Breastfeeding performance in Afar regional state, northeastern Ethiopia: a cross sectional study

Breast feeding techniques and associated factors among lactating primipara mothers during the postpartum period in Debre Markos health institutions, North West Ethiopia

BACKGROUND

Breastfeeding technique is a combination of positioning, attachment, and breast milk suckling. Breastfeeding problems are caused by incorrect breastfeeding practices, which lead to premature discontinuation of breastfeeding. Therefore, this study aimed to determine the proportion of breastfeeding techniques and associated factors among lactating primiparous mothers during the postpartum period in the Debre Markos town health facility in 2021.

METHODS

An institutional-based cross-sectional study was conducted from November 1st to December 30, 2021. A systematic sampling technique was utilized to select study participants. An observational checklist developed by WHO and an interviewer-administered questionnaire were used to collect data from 409 mothers. The collected data were entered into Epi-Data version 4.6.0.4 statistical software and then exported to SPSS version 24.0 for cleaning and analysis. Binary and multivariable logistic regression was carried out to identify the factors associated with the practice of effective breastfeeding techniques. A variable that has a p-value of ≤0.2 was transferred to a multivariable for further analysis. The strength of association was identified using an adjusted odds ratio with a 95% confidence interval, and a p-value <0.05 was taken as statistically significant.

RESULTS

The proportion of practicing effective breastfeeding techniques among lactating primipara mothers was 29.1% (CI: 24.7, 33.3). Baby aged ≥29 days, mothers who were living in urban, mothers who attended college or higher education, mothers who have heard about BFT practices, mothers who received counseling on BFT after delivery, and mothers whose breast nipples had everted were variables that were significantly associated with the practice of effective breastfeeding techniques.

CONCLUSION

The findings of this study revealed that the practice of effective breastfeeding techniques among lactating primipara mothers was lower in the study area. Therefore, healthcare providers should have to counsel mothers on how to position and attach their infants during breastfeeding.

PRACTICE IMPLICATION

The provision of breast-feeding method counseling to nursing mothers is one way to enhance the practices of breast feeding.

The practice of key messages for optimal breastfeeding and associated factors among lactating mothers in the Boset District, Oromia, Ethiopia

Background

Inadequate breastfeeding can lead to significant morbidity, mortality, and long-term adverse health outcomes. Key messages promoting optimal breastfeeding are integral to Essential Nutritional Action, aimed at improving children's nutritional status, especially those under the age of two. However, there is a dearth of data regarding the extent to which lactating mothers adhere to these key messages and the associated factors. Therefore, this study aimed to assess the level of practice of key messages for optimal breastfeeding and identify associated factors among lactating mothers living in the Boset District, Oromia, Ethiopia.

Methods

A community-based cross-sectional study was conducted among 418 lactating mothers from January 1st to February 28th, 2022. The participants were selected using a systematic random sampling technique, and data were collected through interviewer-administered questionnaires. The collected data were entered into Epi Info version 7 and exported to SPSS version 25 for analysis. Binary logistic regressions were performed to examine the association between independent and dependent variables. Adjusted Odds Ratios with a 95% confidence interval were used to estimate the strength of the associations and statistical significance was declared at a p-value < 0.05.

Result

The overall level of practice of key messages for optimal breastfeeding was 63.9% (95% CI: 59.1-68.2). The odds of practicing key messages for optimal breastfeeding were higher for mothers who attended antenatal care four times or more (AOR = 2.7, 95% CI: 1.4-5.3), received counseling on breastfeeding during postnatal care (AOR = 3.7, 95% CI: 2.2-6.4), had a good knowledge of breastfeeding (AOR = 6.2, 95% CI: 3.6-10.7), and had a favorable attitude toward breastfeeding (AOR = 6.1, 95% CI: 3.5-10.6).

Conclusion

Breastfeeding key message practices among lactating mothers in the study area fell below the recommended universal coverage of 90%. Factors identified included the number of antenatal care visits, counseling on breastfeeding, level of knowledge, and attitude toward breastfeeding. Promoting regular antenatal visits, providing thorough postnatal counseling, and enhancing knowledge and attitudes are crucial for improving optimal breastfeeding practices.

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

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.

The effect of unemployment and post-natal care on the exclusive breast-feeding practice of women in Ethiopia: a systematic review and meta-analysis

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.

Exclusive breastfeeding practice and its associated factors among children aged 6-23 months in Woldia Town, Northwest Ethiopia

Background

Inappropriate practice of exclusive breastfeeding (EBF) is still a major problem worldwide.

Objective

To identify exclusive breastfeeding practice and its associated factors among children aged 6-23 months in Woldia Town.

Methods

A Community based cross-sectional study was carried out.Interviewer-administered questionnaire was utilized to collect the data. The questionnaire was adapted from the 2016 Ethiopia Demographic and Health Survey. Hosmer-Lemeshow model was fitted at a P-value of 0.91. Finally, Variables having P-Value <0.05 with 95% CI was considered as significant factors.

Result

The prevalence of exclusive breastfeeding practice was 46.2% (95% CI: 42.0, 49.8). Being employed mothers (AOR=0.62,95% CI:0.44,0.87), being head of a household (AOR=0.52,95% CI:0.32,0.83), not g getting husband support (AOR:0.5,95%CI:0.34,0.74), not fed colostrum's (AOR:0.36,95%CI:0.23,0.57), not affected by traditional belief (AOR:3.59, 95% CI:2.09-6.17) shows significant association with Exclusive breast feeding practice.

Conclusion

The prevalence of exclusive breast feeding practice was relatively lower than the National prevalence. Some demographic variable and traditional beliefs were significantly associated with exclusive breast feeding. Designing model policies that empower the role of women and eradicating bad traditional beliefs in the community is fundamental step.

Determinants of Early Days of Newborn Feeding Malpractice Among Mothers of Children Less Than One Year of Age in Mizan-Aman Town, Southwestern Ethiopia, 2020

Background

Suboptimal breastfeeding practices have remained a global public health issue, particularly in Ethiopia due to early days of newborn breastfeeding practices. Although several measures have been taken to comply with the WHO guidelines, newborn feeding malpractices are widely seen in Ethiopia.

Objective

To assess the prevalence and determinant of early days of newborn feeding malpractices among recently delivered women in Mizan-Aman Town, southwestern Ethiopia, 2020.

Methods

A community-based cross-sectional study of recently delivered women was conducted between March 5/2020 and April 8/2020. A total of 487 mother-to-child (<12month) pairs were selected using a multi-stage randomized sampling technique and the data were collected through a face-to-face interview using a structured questionnaire. The result was analyzed via SPSS version 26. Multivariate logistic regression analysis was used to assess the determinant of newborn feeding malpractices and a p<0.05 was deemed to be significant.

Results

Prevalence of prelacteal feeding, delayed initiation of breastfeeding and colostrum avoidance was approximately 21.9%, 35.5% and 15.5%, respectively. The most common prelacteal food was Rue/“Tenadam”/49 (10.1%). The key reasons for this were: 49 (10.1%) Cultural activity followed by 45 (9.3%) intestinal/ghost/birth clean-ups. Determinants of prelacteal feeding were found to be: mothers who recognize the risks of prelactate feeding, multipara mothers, had ≥4 children and infants birth order between 4 and 6. Likewise, exposure to infant formula advertising, absence of home-to-home health education, multipara mothers and spontaneous vaginal birth were the determinants of colostrum avoidance.

Conclusion

The study found that one in four and one-third of newborns had experience with prelacteal and delayed breastfeeding, respectively. This makes the newborn feeding practice suboptimal in the city. As a result, behavioral modification programs on the prevention of prelacteal feeding and enhancement of early initiation of colostrum feeding practices are recommended.

Four in every ten infants in Northwest Ethiopia exposed to sub-optimal breastfeeding practice

Background

Improper breastfeeding practices significantly impair the health, development, and survival of infants, children, and mothers. A Breastfeeding Performance Index (BPI) is a composite index to describe overall maternal breastfeeding practice with infants under six months of age. To date, there is insufficient evidence on breastfeeding performance index and its associated factors in Ethiopia.

Objective

To assess the breastfeeding performance index and its associated factors in Sekela District, Northwest Ethiopia, 2019.

Methods

A community-based cross-sectional study was conducted on 605 randomly selected mothers having infants aged 6 to 12 months from April 02, 2019 to May 13, 2019. Data was collected using a structured interviewer-administered questionnaire. Multivariable logistic regressions were used to identify independent predictors of BPI.

Results

Two hundred forty-six (40.7%) of mothers had low BPI scores. Mothers who lived alone (AOR = 3.18; 95%CI: 1.15, 8.82), mothers who were merchants (AOR = 2.75; 95%CI:1.05, 7.15), attended three antenatal care (ANC) visits (AOR = 0.42; 95% CI: 0.20, 0.82), attended four antenatal care visits (AOR = 0.35; 95%CI: 0.12, 0.82), received postnatal care (PNC) (AOR = 0.35; 95%CI: 0.19, 0.64), had poor knowledge on breastfeeding (AOR = 3.19;95%CI: 1.14, 8.89) or negative attitudes towards breastfeeding (AOR = 2.70;95%CI: 1.13, 6.45), were independent predictors of low BPI scores.

Conclusions

The prevalence of sub-optimal breastfeeding practice in northwest Ethiopia was very high. A mother living alone, maternal occupation, ANC visits, PNC, maternal breastfeeding knowledge, and attitude towards breastfeeding were independent predictors of low BPI scores. Nutrition promotion should be implemented by considering the above significant factors to decrease inappropriate breastfeeding practice in Northwest Ethiopia.