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Savaş EH, Semerci R, Eroğlu K, Can N, Öztürk A. Impact of psychosexual development theory-based breastfeeding education on infant feeding attitudes and knowledge of primiparous mothers: A randomized controlled study. J Pediatr Nurs 2024; 77:e503-e510. [PMID: 38762425 DOI: 10.1016/j.pedn.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 04/24/2024] [Accepted: 05/08/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE The first year of life is known as the "Oral Stage" in psychosexual development theory. We investigated the impact of psychosexual development theory-based breastfeeding education on primiparous mothers' feeding attitudes and behaviors. DESIGN AND METHODS We conducted this randomized controlled study at a baby-friendly hospital between December 2022 and July 2023. Participants were randomized to intervention (n = 21) and control (n = 19) groups. All participants received the same standard discharge education in the hospital, and the intervention group received additional psychosexual development theory-based breastfeeding education. Data collection for both groups involved conducting face-to-face and telephone interviews, utilizing the Personal Information Form, IOWA Infant Feeding Attitude Scale (IIFAS), Breastfeeding Form, and Psychosexual Theory and Breastfeeding Knowledge Form. The study was recorded in the Clinicaltrials.gov PRS system (ID: NCT06009120). RESULTS The mean IIFAS score of mothers in the intervention group was 76.23 ± 4.10, while mothers in the control group was 66.31 ± 5.72, which was statistically significant (p < .001). Additionally, mothers in the intervention group fed their babies with formula less often on days 5 to 8 after birth (p < .05) and breastfed more frequently and for longer durations on days 3 to 8 compared to the control group (p < .05). CONCLUSIONS Psychosexual development theory-based breastfeeding education reduced the use of formula, increased mothers' attitudes towards breastfeeding, and increased the duration and frequency of breastfeeding. PRACTICE IMPLICATION Integrating psychosexual development theory-based breastfeeding education into routine maternal and infant care may enhance breastfeeding attitudes and practices, potentially improving infant feeding outcomes.
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Affiliation(s)
| | - Remziye Semerci
- Koç University, School of Nursing, Davutpaşa St. No: 4, 34010, Topkapı, Istanbul, Türkiye.
| | - Kafiye Eroğlu
- Istanbul Atlas University, Faculty of Health Sciences, Hamidiye, Anadolu St. No:40, 34408, 34403 Kağıthane, Istanbul, Türkiye.
| | - Nazlı Can
- Koç University Hospital, Davutpaşa St. No: 4, 34010, Topkapı, Istanbul, Türkiye.
| | - Ayça Öztürk
- Koç University, School of Nursing, Davutpaşa St. No: 4, 34010, Topkapı, Istanbul, Türkiye.
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Ipinnimo TM, Olasehinde OK, Sanni TA, Omotoso AA, Alabi RO, Ajayi PO, Adewoye KR, Ojo JO, Oloruntoba O, Adetona A, Adeosun MO, Olanrewaju TM, Aderinwale OA, Osho BO, Fajugbagbe AR, Adeyeye PA, Ajayi AF. Attitude and predictors of exclusive breastfeeding practice among mothers attending under-five welfare clinics in a rural community in Southwestern Nigeria. PLoS One 2024; 19:e0299843. [PMID: 38547170 PMCID: PMC10977687 DOI: 10.1371/journal.pone.0299843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/18/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Much previous research on exclusive breastfeeding has focused on urban and semi-urban communities, while there is still a paucity of data from rural areas. We assessed the attitude and practice of exclusive breastfeeding and its predictors among mothers attending the under-five welfare clinics in a rural community. METHODS A cross-sectional study was conducted among consecutively recruited 217 mothers attending the three health facilities under-five welfare clinics in Ido-Ekiti, Southwest, Nigeria. Information was collected with a semi-structured interviewer-administered questionnaire adapted from previously published research works. Descriptive and inferential statistics were carried out using IBM SPSS Statistics for Windows, Version 26.0. RESULTS More than half of the mothers, 117(53.9%) were ≥30 years old, and 191(88.0%) were married. Almost all, 216 (99.5%) attended an ante-natal clinic; however, 174(80.2%) delivered in the health facility. The respondent's mean ± SD exclusive breastfeeding attitudinal score was 29.94 ± 2.14 (maximum obtainable score was 36), and the proportion of mothers that practiced exclusive breastfeeding was 40.6%. Married mothers were more likely to practice exclusive breastfeeding than their unmarried counterparts (AOR:6.324, 95%CI:1.809-22.114). The common reasons for not practicing exclusive breastfeeding were work schedule 57(26.3%), cultural beliefs and the need to introduce herbal medicine 32(14.7%), and insufficient breast milk 30(13.8%). CONCLUSION This study revealed a good disposition with a suboptimal practice towards exclusive breastfeeding. Also, being married was a positive predictor of exclusive breastfeeding. Therefore, we recommend policies that will improve exclusive breastfeeding among mothers in rural areas, especially those targeting the unmarried, to achieve the World Health Organization's target.
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Affiliation(s)
| | | | - Taofeek Adedayo Sanni
- Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
- Department of Community Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
| | | | | | - Paul Oladapo Ajayi
- Department of Community Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Kayode Rasaq Adewoye
- Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
- Department of Community Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
| | - John Olujide Ojo
- Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
- Department of Community Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
| | | | - Ademuyiwa Adetona
- Department of Community Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
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Terefe B, Shitu K. Exploring the determinants of exclusive breastfeeding among infants under six months in the Gambia using gambian demographic and health survey data of 2019-20. BMC Pregnancy Childbirth 2023; 23:220. [PMID: 37005575 PMCID: PMC10067212 DOI: 10.1186/s12884-023-05544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 03/24/2023] [Indexed: 04/04/2023] Open
Abstract
INTRODUCTION For infants, no one is as nutritious as breastmilk for the rest of their lives. It is a great guarantee for their future health, especially if they can exclusively breastfeed for the next few months, from the moment they are born until the end of the fifth month. Although breastfeeding rates are very low, there is no data record about it in the Gambia. OBJECTIVE This study aimed to assess the status of exclusive breastfeeding and its determinants among infants under six months of age in the Gambia. METHODS It is a secondary data analysis using the 2019-20 Gambia demographic and health survey data. A total of 897 weighted mother-infant paired samples were included in the study. A logistic regression analysis method was employed to declare factors significantly associated with exclusive breastfeeding among infants under six months of age in Gambia. Variables with a p-value of 0.2 were entered into multiple logistic regression analysis, and after controlling other confounding factors, an adjusted odds ratio of 95% CI was applied to identify associated variables. RESULTS Exclusive breastfeeding was found in 53.63% only among infants under six months of age. Being a rural resident (AOR = 2.14, 95% CI: 1.33, 3.41), reading a newspaper (AOR = 5.62, 95% CI: 1.32, 24.09), and being counseled on breastfeeding by a health professional (AOR = 1.36, 95% CI: 1.01, 1.82) are times more likely to practice exclusive breastfeeding, respectively. On the other hand, a child with a fever (AOR = 0.56, 95% CI: 0.37, 0.84), a child whose age is 2-3 months (AOR = 0.41, 95 CI: 0.28, 0.59), and a child whose age is 4-5 months (AOR = 0.11, 95% CI: 0.07, 0.16) is less likely to be fed exclusively than a 0-1-month-old child. CONCLUSION Exclusive breastfeeding remains among the public health challenges in the Gambia. Strengthening health professionals' counseling techniques on breastfeeding and infant illnesses, promoting the pros of breastfeeding, and designing timely policies and interventions are urgently needed in the country.
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Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Po. Box: 196, Gondar, Ethiopia.
| | - Kegnie Shitu
- Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Sultana M, Dhar S, Hasan T, Shill LC, Purba NH, Chowdhury AI, Shuvo SD. Knowledge, attitudes, and predictors of exclusive breastfeeding practice among lactating mothers in Noakhali, Bangladesh. Heliyon 2022; 8:e11069. [PMID: 36276726 PMCID: PMC9578980 DOI: 10.1016/j.heliyon.2022.e11069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/22/2021] [Accepted: 10/07/2022] [Indexed: 11/03/2022] Open
Abstract
Background Mothers' knowledge, attitudes, and practices toward exclusive breastfeeding are crucial to both child and mother's health and wellbeing. Hence, This study aimed to assess knowledge, attitudes, and practices of exclusive breastfeeding among lactating mothers as well as the predictors of their exclusive breastfeeding practice. Methodology This cross-sectional study included 397 mothers having infants aged 0-6 months who sought care at Noakhali Sadar Upazila, Noakhali, Bangladesh. A field-tested and validated Food and Agriculture Organization of the United Nations (FAO) questionnaire was utilized to collect information from participants. Results Of those evaluated; 29.0% of mothers could not define exclusive breastfeeding accurately, 11.3% and 59.3% did not know the benefits of exclusive breastfeeding for babies and mothers, respectively. More than half (51.4%) of the mothers reported feeling good about exclusive breastfeeding for six months, did not find difficulties to breastfeed exclusively for six months (39.5%) and on-demand (58.2%). The mothers had an overall favorable attitude towards exclusive breastfeeding; however, 38.3% of mothers did not exclusively breastfeed their children. Literate mothers tended to exclusively breastfeed more (AOR: 3.06, 95% CI: 1.01-9.32; P = 0.049) than illiterate mothers. Mothers having one baby were more likely to breastfeed exclusively (AOR: 3.07, 95% CI: 1.21-7.78; P = 0.018) than mothers having more than one baby. Moreover, mothers with higher knowledge and favorable attitude had more than two times (AOR: 2.58, 95% CI: 1.315.07; P = 0.006) and forty-three times (AOR: 43.18, 95% CI: 21.513-86.66; P < 0.001) the higher tendency of exclusive breastfeeding compared to others. Conclusion Despite having satisfactory knowledge and attitude, the practice of exclusive breastfeeding among mothers was poor. We recommend that interventions must be focused more on ensuring exclusive breastfeeding practice among mothers in addition to improving their knowledge and attitudes.
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Affiliation(s)
- Marjia Sultana
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Shishir Dhar
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Towhid Hasan
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh,Corresponding author.
| | - Lincon Chandra Shill
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Nafisa Habib Purba
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Akibul Islam Chowdhury
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore 7408, Bangladesh
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Gessese GT, Woldeamanuel BT, Demie TG, Diriba Biratu T, Handebo S. Breastfeeding performance index and associated factors among children aged 0-6 months in Ethiopia: Analysis of the 2019 Ethiopia Mini Demographic and Health Survey. Front Nutr 2022; 9:970737. [PMID: 36263306 PMCID: PMC9574351 DOI: 10.3389/fnut.2022.970737] [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: 06/16/2022] [Accepted: 09/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Infants under the age of 6 months are commonly affected by malnutrition globally. The higher the breastfeeding performance index (BPI), the greater the advantage of breastfeeding will be. However, there is a lack of literature in the context of Ethiopia. Therefore, this study is aimed at investigating the magnitude and determinants of the breastfeeding performance index score among mothers of children under the age of 6 months in Ethiopia. Methods This study was conducted using the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) dataset. A stratified, two-stage cluster sampling technique was used in the study. The survey data were weighted using the “svy” function in STATA version 16. Descriptive statistics, bivariable and multivariable logistic regression were employed in the analysis. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported. The results were considered statistically significant if the p-value was < 0.05. The goodness of fit of the model was checked using the Hosmer–Lemeshow test. Results A total of 4,273 mothers with children under the age of 6 months were included in the analysis. Our analysis revealed that the prevalence of low breastfeeding performance index was 79.05% (95% CI: 78.01, 81.59). A unit increase in child age (AOR = 11.56; 95% CI: 6.97, 19.17), the richest wealth quintile (AOR = 2.76; 95% CI: 1.18, 6.5), a higher level of education (AOR = 5.41; 95% CI: 2.08, 14.05), being married or living with partner (AOR = 2.73; 95% CI: 1.18, 6.27), being women from Somali (AOR = 5.11; 95% CI: 2.08, 12.56), Afar (AOR = 3.03; 95% CI: 1.16, 7.91), Oromia (AOR = 1.88; 95% CI: 1.03, 3.41), Diredawa city administration (AOR = 2.89; 95% CI: 1.04, 8.07), and antenatal care (ANC) visit (AOR = 2.05; 95% CI: 1.31, 3.19) were positively associated with the low breastfeeding performance index. Conclusion The prevalence of the low breastfeeding performance index was found to be high. Hence, the findings of the study suggest the need to target interventions aimed at improving breastfeeding performance toward mothers with higher socioeconomic and demographic status and educational status. Antenatal care clients are among the targets of the intervention.
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Affiliation(s)
- Getachew Tilahun Gessese
- Department of Nutrition, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia,*Correspondence: Getachew Tilahun Gessese
| | - Berhanu Teshome Woldeamanuel
- Department of Epidemiology and Biostatistics, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Takele Gezahegn Demie
- Department of Health Education and Health Promotion, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Tolesa Diriba Biratu
- Department of Epidemiology and Biostatistics, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Simegnew Handebo
- Department of Health Education and Health Promotion, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Abukari AS, Acheampong AK. Breastfeeding practices and coping strategies adopted by lactating nurses and midwives: A qualitative study. J Pediatr Nurs 2022; 66:e61-e66. [PMID: 35637105 DOI: 10.1016/j.pedn.2022.05.017] [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: 02/06/2022] [Revised: 05/22/2022] [Accepted: 05/22/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to explore the breastfeeding practices and coping mechanisms of nurses and midwives to navigate the breastfeeding experience as health professionals. DESIGN AND METHODS A descriptive qualitative design was employed. Twenty-five registered nurses' and midwives' breastfeeding habits and coping methods were explored through five focus group discussions, each with five members. A purposive sampling approach was used to recruit participants. Only women who were currently breastfeeding an infant between the ages of 3 and 18 months were considered. For thematic content analysis, MAXQDA qualitative software was used. RESULTS Breastfeeding practices and breastfeeding coping mechanisms emerged as the two main themes. Theme 1: Breastfeeding practices had four sub-themes: breastfeeding positions, breastfeeding duration, lactation nutrition, and expressed breast milk. Theme 2: breastfeeding coping strategies had four subthemes, support from family and co-workers, crying, praying, and communicating with infants. CONCLUSIONS Due to work and other related pressures, our study indicates a disparity in exclusive breastfeeding practice among registered nurses and midwives. Working lactating health professionals can use some of the study's coping strategies and beneficial breastfeeding practices to enhance effective breastfeeding. PRACTICE IMPLICATIONS Breastfeeding in the ideal sitting posture, eating the right diet to increase milk flow, and freezing breast milk to feed the infant while at work are all strategies proposed to help practicing nurses, midwives, and other working women navigate breastfeeding.
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Affiliation(s)
- Alhassan Sibdow Abukari
- School of Nursing, Wisconsin International University College-Ghana, P.O Box LG, Accra, Ghana
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Mekebo GG, Argawu AS, Likassa HT, Ayele W, Wake SK, Bedada D, Hailu B, Senbeto T, Bedane K, Lulu K, Daraje S, Lemesa R, Aga G, Alemayehu E, Kefale B, Bechera T, Tadesse G, Galdassa A, Olani J, Hemba G, Teferi G, Argaw A, Irana T, Tilahun T, Diriba G. Factors influencing exclusive breastfeeding practice among under-six months infants in Ethiopia. BMC Pregnancy Childbirth 2022; 22:630. [PMID: 35941576 PMCID: PMC9361573 DOI: 10.1186/s12884-022-04955-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/02/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND World Health Organization recommends exclusive breastfeeding (EBF) for the first 6 months of life. EBF has sustainable long-term health benefits for both infants and mothers. Despite its benefits, the practice of EBF in Ethiopia is lower than the internationally recommended one. This study aimed at identifying factors influencing EBF practice among under-6 month infants in Ethiopia. METHODS This study used data drawn from the 2019 Ethiopian Mini Demographic and Health Survey (2019 EMDHS) data. A multivariable logistic regression model was employed to investigate factors significantly associated with EBF practice among under-6 month infants in Ethiopia. An adjusted odds ratio with 95% confidence interval was used to measure the association of factors with EBF practice. RESULTS A total of 566 infants under the age of 6 months were included in the study. The prevalence of exclusive breastfeeding practice was 83% (95% CI: 79.70-86%). Urban residences (AOR: 0.40, 95% CI: 0.22-0.73), mothers having secondary education (AOR: 1.54, 95% CI: 1.29-1.84) and higher education (AOR: 3.18, 95% CI: 0.68-15.02), mothers having ANC visits of 1 to 3 times (AOR: 1.52, 95% CI: 1.24-1.88) and ANC visits of 4 and more times (AOR: 4.27, 95% CI: 1.06-17.25), family size of more than 5 (AOR: 0.45, 95% CI: 0.26-0.88), caesarean births (AOR: 0.63, 95% CI: 0.42-0.95), and deliveries at health facilities (AOR: 2.51, 95% CI: 1.12-5.63) were factors significantly associated with EBF practice among under-6 month infants. CONCLUSION In this study, EBF practice among under-6 month infants was significantly associated with place of residence, maternal educational level, ANC visits, family size, mode of delivery, and place of delivery. Therefore, encouraging ANC visit and promotion of institutional (health facility) delivery are recommended. Furthermore, special attention has to be given to mothers with no or less education to make them better aware of the EBF and its benefits to enhance exclusive breastfeeding practice.
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Affiliation(s)
| | | | | | - Wondimu Ayele
- Department of Biostatistics and Epidemiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Dechasa Bedada
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | - Belema Hailu
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | | | - Ketema Bedane
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | - Kebede Lulu
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | - Sagni Daraje
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | - Reta Lemesa
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | - Gudeta Aga
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | | | | | - Terefa Bechera
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | | | | | - Jiregna Olani
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | - Geribe Hemba
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | - Girma Teferi
- Department of Midwifery, Wolkite University, Wolkite, Ethiopia
| | - Abebe Argaw
- Department of Statistics, Ambo University, Ambo, Ethiopia
| | - Tariku Irana
- Department of Statistics, Ambo University, Ambo, Ethiopia
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Habte MH, Seid SJ, Alemu A, Hailemariam HA, Wudneh BA, Kasa RN, Bitew ZW. The effect of unemployment and post-natal care on the exclusive breast-feeding practice of women in Ethiopia: a systematic review and meta-analysis. Reprod Health 2022; 19:94. [PMID: 35428313 PMCID: PMC9013047 DOI: 10.1186/s12978-022-01404-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Promoting exclusive breastfeeding (EBF) is a major child survival strategy in developing countries like Ethiopia. Studies in EBF are found in a fragmented and inconclusive way in Ethiopia. Therefore, the aim of this study was to examine evidences on the effect of post natal care counseling and maternal employment status on exclusive breastfeeding practice of women in Ethiopia. METHODS A systematic literature search was conducted from PubMed (contains MEDLINE), CINAHL (EBSCO), Global Health, Food Science and Technology Abstracts (FSTA) (EBSCO) and Grey literature sources such as Google and Google scholar. All primary studies on the effects of employment status and/or post-natal care utilization on EBF practices of women in Ethiopia were included. Data analyses were performed using STATA software. Forest plot, I2 test and the Cochrane Q statistics were used to detect heterogeneity among studies. Heterogeneity was considered significant when the I2 value was ≥ 50%, with p-value < 0.05. Publication bias was checked by looking the asymmetry of funnel and confirmed by Egger's regression test at a 5% significant level. The pooled odds ratio (POR) with 95% confidence interval (CI) was used to report the measures of associations. RESULT A total of 622 studies were identified in the initial search of which 42 articles were included this systematic review and meta-analysis. A meta-analysis of 24 studies indicated that maternal employment status was significantly associated (POR = 0.51, 95% CI 0.16, 0.86) EBF practice in that employed mother were less likely to practice to practice EBF. Post-natal care service utilization significantly increases (POR = 1.76, 95% CI 1.32, 2.34) the EBF practice in Ethiopia and it was computed using 25 eligible articles. Besides, the pooled estimates of EBF practice was found to be 62.58% (95% CI 56.98, 68.19, I2 = 96.4%, p < 0.001). CONCLUSION This review found that post-natal care service utilization and maternal employment status has a significant effect on EBF practice. The findings from this review may be used to inform for better supportive and promotive strategies for EBF practice in Ethiopia.
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Affiliation(s)
| | - Seada Jemal Seid
- St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Rahel Nega Kasa
- St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Wako WG, Wayessa Z, Fikrie A. Effects of maternal education on early initiation and exclusive breastfeeding practices in sub-Saharan Africa: a secondary analysis of Demographic and Health Surveys from 2015 to 2019. BMJ Open 2022; 12:e054302. [PMID: 35292494 PMCID: PMC8928244 DOI: 10.1136/bmjopen-2021-054302] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Early initiation of breast feeding (EIBF) and exclusive breast feeding (EBF) are the cheapest, feasible and simplest nutritional interventions for infants. Effects of maternal education on EIBF and EBF are not consistent across studies. This study assessed the effects of maternal education on EIBF and EBF. METHODS A cross-sectional study was done based on data collected for phase 7 Demographic and Health Surveys conducted in 16 sub-Saharan African countries from 2015 to 2019. Data of the last-born children younger than 6 (n=19 103) and 24 (n=75 293) months were analysed to assess associations between maternal education and EIBF and EBF practices, respectively. To assess the associations, X2 test and logistic regression were done. Adjusted ORs (AORs) and their 95% CIs were used to declare statistical significance of the associations. RESULTS After controlling for all other potentially confounding variables, mothers who completed primary school were 1.29 (95% CI AOR: 1.24 to 1.34) times more likely to initiate breast feeding within the first 1 hour of delivery compared with mothers without education. However, mothers with secondary (AOR: 1.01; 95% CI: 0.96 to 1.06) or higher (AOR: 0.96; 95% CI: 0.87 to 1.05) level of education were not significantly different from mothers without education concerning EIBF. Similarly, mothers educated to primary school were 1.37 (95% CI AOR: 1.27 to 1.48) times more likely to exclusively breast feed compared with mothers without education. However, mothers educated to secondary (AOR: 1.07; 95% CI: 0.98 to 1.17) or higher (AOR: 1.07; 95% CI: 0.89 to 1.27) level of education were not significantly different from uneducated mothers regarding EBF practices. CONCLUSIONS Effects of maternal education on EIBF and EBF depend on the level of educational attainment. Future studies should look for reasons for the lower rate of EIBF and EBF among mothers with higher educational status.
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Affiliation(s)
- Wako Golicha Wako
- School of Public Health, Bule Hora University, Bule Hora, Oromia Regional State, Ethiopia
| | - Zelalem Wayessa
- Department of Midwifery, Bule Hora University, Bule Hora, Oromia Regional State, Ethiopia
| | - Anteneh Fikrie
- School of Public Health, Bule Hora University, Bule Hora, Oromia Regional State, Ethiopia
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Siraneh Y, Woldie M, Birhanu Z. End-Users Satisfaction with Positive Deviance Approach as an Intervention to Promote Exclusive Breastfeeding in Jimma, Ethiopia: A Multi-Level Analysis. Int J Womens Health 2022; 14:179-197. [PMID: 35177939 PMCID: PMC8846610 DOI: 10.2147/ijwh.s349053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/04/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Positive deviance approach (PDA) was implemented as an intervention strategy to address the poor practice of exclusive breastfeeding (EBF) in Jimma town, Ethiopia. Understanding the end-users satisfaction and its drivers is essential to determine whether this approach will be viable in the long run. Therefore, we determined the level of users' satisfaction with the intervention and identified multi-level predictors to explain variability. METHODS The data for this follow-up study were collected from September 01 to 25, 2020 among the study participants who were living in the intervention clusters of an earlier trial. A sample of 260 participants were invited to respond to an interviewer-administered structured questionnaire that assessed both individual and community-level variables. The developed tool was refined using experts' view (face validity) and using factor analysis (FA) to validate the satisfaction measurement scales (construct validity). The mean scores were standardized using Percentages Scale Mean Score (PSMS) formulae. Two-level mixed-effects linear regression (linear mixed models) were performed to fit individual, community, and mixed-level variables. All assumptions were checked for each analysis as appropriate and β-estimates at 95% CI and p-value of <0.05 were considered to declare a level of significance. RESULTS The overall level of end-users' satisfaction (PSMS) with PDA as an intervention to improve EBF was 50.9% with a maximum score of 99% and a minimum of 8%. Of the emerged satisfaction measuring scales, the standardized mean score for the user empowerment scale was the highest (53.7%). Five scales were emerged with 84.2% of the total variability explained in users' satisfaction. The mixed-effect model revealed that age, occupation, experience of breastfeeding (BF), knowledge, attitude, self-efficacy, main source of BF information, previous home visit/support received from HEPs, participation in any social activities, and perceived community support for BF were independent two-level predictors of satisfaction. CONCLUSION As an intermediate outcome, more than half of the end-users of the PDA intervention were satisfied. End-users' satisfaction with PDA as an intervention to promote EBF was predicted by multi-level factors. If they chose to use PDA as an intervention, Health program managers should be mindful of the two-level factors identified in this study.
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Affiliation(s)
- Yibeltal Siraneh
- Department of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Mirkuzie Woldie
- Department of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia.,Fenot Project, Department of Population and Public Health, University of British Columbia, Addis Ababa, Ethiopia
| | - Zewdie Birhanu
- Department of Health, Behavior and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Wake GE, Mittiku YM. Prevalence of exclusive breastfeeding practice and its association with maternal employment in Ethiopia: a systematic review and meta-analysis. Int Breastfeed J 2021; 16:86. [PMID: 34717673 PMCID: PMC8557507 DOI: 10.1186/s13006-021-00432-x] [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: 06/03/2020] [Accepted: 10/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background Exclusive breastfeeding is defined as the practice of providing only breast milk for an infant for the first 6 months of life without the addition of any other food or water, except for vitamins, mineral supplements, and medicines. Findings are inconsistent regarding the prevalence of exclusive breastfeeding in Ethiopia. Full-time maternal employment is an important factor contributing to the low rates of practice of exclusive breastfeeding. Empowering women to exclusively breastfeed, by enacting 6 months’ mandatory paid maternity leave can increase the rate of exclusive breastfeeding in the first 6 months of life up to 50%. The purpose of this review was to estimate the pooled prevalence of exclusive breastfeeding and its association with full-time maternal employment in the first 6 months of life for infants in the context of Ethiopia. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used in this systematic review and meta-analysis. All observational studies reporting the prevalence of exclusive breastfeeding and its association with maternal employment in Ethiopia were considered. The search was conducted from 6 November 2020 to 31 December 2020 and all papers published in the English language from 1 January 2015 to 31 December 2020 were included in this review. Results Forty-five studies were included in the final analysis after reviewing 751 studies in this meta-analysis yielding the pooled prevalence of EBF 60.42% (95% CI 55.81, 65.02) at 6 months in Ethiopia. Those full-time employed mothers in the first 6 months were 57% less likely to practice exclusive breastfeeding in comparison to mothers not in paid employment in Ethiopia (OR 0.43; 95% CI 0.31, 0.61). Conclusions Full-time maternal employment was negatively associated with the practice of exclusive breastfeeding in comparison to unemployed mothers. The prevalence of exclusive breastfeeding in Ethiopia is low in comparison to the global recommendation. The Ethiopian government should implement policies that empower women. The governmental and non-governmental organizations should create a conducive environment for mothers to practice exclusive breastfeeding in the workplace. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-021-00432-x.
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Affiliation(s)
- Getu Engida Wake
- College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia.
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Ayalew T, Asmare E. Colostrum avoidance practice among primipara mothers in urban Northwest Ethiopia. A cross-sectional study. BMC Pregnancy Childbirth 2021; 21:123. [PMID: 33573612 PMCID: PMC7879506 DOI: 10.1186/s12884-021-03623-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background Breast milk is the ideal and complete form of nutrition for infants colostrum contains all the necessary nutrients for infants’ growth and development and antibodies that can protect from many childhood illnesses. Understanding the extent of and barriers to colostrum avoidance in Ethiopia is important for learning how to best improve optimal breastfeeding. No single study has been conducted on primigavida mothers in the country. Therefore, this study aimed to assess the rate of colostrum avoidance practice and associated factors among primigavida mothers. Method A community- based cross-sectional study was conducted from March to April 2016 among (n = 398) randomly selected primigavida mothers in Bahir Dar city, northwest Ethiopia. Data were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version25. Bivariate and multivariate logistic regression analyses were carried out. Odds ratio with 95% confidence interval was used to measure the strength of association. Statistical significance was declared at P-value ≤0.05. Results Out of 398 primipara mothers, 8.8% discarded colostrum. The most common reasons for discarding colostrum were; yellow and creamy (39.2%), bad for infant (35.2%), traditional/cultural reason (17.1%) and infant unable to feed (8.5%). Married mothers (AOR = 4.52, 95%CI: 1.13, 18.16), unemployed mothers (AOR = 3.46, 95%CI: 1.15, 10.51), mothers underwent normal delivery (AOR = 5.20, 95%CI: 1.87, 20.90) and mothers who initiated breastfeeding within 1 h (AOR = 2.79, 95%CI: 0.96, 8.16) were less likely to discard colostrum. Conclusion The current study revealed that colostrum was discarded by 8.8% of primipara mothers. Primipara mothers who were married, unemployed, underwent normal delivery and initiated breastfeeding within 1 h were less likely to discard colostrum. These results suggest that multi-sectorial and multi-disciplinary approaches are needed to decrease colostrum avoidance among primipara mothers in Ethiopia.
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Affiliation(s)
- Tilksew Ayalew
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Eden Asmare
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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