 7.81, p = 0.001). The odds of mothers aged 25 to 35 years to practice EBF was up to 8.9 times more than mothers aged less than 25 years (AOR 8.99; 95 % CI: 4.56, 17.73, p = 0.001). The odds of mothers who didn’t receive infant feeding counselling was 0.42 times less likely to practice EBF than those who received Counselling services (AOR 0.42; 95 % CI: 0.24, 0.73, p = 0.002). Employed mothers were found to be 0.36 times less likely to practice EBF than housewives (AOR 0.36; 95 % CI: 0.18, 0.73, p = 0.005). Household income did not show a statistically significant association with EBF.

          Conclusions

          The knowledge and attitude of mothers towards EBF was found to be very high. In this study, two thirds of mothers practiced exclusive breastfeeding. Improving access to information on recommended infant feeding during routine maternal and child health services is recommended. It is important to encourage EBF among the young, employed and urban mothers through proper counselling and mother friendly work environment.

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          Most cited references27

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          Delayed breastfeeding initiation increases risk of neonatal mortality.

          Breastfeeding promotion is a key child survival strategy. Although there is an extensive scientific basis for its impact on postneonatal mortality, evidence is sparse for its impact on neonatal mortality. We sought to assess the contribution of the timing of initiation of breastfeeding to any impact. This study took advantage of the 4-weekly surveillance system from a large ongoing maternal vitamin A supplementation trial in rural Ghana involving all women of childbearing age and their infants. It was designed to evaluate whether timing of initiation of breastfeeding and type (exclusive, predominant, or partial) are associated with risk of neonatal mortality. The analysis is based on 10,947 breastfed singleton infants born between July 2003 and June 2004 who survived to day 2 and whose mothers were visited in the neonatal period. Breastfeeding was initiated within the first day of birth in 71% of infants and by the end of day 3 in all but 1.3% of them; 70% were exclusively breastfed during the neonatal period. The risk of neonatal death was fourfold higher in children given milk-based fluids or solids in addition to breast milk. There was a marked dose response of increasing risk of neonatal mortality with increasing delay in initiation of breastfeeding from 1 hour to day 7; overall late initiation (after day 1) was associated with a 2.4-fold increase in risk. The size of this effect was similar when the model was refitted excluding infants at high risk of death (unwell on the day of birth, congenital abnormalities, premature, unwell at the time of interview) or when deaths during the first week (days 2-7) were excluded. Promotion of early initiation of breastfeeding has the potential to make a major contribution to the achievement of the child survival millennium development goal; 16% of neonatal deaths could be saved if all infants were breastfed from day 1 and 22% if breastfeeding started within the first hour. Breastfeeding-promotion programs should emphasize early initiation as well as exclusive breastfeeding. This has particular relevance for sub-Saharan Africa, where neonatal and infant mortality rates are high but most women already exclusively or predominantly breastfeed their infants.
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            Global trends in exclusive breastfeeding

            Background Infant and young child feeding is critical for child health and survival. Proportion of infants 0–5 months who are fed exclusively with breast milk is a common indicator used for monitoring and evaluating infant and young child feeding in a given country and region. Despite progress made since 1990, a previous review in 2006 of global and regional trends found improvement to be modest. The current study provides an update in global and regional trends in exclusive breastfeeding from 1995 to 2010, taking advantage of the wealth of data from recent household surveys. Methods Using the global database of infant and young child feeding maintained by the United Nations Children’s Fund, the authors examined estimates from 440 household surveys in 140 countries over the period between 1995 and 2010 and calculated global and regional averages of the rate of exclusive breastfeeding among infants 0–5 months for the two time points to assess the trends. Results Trend data suggest the prevalence of exclusive breastfeeding among infants younger than six months in developing countries increased from 33% in 1995 to 39% in 2010. The prevalence increased in almost all regions in the developing world, with the biggest improvement seen in West and Central Africa. Conclusions In spite of the well-recognized importance of exclusive breastfeeding, the practice is not widespread in the developing world and increase on the global level is still very modest with much room for improvement. Child nutrition programmes worldwide continue to require investments and commitments to improve infant feeding practices in order to have maximum impact on children’s lives.
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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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                Author and article information

                Contributors
                maezymitiku@gmail.com
                mdamte5@gmail.com
                z.kebede@malariaconsortium.org
                Journal
                Int Breastfeed J
                Int Breastfeed J
                International Breastfeeding Journal
                BioMed Central (London )
                1746-4358
                13 August 2015
                13 August 2015
                2015
                : 10
                : 23
                Affiliations
                [ ]Addis Ababa City Government Health Bureau, Addis Ketema Sub City Health Department, Addis Ababa, Ethiopia
                [ ]Private Health Sector Program, P O Box 2372, Code 1250 Addis Ababa, Ethiopia
                [ ]Malaria Consortium, Addis Ababa, Ethiopia
                Article
                49
                10.1186/s13006-015-0049-2
                4534166
                26269708
                31694f2b-f75d-4922-9d48-b6c4372b44d2
                © Asfaw et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 March 2015
                : 6 August 2015
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Obstetrics & Gynecology
                Obstetrics & Gynecology

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