Prevalence and Associated Factors of exclusive breast-feeding practice among Mothers with Infants Under Six Months of Age attending pediatrics OPD and EPI in Asella Referral and Teaching Hospital, East Arsi, Oromia, Ethiopia
Authors:   Arsi University College of Health Science Department of Public Health Asella city, Ethiopia, Aredo Melese Tadesse , Ferede Abebe , Abdeta Gizachew , Tekle Addis Wordofa ,   Arsi University College of Health Science Department of Public Health Asella city, Ethiopia, Shemsedin Abduselam , Zemedkun Biniyam , Tamirat Haile , Feleke Hanna , Korenti Kalkidan , Wondimu Lidya 
Published: January 2025

Introduction: Exclusive breastfeeding is a highly effective and cost-efficient intervention for preventing childhood morbidities and mortalities. It can prevent approximately 13% of childhood deaths, which equates to saving at least 1.2 million children worldwide each year. However, globally, only about 35% of infants are exclusively breastfed. In developing countries, the rate is 38% for infants under six months, while in Ethiopia, approximately 52% of infants in this age group are exclusively breastfed.

Objective: This study aims to assess the prevalence of exclusive breastfeeding practices and identify the associated factors among mothers of infants under six months old who are attending the pediatric outpatient department (OPD) and immunization clinics (EPI) at ARTH.

Methodology: An institutional-based cross-sectional study design was employed. Data were collected using a structured questionnaire administered by six graduating Public Health students from Asella Health Science College, who received a two-day training. The collected data were coded, cleaned, and entered into Epi Info, then exported to SPSS version 26 for analysis. Descriptive statistics were used to present the respondents' characteristics through frequencies, percentages, summary measures, tables, and graphs. Bivariate and multivariate analyses were conducted to identify factors associated with exclusive breastfeeding, using odds ratios with 95% confidence intervals. A significance level was set at a p-value < 0.05.

Result: Around (40.4%) of mothers Out of 384 eligible mothers, all 384 agreed to participate in the study, resulting in a response rate of 100%. Approximately one-third (36.2%) of the mothers were aged between 25 and 29 years. Regarding the reasons mothers cited for not breastfeeding, 36.5% reported that they believed breast milk was insufficient, 13% mentioned that the infant was thirsty, and 8% cited a lack of time

Among the various socio-demographic, health service, maternal, and infant-related factors assessed, several determinants were identified for higher chances of EBF practice. These factors include:

Age of the infant: Younger infants (0-3 months) are more likely to be exclusively breastfed compared to older infants (4-5 months).

Maternal occupation: Unemployed mothers are more likely to practice EBF than employed mothers.

Household income: Mothers with lower monthly incomes are more likely to practice EBF.

Conclusion and recommendation:

The study revealed a high participation rate of 100% among the 384 eligible mothers, with a significant portion (36.2%) aged between 25 and 29 years. Despite the positive response, barriers to breastfeeding were identified, with 36.5% of mothers believing that breast milk was insufficient, 13% indicating their infants were thirsty, and 8% citing time constraints as reasons for not breastfeeding.

Several socio-demographic and health-related factors significantly influence the practice of exclusive breastfeeding (EBF). Younger infants (0-3 months) are more likely to be exclusively breastfed compared to those aged 4-5 months. Additionally, unemployed mothers and those with lower household incomes demonstrate higher rates of EBF practice.

Recommendations:

1. Education and Support: Implement educational programs aimed at addressing misconceptions about breast milk sufficiency and providing practical support for breastfeeding mothers, especially those returning to work.

2. Targeted Interventions: Focus on supporting employed mothers with resources and strategies to facilitate EBF, such as flexible work policies and access to breastfeeding-friendly environments.

3. Income-Based Initiatives: Develop targeted initiatives to support lower-income families in their breastfeeding efforts, ensuring access to necessary resources and information.