Factors Associated with Time to Cease Exclusive Breastfeeding Among Infants Aged 6–9 Months, Kirkos Sub-City, Addis Ababa, Ethiopia: Survival Analysis

Abstract

Introduction: Notwithstanding the World Health Organization’s (WHO) guideline for exclusive breastfeeding (EBF) for the first six months of an infant’s life, its prevalence remains low in both developed and developing countries. Although breastfeeding is widely practiced in Ethiopia, only 59% of the children under the age of six months were exclusively breastfed. Objective: This study aimed to assess the time to cessation of EBF and associated factors among infants aged 6–9 months in health facilities under Kirkos sub-city, Addis Ababa, Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 287 mothers attending Kirkos sub-city health facilities from September 1 to 30, 2020. Bivariable and multivariable Cox regression models were fitted to identify factors associated with the time to cessation of EBF. Results: According to this finding, the median period for EBF discontinuation was 6 months. Early cessation of EBF was 130 (45.8%) days. Mothers with average household monthly income <15 USD [AHR, 5.31 (95% CI: 2.82, 9.99)] and 15–30 USD [AHR, 2.59 (95% CI: 1.41, 4.77)], EBF counseling at post-natal care [AHR, 0.18 (95% CI: 0.10, 0.31)], media access [AHR, 1.67 (95% CI: 1.06, 2.63)], child comorbidity [AHR, 0.51 (95% CI: 0.29, 0.88)], bottle feeding [AHR, 3.28 (95% CI: 2.14 5.01)], unfavorable attitude towards EBF [AHR, 3.59 (95% CI: 2.02, 6.40)] were significant factors associated with the hazard of cessation of EBF. Conclusion: In this investigation, the cumulative survival probability of EBF to 6 months was 45.8%, with a median duration of 6 months (95% CI 5.83–6.18) months. Unfavorable attitudes, child comorbidity, and bottle feeding were factors associated with earlier cessation of EBF. Media access, household monthly higher income, and EBF counseling at postnatal care were factors associated with prolonged EBF. As a result, supporting behavioral change and media access for effective communication on EBF duration practice following the established standard should be targeted during both ante-natal and post-natal care visits.