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Amzat J, Aminu K, Matankari B, Ismail A, Almu B, Kanmodi KK. Sociocultural context of exclusive breastfeeding in Africa: A narrative review. Health Sci Rep 2024; 7:e2115. [PMID: 38742092 PMCID: PMC11089088 DOI: 10.1002/hsr2.2115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 04/20/2024] [Accepted: 04/27/2024] [Indexed: 05/16/2024] Open
Abstract
Background and Aims Although exclusive breastfeeding (EBF) has many benefits, it is not commonly practiced in several countries as a result of context-specific challenges. EBF practice is thus a global health discourse because over 200 million children suffer from malnutrition despite the abundance of human milk. The risk of starvation remains very high among African children with less than 40% of them exclusively breastfed. In Africa, the adoption or nonadherence to EBF is a sociocultural issue. Hence, this narrative review examined the sociocultural context of EBF in the region. Methods PubMed, Google Scholar, and Scopus were searched using keywords related to EBF and Africa. Relevant data from selected studies were synthesized narratively and reported using a structured narrative format. Results EBF is strongly rooted in every culture and is a culturally determined behavior. Some believe that colostrum is dirty and harmful to newborns and, thus, needs to be purified. Despite the belief that human milk is the best food for babies, mothers often complement human milk with other foods right from birth because of perceived lactation inadequacy. Most African mothers believe in prelacteal feeding to help cleanse the infant's gastrointestinal tract for digestion, quench thirst, flush the bladder and help the mother to rest after childbirth before breastfeeding (BF) is initiated. The role of significant others was equally found important in the decision and duration of BF. The availability of family support (especially from grandmothers and husbands) reportedly encouraged EBF in Africa. The duration and exclusivity of BF in Africa are negatively associated with demographic variables like young age, low level of education, being unmarried, low income, out of employment, and parity (first-time mother). Conclusion While there have been some efforts and policies to improve EBF, it is important to consider context-specific challenges and sociocultural factors. There is a need for more deliberate efforts to encourage mothers through the implementation of effective best practices concerning EBF in Africa.
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Affiliation(s)
- Jimoh Amzat
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
- Department of SociologyUniversity of JohannesburgJohannesburgSouth Africa
| | - Kafayat Aminu
- Centre for Child and Adolescent Mental HealthUniversity College HospitalIbadanNigeria
| | | | - Abbas Ismail
- Department of SociologyUmaru Musa Yar'adua UniversityKatsinaNigeria
| | - Bello Almu
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
| | - Kehinde Kazeem Kanmodi
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- School of DentistryUniversity of RwandaKigaliRwanda
- Cephas Health Research Initiative IncIbadanNigeria
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Abebe GF, Tilahun M, Tadesse H, Seid A, Yigremachew T, Birhanu AM, Girma D. Predictors of delayed initiation of breast milk and exclusive breastfeeding in Ethiopia: A multi-level mixed-effect analysis. PLoS One 2024; 19:e0301042. [PMID: 38568996 PMCID: PMC10990229 DOI: 10.1371/journal.pone.0301042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/10/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Despite the well-established benefits of early initiation of breastfeeding and exclusive breastfeeding for the first six months to promote optimal neonatal and child health, evidence indicates that in Ethiopia, a significant number of newborns initiate breastfeeding late, do not adhere to exclusive breastfeeding (EBF) for the recommended duration, and instead are fed with bottles. OBJECTIVE To determine the proportion of delayed initiation of breast milk, exclusive breastfeeding, and its individual and community-level predictors among mothers in Ethiopia. METHODS A secondary data analysis was done using the 2019 Ethiopian Mini Demographic Health Survey data. We examined a weighted sample of 2,012 children born within the past 24 months and 623 children aged 0-5 months at the time of the survey. The data analysis was done using STATA version 15. To understand the variation in delayed initiation and exclusive breastfeeding, statistical measures such as the Intraclass correlation coefficient, median odds ratio, and proportional change in variance were calculated. We employed a multilevel mixed-effects logistic regression model to identify predictors for each outcome variable. Statistical significance was determined with a p-value < 0.05. RESULTS The proportion of delayed initiation of breast milk and exclusive breastfeeding were 24.56 and 84.5%, respectively. Women aged 34-49 years old (AOR = 0.33: 95% CI; 0.15-0.72), having a television in the house (AOR = 0.74: 95%CI; 0.33-0.97), delivered by cesarean section (AOR = 3.83: 95% CI; 1.57-9.32), and resided in the Afar regional state (AOR = 1.43: 95%CI; 1.03-12.7) were significantly associated with delayed initiation of breast milk. On the other hand, attended primary education (AOR = 0.67: 95%CI; 0.35-0.99), secondary education (AOR = 0.34: 95%CI; 0.19-0.53), women whose household headed by male (AOR = 0.68; 95% CI; 0.34-0.97), and rural residents (AOR = 1.98: 95%CI; 1.09-3.43) were significantly associated with exclusive breastfeeding practice. CONCLUSION Health promotion efforts that encourage timely initation of breast milk and promote EBF, focused on young mothers, those who gave birth through cesarean section, and those residing in urban and the Afar regional state. Furthermore, government health policymakers and relevant stakeholders should consider these identified predictors when revising existing strategies or formulating new policies.
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Affiliation(s)
- Gossa Fetene Abebe
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Menen Tilahun
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Hana Tadesse
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Abdu Seid
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Tariku Yigremachew
- School of Medicine, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Anteneh Messele Birhanu
- School of Medicine, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
| | - Desalegn Girma
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Teferi, Ethiopia
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Wondmeneh TG. Pre-lacteal feeding practice and its associated factors among mothers with children under the age of two years in Dubti town, Afar region, North East Ethiopia: a community based mixed study design. Front Glob Womens Health 2024; 4:1315711. [PMID: 38264409 PMCID: PMC10803488 DOI: 10.3389/fgwh.2023.1315711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024] Open
Abstract
Background Pre-lacteal feeding prevents the early initiation of breastfeeding and exclusive breastfeeding. It is understudied in Afar, a pastoral region in northeast Ethiopia. The study assessed the prevalence of pre-lacteal feeding practice and its associated factors among mothers with children under the age of two years in Dubti, North East Ethiopia. Methods A community-based mixed-study design was employed. A systematic sampling technique was used to recruit 370 study participants for the quantitative study, while purposive sampling was used to select 17 study participants for the qualitative study. Logistic regression analysis was used to determine the association between independent variables and dependent variable. The results of logistic regression analysis were presented as an odd ratio with a 95% CI. A P-value <0.05 was used as a cutoff point to determine statistical significance. The qualitative data were analyzed using a thematic approach. Results Pre-lacteal feeding was practiced by 36% of mothers. Afar ethnicity (AOR = 2.5, 95% CI: 1.2-5.1), an extended family size (≥5) (AOR = 1.73, 95% CI: 1.02-2.9), a birth interval of less than 2 years (AOR = 2.77, 95% CI: 1.59-4.82), the first birth order of an indexed child (AOR = 3.87, 95% CI: 2.14-7.0), male-indexed children (AOR = 2.95, 95% CI: 1.67-5.2), and no antenatal care visits (AOR = 2.67, 95% CI: 1.67), or once or twice antenatal visits were significantly associated with pre-lacteal feeding practice. Breastfeeding counseling (AOR = 0.38, 95% CI: 0.2-0.7) and delivery at a health institution (AOR = 0.3, 95% CI: 0.17-0.55) were protective factors of pre-lacteal feeding practice. The most common pre-lacteal foods were dairy products, water, and certain plant species. Cultural beliefs are the main reason for practicing these pre-lacteal feedings. Conclusion A significant number of study participants practiced prelacteal feeding. A public health campaign emphasizing the importance of antenatal care follow-ups should be initiated. Breastfeeding counseling and delivery in a health facility should also be strengthened. Community health education about the disadvantages of pre-lacteal feeding practices should be provided to reduce traditional beliefs.
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Kebede N, Bogale EK, Zewdie A, Kassie TD, Anagaw TF, Mazengia EM, Gelaw SS, Fenta ET, Eshetu HB. Factors associated with the plan to pre-lacteal feeding for the first 6 months among Ethiopian mothers: a multilevel mixed effects analysis of 2019 performance monitoring for action Ethiopia. BMC Nutr 2023; 9:123. [PMID: 37924158 PMCID: PMC10625192 DOI: 10.1186/s40795-023-00784-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
INTRODUCTION Despite efforts to promote exclusive breastfeeding for the first six months of life, pre-lacteal feeding remains prevalent in Ethiopia. The study will use data from the 2019 Performance Monitoring for Action Ethiopia (PMA-ET), which is a nationally representative survey that collects information on maternal and child health indicators. Therefore, this study aims to identify individual and community-level factors associated with the plan to pre-lacteal feeding for the first six months among mothers in Ethiopia. METHODS The datasets from the 2019 Performance Monitoring for Action Ethiopia Survey were analyzed in this study, which included 685 mothers from the survey. Stata version 17.0 was used for data analysis. Multi-level mixed-effect logistic regression was utilized to identify individual and community-level factors that are linked with the plan to pre-lacteal feeding. The strength and direction of the association were presented using an adjusted odds ratio with a 95% confidence interval, and statistical significance was declared at a P value less than 0.05. RESULTS The study found that factors significantly associated with the plan to pre-lacteal feeding included mothers without higher education (AOR = 2.5, 95% CI: 1.204-1.204), mothers belonging to poor households (AOR = 11.1, 95% CI: 3.482-35.175), and women in clusters with poor wealth status (AOR = 0.2, 95% CI: 0.043-0.509). CONCLUSION As per the findings of the study, both individual and community-level factors were found to influence the decision to practice pre-lacteal feeding. Educational status and household wealth were significant individual-level factors associated with pre-lacteal feeding, whereas community wealth status was a significant community-level factor. To address this issue, it is recommended to focus on increasing the education level of mothers from lower socioeconomic backgrounds and providing education on the benefits of exclusive breastfeeding and the risks associated with pre-lacteal feeding. These efforts can help in reducing the prevalence of this harmful practice.
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Affiliation(s)
- Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Eyob Ketema Bogale
- Health Promotion and Behavioural Science Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amare Zewdie
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tadele Derbew Kassie
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Tadele Fentabil Anagaw
- Health Promotion and Behavioural Science Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Elyas Melaku Mazengia
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Sintayehu Shiferaw Gelaw
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Eneyew Talie Fenta
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Promotion and Health Behaviour, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, PO.Box.196, Gondar, Ethiopia
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Yalcin SS, Aydin Aksoy E, Yalcin S, Eryurt MA. Breastfeeding status and determinants of current breastfeeding of Syrian refugee children in Turkey. Int Breastfeed J 2023; 18:10. [PMID: 36721151 PMCID: PMC9890821 DOI: 10.1186/s13006-022-00538-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 12/20/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Turkey hosts the highest number of refugees in the World including 65% of Syrian refugees who reside in Turkey. Mothers and children were the most negatively affected among the Syrian refugees who had to migrate from their countries as a result of the civil war in Syria. One of the most important issues in terms of child health is breastfeeding. Breastfeeding in migrants should be promoted worldwide to mitigate infant mortality and diseases. The aim of this study is to examine the association between breastfeeding status in Syrian refugee children under two years and socio-demographic characteristics of Syrian refugee mothers with further analysis of Turkey Demographic and Health Survey-Syrian Migrant-2018 (TDHS-SM-2018) data. METHODS: The data source is the TDHS-SM-2018. Data for the last-born children with a gestational duration greater than 32 weeks from the mothers' singleton pregnancy, aged less than two years old and living with the mother were included (unweighted n = 744). The dependent variable was the breastfeeding status (breastfeeding in the last 24 h during the study period) in children under two years. Complex sample logistic regression evaluated the associations. RESULTS The percentage of breastfeeding in children under the age of two years was found to be 62.4%, and the total median breastfeeding duration was 14.6 months. Univariate analysis showed that the earlier mothers immigrated to Turkey, the higher the current breastfeeding rate. Breastfeeding rates were found to be higher among people living in the South and East regions (65.2% and 65.1% respectively). Multivariable binary complex sample logistic regression revealed that breastfeeding status at the study period was associated with long preceding birth interval; delivery in a public hospital; absence of prelacteal feeding; being non-pregnant; and the region and age of the child. No relationship for current breastfeeding was found with maternal activities, maternal life satisfaction, financial satisfaction, and educational status. CONCLUSION Current breastfeeding in our sample was more likely among mothers with a longer birth interval who avoided prelacteal feeding. The Baby-Friendly approach and family planning services should be integrated into refugee health centers.
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Affiliation(s)
- Siddika Songül Yalcin
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Esin Aydin Aksoy
- grid.14442.370000 0001 2342 7339Departmant of Social Pediatrics, Institute of Child Health, Hacettepe University, Ankara, Turkey
| | - Suzan Yalcin
- grid.17242.320000 0001 2308 7215Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Selçuk University, Konya, Turkey
| | - Mehmet Ali Eryurt
- grid.14442.370000 0001 2342 7339Institute of Population Studies, Hacettepe University, Ankara, Turkey
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Is Infant and Young Child-feeding (IYCF) a potential double-duty strategy to prevent the double burden of malnutrition among children at the critical age? Evidence of association from urban slums in Pune, Maharashtra, India. PLoS One 2022; 17:e0278152. [PMID: 36455056 PMCID: PMC9714859 DOI: 10.1371/journal.pone.0278152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND This study characterized undernutrition among children (0-24 months) by age groups specified for Infant and Young Child-feeding (IYCF) and determined the association between child malnutrition and IYCF. METHODS This cross-sectional survey recruited mother-children dyads (N = 1443). WHO standards were used to assess nutritional status and IYCF indicators. Multivariate analyses were performed to assess the association between IYCF and nutritional indicators. RESULTS Stunting, underweight, wasting, overweight, and obesity were prevalent in 33.1%, 26%, 20.2%, 4.6%, and 2.9% of the children, respectively. Age-wise distribution of undernutrition identified severity of stunting and underweight at 10-24 months (median < -1.6 SD; < -1.2 SD; 25th percentile at -2.6 & -2.2 SD respectively) and wasting highest at 0-6 months (25th percentile close to -2SD). Boys manifested higher stunting (lower value -5.2 SD) and were more wasted (lower value -4.7 SD). IYCF prevalence recorded early initiation at 45.2%, exclusive breastfeeding at 23.1%, and prelacteal and bottle-feeding at 37.5 and 22.5% respectively. Child minimum diet diversity (MDD) ≥4 was not achieved by 84%. Minimum meal frequency and minimum acceptable diet were achieved by 75% and 14% respectively. Bottle-feeding increased the odds of wasting [AOR: 1.501 (95% CI: 1.062-2.121)], severe stunting [AOR: 1.595 (95% CI: 1.079-2.358)] and underweight [AOR: 1.519 (95% CI 1.102-2.094)]. Wasting according to BAZ scores was associated with delayed initiation of breastfeeding [AOR: 1.387 (95% CI: 1.018-1.889)] and bottle feeding [AOR: 1.538 (95% CI: 1.087-2.175)]. Delayed introduction of complementary feeding increased the odds of severe stunting [AOR: 2.189 (95% CI: 1.090-4.399)]. Formula feeding increased the odds of underweight [AOR: 1.738 (95% CI: 1.046-2.888)] and obesity [AOR: 4.664 (95% CI: 1.351-16.10)]. Prelacteal feeding increased the odds of severe forms of stunting and underweight by 56% and 79% respectively, and overweight by 96%. CONCLUSION Setting and age-specific interventions to improve age-appropriate child-feeding practices are vital to address the double burden of malnutrition in the critical age group.
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Yigletu S, Tendulkar SA, Holmes AC, Abdelmenan S, Tadesse A, Berhane HY, Kosinski KC. Key correlates of exclusive breastfeeding at three timepoints: Evidence from Ethiopia. REPRODUCTIVE, FEMALE AND CHILD HEALTH 2022; 1:99-110. [PMID: 38047292 PMCID: PMC10691011 DOI: 10.1002/rfc2.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/30/2022] [Indexed: 12/05/2023]
Abstract
Aim To compare factors associated with exclusive breastfeeding (EBF) within 1 h of birth, within 3 days, and within the first 6 months post-birth. Methods We used multivariate logistic regression models and data from "The Alive and Thrive Phase 2 Amhara Baseline Survey 2015" from Ethiopia (N = 3113). Results Giving colostrum was strongly associated with EBF at all three time points, controlling for multiple confounders. Putting the baby to the breast before cleaning the baby and before cleaning the mother was significantly associated with EBF within 1 h and for the first 3 days. EBF within an hour of birth was more likely for girl babies than boy babies. Having a healthcare professional check whether the baby was sucking well was significantly associated with EBF 3 days post-birth. Conclusions The World Health Organization recommends breastfeeding within 1 h of birth and exclusively thereafter for 6 months, which can improve health outcomes for infants and children. In Ethiopia, many factors influence breastfeeding practices, but little is known about how these factors differ at various key timepoints in the 6 months after birth. Our study provides important information on correlates of EBF at three timepoints and shows that factors that are significantly correlated with EBF vary over time. Future research should assess the potential causal links among statistically significant associations between EBF and risk factors at various times between birth and 6 months of age. Ultimately, these findings have the potential to inform areas of intervention related to promoting EBF.
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Affiliation(s)
- Seblewongel Yigletu
- Department of Community Health, Tufts University, Medford, Massachusetts, USA
| | | | - Ashley C. Holmes
- Department of Community Health, Tufts University, Medford, Massachusetts, USA
| | | | - Amare Tadesse
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Hanna Y. Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Karen C. Kosinski
- Department of Community Health, Tufts University, Medford, Massachusetts, USA
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Amaje E, Gebremeskel F, Tufa G, Gelchu M, Wayessa ZJ. Colostrum Avoidance Practices and Its Associated Factors among Mothers of Children Aged Less Than 12 Months in Jinka Town, South Ethiopia, 2020. A Community Based Cross Sectional Study. Health Serv Res Manag Epidemiol 2022; 9:23333928221106056. [PMID: 35693462 PMCID: PMC9184999 DOI: 10.1177/23333928221106056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/13/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background Even though colostrum discarding hurts child health, little is known about the extent of the problem and its contributing factors in Southern Ethiopia. This study aimed to determine the prevalence of colostrum avoidance practices and associated factors among mothers of children aged less than 12 months in Jinka town, South Ethiopia. Methods A community-based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2020. A total of 420 mothers having children less than 12 months of age were selected by systematic sampling technique. The data were collected by using pretested interviewer-administered and semi-structured questionnaires. The data was entered using EPI DATA 3.1 and exported to SPSS version 23 for analysis. Descriptive statistics, binary and multivariable logistic regression analysis were done. Adjusted odds ratio with 95% CI at a p-value < 0.05 was estimated to identify statistically significant variables with colostrum avoidance practices. Results The prevalence of colostrum avoidance practice was 9.8% [95% CI: (6.9–12.5)]. Delayed initiation of breastfeeding [AOR = 9.08(95% CI 4.16–19.83)], lack of breastfeeding counseling [AOR = 2.33(95% CI 1.11–4.87)], home delivery of index child [AOR = 2.48 (95% CI 1.16–5.27)] and poor knowledge on breastfeeding [AOR = 4.55(95% CI 1.95–10.63)] were factors associated with colostrum avoidance practices. Conclusion Colostrum avoidance practice among mothers of children aged less than 12 months in Jinka town was high. Delayed initiation of breastfeeding, lack of breastfeeding counseling, home delivery, and knowledge of breastfeeding practice were factors associated with colostrum avoidance practice.
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Affiliation(s)
- Elias Amaje
- School of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Feleke Gebremeskel
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Girma Tufa
- Department of Midwifery, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Miesa Gelchu
- School of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
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Birhan TY, Alene M, Seretew WS, Taddese AA. Magnitude and determinants of breastfeeding initiation within one hour among reproductive women in Sub-Saharan Africa; evidence from demographic and health survey data: a multilevel study. BMC Public Health 2022; 22:1062. [PMID: 35624450 PMCID: PMC9145512 DOI: 10.1186/s12889-022-13114-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background Early initiation of breastfeeding is one of the most simple and essential intervention for child development and survival in the world. World Health Organization recommended to begin breast milk with one hour after delivery. The objective of this study was to determine the magnitude of early initiation of breastfeeding in Sub-Saharan Africa using DHS data set. Methods This study was carried out within 32 Sub-Saharan African countries from 2010–2020, a pooled study of early initiation of breastfeeding was performed. For assessing model fitness and contrast, intra-class correlation coefficient, median odds ratio, proportional change in variance, and deviance were used. In order to identify possible covariates associated with early initiation of breastfeeding in the study area, the multilevel multivariable logistic regression model was adapted. Adjusted Odds Ratio was used with 95% confidence interval to declare major breastfeeding factors. Result The pooled prevalence of early initiation of breastfeeding in Sub-Saharan Africa countries was 57% (95% CI; 56%—61%), the highest prevalence rate of early initiation of breastfeeding was found in Malawi while the lowest prevalence was found in Congo Brazzaville (24%). In multilevel multivariable logistic regression model; wealth index (AOR = 1.20; 95% CI 1.16 – 1.26), place of delivery (AOR = 1.97; 95% CI 1.89 – 2.05), skin-to-skin contact (AOR = 1.51; 95% CI 1.47 – 1.57), mode of delivery (AOR = 0.27; 95% CI 0.25 – 0.29), media exposure (AOR = 1.36; 95% CI 1.31 – 1.41) were significantly correlated with early initiation of breastfeeding in Sub-Saharan Africa. Conclusion The magnitude of early initiation of breastfeeding rate was low in Sub-Saharan Africa. Covariates significantly associated with early initiation of breastfeeding was wealth index, place of delivery, mode of delivery, women educational status, and media exposure. Structural improvements are required for women with caesarean births to achieve optimal breastfeeding practice in Sub-Saharan Africa.
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Affiliation(s)
- Tilahun Yemanu Birhan
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Muluneh Alene
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Wullo Sisay Seretew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Asefa Adimasu Taddese
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Beyene GM, Azale T, Gelaye KA, Ayele TA. Effect of antenatal depression on the initiation of breastfeeding in South Gondar zone, Northwest Ethiopia: A population-based prospective cohort study. Heliyon 2022; 8:e08759. [PMID: 35079650 PMCID: PMC8777141 DOI: 10.1016/j.heliyon.2022.e08759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/20/2021] [Accepted: 01/09/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Delayed initiation of breastfeeding has been found to increase early neonatal morbidity, mortality, and impaired mother-infant bonding. However, there is no study that revealed the effect of antenatal depression on breastfeeding initiation in Ethiopia. This study aimed to see the effect of antenatal depression on the practice of initiation of breastfeeding among women in urban Ethiopia. METHODS The Edinburgh Postnatal Depression Scale (EPDS) was administered to 970 women in the second and third trimesters of pregnancy to screen for antenatal depression. Information was collected on initiation of breastfeeding of newborns and mother's socio-demographic, obstetric, clinical, psychosocial, and behavioral factors. A logistic regression model was used to adjust for the confounders and determine association between antenatal depression and initiation of breastfeeding. RESULTS The cumulative incidence of late initiation of breastfeeding (LIBF) was found to be 166 (18.34%). The cumulative incidence of LIBF in those born from depressed pregnant women was 37% as compared to 8.4% in nondepressed. Antenatal depression at the second and third trimester of pregnancy remained a potential predictor of late initiation of breastfeeding after adjusting for potential confounders (AOR = 6.42: (95% CI 3.72, 11.05)). A significant association was also seen between infants who were born by cesarean section, a complication of current pregnancy, inadequate ANC follow-up, lack of advice about the importance of early initiation of breastfeeding (EIBF), home delivery, and low quartile of wealth index and late initiation of breastfeeding. CONCLUSIONS These findings suggest that screening for antenatal depression can help to identify women at risk for late initiation of breastfeeding. Health care providers shall have to give emphasis on the treatment of antenatal depression to benefit both the mother and the physical health, growth, and development of the fetus.
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Affiliation(s)
- Getnet Mihretie Beyene
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Seyoum K, Tekalegn Y, Quisido B. Determinants and prevalence of early initiation of breastfeeding: Does the place of delivery matter? A comparative cross-sectional study based on the 2016 Ethiopian demographic and health survey data. POPULATION MEDICINE 2021. [DOI: 10.18332/popmed/144318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Akello R, Kimuli D, Okoboi S, Komuhangi A, Izudi J. Prelacteal feeding among infants within the first week of birth in eastern Uganda: evidence from a health facility-based cross-sectional study. Int Breastfeed J 2021; 16:77. [PMID: 34641932 PMCID: PMC8507326 DOI: 10.1186/s13006-021-00425-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/21/2021] [Indexed: 11/18/2022] Open
Abstract
Background Prelacteal feeding hinders early initiation of breastfeeding and exclusive breastfeeding but is understudied in Uganda. We examined the prevalence and factors associated with prelacteal feeding among postpartum mothers in Kamuli district in rural eastern Uganda. Methods We conducted a cross-sectional study between December 2020 and January 2021 at four large healthcare facilities and randomly sampled mother-baby pairs attending postnatal care and immunization clinics. Prelacteal feeding was defined as giving anything to eat or drink to a newborn other than breast milk within the first 0–3 days of life. Data were collected using a researcher-administered questionnaire and summarized using frequencies and percentages. The Chi-squared, Fisher’s exact, and Student’s t-tests were used for comparison while the factors independently associated with prelacteal feeding were determined using modified Poisson regression analysis, reported as an adjusted prevalence risk ratio (aPRR) with corresponding 95% confidence intervals (CI). Results Of 875 participants enrolled, 319 (36.5%) practiced prelacteal feeding. The likelihood of prelacteal feeding was lower among participants who were unemployed (aPRR 0.70; 95% CI 0.5, 0.91), married (aPRR 0.71; 95% CI 0.58, 0.87), had received health education on infant feeding practices (aPRR 0.72; 95% CI 0.60, 0.86), had a spontaneous vaginal delivery (aPRR 0.76; 95% CI 0.61, 0.95), had delivered in a health facility (aPRR 0.73; 95% CI 0.60, 0.89), and who knew that prelacteal feeding could lead to difficulties in breathing (aPRR 0.70; 95% CI 0.57, 0.86). Conversely, prelacteal feeding was more likely among participants who had attended antenatal care at a public health facility during the most recent pregnancy (aPRR 2.41; 95% CI 1.71, 3.39) and those who had travelled more than 5 km to a health facility for postnatal care services (aPRR 1.46; 95% CI 1.23, 1.72). Conclusions The prevalence of prelacteal feeding among postpartum mothers in rural eastern Uganda is slightly higher than the national average. Accordingly, there is a need to continuously educate mothers and staff on infant feeding practices to tackle the factors influencing prelacteal feeding and promote appropriate infant and young child feeding practices as emphasized in the baby-friendly health facility initiative policy.
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Affiliation(s)
- Racheal Akello
- Institute of Public Health, Clarke International University, P.O. Box 7782, Kampala, Uganda
| | - Derrick Kimuli
- Directorate of Socio-Economic Surveys, Uganda Bureau of Statistics, P.O. Box 7186, Kampala, Uganda
| | - Stephen Okoboi
- Institute of Public Health, Clarke International University, P.O. Box 7782, Kampala, Uganda.,Infectious Diseases Institute, Makerere University College of Health Sciences, P.O. Box 22418, Kampala, Uganda
| | - Alimah Komuhangi
- Institute of Public Health, Clarke International University, P.O. Box 7782, Kampala, Uganda
| | - Jonathan Izudi
- Institute of Public Health, Clarke International University, P.O. Box 7782, Kampala, Uganda. .,Infectious Diseases Institute, Makerere University College of Health Sciences, P.O. Box 22418, Kampala, Uganda. .,Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
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Teshale AB, Worku MG, Tessema ZT, Tesema GA. Prelacteal feeding practice and its associated factors among mothers having children less than 2 years of age in East Africa: a multilevel analysis of the recent demographic and health surveys. Int Breastfeed J 2021; 16:68. [PMID: 34496922 PMCID: PMC8424961 DOI: 10.1186/s13006-021-00414-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 08/24/2021] [Indexed: 11/17/2022] Open
Abstract
Background Prelacteal feeding is a major public health problem that increases the risk of morbidity and mortality in children. It also result delayed breastfeeding initiation and interferes with exclusive breastfeeding. Although numerous studies have been done on prelacteal feeding in individual East African countries, most of them did not consider community-level factors that could affect the likelihood of prelacteal feeding. This study, thus, aimed to assess the pooled prevalence and associated factors of prelacteal feeding practice in East Africa. Methods We used pooled data from the 12 east Africa countries Demographic and Health Surveys (DHS). A total weighted sample of 33,423 women was included in the final analysis. We employed multilevel logistic regression analysis to assess factors associated with prelacteal feeding practice. Finally, the Adjusted odds ratio (AOR) with 95% Confidence (CI) interval was reported and variables with p value< 0.05, in the multivariable analysis, were declared to be significant predictors of prelacteal feeding practice. Result In this study, the pooled prevalence of prelacteal feeding practice was 11.85% (95%CI: 11.50, 12.20) with great variation between countries, ranging from 3.08% (95%CI: 2.35, 3.81) in Malawi to 39.21% (95%CI: 36.36, 42.06) in Comoros. Both individual and community-level factors were associated with prelacteal feeding practice. Of the individual-level factors, home delivery, multiple birth, cesarean delivery, non-exposure to media, delayed initiation of breastfeeding, and being a small-sized baby were associated with higher odds of prelacteal feeding practice. Among the community-level factors, rural residence and higher community-level of media exposure were associated with lower odds of prelacteal feeding practice. Conclusion In this study, the pooled prevalence of prelacteal feeding is high. Both individual and community level variables were associated with prelacteal feeding practice. Therefore, individual and community-level interventions that encourage mothers to deliver in the health facility and promoting timely initiation of breastfeeding are needed to reduce prelacteal feeding practices in east Africa. Moreover, media campaigns regarding this harmful traditional practice could be strengthened.
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Affiliation(s)
- Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Mose A, Abebe H. Prelacteal feeding practice and its determinant factors among mothers having children less than 6 months of age in Bure district, Northwest Ethiopia: a community-based cross-sectional study. BMJ Open 2021; 11:e046919. [PMID: 34475152 PMCID: PMC8413938 DOI: 10.1136/bmjopen-2020-046919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 08/18/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The main aim of this study was to assess prelacteal feeding practice and its determinant factors among mothers having children less than 6 months of age in Bure district, Northwest Ethiopia. DESIGN Community-based cross-sectional study design. SETTING Northern Ethiopia. PARTICIPANTS The present study was conducted among 621 mothers who had children less than 6 months of age in Bure district, Northwest Ethiopia, from 1 March 2019 to 30 March 2019. PRIMARY OUTCOME Mothers prelacteal feeding practice, modelled using multivariable logistic regression. SECONDARY OUTCOME Determinant factors of prelacteal feeding practice. RESULTS This study found that the prevalence of prelacteal feeding practice was 11.6% ((95% CI 9.0% to 14.2%)). Delayed initiation of breast feeding (adjusted OR, AOR=5.4, 95% CI 2.2 to 13.5), mothers who did not get counselling of breast feeding (AOR=2.9, 95% CI 1.2 to 7.2), home delivery (AOR=6.9, 95% CI 2.2 to 21.5), primiparous mothers (AOR=4.1, 95% CI 1.4 to 12.2), a newborn with history of neonatal illness (AOR=3.3, 95% CI 1.3 to 8.5) and lack of postnatal care visits (AOR=3.9, 95% CI 1.3 to 11.8) were determinant factors of prelacteal feeding practice. CONCLUSIONS Delayed initiation of breast feeding, mothers who did not get counselling of breast feeding, home delivery, primiparous mothers, newborns with a history of neonatal illness and lack of postnatal care visits were determinant factors of prelacteal feeding practice. Therefore, healthcare workers should provide a home to home health education for mothers on the merits of early initiation of breast feeding, promote institutional delivery, enhance maternal health-seeking behaviour and encourage mothers to have postnatal care visits is recommended.
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Affiliation(s)
- Ayenew Mose
- Midwifery, Wolkite University, Welkite, Ethiopia
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Adem A, Assefa N, Deresa M, Yuya M, Ayana GM, Negash B, Beshir T, Merga BT. Prelacteal Feeding Practices and Its Associated Factors among Mother of Children Less Than 2 Years of Age in Kersa District, Eastern Ethiopia. Glob Pediatr Health 2021; 8:2333794X211018321. [PMID: 34095353 PMCID: PMC8142237 DOI: 10.1177/2333794x211018321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background. Prelacteal feeding is defined as administration of
any substances other than breast milk to newborn babies during the first 3 days
after birth. Despite its negative health outcomes, it is commonly practiced in
developing countries. Therefore, this study aimed at assessing the prevalence of
pre-lacteal feeding practices and associated factors among mothers of children
aged less than 2 years of age in Kersa district, Eastern Ethiopia.
Method. A community-based cross-sectional study design was
conducted among 465 mothers having children aged less than 2 years in Kersa
district. A multistage sampling technique was used to select study participants.
Binary logistic regression analysis was fitted to identify factors associated
with prelacteal feeding practices. Variables with a P-value
<.05 were identified as statistically significant factors.
Results. The prevalence of pre-lacteal feeding in Kersa
district was 46.4% (95% CI; 42.0%, 51.5%). Initiating breastfeeding after 1 hour
of delivery (AOR = 10.80, 95% CI: (5.79, 20.17)), giving birth at home
(AOR = 2.77, 95% CI: (1.41, 5.46)), not knowing risks associated with
pre-lacteal feeding (AOR = 3.25, 95% CI: (1.72, 6.15)) and perceiving
pre-lacteal feeding as beneficial (AOR = 9.56, 95% CI: (4.45, 20.52)) were
factors significantly associated with practice pre-lacteal feeding practices.
Conclusion. Significant proportions of mothers were
practicing pre-lacteal feeding in the study area. Late initiation of
breastfeeding, home delivery, not knowing risks of prelacteal feeding, and
perceiving pre-lacteal feeding as beneficial were contributing factors for
practicing of pre-lacteal feeding. Therefore, promoting institutional delivery
and timely initiation of breastfeeding would reduce prelacteal feeding in Kersa
district.
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Affiliation(s)
- Ahmedzekuwan Adem
- Bisidimo General Hospital, Oromia Regional Health Bureau, Bisidimo, Ethiopia
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Deresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Yuya
- Department of Reproductive and Nutrition, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Galana Mamo Ayana
- Department of Biostatistics and Epidemiology, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Belay Negash
- Department of Public Health and Health Policy, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Temam Beshir
- Department of Biostatistics and Epidemiology, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bedasa Taye Merga
- Department of Public Health and Health Policy, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Legesse Liben M, Adem R, Yimer NB. The effect of antenatal care on colostrum avoidance in pastoralists: The case of Afar, Northeast Ethiopia. Glob Pediatr Health 2021; 8:2333794X211013764. [PMID: 34017907 PMCID: PMC8114240 DOI: 10.1177/2333794x211013764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Breastfeeding is sufficient for infants in the first 6 months of life and is important to maintain maternal health. Evidences revealed that neonatal mortality is higher among children who received colostrum as compared to those who are deprived of colostrum. Therefore, this study aimed to assess the factors associated with colostrum avoidance practice among pastoralists in Afar Regional State, Northeast Ethiopia. A community-based cross-sectional study was conducted on 1188 mother-child pairs in Afar Regional State in June 2016. Univariable and multivariable logistic regression analyses were carried out to identify the predictors of colostrum avoidance. Statistical significance was declared at P-value <.05. About 40% of children deprived of colostrum. Mothers aged 20 to 34 years (AOR: 1.79; 95% CI: 1.18, 2.73), not attending antenatal checkup (AOR: 1.82; 95% CI: 1.64, 2.85), receiving prelacteal feeding (AOR: 2.21; CI: 1.88, 3.93) and late initiation of breastfeeding (AOR: 2.71; 95% CI: 2.02, 3.65) were positively associated with colostrum avoidance. Nearly 4 in 10 children deprived of colostrum. Therefore, promoting antenatal care and strengthening service-based counseling on proper newborn feeding practices will be important to improve colostrum feeding.
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Affiliation(s)
| | - Reem Adem
- Afar Regional Health Bureau, Afar, Ethiopia
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Birhan TY, Seretew WS, Alene M. Trends and determinants of breastfeeding within one hour in Ethiopia, further analysis of Ethiopian Demographic and Health Survey: multivariate decomposition analysis. Ital J Pediatr 2021; 47:77. [PMID: 33771215 PMCID: PMC8004466 DOI: 10.1186/s13052-021-01032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background Despite the substantial efforts to improve timely/early initiation of breastfeeding, avoidance of colostrum, and delayed initiation of breastfeeding remains a big challenge in developing countries. Therefore, this study aimed to analyze the trends of early breastfeeding rate over time based on the Ethiopian Demographic and Health Survey (EDHS). Methods Secondary data analysis was conducted based on the Ethiopian Demographic Health Surveys (EDHSs) conducted in 2005, 2011, and 2016. A total weighted sample of 9, 111, 10,106, and 8564 in 2005, 2011, and 2016 respectively were included for analysis. Trend and Logistic based decomposition analysis technique was used for analyzing the trends of early breastfeeding initiation over time and factors contributing to the change in early breastfeeding initiation rate. STATA 15 was employed for data management and analyses. All analyses presented in this paper were weighted for the sampling probabilities and non-response. Result Among children age less than 5 years the rate of early breastfeeding initiation rate overtime was increased from 70.5% in 2005 to 72.7% in 2016. The highest rate of improvement was seen in the second phase of the study (2011–2016) while it shows a decline in the first phase (2005–2011) from 70.5 to 55.1%. The decomposition analysis indicated that about half of the overall change in early breastfeeding initiation rate was due to the difference in women’s composition. Particularly, an increase in health facility delivery and vaginal delivery was a significant predictor of the increasing rate of early breastfeeding initiation over the surveys. Conclusion Early initiation of breastfeeding slightly increasing over the last 10 years in Ethiopia. Half of the overall increase in the early initiation of breastfeeding was due to the change in compositional characteristics of women over 10 years in Ethiopia. Change in the composition of women according to health facility delivery and vaginal delivery were the major source of the increase in early breastfeeding initiation over time. Public interventions including promoting health facility delivery of women for further improvements of early breastfeeding initiation should be needed.
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Affiliation(s)
- Tilahun Yemanu Birhan
- Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Wullo Sisay Seretew
- Department of Epidemiology and Biostatistics, Institute of public health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Muluneh Alene
- Department of Public Health, College of Health Science, DebreMarkos University, Debre Markos, Ethiopia
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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. Ital J Pediatr 2021; 47:55. [PMID: 33750442 PMCID: PMC7941680 DOI: 10.1186/s13052-021-01010-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/26/2021] [Indexed: 12/04/2022] Open
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. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-021-01010-x.
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Hassen SL, Temesgen MM, Marefiaw TA, Ayalew BS, Abebe DD, Desalegn SA. Infant and Young Child Feeding Practice Status and Its Determinants in Kalu District, Northeast Ethiopia: Community-Based Cross-Sectional Study. NUTRITION AND DIETARY SUPPLEMENTS 2021. [DOI: 10.2147/nds.s294230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Teshale AB, Worku MG, Tesema GA. Spatial distribution and determinants of the change in pre-lacteal feeding practice over time in Ethiopia: A spatial and multivariate decomposition analysis. PLoS One 2021; 16:e0244574. [PMID: 33444391 PMCID: PMC7808656 DOI: 10.1371/journal.pone.0244574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 12/11/2020] [Indexed: 11/18/2022] Open
Abstract
Background Pre-lacteal feeding persists in low and middle-income countries as deep-rooted nutritional malpractice. It imposes significant negative consequences on neonatal health, including increased risk of illness and mortality. Different studies revealed that pre-lacteal feeding practice is decreased over time. Even though different studies are done on the prevalence and determinants of pre-lacteal feeding practice, up to our knowledge, the spatial distribution and the determinants of the change in pre-lacteal feeding practice over time are not researched. Objective To assess the spatial distribution and determinants of the change in pre-lacteal feeding practice over time in Ethiopia. Methods We used the Ethiopian demographic and health surveys (EDHSs) data. For this study, a total weighted sample of 14672 (5789 from EDHS 2005, 4510 from EDHS 2011, and 4373 from EDHS 2016) reproductive-age women who gave birth within two years preceding the respective surveys and whoever breastfeed were used. The logit-based multivariate decomposition analysis was used to identify factors that contributed to the decrease in pre-lacteal feeding practice over the last 10 years (from 2005 to 2016). Using the 2016 EDHS data, we also conducted a spatial analysis by using ArcGIS version 10.3 and SaTScan version 9.6 software to explore the spatial distribution and hotspot clusters of pre-lacteal feeding practice. Result Pre-lacteal feeding practice was decreased from 29% [95% Confidence interval (CI): 27.63–29.96%] in 2005 to 8% [95% CI: 7.72–8.83%] in 2016 with annual rate of reduction of 7.2%. The overall decomposition analysis showed that about 20.31% of the overall decrease in pre-lacteal feeding practice over the last 10 years was attributable to the difference in composition of women (endowment) across the surveys, while, the remaining 79.39% of the overall decrease was explained by the difference in the effect of characteristics (coefficient) across the surveys. In the endowment component, the difference in composition of residence, perception of distance from the health facility, maternal educational level, wealth status, occupation, ANC visit, place of delivery, the timing of breastfeeding initiation, and wanted last-child/pregnancy were found to be significant contributing factors for the decrease in pre-lacteal feeding practice. After controlling for the role of compositional changes, the difference in the effect of distance from the health facility, wealth status, occupation, antenatal care (ANC) visit, and wanted last-child/pregnancy across the surveys were significantly contributed to the observed decrease in pre-lacteal feeding practice. Regarding the spatial distribution, pre-lacteal feeding practice was non-random in Ethiopia in which the primary and secondary clusters’ of pre-lacteal feeding identified in Somalia and the Afar region respectively. Conclusion Pre-lacteal feeding practice has shown a significant decline over the 10-year period. Program interventions considering women with poor maternal health service utilization such as ANC visits, women with poor socioeconomic status, women with an unintended pregnancy, and women from remote areas especially at border areas such as Somali and Afar could decrease pre-lacteal feeding practice in Ethiopia.
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Affiliation(s)
- Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Jeyakumar A, Jungari S, Nair R, Menon P, Babar P, Bhushan B, Yogita H, Ali J, Saddichha M, Bhagyashree M, Monika P, Sakshi S. Prevalence and Determinants of Early Initiation (EI), Exclusive Breastfeeding (EBF), and Prelacteal Feeding among Children Aged 0-24 Months in Slums of Pune City, in Maharashtra. Ecol Food Nutr 2020; 60:377-393. [PMID: 33334182 DOI: 10.1080/03670244.2020.1858407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Infant and young child feeding practices remain a public health challenge in India. We determined the socio-demographic risk factors for early initiation, exclusive breastfeeding and prelacteal feeding in the urban slums of Pune city.A cross sectional survey of mother (N=1443) children (< 2 years) dyads was performed. Socio-demographic, maternal and child characteristics were recorded. Breastfeeding practices were assessed using WHO indicators. Multiple logistic regression was employed to model associations between socio-demographic factors and breastfeeding indicators.Early initiation was reported by 45.2%, prelacteal feeding by 37.5% and exclusive breastfeeding by 23.7%. Caesarean delivery decreased the odds of early initiation (AOR: 0.403; 95% CI; 0.303.-0.536) and exclusive breastfeeding (OR: 0.675; 95% CI: 0. 478-0.953), while it increased the odds of prelacteal feeding (AOR: 3.525; 95% CI: 2.653-4.683). Delivery in a public health care facility increased the odds of early initiation (AOR: 1.439; 95% CI: 1.095-1.891) and exclusive breastfeeding (OR: 0.514; 95% CI: 0.366-0.720), while it decreased the odds of prelacteal feeding (AOR: 0.421; 95% CI: 0.318-0.559). Odds of early initiation decreased significantly in very low-birth-weight (AOR: 0.209; CI: 0.76-0.567) whereas, it increased odds of prelacteal feeding (AOR: 1.389; 95% CI: 0.640-3.019), (AOR: 0.483; 95% CI: 0.262-0.889). Religion other than Hindu or Muslim, age of the mother between 26-30 years increased the odds of exclusive breastfeeding and parity <2 increased the odds of prelacteal feeding.Interventions that address setting specific determinants, focusing on local contexts are essential to improve child feeding practices in urban slums.
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Affiliation(s)
- Angeline Jeyakumar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India.,School of Tourism and Hospitality Management, University of Johannesburg, Johannesburg, South Africa
| | - Suresh Jungari
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Raji Nair
- Department of Paediatrics, UNICEF, Mumbai, India
| | - Pramila Menon
- Dr. D.Y. Patil Medical College and Hospital, Pimpri - Chinchwad, India
| | - Prasad Babar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Barai Bhushan
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Hulsurkar Yogita
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Janan Ali
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Marathe Saddichha
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Mitragotri Bhagyashree
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Phadake Monika
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Sneha Sakshi
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
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Ali NB, Karim F, Billah SKM, Hoque DMDE, Khan ANS, Hasan MM, Simi SM, Arifeen SEL, Chowdhury MAK. Are childbirth location and mode of delivery associated with favorable early breastfeeding practices in hard to reach areas of Bangladesh? PLoS One 2020; 15:e0242135. [PMID: 33186387 PMCID: PMC7665793 DOI: 10.1371/journal.pone.0242135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/28/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Early initiation of breastfeeding within one hour of birth (EIBF) and no prelacteal feeding are WHO recommended practices for improving maternal and newborn health outcomes. Globally, EIBF can avert around 22% of newborn death. In recent years, Bangladesh has experienced increasing facility delivery coverage and cesarean section rates. However, the impact of these changes on early breastfeeding initiation in hard to reach areas (HtR) of the country is still poorly understood. Therefore, this study aimed to examine the independent associations between childbirth locations and mode of delivery with favorable early breastfeeding practices in four hard to reach areas of Bangladesh. METHOD We extracted data from a cross-sectional study conducted in four HtR areas of Bangladesh in 2017. A total of 2768 women, having birth outcomes in the past 12 months of the survey, were interviewed using structured questionnaires. EIBF and no prelacteal feeding were considered as favorable early breastfeeding practices. The categories of childbirth locations were defined by the place of birth (home vs. facility) and the delivery sector (public/NGO vs. private). The mode of delivery was categorized into vaginal delivery and cesarean section. Generalized linear models were used to test the independent associations while adjusting for potential confounders. RESULTS The prevalence of EIBF practices were 69.6%(95% CI:67.8-71.3); 72.2%(95% CI:67.8-71.3) among home births Vs 63.0%(95% CI:59.5%-66.4%) among facility births. Around 73.9% (95% CI:72.3-75.6) mother's in the study areas reported no-prelacteal feeding. Compared to home births, women delivering in the facilities had lower adjusted odds of EIBF (aOR = 0.51; 95%CI:0.35-0.75). Cesarean section was found to be negatively associated with EIBF (aOR = 0.20; 95%CI:0.12-0.35), after adjusting for potential confounders. We could not find any significant associations between the place of birth and mode of delivery with no prelacteal feeding. DISCUSSIONS This study found that facility births and cesarean deliveries were negatively associated with EIBF. Although the implementation of "Baby-Friendly Hospital Initiatives" could be a potential solution for improving EIBF and no prelacteal feeding practices, the challenges of reduced service availability and accessibility in HtR areas must be considered while devising effective intervention strategies. Future studies can explore potential interventions to promote early breastfeeding for facility births and cesarean deliveries in HtR areas.
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Affiliation(s)
- Nazia Binte Ali
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Farhana Karim
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - S. K. Masum Billah
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Abdullah Nurus Salam Khan
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Mohammad Mehedi Hasan
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sonjida Mesket Simi
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shams E. L. Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohiuddin Ahsanul Kabir Chowdhury
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
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Pre-lacteal feeding practices and associated factors among mothers of children aged less than 12 months in Jinka Town, South Ethiopia, 2018/19. PLoS One 2020; 15:e0240583. [PMID: 33048981 PMCID: PMC7553318 DOI: 10.1371/journal.pone.0240583] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 09/29/2020] [Indexed: 11/19/2022] Open
Abstract
Background Pre-lacteal feeding is one of the major harmful practices being faced while feeding the newborns. Although it affects child health, little is known about the extent of the problem and its contributing factors in the study area. Therefore, this study aimed to figure the prevalence of pre-lacteal feeding practices and associated factors among mothers of children aged less than 12 months in Jinka Town. Methods A community-based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2019. A total of 430 mothers, having children less than 12 months of age, were selected by systematic sampling technique. The data were collected by using pretested and interviewer- administered structured questionnaires. The data were entered using epidata 4.2.1 and exported to SPSS version 23 for analysis. Adjusted odds ratios, 95% confidence intervals and p-values were reported. Results The prevalence of pre-lacteal feeding practice was 12.6% [95% CI (9.5–15.7)]. Having no maternal education [AOR = 4.82(95%CI 1.60–14.24)], colostrum avoidance [AOR = 4.09(95% CI 1.62–7.67)], lack of breast feeding counseling [AOR: = 2.51(95% CI 1.20–5.25)], home delivery [AOR = 3.34 (95% CI 1.52–7.33)], lack of knowledge about risks of pre-lacteal feeding [AOR = 2.86 (95% CI 1.30–6.29] and poor knowledge on breast feeding practices [AOR = 3.63(95% CI 1.62–8.11)] were factors associated with pre-lacteal feeding practices. Conclusion Pre-lacteal feeding practice among mothers of children aged less than 12 months in Jinka town was found to be higher than the national prevalence. Illiterate, colostrum avoidance, lack of breastfeeding counseling, home delivery, lack of knowledge on the risk of pre-lacteal feeding, and poor knowledge on breastfeeding practice were factors associated with pre-lacteal feeding practices.
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Bayih WA, Mekonen DK, Kebede SD. Prevalence and associated factors of prelacteal feeding among neonates admitted to neonatal intensive care units, North central Ethiopia, 2019. BMC Public Health 2020; 20:1457. [PMID: 32977790 PMCID: PMC7519479 DOI: 10.1186/s12889-020-09578-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 09/21/2020] [Indexed: 11/21/2022] Open
Abstract
Background Prelacteal feeding compromises the benefits of exclusive breastfeeding, thereby increasing neonatal malnutrition, infection and mortality. About 26% of the Ethiopian neonates are given prelacteal feeds and nearly 48% of whom are attributed to Amhara region. Besides, prior Ethiopian studies have shown significance of the problem at different community settings in the country. However, the prevalence and associated factors of prelacteal feeding among neonatal admissions has been overlooked in the country in general and in the study area in particular. Therefore, this study was aimed to assess the prevalence and associated factors of prelacteal feeding among neonatal admissions in the study setting. Methods A cross-sectional study was conducted among 321 mother-neonate pairs admitted to Neonatal Intensive Care Unit (NICU) of Debre Tabor General Hospital between September 2018 and February 2019. Every fourth mother neonate pair was included to the study. Multivariable logistic regressions were fitted to find out adjusted odds ratios (AORs) of factors associated with pre-lacteal feeding. Results The prevalence of prelacteal feeding was 20.2% [95% CI: 15.31–26.75%]. Plain water was the most common prelacteal food (32.3%). Factors associated with prelacteal feeding include rural residence (AOR = 4.07, 95% CI: 1.30, 12.81), primiparity (AOR = 4.50, 95% CI: 1.30–12.81), less than four ANC visits (AOR = 4.71, 95% CI: 1.23–17.84), spousal accompany to ANC (AOR = 0.20, 95% CI: 0.05–0.75), home delivery (AOR = 5.94, 95% CI: 1.80–19.67), having twin newborns (AOR = 6.69, 95% CI: 1.25, 35.91) and maternal belief on the purported advantages of prelacteal feeding (AOR = 2.74, 95% CI: 2.09–25.39). Conclusion and recommendation One out of five sick neonates was given prelacteal feeds. Twin neonates, home delivered neonates, rural neonates, neonates born to primiparous mothers, neonates delivered from mothers who had less than four ANC visits, neonates born to mothers who weren’t accompanied by their spouse during ANC and those born to mothers who believe on the purported advantages of prelacteal feeding had higher odds of receiving prelacteal feeds. Therefore, mothers of these vulnerable neonates should be provided with more emphasis about counseling of infant and young child feeding practice during their stay at NICU.
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Affiliation(s)
- Wubet Alebachew Bayih
- Department of Pediatrics and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, P.O.BOX 272, Debre Tabor, Ethiopia.
| | - Demewoz Kefale Mekonen
- Department of Pediatrics and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, P.O.BOX 272, Debre Tabor, Ethiopia
| | - Solomon Demis Kebede
- Department of Pediatrics and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, P.O.BOX 272, Debre Tabor, Ethiopia
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Magnitude of Prelacteal Feeding and Its Associated Factors among Mothers Having Children Less than One Year of Age: A Community-Based Cross-Sectional Study in Rural Eastern Zone, Tigray, Ethiopia. ADVANCES IN PUBLIC HEALTH 2020. [DOI: 10.1155/2020/4926890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background. Prelacteal feeding is an obstacle to optimal breastfeeding practices in developing countries. It directly or indirectly affects the health of the infants. Despite its importance, this issue has received little attention in Ethiopia. As a result, this study aimed to assess prelacteal feeding and associated factors among mothers of children aged less than 12 months in the rural eastern zone, Tigray, Ethiopia.Methods. Community-based cross-sectional study design was employed. The final sample size was 828, and the multistage sampling technique was used. Pretested and structured interviewer-administered tool was used for data collection. Data were entered, coded, and cleaned by Epi-Info version 7 and analyzed by using SPSS 22.0. Multivariable logistic regression was used to control the effect of confounding.Results. Eight hundred three mothers participated in this study. During the first three days after birth, 198 (24.7%) mothers practiced prelacteal feeding. Parity (AOR: 1.52, 95% CI: 1.04–2.23), late initiation of breastfeeding (AOR: 1.83, 95% CI: 1.30–2.59), and colostrum discard (AOR: 1.57, 95% CI: 1.06–2.33) were strongly associated with prelacteal feeding practice.Conclusion and Recommendation. One-fourth of participants practiced prelacteal feeding. Late initiation of breastfeeding, colostrum discard, and parity were significant determinants of prelacteal feeding. Awareness creation and health education concerning the advantages of early initiation of breastfeeding and the importance of colostrum during their health visits is necessary.
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Asim M, Ahmed ZH, Hayward MD, Widen EM. Prelacteal feeding practices in Pakistan: a mixed-methods study. Int Breastfeed J 2020; 15:53. [PMID: 32513203 PMCID: PMC7278149 DOI: 10.1186/s13006-020-00295-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prelacteal feeding, the feeding a newborn substances or liquids before breastfeeding, is a common cultural practice in Pakistan, but is associated with neonatal morbidity and mortality because it delays early initiation of breastfeeding. In this study, we sought to examine the social and cultural factors associated with prelacteal feeding in Pakistan. METHODS This mixed-method study used data from the Pakistan Demographic and Health Survey (PDHS) 2012-13. Findings from the survey were complemented by qualitative interviews with mothers and healthcare providers. In a subset of PDHS dyads (n = 1361) with children (0-23 months), descriptive statistics and bivariate and multivariable logistic regression analysis examined factors associated with prelacteal feeding. The qualitative study included in-depth interviews with six mothers and six health care providers, which were analyzed using NVivo software version 10. RESULTS In PDHS, a majority of children (64.7%) received prelacteal feeding. The most common prelacteal food was milk other than breast milk (24.5%), while over a fifth (21.8%) of mothers reported giving honey and sugar water. Factors associated with prelacteal feeding included: birth at public health facilities (AOR 0.46, 95% CI 0.02, 0.95), maternal primary education (AOR 2.28, 95% CI 1.35, 3.85), and delayed breastfeeding initiation (AOR 0.03, 95% CI 0.01, 0.61). In our qualitative study, the major themes found associated with prelacteal feedings included: easy access to prelacteal substances at health facilities, deliveries in private health facilities, prelacteals as a family tradition for socialization, insufficient breast milk, Sunna of Holy Prophet, and myths about colostrum. CONCLUSIONS These data indicate that prelacteal feeding is a well-established practice and social norm in Pakistan. Policies and interventions aimed at promoting breastfeeding need to take these customs into consideration to achieve the desired behavioral changes.
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Affiliation(s)
- Muhammad Asim
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Department of Sociology, University of Sargodha, Sargodha, Pakistan
- Population Research Center, University of Texas at Austin, Austin, USA
| | - Zarak Husain Ahmed
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Mark D. Hayward
- Department of Sociology & Population Research Center, University of Texas at Austin, Austin, USA
| | - Elizabeth M. Widen
- Department of Nutritional Sciences & Population Research Center, University of Texas at Austin, Austin, Texas USA
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Abitew DB, Yalew AW, Bezabih AM, Bazzano AN. Predictors of relapse of acute malnutrition following exit from community-based management program in Amhara region, Northwest Ethiopia: An unmatched case-control study. PLoS One 2020; 15:e0231524. [PMID: 32320426 PMCID: PMC7176369 DOI: 10.1371/journal.pone.0231524] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 03/25/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Community-based management of acute malnutrition (CMAM) is an effective program to manage children with acute malnutrition, including both severe and moderate acute malnutrition. However, little is known about continued child nutritional status after discharge from community based management of acute malnutrition programs in Ethiopia. OBJECTIVE The study aimed to identify factors associated with relapse of acute malnutrition among children 6-59 months after been discharged recovered from community based management program in South Gondar Zone, Northwest Ethiopia. METHODS A case-control study was conducted in three districts of South Gondar Zone by tracing children age 6-59 months who were reported as recovered from the community based management program. Sample size calculated for the first objective of assessing prevalence of severe acute malnutrition among children following discharge as recovery using Epi- Info version 7.1.3.3 StatCalc taking 95% CL, 17.8% post discharge relapse (Ashraf H, et al. (2012), 3% margin of error, design effect of 2 and adding 5% non-response rate was the largest sample size and used to this study. Children with Mid Upper Arm Circumference (MUAC) <12.5cm constituted cases and children with > = 12.5cm served as controls. Data were collected from 10 November 2017 to 30 January 2018 using a survey questionnaire and families were asked to bring children to a health facility for anthropometric measurements, following which data were entered and analyzed. Bivariate and multivariable logistic regression models were utilized to measure association between the risk factors and acute malnutrition. RESULTS Overall, 1,273 participants were interviewed. The mean age in months of children was 23.1 (±9.1 SD) for cases and 23.1 (±8.9 SD) for controls. About 40% of the cases and 50% of the controls were female children. The factors associated with acute malnutrition were: male children (AOR = 1.84, 95% CI: 1.42-2.39), living in a food insecure household (AOR = 1.67, 95% CI:1.15-2.44), non-receipt of Vitamin A supplement (AOR = 1.76, 95% CI: 1.28-2.41), prelacteal feeding (AOR = 2.81 (95%CI, 1.57-5.05), distance to water source more than 15 walk (AOR = 1.88, 95% CI:1.32-2.71), less frequent self-reported hand washing (AOR = 1.35, 95% CI:1.05-1.75), mother not having consumed extra food during this pregnancy/lactation (AOR = 1.36, 95% CI: 1.03-1.78), and respondent age above 30 years (AOR = 1.43, 95% CI:1.10-1.87). CONCLUSION The key factors contributing to relapse of acute malnutrition were related to childcare and feeding practices. Social and behavior change communication strategies targeting families at risk of undernutrition, along with improved food security and integrated programming are recommended to prevent relapse of acute malnutrition.
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Affiliation(s)
| | | | | | - Alessandra N. Bazzano
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America
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Ogundele T, Ogundele OA, Adegoke AI. Determinants of prelacteal feeding practices among mothers of children aged less than 24 months in Ile-Ife Southwest Nigeria: a community cross-sectional study. Pan Afr Med J 2019; 34:172. [PMID: 32153712 PMCID: PMC7046104 DOI: 10.11604/pamj.2019.34.172.17642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 07/11/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Prelacteal feeding remains an obstacle in achieving the best breastfeeding practices in the country. The growing poor breastfeeding practices are made worse by the continued engagement of the communities in prelacteal feeding practices. This study aimed at assessing the determinants of prelacteal feeding among mothers of children aged less than 24 months in Ile-Ife Southwest, Nigeria. METHODS A community-based cross-sectional study that employed quantitative and qualitative methods. Two hundred and fifty-five (255) mother with children aged 0-23 months were recruited into the study using a multistage sampling technique. SPSS version 20 was used for data analysis Descriptive statistics, bivariate and multivariable logistic regression analysis was done. RESULTS In this study, 26.3% of children were given prelacteal feeds. Glucose water (46.3%), sugar water (25.4%) and infant formula (17.9%) were commonly given prelacteal feeds. On multivariate analysis initiating breastfeeding after one hour (Adjusted Odds Ratio (AOR): 2.74, 95% CI 1.43, 5.23), not attending antenatal clinic (AOR = 2.52, 95% CI 1.05, 5.33), delivery via caesarian section 52% (AOR = 1.52, 95 % CI 1.10, 6.34) were associated with increased odds of giving prelacteal feeds. Delivery attended by health professional 25% (AOR = 0.75. 95% CI 0.42, 0.97), highest wealth quintiles 21% (AOR =0.79, 95 % CI 0.51, 0.94) were associated with lowers odds of giving prelacteal feeds. CONCLUSION Prelacteal feeding was prevalent in the study community and associated with community, individual and health service-related factors. Intervention that strengthens individual and community access to appropriate health information and maternal health services is vital in reducing prelacteal feeding practices.
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Affiliation(s)
- Tolulope Ogundele
- Department of Paediatrics, University of Medical Sciences, Ondo City, Ondo State, Nigeria
| | | | - Adedokun Isaac Adegoke
- Department of Obstetrics and Gynaecology, University of Medical Sciences Teaching Hospitals Complex, Ondo City, Ondo State, Nigeria
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Early initiation of breastfeeding and associated factors among mothers of aged less than 12 months children in rural eastern zone, Tigray, Ethiopia: cross-sectional study. BMC Res Notes 2019; 12:671. [PMID: 31639055 PMCID: PMC6805677 DOI: 10.1186/s13104-019-4718-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/10/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The objectives of this study were to assess early initiation of breastfeeding and associated factors among mothers of aged less than 12 months children in the rural eastern zone, Tigray, Ethiopia. RESULTS Totally 803 mother-child pairs were participated in this study with a response rate of 99.25%. Out of this, 787 mothers had ever breastfed their children. Four hundred eighty-seven (61.9%) mothers initiated breastfeeding within 1 h after they gave birth. Mothers having an educational status of primary education were about 2 times more likely to initiate breastfeeding within 1 h of birth [AOR: 1.99, 95% CI 1.36-2.92] and those mothers having secondary education and above were 3.23 times more likely to start breastfeeding [AOR = 3.23, 95% CI 1.99-5.26]. Mothers who had mistimed pregnancy were 58% less likely to initiate breastfeeding within 1 h of birth [AOR: 0.42, 95% CI 0.27-0.65]. On the other hand, mothers who had delivered their child vaginally were 4.6 times more likely to start early initiation of breast feeding [AOR: 4.59, 95% CI 1.99-10.56].
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Kassahun G, Wakgari N, Abrham R. Patterns and predictive factors of unhealthy practice among mothers during pregnancy, childbirth, postnatal and newborn care in Southern Ethiopia: a community based cross-sectional study. BMC Res Notes 2019; 12:594. [PMID: 31533813 PMCID: PMC6751892 DOI: 10.1186/s13104-019-4631-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 09/10/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the magnitude, patterns and predictive factors of unhealthy practice among mothers during pregnancy, childbirth, postnatal and newborn care in Southern Ethiopia. RESULTS Among the total participants, 29.0% mothers performed at least one unhealthy practice during pregnancy, childbirth, postnatal period and newborn care. This study identified the following harmful practices such as food prohibition (53.2%), home delivery (41.5%), discarding colostrum (18.6%), application of substance on the cord stump (12.1%), delayed breast feeding (28.4%), prelacteal feeding (43.0%) and early bathing (49.3%). Being grand multiparous (AOR = 2.528, 95% CI 1.037-6.166), being illiterate (AOR = 7.611, 95% CI 2.375-24.396) and lack of awareness on the effect of unhealthy practice (OR = 4.673, 95% CI 1.163-18.774) were independent predictors of outcome variable.
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Affiliation(s)
- Getinet Kassahun
- Department of Midwifery, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia.
| | - Negash Wakgari
- Department of Midwifery, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Ahmed KY, Page A, Arora A, Ogbo FA. Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016. Int Breastfeed J 2019; 14:40. [PMID: 31528197 PMCID: PMC6740001 DOI: 10.1186/s13006-019-0234-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/03/2019] [Indexed: 12/22/2022] Open
Abstract
Background At the national level in Ethiopia, there is limited knowledge of trends and factors associated with early initiation of breastfeeding and exclusive breastfeeding (EBF), particularly during the Millenium Development Goal (MDG) era (2000–2015). The study aimed to examine the trends and determinants of early initiation of breastfeeding and EBF in Ethiopia between 2000 and 2016. Methods Using the Ethiopia Demographic and Health Survey (EDHS) data for the years: 2000 (n = 3680), 2005 (n = 3528), 2011 (n = 4037) and 2016 (n = 3861), trends in early initiation of breastfeeding and EBF were estimated. Multivariate logistic regression models that adjusted for confounders, sampling weight, clustering and stratification were used to examine the association between socioeconomic, demographic, health service and community level factors with early initiation of breastfeeding and EBF from 2000 to 2016. Results The prevalence of early initiation of breastfeeding increased from 48.8% in 2000 to 75.7% in 2016 in Ethiopia. Improvement in EBF prevalence was not statistically significant (from 54.5% in 2000 to 59.9% in 2016). Over the study period, informal maternal employment (Adjusted Odds Ratio [aOR] 0.75; 95% Confidence Interval [CI] 0.68, 0.83), frequent antenatal care visits (aOR 0.74; 95% CI 0.65, 0.85), and cesarean birthing (aOR 0.22; 95% CI 0.17, 0.30) were associated with delayed initiation of breastfeeding. Birthing in the health facility (aOR 1.35; 95% CI 1.05, 1.75) and residing in the metropolis region (aOR 1.95; 95% CI 1.65, 2.32) were associated with timely initiation of breastfeeding. In a similar period, informally employed mothers (aOR 1.37; 95% CI 1.15, 1.63) and those with six or more family size (aOR 1.46; 95% CI 1.10, 1.93) were more likely to exclusively breastfeed their babies. Conclusion Early initiation of breastfeeding improved in Ethiopia during the MDG era but it is still below the national target; progress in EBF remained slow. To improve breastfeeding outcomes and meet the global breastfeeding targets in Ethiopia, infant feeding efforts should focus on improving key modifiable factors, including place and mode of birthing and socioeconomic status of mothers.
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Affiliation(s)
- Kedir Y Ahmed
- 1Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia.,2College of Medicine and Health Sciences, Samara University, PO Box: 132, Samara, Ethiopia
| | - Andrew Page
- 1Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Amit Arora
- 1Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia.,3School of Science and Health, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia.,4Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Sydney, Australia.,5Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Weastmead, NSW Australia
| | - Felix Akpojene Ogbo
- 1Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia.,General Practice Unit, Prescot Specialist Medical Centre Makurdi, Welfare Quarters, Makurdi, Benue State 972261 Nigeria
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Effects of Early Initiation of Breastfeeding on Exclusive Breastfeeding Practices of Mothers in Rural Haiti. J Pediatr Health Care 2019; 33:561-567. [PMID: 31153727 DOI: 10.1016/j.pedhc.2019.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 02/19/2019] [Accepted: 02/25/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Rates and relationships of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) of mothers in rural Haiti were examined. Prelacteal and complementary feedings were identified. METHODS With a cross-sectional descriptive design, survey data from mothers (N = 195) were collected at three intervals after birth. Data were analyzed for indicators of EIBF, EBF, and complementary feedings. RESULTS Overall, 148 (75.9%) mothers reported EIBF, and 75 (38.5%) reported EBF. EIBF was associated with EBF, with an adjusted relative risk 1.35 (95% confidence interval = [0.84, 2.18]). Several nutritive and nonnutritive substances interrupted EBF during the first 6 months of life. DISCUSSION Haiti has an under-five mortality rate of 67.0/1,000 live births, exceeding the mean of 46.5/1,000 live births for developing regions. Both EIBF and EBF are associated with decreased neonatal and early infant mortality. Country-specific data are needed to inform and develop breastfeeding initiatives and community-level campaigns to improve the prevalence of EIBF and EBF in Haiti.
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Tongun JB, Sebit MB, Ndeezi G, Mukunya D, Tylleskar T, Tumwine JK. Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey. Glob Health Action 2019; 11:1523304. [PMID: 30295171 PMCID: PMC6179051 DOI: 10.1080/16549716.2018.1523304] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: Pre-lacteal feeding (PLF) is a barrier to optimal breastfeeding and increases the risk of diarrhoea and acute respiratory tract infections in infants.The prevalence and predictors of PLF are not well studied in South Sudan. Understanding the predictors of PLF is crucial in designing interventions to increase exclusive breastfeeding (EBF) rates. Objective: To assess the prevalence and factors associated with PLF in Jubek State, South Sudan. Method: This was a community based cross-sectional study of 810 mothers of children under two years of age in Jubek State, South Sudan. Mothers were interviewed in their homes using a semi-structured questionnaire to collect data on PLF, socio-demographic and birth characteristics. Multivariable analysis was used to identify factors independently associated with PLF. Results: A total of 426/810 (53 %), 95% confidence interval (CI) [48 %, 59 %] mothers had given pre-lacteal feeds to their infants. The commonest pre-lacteal feeds included glucose solution (54%), water (26%), and infant formula (14%). Having received antenatal breastfeeding counselling decreased the odds of PLF [adjusted odds ratio (AOR) 0.60; 95% CI (0.43, 0.82)]; while discarding of colostrum increased the use of pre-lacteal feeds [AOR 1.57; 95% CI (1.17, 2.11)]. Conclusion: The prevalence of PLF in South Sudan is high. Predictors of PLF included lack of breastfeeding counselling and discarding of colostrum. Infant feeding counselling should be given to all pregnant women in the health facilities and communities. The counselling should emphasize the health benefits of colostrum and discourage the practice of discarding it.
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Affiliation(s)
- Justin Bruno Tongun
- a Centre for International Health , University of Bergen , Bergen , Norway.,b Department of Paediatrics and Child Health , College of Medicine, University of Juba , Juba , South Sudan
| | - Mohamedi Boy Sebit
- c Department of Internal Medicine , College of Medicine, University of Juba , Juba , South Sudan
| | - Grace Ndeezi
- d Department of Paediatrics and Child Health, School of Medicine , College of Health Sciences, Makerere University , Kampala , Uganda
| | - David Mukunya
- a Centre for International Health , University of Bergen , Bergen , Norway
| | - Thorkild Tylleskar
- a Centre for International Health , University of Bergen , Bergen , Norway
| | - James K Tumwine
- d Department of Paediatrics and Child Health, School of Medicine , College of Health Sciences, Makerere University , Kampala , Uganda
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Jimoh AO, Adaji SE, Adelaiye H, Olorukooba AA, Bawa U, Ibrahim HI, Garba C, Mfuh AL, Idris S, Shittu SO. A cross-sectional study of traditional practices affecting maternal and newborn health in rural Nigeria. Pan Afr Med J 2019; 31:64. [PMID: 31007811 PMCID: PMC6457866 DOI: 10.11604/pamj.2018.31.64.15880] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/27/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction Certain traditional practices which have negative effects on maternal and child health continue to be practiced in sub-Saharan African countries. A survey was carried out in a rural village in Nigeria to understand the scale and range of these practices. Methods This was a cross-sectional study in which trained interviewers administered pre-tested questionnaires on child-bearing women using questionnaires embedded on android devices. Results The median age of marriage and pregnancy were 15 and 16 years respectively. Home births were high (90.4%) while non-skilled birth attendant was 87.4%. The community had a son preference index ratio of 1:4.1. Up to 81.5% of mothers responded that one form of unhygienic traditional procedure or the other was performed on their children. Time to initiation of breast feeding was in hours in the majority (76.3%) of mothers, with a high rate of use of prelacteal feeds (85.2%). Being an adolescent mother (AOR 0.403, 95%CI 0.203, 0,797) and utilizing a skilled provider at birth (AOR 0.245, 95%CI 0.088, 0.683) were associated with less likelihood of having an unhygienic procedure performed on children. Conclusion The findings of our study suggest that traditional practices which could have negative effects on maternal and child health are still ongoing in the study community. Child protection laws and safeguarding principles could help to reduce these practices and would need to be developed and implemented in these settings where these practices are still prevalent.
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Affiliation(s)
| | - Sunday Enema Adaji
- Department of Obstetrics and Gynaecology, Ahmadu Bello University, Zaria, Nigeria
| | | | | | - Umma Bawa
- Department of Obstetrics and Gynaecology, Ahmadu Bello University, Zaria, Nigeria
| | | | - Comfort Garba
- Community Midwife, CBS Research Group, PRHI, Ahmadu Bello University Zaria, Nigeria
| | - Anita Lukong Mfuh
- Department of Nursing Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Suleiman Idris
- Department of Community Medicine, Ahmadu Bello University Zaria, Nigeria
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Tewabe T. Prelacteal Feeding Practices among Mothers in Motta Town, Northwest Ethiopia: A Cross-sectional Study. Ethiop J Health Sci 2019; 28:393-402. [PMID: 30607052 PMCID: PMC6308743 DOI: 10.4314/ejhs.v28i4.5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Optimal breastfeeding is recommended up to two years, i.e, it prevents 1.4 million child deaths per year. Despite this prelacteal feeding is commonly practiced in Ethiopia due to different reasons. The objective of this study was to assess prelacteal feeding and associated factors among mothers who have infants less than six months of age. Method A community based quantitative cross sectional study was conducted from April 7, 2015 to May 7, 2015. Using simple random sampling method total of 423 mothers with infant less than six months old were included in this study. The data were collected by using an interviewer admini stered questionnaire. Both simple and multiple logistic regression analyses were computed to identify factors associated with prelacteal feeding. Results Prevalence of prelacteal feeding was 20.3% [95% CL: 16.38% – 24.02%]. The most common prelacteal feeding in the study area was butter (62.2%). Mothers with young infant who fed colostrum [AOR=3.540 (1.534, 8.173), initiated breastfeeding on time [AOR=4.4832 (1.823, 11.028)] and supported by husband's [AOR=2.686 (1.037, 6.953)] were less likely to practice prelacteal feeding to their infant than their counterparts. Conclusions Prelacteal feeding was common in the study area. Colostrum feeding, timely initiations of breastfeeding and husband support were the independent predictors of prelacteal feeding practices. Recommendation to avoid prelacteal feeding practices were: increasing the habit of mothers to initiate breastfeeding timely and to feed colostrum through education, empowering husbands regarding to breastfeeding and avoiding traditional practices that hinder optimal breastfeeding like colostrum avoidance.
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Affiliation(s)
- Tilahun Tewabe
- Peaditrics and Childe Health Nursing, Bahir Dar Univesity, Ethiopia
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Bergamaschi N, Oakley L, Benova L. Is childbirth location associated with higher rates of favourable early breastfeeding practices in Sub-Saharan Africa? J Glob Health 2019; 9:010417. [PMID: 30774943 PMCID: PMC6368939 DOI: 10.7189/jogh.09.010417] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Favourable early breastfeeding practices have a beneficial impact throughout an infants’ lifespan. Childbirth location is likely to affect these practices through support during the intrapartum and immediate postpartum period. This study aimed to investigate the association between childbirth location and favourable early breastfeeding practices in Sub-Saharan Africa (SSA). Methods Demographic and Health Survey (2000–2013) data across 30 SSA countries were utilised. Childbirth location was categorised as home vs facility, and further into public vs private sector. Early breastfeeding practices included: early initiation of breastfeeding (EIBF) (within 1 hour of birth), and no prelacteal feeding (fed only breast milk in the first 3 days). Multivariate logistic regression models adjusted for confounders were used to assess this association. Results Overall, 50.0% (country range 32.6%-95.5%) of infants received EIBF and 61.0% had no prelacteal feeding. Compared with home births, facility deliveries had higher adjusted odds of EIBF (adjusted odds ratio, aOR = 1.39, 95% confidence interval (CI) = 1.30-1.48, P < 0.001) and no prelacteal feeding (aOR = 1.75, 95% CI = 1.63-1.89, P < 0.001). Private sector facilities had lower adjusted odds of no prelacteal feeding (aOR = 0.89, 95% CI = 0.81-0.99, P = 0.036) when compared to public sector facilities. There was no evidence to suggest delivery sector was associated with EIBF (aOR = 0.93, 95% CI = 0.85-1.03, P = 0.212). Conclusions This study showed early breastfeeding practices are suboptimal and are associated with delivery location in SSA. Further research is required to better understand how characteristics of care may explain these patterns in order to improve feeding practices.
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Affiliation(s)
- Natasha Bergamaschi
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Ealing Hospital, London North West University Healthcare NHS Trust, London, United Kingdom
| | - Laura Oakley
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Lenka Benova
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Argaw MD, Asfaw MM, Ayalew MB, Desta BF, Mavundla TR, Gidebo KD, Frew AH, Mitiku AD, Desale AY. Factors associated with prelacteal feeding practices in Debre Berhan district, North Shoa, Central Ethiopia: a cross-sectional, community-based study. BMC Nutr 2019; 5:14. [PMID: 32153927 PMCID: PMC7050708 DOI: 10.1186/s40795-019-0277-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/04/2019] [Indexed: 11/10/2022] Open
Abstract
Background Prelacteal feeding is one of the major harmful newborn feeding practices and is top on the list of global public health concerns. The practice deprives newborns of valuable nutrients and protection of colostrum and exposes them to preventable morbidity and mortality. Studying the prevalence and factors influencing the prelacteal feeding practice of mothers will help program managers and implementers to properly address broad major public health problems. Therefore, this study aims to investigate the prevalence of prelacteal feeding practices and its associated factors among mother-infant dyads in the Debre Berhan district of North Shoa administrative zone, central Ethiopia. Methods A community-based cross-sectional study design was conducted from January through to April 2014 among 634 mother-infant dyads. The data were entered into EPI Info version 3.5.1. (CDC, Atlanta, Georgia). All statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) research IBM version 20.0. The prevalence of prelacteal feeding was determined using the ‘recall since birth’ method. Multi-variable logistic regression analysis was employed to control confounders in determining the association between prelacteal feeding practices and selected independent variables. Adjusted Odds Ratio (AOR), with 95% Confidence Interval (CI) and P < 0.05 was used to claim statistical significance. Results The prevalence of prelacteal feeding practice was 14.2% (95% CI: 11.00–17.00%). Slightly greater than half, 48 (53.3%) of prelacteal fed newborns were given butter. Home delivery was a major risk factor for practicing prelacteal feeding. Mothers who delivered their indexed infant at home practiced prelacteal feeding over four folds more than mothers who delivered in a health institution (Adjusted Odds Ratio (AOR) 4.70; 95% CI: 2.56–8.60, p-value = 0.001). Mothers who did not initiate breastfeeding within an hour were six times more likely to practice prelacteal feeding (AOR 5.58; 3.21–9.46, p-value = 0.001). Similarly, with regards to the occupation of mothers, farmers practiced prelacteal feedings (AOR 4.33; 95% CI: 1.73–10.81, p-value = 0.002) up to four folds more than their counterpart housewives. Mothers who can read and write are 54% less likely to practice prelacteal feeding than their counterpart, illiterate mothers, with (AOR 0.46; 95% CI: 0.22–0.98, p-value = 0.044). Conclusions In the Debre Berhan town of North Shoa administrative zone, central Ethiopia, almost one-sixth of mothers practiced prelacteal feeding. Therefore, improving access to information about appropriate newborn feeding practices, encouraging mothers to deliver their babies in health institutions and inspiring them to initiate breastfeeding within an hour of birth is recommended.
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Affiliation(s)
- Mesele Damte Argaw
- USAID Transform: Primary Health Care, JSI Research & Training Institute, Inc., P.O. Box 1392 code, 1110 Addis Ababa, Ethiopia.,2Department of Health Studies, University of South Africa, Pretoria, South Africa
| | | | | | - Binyam Fekadu Desta
- USAID Transform: Primary Health Care, JSI Research & Training Institute, Inc., P.O. Box 1392 code, 1110 Addis Ababa, Ethiopia.,2Department of Health Studies, University of South Africa, Pretoria, South Africa
| | | | - Kassa Daka Gidebo
- 5School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | - Aychiluhim Damtew Mitiku
- USAID Transform: Primary Health Care, JSI Research & Training Institute, Inc., P.O. Box 1392 code, 1110 Addis Ababa, Ethiopia
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John JR, Mistry SK, Kebede G, Manohar N, Arora A. Determinants of early initiation of breastfeeding in Ethiopia: a population-based study using the 2016 demographic and health survey data. BMC Pregnancy Childbirth 2019; 19:69. [PMID: 30760226 PMCID: PMC6373137 DOI: 10.1186/s12884-019-2211-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/01/2019] [Indexed: 11/23/2022] Open
Abstract
Background Timely breastfeeding initiation is a simple but important measure that has protective effects on infants and mothers. This study aims to determine the predictors of early breastfeeding initiation among mothers residing in Ethiopia. Methods This study employed the 2016 Ethiopian Demographic and Health Survey data. A total of 5546 children born during the last 24 months at the time of survey were included for analysis from nine regional states and two city administration areas. Socio-demographic and socio-economic factors including individual, household and community-level factors were examined of their significance against the outcome variable of early initiation of breastfeeding using a mixed-effect logistic regression model. Results The proportion of infants who had timely initiation of breastfeeding was 74.3% (n = 3064). In the multivariate logistic regression analysis, mothers who delivered with assistance of one or more health professionals had 68% (AOR 1.68; 95% CI: 1.23, 2.29) higher odds of initiating timely breastfeeding. In addition, mothers delivering by a caesarean section had 86% reduced odds of early breastfeeding initiation (AOR 0.14; 95% CI: 0.09, 0.22) when compared to mothers who had vaginal delivery. In terms of socio-demographic factors, the odds of early breastfeeding initiation were more than two and half times higher particularly for mothers residing particularly in Oromiya (AOR 2.58; 95% CI: 1.84, 3.63) and Southern Nations Nationalities and Peoples (SNNP) (AOR 2.75; 95% CI: 1.86, 4.05). In addition, timely breastfeeding initiation was also significantly associated with wealth index with wealthier mothers having 43% higher odds compared to mothers of poorest households (AOR 1.43; 95% CI: 1.07, 1.92). Other factors such as age, gender and birth order of the infant also had significant associations with early breastfeeding initiation. Conclusion Early breastfeeding initiation in Ethiopia is inextricably associated with various socio-demographic, biomedical, and socio-economic factors. The study findings can potentially inform mothers and the wider community on the benefits of timely breastfeeding initiation and policymakers and community leaders to target health promotional interventions and resources where needed.
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Affiliation(s)
- James Rufus John
- School of Nursing and Midwifery, Western Sydney University, Campbelltown, NSW, Australia.,Capital Markets Cooperative Research Centre, Sydney, Australia
| | - Sabuj Kanti Mistry
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Getahun Kebede
- University of Tasmania, Faculty of Health, School of Health Sciences, Launceston, Tasmania, Australia.,University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia
| | - Narendar Manohar
- School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia
| | - Amit Arora
- School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia. .,Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia. .,Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, Australia. .,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia.
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Prelacteal feeding practice and its associated factors among mothers of children age less than 24 months old in Southern Ethiopia. Ital J Pediatr 2019; 45:15. [PMID: 30646943 PMCID: PMC6334461 DOI: 10.1186/s13052-019-0604-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 01/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although Pre-lacteal feeding is a barrier for implementation of optimal breastfeeding practices and increases the risk of neonatal illness and mortality, still it is continued as a deep-rooted nutritional malpractice in developing countries. In Ethiopia pre-lacteal feeding continued as one of the nutritional malpractices in newborns. Therefore the aim of this study was to assess pre-lacteal feeding practice and its determinants among mothers of children less than 24 months of age in Sodo zuria district, Wolaita zone, Southern Ethiopia. METHODS Community-based cross-sectional study was conducted from February 15, 2017 to March 12, 2017 in Sodo zuria district, Wolaita zone, Southern Ethiopia. Five hundred five (505) mothers of children aged less than 24 months were selected by multistage randomized sampling technique and the data were collected by using interview based structured questionnaire. Descriptive statistics, binary and multivariable logistic regression analysis were employed to identify the factors associated with pre-lacteal feeding practices. Variables with a p-value < 0.05 were identified as statistically significant factors. RESULTS The prevalence of pre-lacteal feeding practice was 20.6%. The common type of pre-lacteal feeding given was plain water; 38(7.7%) and the major reason was insufficient breast milk 32(6.5%). Mothers living with extended family type (AOR = 10.64, 95% CI: 1.05, 10.71), Lack of breastfeeding counseling (AOR = 5.16, 95% CI: 1.76, 15.13) and mothers who avoid colostrum (AOR = 9.72, 95% CI: 3.46, 27.30) were statistically significant positive predictors of pre-lacteal feeding practice. CONCLUSION & RECOMMENDATION Pre-lacteal feeding is commonly practiced in Soddo zuria district. Mothers who live with extended family type, mothers who did not get breastfeeding counseling and mothers who avoid colostrum were statistically significant positive predictors of pre-lacteal feeding practice. Therefore, strengthening breastfeeding counseling about the risks associated with pre-lacteal feeding and colostrum feeding intervention should be integrated. Promotion of intensive nutrition education program, on the benefit of colostrum by giving special emphasis to extended family mothers should be implemented in the community.
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Prelacteal feeding and associated factors among mothers having children less than 24 months of age, in Mettu district, Southwest Ethiopia: a community based cross-sectional study. BMC Res Notes 2019; 12:9. [PMID: 30616665 PMCID: PMC6323699 DOI: 10.1186/s13104-019-4044-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/02/2019] [Indexed: 01/08/2023] Open
Abstract
Objective Despite prelacteal feeding contravenes with exclusive breastfeeding, it is a prevailing problem in Ethiopia. However, its burden and factors were not investigated in Mettu district. Therefore, the objective of our study was to conduct the burden of prelacteal feeding and its associated factors. Community-based cross-sectional study was conducted among 730 mother–child pairs. Stratified cluster sampling was used. Data were collected by face- to- face interview. Logistic regression model was fitted. Results A total of 719 mother–child pairs with a response rate of 98.5% were participated. The overall proportion of prelacteal feeding among mothers was 14.2% [95% CI (12.0, 17.0)]. No maternal education [AOR: 3.54 (95% CI 1.7, 6.98)], single ANC visits [AOR: 6.87 (95% CI 3.21, 14.73)], didn’t know risks of prelacteal feeding [AOR: 2.73 (95% CI 1.47, 5.05)], colostrums avoidance [AOR: 6.030 (95% CI 3.48, 10.46)], home delivery [AOR: 3.04 (95% Cl 1.60, 5.75] and cesarean delivery [AOR: 4.27 (95% CI 2.28, 7.99)] were significantly associated factors. Prelacteal feeding among mother–child pairs was high. Hence, increasing maternal education and institutional delivery are vital for prompt infant feeding.
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Temesgen H, Negesse A, Woyraw W, Getaneh T, Yigizaw M. Prelacteal feeding and associated factors in Ethiopia: systematic review and meta-analysis. Int Breastfeed J 2018; 13:49. [PMID: 30505338 PMCID: PMC6260692 DOI: 10.1186/s13006-018-0193-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022] Open
Abstract
Background Prelacteal feeding can be defined as giving any solid or liquid foods other than breast milk during the first three days after birth. It affects timely initiation of breastfeeding and exclusive breastfeeding practices. Even though the issue was investigated in Ethiopia, fragmented and inconsistent findings were reported. Therefore, the main objective of this meta-analysis was to estimate the pooled prevalence of prelacteal feeding and associated factors in Ethiopia. Methods The preferred reporting items for systematic reviews and meta-analyses guideline was followed. Articles were systematically searched through different searching mechanisms. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument adapted for cross-sectional study design was used for quality assessment of each individual study. The total of 28 studies were included and analyzed. The random effect model was used to estimate the pooled prevalence; subgroup analysis and meta-regression were performed to identify the probable source of heterogeneity. Both Egger’s, and Begg’s test were used to check publication bias. The effects between associated factor variables, and prelacteal feeding practices were tested. Results A total of 492 studies were retrieved and 28 studies were included in the meta-analysis. The pooled prevalence of prelacteal feeding practice in Ethiopia was 25.29% (95% Confidence Interval [CI] 17.43, 33.15) with severe heterogeneity (I2 = 99.7, p < 0.001) and no publication bias. Antenatal care (Odds Ratio [OR] 0.25, 95% CI 0.09, 0.69), counselling on infant feeding (OR 0.37, 95% CI 0.22, 0.63), timely initiation of breastfeeding (OR 0.28, 95% CI 0.21, 0.38) and an urban residence (OR 0.47, 95% CI 0.26, 0.86) had lower odds, while home birth had higher odds (OR 3.93, 95% CI 2.17, 7.10) of prelacteal feeding in Ethiopia. Conclusions In Ethiopia, one in four children were given prelacteal foods. Mothers who gave birth at home are more prone to give prelacteal foods. Whereas, antenatal care, timely initiation of breastfeeding, counseling on infant feeding and an urban residence decreases prelacteal feeding practices in Ethiopia. Therefore, the government and health institutions should focus to increase maternal health service utilization and promote infant and young child feeding practices according to the guideline.
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Affiliation(s)
- Habtamu Temesgen
- 1Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Ayenew Negesse
- 1Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Wubetu Woyraw
- 1Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Temesgen Getaneh
- 2Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Molla Yigizaw
- 3Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Takele WW, Tariku A, Wagnew F, Ekubagewargies DT, Getinet W, Derseh L, Anlay DZ. Magnitude of prelacteal feeding practice and its association with place of birth in Ethiopia: a systematic review and meta-analysis, 2017. Arch Public Health 2018; 76:63. [PMID: 30377528 PMCID: PMC6196449 DOI: 10.1186/s13690-018-0308-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 08/20/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Prelacteal feeding is one of the commonest inappropriate child feeding practice which exposes to malnutrition, infection, and neonatal mortality. However, there is no systematic review and meta-analysis that estimates the pooled prevalence of prelacteal feeding and its association with place of birth in Ethiopia. Therefore, this study aimed at investigating the magnitude of prelacteal feeding practice and its association with home delivery in the country. METHODS Primary studies were accessed through, HINARI and PubMed databases. Additionally, electronics search engines such as Google Scholar, and Google were used. The Joana Briggs Institute quality appraisal checklist was used to appraise the quality of studies. Data were extracted using Microsoft Excel spreadsheet. Heterogeneity between the studies was examined using the I2 heterogeneity test. The DerSimonian and Liard random-effect model was used. The random effects were pooled after conducting subgroup and sensitivity analyses. Publication bias was also checked. RESULTS A total of 780 primary studies were accessed. However, about 24 studies were included in the qualitative description and quantitative analysis of the prevalence of prelacteal feeding. To examine the association between home delivery and prelacteal feeding practice, only six studies were included. The prevalence of prelacteal feeding ranged from 6.1-75.8%. The pooled prevalence of prelacteal feeding among Ethiopian children was 26.95% (95% CI: 17.76%, 36.14%). The highest prevalence was observed in the Afar region. The pooled odds of prelacteal feeding among women who gave birth at home was increased by 5.16 (95% CI: 3.7, 7.2) folds as compared to those who gave birth at Health institutions. CONCLUSION Prelacteal feeding practice in Ethiopia was found to be high. Home delivery was strongly associated with prelacteal feeding practice. Therefore, promoting institutional delivery and strengthening of the existing child nutrition strategies are recommended.
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Affiliation(s)
- Wubet Worku Takele
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Tariku
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fasil Wagnew
- Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Daniale Tekelia Ekubagewargies
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondale Getinet
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lema Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Degefaye Zelalem Anlay
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tekaly G, Kassa M, Belete T, Tasew H, Mariye T, Teshale T. Pre-lacteal feeding practice and associated factors among mothers having children less than two years of age in Aksum town, Tigray, Ethiopia, 2017: a cross-sectional study. BMC Pediatr 2018; 18:310. [PMID: 30253771 PMCID: PMC6156946 DOI: 10.1186/s12887-018-1284-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 09/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pre-lacteal feeding has continued as a deep-rooted nutritional malpractice in developing countries. Pre-lacteal feeding is a barrier to the implementation of optimal breastfeeding practices and increases the risk of neonatal early-life diseases and mortality. Therefore, the aim of this study was to assess pre-lacteal feeding practice and associated factors among mothers having children less than 2 years of age in Aksum town, central Tigray, Ethiopia. METHODS A community-based cross-sectional study was conducted to interview 477 mother-child pairs by systematic random sampling technique. Data were collected through interviewer-administered semi-structured questionnaires. Data were coded, entered, cleaned and edited using EPIDATA version 3.1 and export to SPSS Version 22.0 for analysis. To identify the significant variables binary logistic regression were employed. Variables with p-value < 0.05 at 95% CI in multivariate logistic regression were considered statistically significant. RESULT The prevalence of pre-lacteal feeding in Aksum town was 10.1% (95% CI: 7.3%, 13%). Mothers with no previous birth (AOR: 2.93(95% CI:1.21,7.09)), birth spacing less than 24 (AOR: 2.88(95% CI: 1.15,7.25)), colostrum discarding (AOR: 6.72 (95% CI: 2.49,18.12)), less than four anti natal care follow up (AOR: 10.55 (95% CI: 4.78,23.40)), those who underwent cesarean section (AOR: 4.38 (95% CI:1.72,11.12)) and maternal believe on purported advantage of pre-lacteal feeding (AOR: 3.36 (95%CI: 1.62,6.96)) were more likely to practice pre-lacteal feeding to their infants. CONCLUSIONS Pre-lacteal feeding is still practiced in the study area. Childbirth spacing, colostrum discarding, antenatal Care follow up, maternal belief in pre-lacteal feeding was contributing factors for practicing of pre-lacteal feeding. Coordination and sustaining the existing strategies and approaches are recommended to give emphasis on the nutritional value of colostrum and anti-natal care follow up.
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Affiliation(s)
- Girmay Tekaly
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Health Science, Aksum University, Aksum, Ethiopia.
| | - Mekuria Kassa
- Department of Nursing, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Tilahun Belete
- Department of Nursing, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Hagos Tasew
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Health Science, Aksum University, Aksum, Ethiopia
| | - Tekelwoini Mariye
- Department of Adult Health Nursing, School of Nursing, College of Health Science, Aksum University, Aksum, Ethiopia
| | - Tsega Teshale
- Department of Medical Laboratory, College of Health Science, Aksum University, Aksum, Ethiopia
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Habtewold TD, Mohammed SH, Endalamaw A, Akibu M, Sharew NT, Alemu YM, Beyene MG, Sisay TA, Birhanu MM, Islam MA, Tegegne BS. Breast and complementary feeding in Ethiopia: new national evidence from systematic review and meta-analyses of studies in the past 10 years. Eur J Nutr 2018; 58:2565-2595. [PMID: 30229308 DOI: 10.1007/s00394-018-1817-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 08/07/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE The aim of this systematic review and meta-analysis was to provide a national estimate of breast and complementary feeding practices and its predictors in Ethiopia. METHODS PubMed, SCOPUS, EMBASE, CINHAL, Web of Science and WHO Global Health Library electronic databases were searched for all available literature published until April 2018. Observational studies including cross-sectional, case-control and cohort studies were included. Newcastle-Ottawa Scale was used to assess the quality of studies. Heterogeneity of studies was quantified using Cochran's Q χ2 statistic and Higgins's method (I2). A meta-analysis using a weighted inverse variance method was performed. Subgroup analysis was carried out based on region and study area. RESULTS In total, 70 studies that involved > 55,000 women from nine regions and two chartered cities in Ethiopia were included. The pooled national prevalence for timely initiation of breastfeeding (TIBF), exclusive breastfeeding (EBF) and timely initiation of complementary feeding was 66.5%, 60.1% and 62.5%, respectively. Guidance and counselling on breastfeeding, vaginal delivery and health institution delivery significantly increased the odds of TIBF and EBF. In addition, TIBF significantly associated with high EBF practice. Maternal occupational status significantly associated with low EBF practice, but not TIBF. CONCLUSIONS Based on the WHO standard, the current breast and complementary feeding practice in Ethiopia is good and improving. Integrated intervention is still required for further improvement and minimizing the effect of occupational status.
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Affiliation(s)
- Tesfa Dejenie Habtewold
- Department of Nursing, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia. .,Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
| | - Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus (TUMS-IC), Tehran, Islamic Republic of Iran
| | - Aklilu Endalamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Akibu
- Department of Nursing, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nigussie Tadesse Sharew
- Department of Nursing, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Yihun Mulugeta Alemu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Tesfamichael Awoke Sisay
- Department of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mulugeta Molla Birhanu
- Department of Adult Health Nursing, School of Nursing, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Md Atiqul Islam
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Balewgizie Sileshi Tegegne
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Bruno Tongun J, Sebit MB, Mukunya D, Ndeezi G, Nankabirwa V, Tylleskar T, Tumwine JK. Factors associated with delayed initiation of breastfeeding: a cross-sectional study in South Sudan. Int Breastfeed J 2018; 13:28. [PMID: 30002722 PMCID: PMC6034205 DOI: 10.1186/s13006-018-0170-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 06/11/2018] [Indexed: 12/17/2022] Open
Abstract
Background The global breastfeeding recommendation states that all infants should be put to the breast within one hour of birth, which is defined as timely initiation or early initiation of breastfeeding. Early initiation of breastfeeding is associated with reduced risk in infant illness and death. Understanding the determinants of delay in initiation of breastfeeding might spur health staff and policy makers to foster timely breastfeeding. We assessed the prevalence and determinants of delay in initiation of breastfeeding among mothers in Juba Teaching Hospital. Methods The present study enrolled 806 mother-infant pairs within 24 hrs of birth in Juba Teaching Hospital in 2017. The mothers were interviewed about the time of initiation of breastfeeding, sociodemographic and birth characteristics. The independent variables associated with delay in initiation of breastfeeding were identified using multivariable logistic regression analysis. Results In the current study, 52% (418/806) of the mothers initiated breastfeeding later than one hour after birth. Birth by Caesarean section (Adjusted Odds Ratio [AOR] 41; 95% Confidence Interval [CI] 12.21, 138), discarding of colostrum (AOR 9.89; 95% CI 4.14, 23.62), unmarried mothers (AOR 3.76; 95% CI 1.53, 9.24), exposure to infant formula advertisement (AOR 1.82; 95% CI 1.09, 3.02) and no house ownership (AOR 1.52; 95% CI 1.11, 2.09) were independent factors associated with delay in initiation of breastfeeding. Conclusion We found that more than half of the mothers delayed the initiation of breastfeeding. Therefore, we recommend training on best breastfeeding practices and counselling skills for health staff in Juba Teaching Hospital. Policy dialogue, with the relevant ministries and departments on the promotion and protection of early initiation of breastfeeding is crucial.
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Affiliation(s)
- Justin Bruno Tongun
- 1Centre for International Health, University of Bergen, Bergen, Norway.,2Department of Paediatrics and Child Health, College of Medicine, University of Juba, Juba, South Sudan
| | - Mohammed Boy Sebit
- 3Department of Internal Medicine, College of Medicine, University of Juba, Juba, South Sudan
| | - David Mukunya
- 1Centre for International Health, University of Bergen, Bergen, Norway
| | - Grace Ndeezi
- 4Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Victoria Nankabirwa
- 1Centre for International Health, University of Bergen, Bergen, Norway.,5School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - James K Tumwine
- 4Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Mrayan L, Abujilban S, Abuidhail J, Alshraifeen A. Traditional neonatal care practices in Jordan: A qualitative study. Nurs Health Sci 2018; 20:486-493. [DOI: 10.1111/nhs.12540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/13/2018] [Accepted: 04/29/2018] [Indexed: 01/27/2023]
Affiliation(s)
- Lina Mrayan
- Department of Maternal, Child and Family Health Nursing; Hashemite University; Zarqa Jordan
| | - Sanaa Abujilban
- Department of Maternal, Child and Family Health Nursing; Hashemite University; Zarqa Jordan
| | - Jamila Abuidhail
- Department of Maternal, Child and Family Health Nursing; Hashemite University; Zarqa Jordan
| | - Ali Alshraifeen
- Department of Maternal, Child and Family Health Nursing; Hashemite University; Zarqa Jordan
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Yimer NB, Liben ML. Effects of home delivery on colostrum avoidance practices in North Wollo zone, an urban setting, Ethiopia: a cross sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2018; 37:4. [PMID: 29482631 PMCID: PMC6389058 DOI: 10.1186/s41043-018-0134-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 01/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Colostrum is the first liquid that is produced in the first few days after delivery. It is the perfect first food for newborns which is considered as an infant's first immunization. Despite of this fact colostrum is discarded as unclean and bad for the infant's health. This study aimed to investigate the prevalence and the factors associated with colostrum avoidance in Woldia, Kobo and Lalibela town administrations of North Wollo zone. METHODS A quantitative community based cross sectional study was employed in March 2015 on 810 mothers of children aged less than 24 months. Descriptive statistics, binary and multivariable logistic regression analysis were employed to identify the factors associated with colostrum avoidance. Variables with a p-value < 0.05 in the multivariable model were identified as predictors of colostrum avoidance practices. RESULTS Colostrum was discarded by 12.0% (95%CI: 10.0-14.0%) of mothers of children aged less than 24 months. In multivariable logistic regression analysis late initiation of breastfeeding [AOR (95% CI) =2.03 (1.18, 3.49)], prelacteal feeding [AOR (95% CI) =3.38 (1.83, 6.24)], mothers not living with their husband [AOR (95% CI) = 2.24 (1.22, 4.12)] and delivering the index child at home [AOR (95% CI) =2.92 (1.521, 5.59)] were independent positive predictors of colostrum avoidance practices. CONCLUSION The foundation of any nutrition package for the prevention of childhood malnutrition is the promotion of an optimal breastfeeding practices, including colostrum feeding, in the community. Therefore, promoting institutional delivery, early initiation of breastfeeding and creating awareness on the dangers of prelacteal feeding and the advantages of colostrum feeding are recommended interventions to reduce colostrum avoidance practices in the study area.
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Affiliation(s)
- Nigus Bililign Yimer
- Department of Midwifery, Faculty of Health Sciences, Woldia University, Amhara, Ethiopia
| | - Misgan Legesse Liben
- Department of Public Health, College of Medical and Health sciences, Samara University, P.O.Box 132, Afar, Ethiopia
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Chea N, Asefa A. Prelacteal feeding and associated factors among newborns in rural Sidama, south Ethiopia: a community based cross-sectional survey. Int Breastfeed J 2018; 13:7. [PMID: 29467812 PMCID: PMC5819158 DOI: 10.1186/s13006-018-0149-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 02/02/2018] [Indexed: 11/18/2022] Open
Abstract
Background The practice of giving prelacteal feeds deprive a newborn of valuable nutrients and expose the newborn to risks of infection. Despite its negative health outcomes, prelacteal feeding prevails in Ethiopia. Therefore, the current study was undertaken to assess the prevalence of prelacteal feeding practices and its associated factors in a rural community in south Ethiopia. Methods We conducted a community based cross-sectional study of 597 mothers of children aged less than six months. Mothers were selected using a multistage cluster sampling technique from Hawela Tula, a rural catchment under Hawassa City Administration. Newborns exposed to any foods, substances or drinks other than human milk before the initiation of breastfeeding or during the first three days of birth were regarded as receiving prelacteal feeds. Descriptive summaries were done to present the main findings; bivariate and multivariate logistic regression analyses were undertaken to identify variables associated with prelacteal feeding practices. Results Among the total infants, 25.5% (95% confidence interval [CI] 23.5%, 27.5%) were found to be exposed to prelacteal feeds. Boiled water (36.8%) and fresh butter (32.2%) were the top two prelacteal foods. The prevalence of prelacteal feeding was higher among infants whose mothers are housewives, and among infants born to mothers aged between 21 and 34 years. Almost two-third (64.3%) of mothers who exposed their newborn to prelacteal feeds did so with advice from their parents. Mothers who had poor knowledge on breastfeeding were nine times more likely to practice prelacteal feeding compared to those with good knowledge (adjusted odds ratio [AOR] 8.9, 95% CI 4.2, 18.7). Lack of knowledge on the risks associated with prelacteal feeding (AOR 6.8; 95% CI 2.6, 17.8) and misconceptions about breastfeeding (AOR 8.1; 95% CI 3.9, 16.6) were associated with prelacteal feeding. However, mothers’ place of delivery and attendance at breastfeeding counseling sessions showed no association with the practice of prelacteal feeding. Conclusions Prelacteal feeding is commonly practiced in the study area. Raising women’s awareness on the consequences of prelacteal feeding is warranted. Involving parents of women when promoting optimal infant feeding practices should be emphasized.
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Affiliation(s)
- Nana Chea
- 1School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Anteneh Asefa
- 1School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.,2Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia
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Ekubay M, Berhe A, Yisma E. Initiation of breastfeeding within one hour of birth among mothers with infants younger than or equal to 6 months of age attending public health institutions in Addis Ababa, Ethiopia. Int Breastfeed J 2018; 13:4. [PMID: 29410699 PMCID: PMC5782370 DOI: 10.1186/s13006-018-0146-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 01/08/2018] [Indexed: 12/01/2022] Open
Abstract
Background Breast milk is comprised of the essential nutrients that an infant needs in the first six months of life. Timely initiation of breastfeeding guarantees that infants receive the colostrum, ‘the first breastmilk’, which contains antibodies that protect the newborn against diseases. Breastfeeding within the first hour of life prevents newborn death due to sepsis, pneumonia, diarrhea and hypothermia. Although breastfeeding is a common practice in sub-Saharan Africa, evidence show that early initiation of breastfeeding is low. Methods We conducted a cross-sectional study of 583 mothers with infants younger than or equal to 6 months of age attending Maternal and Child Health (MCH) clinics of public health institutions in Addis Ababa, Ethiopia from April to May 2012. A simple random sampling design was used to select the institutions included in this study. Data from mothers of infants were collected using interviewer-administered questionnaire. We analyzed the data to examine factors associated with initiation of breastfeeding within one hour of birth using logistic regression models. Results Of 564 (96.7%, 564/583) mothers who breastfed their infants, 58.3% (329/564) initiated breastfeeding within one hour of birth. In the adjusted analysis, mothers who had three or more infants had about twice higher odds of timely initiation of breastfeeding within one hour of birth (Adjusted Odds Ratio [aOR] 2.10; 95% Confidence Interval [CI]1.04, 4.30) compared with mothers who had one infant. Furthermore, women who started antenatal care at their fourth month of pregnancy or later had a 49.0% higher odds of initiation of breastfeeding within one hour of birth (aOR 1.49; 95% CI 1.01, 2.19) compared to mothers who started antenatal care before their fourth month of pregnancy. Conclusions Initiation of breastfeeding within one hour of birth was low. Initiation of breastfeeding within one hour of birth was highest among multiparous women, mothers aged 30–34 years, and women who began antenatal care at their fourth month of pregnancy or later. Public health officials and health care providers should consider interventions to promote and support early initiation of breastfeeding.
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Affiliation(s)
- Meseret Ekubay
- 1Department of Nursing, College of Health Sciences, Institute of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Aster Berhe
- Midwifery Advisor, UNFPA Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Engida Yisma
- 3School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,4Robinson Research Institute, School of Medicine, The University of Adelaide, Adelaide, Australia
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Hoche S, Meshesha B, Wakgari N. Sub-Optimal Breastfeeding and Its Associated Factors in Rural Communities of Hula District, Southern Ethiopia: A Cross-Sectional Study. Ethiop J Health Sci 2018; 28:49-62. [PMID: 29622907 PMCID: PMC5866289 DOI: 10.4314/ejhs.v28i1.7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 01/01/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Sub-optimal breast feeding contributed a significant number of infants' death. Although breast feeding is universal in Ethiopia, the practice is not optimal. Hence, this study assessed the prevalence of sub-optimal breast feeding practice and its associated factors in rural communities of Hula District, Southern Ethiopia. METHODS A community based cross-sectional study was conducted among 634 women with infants aged 6 to 12 months. Multistage sampling technique was employed to select study subjects. Interviewer administered structured questionnaire was used for data collection. Data were entered and analyzed by using SPSS version 20.0. Bivariate and multivariate logistic regression was used to identify predictors of delayed initiation of breastfeeding and non-exclusive breastfeeding. RESULTS The prevalence of suboptimal breast feeding of infants was found to be 56.9%. Nearly half (49.4%) of the mothers delayed initiation of breast feeding, and 13.4% of the infants were fed breast non-exclusively. Having formal education [AOR: 1.74; 95% CI (1.17, 2.59)], family size < 5 [AOR=1.59; 95% CI (1.03, 2.45)], having one under five child [AOR=1.88; 95% CI (1.29, 2.75)], lower number of antenatal care visits [AOR= 2.40; 95% CI (1.68, 3.43)] and lack of counseling on breastfeeding [AOR= 1.69; 95% CI (1.19, 2.41)] were negatively associated with delayed initiation of breast feeding. Similarly, not attending formal education, low birth order and lack of knowledge about exclusive breastfeeding were also negatively associated with exclusive breastfeeding practice. CONCLUSION In this study, sub-optimal breast feeding was found to be high. Delayed initiation and non-exclusive breastfeeding practices were major contributors to sub-optimal breast feeding.
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Affiliation(s)
| | - Berhan Meshesha
- College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Negash Wakgari
- School of Nursing and Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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