Time to early cessation of exclusive breast feeding and associated factors among 6-12 months old children: Survival analysis.

Abstract

WHO and UNICEF (1990) have recommended EBF for six months, followed by an introduction of complementary foods at the age of six months with continued breastfeeding for the first 24 months or more. Exclusive breastfeeding (EBF) during the first 6 months of life reduces infant morbidity and mortality. According to Ethiopia Demographic Health Survey (DHS), only 58% of children were exclusively breastfed during the first 6 months of age. The study aimed to identify time to early cessation of EBF and associated factors among 6-12 months old children in Lanfuro Woreda, Silte Zone. A community-based cross-sectional study was conducted in Lanfuro Woreda, Silte Zone, from March to April 2017. A total of 636 mothers with 6-12 months old infants from ten randomly selected kebeles were included. Both quantitative and subjective information assortment techniques were utilized. The Kaplan-Meier curve with log-rank test was used to compare the survival difference by the selected covariates. Both bivariate (P<0.25) and multivariable (P<0.05) Cox Proportional Hazards model were fitted to identify factors predicting time to early cessation of EBF. The median duration of exclusive breastfeeding was 6.22 months. The highest proportion of cessation of exclusive breastfeeding occurred during the first four to five months. Early cessation of exclusive breastfeeding was observed in 295 (48%). Place of residence (AHR: 1.6; 95% CI=1.14-2.20), knowledge on EBF (AHR=1.31; 95% CI=1.02-1.68), type of delivery (AHR: 2.41; 95% CI=2.24-3.68), pre-lacteal feeding (AHR=1.8; 95% CI=1.32-2.36) and household food insecurity (AHR=5.02; 95% CI=3.89-6.50) were significant independent factors which were associated with time to early cessation of exclusive breastfeeding. There are still sizable proportions of children not enjoying exclusive breastfeeding for the first full six months. Being an urban resident and coming from food-insecure households, giving birth by CS, having low knowledge on EBF, and giving pre-lacteal feeding were factors associated with time to early cessation of EBF. Multi-sectoral action should be taken for respective predictors of time to early cessation of EBF.