Predictors of non-exclusive breastfeeding at 6 months among rural mothers in east Ethiopia: a community-based analytical cross-sectional study
Exclusive breastfeeding in infants aged under six months is a simple and cost-effective feeding method that ensures better infant and child survival and boosts the achievement of child related Millennium Development Goals in the developing world. Identifying factors associated with good breastfeeding practice helps to increase its coverage and maximize its advantages through improved advocacy. The objective of this study was to identify the predictors of non-exclusive breastfeeding in the rural areas of eastern Ethiopia.
A community-based analytical cross-sectional study was conducted on mother/caregiver–child pairs in east Ethiopia from July to August 2011. Data on infant feeding practices were collected by trained interviewers who used a pretested and structured questionnaire. Odds ratio with a 95% confidence interval was estimated for the predictors of non-exclusive breastfeeding using the multivariable logistic regression.
The prevalence of non-exclusive breastfeeding in infants aged under six months, was 28.3%. Non-exclusive breastfeeding was more likely to be practiced by mothers who were not married at the moment [AOR (95% CI) = 2.6 (1.1, 6.0)], mothers who had no access to health facility [AOR (95% CI) = 2.9 (1.9, 4.3)], and mothers whose knowledge about infant and young child feeding practices was low [AOR (95% CI) = 3.4 (2.4, 4.7)].
Non–exclusive breastfeeding was more common among mothers with no marital relationships, poor access to health facilities, and inadequate knowledge about infant and young child feeding practices. Family support, education, and behavior change communication on infant feeding, especially on exclusive breastfeeding, at the community level may improve the knowledge, behavior, and practice of mothers on optimal infant and young child feeding practices.
- Indicators for assessing infant and young child feeding practices: Definitions. Conclusions of a consensus meeting held 6–8 November 2007. Washington D.C., USA
- The state of breastfeeding in 33 countries: tracking infant and young child feeding policies and programmes worldwide.
- Imtiaz, YM, Saleem, M (2009) Exclusive breastfeeding and child survival in Pakistan and other south Asian countries. Pak J Nutr 8: pp. 910-911 CrossRef
- Qiu, L, Zhao, Y, Binns, CW, Lee, AH, Xie, X (2009) Initiation of breastfeeding and prevalence of exclusive breastfeeding at hospital discharge in urban, suburban, and rural areas of Zhejiang China. International Breastfeeding Journal 4: pp. 1 CrossRef
- Perera, PJ, Fernando, M, Warnakulasuria, T, Ranathunga, N (2011) Feeding practices among children attending child welfare clinics in Ragama MOH area: a descriptive cross-sectional study. International Breastfeeding Journal 6: pp. 18 CrossRef
- Learning from large-scale community-based programmes to improve breastfeeding practices.
- Ma, J-Q, Zhou, L-L, Hu, Y-Q, Liu, J-R, Liu, S-S, Zhang, J, Sheng, X-Y (2012) A summary index of infant and child feeding practices is associated with child growth in urban shanghai. BMC Public Health 12: pp. 568 CrossRef
- The state of the World’s children: children in an urban world.
- Agho, KE, Dibley, MJ, Odiase, JI, Ogbonmwan, SM (2011) Determinants of exclusive breastfeeding in Nigeria. BMC Pregnancy Childbirth 11: pp. 2 CrossRef
- Venancio, SI, Monteiro, CA (2005) Individual and contextual determinants of exclusive breastfeeding in Sa˜o Paulo, Brazil: a multilevel analysis. Public Health Nutr 9: pp. 40-46
- The state of the World's children special edition: celebrating 20 years of the convention on the rights of the child.
- Ethiopia demographic and health survey 2011. Central Statistical Agency and ICF International, Addis Ababa, Ethiopia and Calverton, Maryland, USA
- Chudasama, RK, Amin, CD, Parikh, YN (2009) Prevalence of exclusive breastfeeding and its determinants in first 6 months of life: a prospective study. Online Journal of Health and Allied Sciences 8: pp. 1
- Breastfeeding in the WHO multicentre growth reference study. Acta Paediatr Suppl 450: pp. 16-26
- Al-Sahab, B, Lanes, A, Feldman, M, Tamim, H (2010) Prevalence and predictors of 6 - month exclusive breastfeeding among Canadian women: a national survey. BMC Pediatr 10: pp. 20 CrossRef
- Shi, L, Zhang, J, Wang, Y, Guyer, B (2008) Breastfeeding in rural China: association between knowledge, attitudes, and practices. J Hum Lact 24: pp. 377-385 CrossRef
- Mihrshahi, S, Ichikawa, N, Shuaib, M, Oddy, W, Ampon, R, Dibley, MJ, Kabir, AKML, Peat, JK (2007) Prevalence of exclusive breastfeeding in Bangladesh and its association with diarrhoea and acute respiratory infection: results of the multiple indicator cluster survey 2003. J Health Popul Nutr 25: pp. 195-204
- Tan, KL (2011) Factors associated with exclusive breastfeeding among infants under - six months of age in peninsular Malaysia. International Breastfeeding Journal 6: pp. 2 CrossRef
- Koosha, A, Hashemifesharaki, R, Mousavinasab, N (2008) Breastfeeding patterns and factors determining exclusive breast-feeding. Singapore Med J 49: pp. 1002-1006
- Inayati, DA, Scherbaum, V, Purwestri, RC, Hormann, E, Wirawan, NN, Suryantan, J, Hartono, S, Bloem, MA, Pangaribuan, RV, Biesalski, HK, Hoffmann, V, Bellows, AC (2012) Infant feeding practices among mildly wasted children: a retrospective study on Nias island, Indonesia. International Breastfeeding Journal 7: pp. 3 CrossRef
- Nutrition of young children and women, Ethiopia 2005: findings from the 2005 Ethiopia demographic and health survey. Macro International Inc, Calverton, Maryland, USA
- Alemayehu, T, Haidar, J, Habte, D (2009) Determinants of exclusive breastfeeding practices in Ethiopia. Ethiopian Journal of Health Development 23: pp. 12-18 CrossRef
- Mukuria, AG, Kothari, MT, Abderrahim, N (2006) Infant and young child feeding updates. ORC Macro, Calverton, Maryland, USA
- Black, RE, Allen, LH, Bhutta, ZA, Caulfield, LE, de Onis, M, Ezzati, M, Mathers, C, Rivera, J (2008) Maternal and child under-nutrition: global and regional exposures and health consequences. Lancet 371: pp. 243-260 CrossRef
- Infant and young child feeding: model chapter for text books for medical students and allied health professionals. World Health Organization, Switzerland
- Tan, KL (2009) Factors associated with non-exclusive breastfeeding among 4-week post-partum mothers in Klang district, Peninsular Malaysia. Malalysian Journal of Nutrition 15: pp. 11-18
- Ulak, M, Chandyo, RK, Mellander, L, Shrestha, PS, Strand, TA (2012) Infant feeding practices in Bhaktapur, Nepal: a cross-sectional, health facility based survey. International Breastfeeding Journal 7: pp. 1 CrossRef
- Kimani-Murage, EW, Madise, NJ, Fotso, JC, Kyobutungi, C, Mutua, MK, Gitau, TM, Yatich, N (2011) Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health 11: pp. 396 CrossRef
- Radzniwan, AR, Azimah, NM, Zuhra, H, Khairani, O (2009) Breastfeeding practice and knowledge among mothers attending an urban Malaysian maternal and child health clinic. Medicine and Health 4: pp. 1-7
- Sapna, SP, Ameya, AH, Rooma, SP, Aarti, P, Rashid, AK, Narayan, KA (2009) Prevalence of exclusive breastfeeding and its correlates in an urban slum in western India. International eJournal of Science Medicine & Education 3: pp. 14-18
- Saha, KK, Frongillo, EA, Alam, DS, Arifeen, SE, Persson, LA, Rasmusse, KM (2008) Household food security is associated with infant feeding practices in rural Bangladesh. Journal of Nutrition 138: pp. 1383-1390
- Gomes, GP, Gubert, MB (2012) Breastfeeding in children under 2 years old and household food and nutrition security status. Jornal de pediatria 88: pp. 279-282
- Setegn, T, Belachew, T, Gerbaba, M, Deribe, K, Deribew, A, Biadgilign, S (2012) Factors associated with exclusive breastfeeding practices among mothers in Goba district, south east Ethiopia: a cross-sectional study. International Breastfeeding Journal 7: pp. 17 CrossRef
- Tamiru, D, Belachew, T, Loha, E, Mohammed, S (2012) Sub-optimal breastfeeding of infants during the first six months and associated factors in rural communities of Jimma arjo Woreda, Southwest Ethiopia. BMC Public Health 12: pp. 363 CrossRef
- Health service coverage. Kersa District Health Office, Eastern Hararge Oromia Ethiopia
- Health extension program in Ethiopia profile. Health Extension and Education Center Federal Ministry of Health, Addis Ababa, Ethiopia
- Ethiopia demographic and health survey (EDHS) 2005. Central Statistical Agency and ORC Macro, Addis Ababa, Ethiopia and Calverton, Maryland, USA
- Kolenikov, S, Angeles, G (2009) Socio-economic status measurement with discrete proxy variables: is principal component analysis a reliable answer?. Review of Income and Wealth 55: pp. 128-165 CrossRef
- Coates, J, Anne, S, Paula, B (2007) Household food insecurity access scale (HFIAS) for measurement of household food access: indicator guide: version 3. Food and Nutrition Technical Assistance Project, Academy for Educational Development, Washington, D.C
- Roberts, P, Priest, H (2006) Reliability and validity in research. Nurs Stand 20: pp. 41-45
- Belachew, T, Hadley, C, Lindstrom, D, Gebremariam, A, Lachat, C, Kolsteren, P (2011) Food insecurity, school absenteeism and educational attainment of adolescents in Jimma zone southwest Ethiopia: a longitudinal study. Nutr J 10: pp. 29 CrossRef
- Ekambaram, M, Bhat, B, Vishnu, B, Padiyath Ahamed, MA (2010) Knowledge, attitude and practice of breastfeeding among postnatal mothers. Current Pediatric Research 14: pp. 119-124
- Pan, Y, Jackson, R (2009) Ethnic difference in the relationship between acute inflammation and serum ferritin in US adult males. Epidemiol Infect 136: pp. 421-431
- Baker, EJ, Sanei, LC, Franklin, N (2006) Early initiation of and exclusive breastfeeding in large-scale community-based programmes in Bolivia and Madagascar. J Health Popul Nutr 24: pp. 530-539
- Predictors of non-exclusive breastfeeding at 6 months among rural mothers in east Ethiopia: a community-based analytical cross-sectional study
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
International Breastfeeding Journal
- Online Date
- August 2013
- Online ISSN
- BioMed Central
- Additional Links
- Non-exclusive breastfeeding
- Children under-two
- Author Affiliations
- 1. College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- 2. Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- 3. Department of Epidemiology and Biostatistics, School of Public Health, Addis Ababa University, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia