Early initiation of breastfeeding and exclusive breastfeeding practices and associated factors among first-time mothers attending governmental maternal and child health clinics in Gondar town, Northwest Ethiopia: a mixed method study.

Abstract

Background: Early initiation of breastfeeding and exclusive breastfeeding are among those optimal breastfeeding practices endorsed by World Health Organization to reduce child morbidity and mortality. However, worldwide, less than half of the mothers practiced early initiation and exclusive breastfeeding including first-time mothers who need even more emphasis as their decision to initiate early and exclusively breastfeed their first child raises the likelihood of doing the same for the subsequent. This study aimed to assess early initiation and exclusive breastfeeding practices and associated factors among first-time mothers attending governmental maternal and child health clinics in Gondar town, Northwest Ethiopia.

Methods: A facility-based cross-sectional quantitative study on 885 first-time mothers selected by two-stage sampling complemented by a phenomenological qualitative study on 23 purposively chosen participants was conducted from February 24 to May 27, 2021. The quantitative study involved a pre-tested structured questionnaire and binary logistic regression was done for data analysis. The qualitative study involved in-depth interview, and the data was thematically analyzed.

Result: In this study, 74.7% (95% CI 71.8, 77.5) of the mothers practiced early initiation while 46.8% (95% CI 43.5, 50.1) of them breastfed exclusively. Vaginal delivery (AOR 5.63, 95% CI 3.64, 8.71), not giving prelacteal feeding (AOR 5.54, 95% CI 3.50, 8.78) and colostrum feeding (AOR 2.89, 95%CI 1.85, 4.52) were predictors of early initiation of breastfeeding. On the other hand; delivery at a health facility (AOR 3.13, CI 1.58, 6.18), number of PNC visits [1 visit (AOR 1.88, CI 1.27, 2.77), 2-3 (AOR 1.97, CI 1.25, 3.12) and ≥ 4 (AOR 3.61, CI 1.53, 8.54)], not giving prelacteal (AOR 2.14, CI 1.32, 3.48), husband's support (AOR 2.34, CI 1.13, 4.83) and health workers' support (AOR 4.34, CI 1.98, 9.53) were found to be determinants for exclusive breastfeeding which were also shown in the qualitative.

Conclusion: The magnitudes of early initiation and exclusive breastfeeding practices were lower than the national target and global recommendation for universal coverage plus most of the significant factors were maternal and child health service related factors. So, strengthening the services is crucial and the main focus should be on first-time mothers.