Predictors of late initiation of breastfeeding practice in Ethiopia: a multilevel mixed-effects analysis of recent evidence from EDHS 2019

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Abstract

Objectives

To identify the predictors of late initiation of breastfeeding practice in Ethiopia.

Design

Cross-sectional study design.

Setting

Ethiopia.

Participants

A total of 1982 weighted samples of mothers with children aged under 24 months were included.

Outcome measure

Late initiation of breastfeeding practice.

Results

The prevalence of late breastfeeding initiation practice is 26.4% (95 CI 24.4 to 28.3). Being a young mother (15–24 years) (adjusted odds ratio (AOR) =1.66; 95 CI 1.06 to 2.62), no antenatal care (ANC) visit (AOR=1.45; 95 CI 1.04 to 2.02), caesarean section (AOR=4.79; 95 CI 3.19 to 7.21) and home delivery (AOR=1.53; 95 CI 1.14 to 2.06) were found to be the determinants of late initiation of breast feeding.

Conclusion

More than one-fourth of newborn children do not start breast feeding within the WHO-recommended time (first hour). Programmes should focus on promoting the health facility birth and increasing the ANC visits. Further emphasis should be placed on young mothers and those who deliver via caesarean section to improve the timely initiation of breast feeding.

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Most cited references 58

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A brief conceptual tutorial of multilevel analysis in social epidemiology: linking the statistical concept of clustering to the idea of contextual phenomenon.

Juan Merlo, Basile Chaix, Min Yang … (2005)

This didactical essay is directed to readers disposed to approach multilevel regression analysis (MLRA) in a more conceptual than mathematical way. However, it specifically develops an epidemiological vision on multilevel analysis with particular emphasis on measures of health variation (for example, intraclass correlation). Such measures have been underused in the literature as compared with more traditional measures of association (for example, regression coefficients) in the investigation of contextual determinants of health. A link is provided, which will be comprehensible to epidemiologists, between MLRA and social epidemiological concepts, particularly between the statistical idea of clustering and the concept of contextual phenomenon. The study uses an example based on hypothetical data on systolic blood pressure (SBP) from 25,000 people living in 39 neighbourhoods. As the focus is on the empty MLRA model, the study does not use any independent variable but focuses mainly on SBP variance between people and between neighbourhoods. The intraclass correlation (ICC = 0.08) informed of an appreciable clustering of individual SBP within the neighbourhoods, showing that 8% of the total individual differences in SBP occurred at the neighbourhood level and might be attributable to contextual neighbourhood factors or to the different composition of neighbourhoods. The statistical idea of clustering emerges as appropriate for quantifying "contextual phenomena" that is of central relevance in social epidemiology. Both concepts convey that people from the same neighbourhood are more similar to each other than to people from different neighbourhoods with respect to the health outcome variable.

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Timing of breastfeeding initiation and exclusivity of breastfeeding during the first month of life: effects on neonatal mortality and morbidity--a systematic review and meta-analysis.

Jehangir Khan, Linda Vesel, Rajiv Bahl … (2015)

The purpose of this study was to review the evidence on the effect of initiation of breastfeeding early after birth and of exclusive breastfeeding during the first month in reducing neonatal mortality and morbidity. We searched Cochrane and PubMed databases for all available papers addressing our review questions and identified eleven papers. Data were extracted using a standard abstraction form. Evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation system. Meta-analysis was done using STATA 11.0. Early initiation of breastfeeding was associated with a reduced risk of neonatal mortality. Initiating breastfeeding after the first hour doubled the risk of neonatal mortality. Exclusively breastfed neonates had a lower risk of mortality and infection-related deaths in the first month than partially breastfed neonates. Exclusively breastfed neonates also had a significantly lower risk of sepsis, diarrhea and respiratory infections compared with those partially breastfed. The pooled evidence indicates that substantial benefits in reducing neonatal mortality and morbidity can be achieved with effective promotion of early initiation of breastfeeding and exclusive breastfeeding during the first month of life.

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Is Open Access

Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis

Emily R. Smith, Lisa Hurt, Ranadip Chowdhury … (2017)

Objective To assess the existing evidence regarding breastfeeding initiation time and infant morbidity and mortality. Study design We conducted a systematic review and meta-analysis. We searched Pubmed, Embase, Web of Science, CINAHL, Popline, LILACS, AIM, and Index Medicus to identify existing evidence. We included observational studies and randomized control trials that examined the association between breastfeeding initiation time and mortality, morbidity, or nutrition outcomes from birth through 12 months of age in a population of infants who all initiated breastfeeding. Two reviewers independently extracted data from eligible studies using a standardized form. We pooled effect estimates using fixed-effects meta-analysis. Results We pooled five studies, including 136,047 infants, which examined the association between very early breastfeeding initiation and neonatal mortality. Compared to infants who initiated breastfeeding ≤1 hour after birth, infants who initiated breastfeeding 2–23 hours after birth had a 33% greater risk of neonatal mortality (95% CI: 13–56%, I2 = 0%), and infants who initiated breastfeeding ≥24 hours after birth had a 2.19-fold greater risk of neonatal mortality (95% CI: 1.73–2.77, I2 = 33%). Among the subgroup of infants exclusively breastfed in the neonatal period, those who initiated breastfeeding ≥24 hours after birth had an 85% greater risk of neonatal mortality compared to infants who initiated <24 hours after birth (95% CI: 29–167%, I2 = 33%). Conclusions Policy frameworks and models to estimate newborn and infant survival, as well as health facility policies, should consider the potential independent effect of early breastfeeding initiation.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2024

Publication date (Electronic): 10 April 2024

Volume: 14

Issue: 4

Electronic Location Identifier: e081069

Affiliations

[1]departmentDepartment of Nursing, College of Health Science , Woldia University , Woldia, Ethiopia

Author notes

[Correspondence to ] Ribka Nigatu Haile; nigaturebecca@ 123456gmail.com

Author information

Ribka Nigatu Haile http://orcid.org/0000-0003-1193-5920

Biruk Beletew Abate http://orcid.org/0000-0003-0833-2504

Tegene Atamenta Kitaw http://orcid.org/0000-0002-7199-1249

Article

Publisher ID: bmjopen-2023-081069

DOI: 10.1136/bmjopen-2023-081069

PMC ID: 11015321

PubMed ID: 38604642

SO-VID: 4d3b071c-9970-45dc-b5e5-b157303a28f9

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 22 October 2023

Date accepted : 26 March 2024

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ScienceOpen disciplines: Medicine

Keywords: paediatrics,community child health,nutritional support,nutrition & dietetics

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ScienceOpen disciplines: Medicine

Keywords: paediatrics, community child health, nutritional support, nutrition & dietetics

Predictors of late initiation of breastfeeding practice in Ethiopia: a multilevel mixed-effects analysis of recent evidence from EDHS 2019

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Abstract

Objectives

Design

Setting

Participants

Outcome measure

Results

Conclusion

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Karger: Nephrology

Most cited references 58

A brief conceptual tutorial of multilevel analysis in social epidemiology: linking the statistical concept of clustering to the idea of contextual phenomenon.

Timing of breastfeeding initiation and exclusivity of breastfeeding during the first month of life: effects on neonatal mortality and morbidity--a systematic review and meta-analysis.

Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis

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