Of the 423 eligible mothers, 413 agreed to participate in the study, which made a response rate of 97.6%. Three hundred and sixty study participants were Amhara (87.2%), 36 (8.7%) Awi and 11 (4.1%) other ethnicities including Tigre and Oromo (Table 1). With regard to religion, the majority (83.8%) were orthodox Christian. The mean age of the mothers was 29.2 years (standard deviation, SD ± 4.9). The mean age of the infants was 3.4 months (SD ± 1.6).
Maternal and child health service utilization characteristics
The majority (78%) of mothers had antenatal care during their pregnancy, but only 47.9% received counseling concerning breastfeeding during their care (Table 2). The majority (72.6%) of the study participants had a postnatal care visit within 45 days of giving birth, and 67.3% were counseled about infant feeding at this visit.
Breastfeeding information and knowledge
The majority (90.1%) of study participants had received breastfeeding information (Table 3). Over two thirds (61.7%) of mothers did not have adequate knowledge of breastfeeding. More than half (57.4%) of mothers knew that the first milk (colostrum) should be given to an infant (Table 4).
In this study all participants had initiated breastfeeding. Two hundred and fourteen respondents (51.8%) initiated breastfeeding immediately/within one hour of birth. The majority (75.8%) of infants were given prelacteal feeding. The prevalence of exclusive breastfeeding during the seven days before the interview was 60.8% (95% CI: 55.8%, 65.8%). Common reasons reported by mothers for not feeding breast milk only during the first six months of life includs; breastfeeding is not compatible with work, breastfeeding only is not sufficient for an infant, and they did not have enough milk (Table 5).
Factors associated with exclusive breastfeeding
Hosmer-Lemeshow goodness-of-fit test (p = 0.617) was used to assess the fitness of the model. During the bivariate logistic regression analysis, educational status of the mother, employment status of mother, educational status of the husband, breastfeeding counseling during ANC, infant feeding counseling during PNC, colostrum feeding, prelacteal feeding and knowledge about breastfeeding were significantly associated with EBF.
During the multivariate logistic regression analysis; occupation of mother, breastfeeding counseling during ANC, infant feeding counseling during PNC, prelacteal feeding and knowledge about breastfeeding were significantly associated with EBF practice. But, educational status of the mother, educational status of the husband and colostrum feeding were not associated with EBF practice.
Unemployed mothers were 1.98 times more likely to exclusively breastfeed than employed mothers [AOR = 1.98 (1.21, 3.22)] (Table 6). Mothers who received counseling about breastfeeding during ANC were 2.44 times more likely to exclusively breastfed their infants compared to those who didn’t receive counseling [AOR = 2.44 (1.53, 3.91)]. Receiving counseling during PNC concerning infant feeding increased the likelihood of mothers feeding breast milk only by 5.03 times when compared to those who received no counseling during PNC [AOR = 5.03 (3.04, 8.31)]. Those mothers who didn’t give prelacteal feeding for their infant were 3.44 times more likely to exclusively breastfeed compared to those who gave prelacteal feeds[AOR = 3.44 (1.88, 6.33)]. Mothers who had adequate knowledge about breastfeeding were 2.57 times more likely to exclusively breastfeed their infants than those who didn’t have adequate knowledge on breastfeeding [AOR = 2.57 (1.57, 4.19)].