Higher educational and economic status are key factors for the timely initiation of breastfeeding in Ethiopia: A review and meta-analysis.

Publisher: Wiley-Blackwell Country of Publication: Norway NLM ID: 9205968 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1651-2227 (Electronic) Linking ISSN: 08035253 NLM ISO Abbreviation: Acta Paediatr Subsets: MEDLINE

Publication: 2007- : Oslo : Wiley-Blackwell
Original Publication: Oslo : Scandinavian University Press, c1992-

Breast Feeding* ; Economic Status*; Educational Status ; Ethiopia ; Female ; Humans ; Pregnancy ; Socioeconomic Factors

Aim: To investigate the association between initiation of breastfeeding within 1 hour after birth (TIBF) and maternal educational status, paternal educational status, household income, marital status, media exposure and parity in Ethiopia.
Methods: We searched PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases. All studies were conducted in Ethiopia and published from 2000 to 2019 were included. To obtain the pooled odds ratio (OR), data were fitted in random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ ² and I ² statistics. This meta-analytic review was reported in compliance with the PRISMA statement.
Results: Out of 553 studies retrieved, 25 fulfilled our inclusion criteria. High maternal educational status (P < .001), paternal educational status (P = .001) and household income (P = .002), being married (P = .001) and multiparity (P = .01) were significantly associated with TIBF. There was no significant publication bias.
Conclusions: Our meta-analysis showed that TIBF was associated with high educational and economic status, being married and multiparity. This suggests that the meta-analysis detected small associations that many previous studies in Ethiopia have not been able to show. Our findings can be useful for comparisons with other countries.
(© 2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

WHO, UNICEF, USAID, AED, UCDAVIS, IFPRI. Indicators for assessing infant and young child feeding practices: part 1: definitions. 2008.
Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380:2224-2260.
Khan J, Vesel L, Bahl R, Martines JC. 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. Matern Child Health J. 2015;19:468-479.
Lauer JA, Betrán AP, Barros AJ, de Onís M. Deaths and years of life lost due to suboptimal breast-feeding among children in the developing world: a global ecological risk assessment. Public Health Nutr. 2006;9:673-685.
Kebede T, Woldemichael K, Jarso H, Bekele BB. Exclusive breastfeeding cessation and associated factors among employed mothers in Dukem Town, Central Ethiopia. Int Breastfeed J. 2020;15:1-10.
Ethiopian Public Health Institute (EPHI) [Ethiopia] and ICF. Ethiopia mini Demographic and Health Survey 2019: key Indicators. Rockville, Maryland: EPHI and ICF;2019: 1-35.
Ethiopia Federal Ministry of Health. Ethiopian National Strategy for Infant and Young Child Feeding (IYCF). Addis Ababa, Ethiopia: Federal Ministry of Health, Family Health Department;2004;1-21.
Federal Democratic Republic of Ethiopia Ministry of Health. Health Sector Transformation Plan (HSTP ) 2015/16-2019/20 (2008-2012 EFY). Addis Ababa, Ethiopia: Federal Ministry of Health; 2015: 1-184.
Federal Democratic Republic of Ethiopia. National Nutrition Program 2016-2020. Addis Ababa, Ethiopia: Federal Ministry of Health;2016: 1-94.
World Health Organization. Babies and mothers worldwide failed by lack of investment in breastfeeding. Saudi Med J. 2017;38:974-975.
Alzaheb RA. A review of the factors associated with the timely initiation of breastfeeding and exclusive breastfeeding in the Middle East. Clin Med Insights Pediatr. 2017;11:1-15.
Sharma IK, Byrne A. Early initiation of breastfeeding: a systematic literature review of factors and barriers in South Asia. Int Breastfeed J. 2016;11:1-12.
Habtewold T, Mohammed S, Endalamaw A, et al. Breast and complementary feeding in Ethiopia: new national evidence from systematic review and meta-analyses of studies in the past 10 years. Eur J Nutr. 2018;58:2565-2595.
Habtewold TD, Sharew NT, Alemu SM. Evidence on the effect of gender of newborn, antenatal care and postnatal care on breastfeeding practices in Ethiopia: a meta-analysis and meta-regression analysis of observational studies. BMJ Open. 2019;9:1-19.
Alemu SM, Alemu YM, Habtewold TD. Association of age and colostrum discarding with breast-feeding practice in Ethiopia: systematic review and meta-analyses. Public Health Nutr. 2019;22:2063-2082.
Habtewold TD, Islam MA, Sharew NT, Mohammed SH, Birhanu MM, Tegegne BS. SystEmatic review and meta-aNAlysis of infanT and young child feeding practices (ENAT-P) in Ethiopia: protocol. BMJ Open. 2017;7:1-6.
Moher D, Liberati A, Tetzlaff J, Altman DG; Prisma Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine. 2009;6:1-6.
Tsumoto S, Hirano S. Formal analysis of leave-one-out methods based on decremental sampling scheme. 2014;2:371-8.
Demilew YM, Tafere TE, Abitew DB. Infant and young child feeding practice among mothers with 0-24 months old children in slum areas of Bahir Dar city, Ethiopia. Int Breastfeed J. 2017;12:1-9.
Belachew A. Timely initiation of breastfeeding and associated factors among mothers of infants age 0-6 months old in Bahir Dar city, Northwest, Ethiopia, 2017: a community based cross-sectional study. Int Breastfeed J. 2019;14:1-6.
Ayalew T, Tewabe T, Ayalew Y. Timely initiation of breastfeeding among first time mothers in Bahir Dar city, Northwest, Ethiopia, 2016. Pediatr Res. 2019;85:612-616.
Tamir. Assessment of optimal breastfeeding among working and stay-at-home mothers in Bahir Dar town Amhara regional state, North West of Ethiopia. 2010.
Woldemichael B, Kibie Y. Timely initiation of breastfeeding and its associated factors among mothers in Tiyo Woreda, Arsi zone, Ethiopia: a community-based cross sectional study. Clinics Mother Child Health. 2016;13:1-6.
Deregh. Breastfeeding practices among mothers of babies admitted to NICU, TAH, Addis Ababa, and factors influencing practice. 2012.
Tamiru D, Tamrat M. Constraints to the optimal breastfeeding practices of breastfeeding mothers in the rural communities of Arba Minch Zuria Woreda, Ethiopia: a community-based, cross-sectional study. S Afr J Clin Nutr. 2015;28:134-139.
Tamiru D, Belachew T, Loha E, Mohammed S. Sub-optimal breastfeeding of infants during the first six months and associated factors in rural communities of Jimma Arjo Woreda, Southwest Ethiopia. BMC Public Health. 2012;12:1-9.
Mekonen L, Seifu W, Shiferaw Z. Timely initiation of breastfeeding and associated factors among mothers of infants under 12 months in South Gondar zone, Amhara regional state, Ethiopia; 2013. Int Breastfeed J. 2018;13:1-8.
Setegn T, Gerbaba M, Belachew T. Determinants of timely initiation of breastfeeding among mothers in Goba Woreda, South East Ethiopia: a cross sectional study. BMC Public Health. 2011;11:1-7.
Liben ML, Yesuf EM. Determinants of early initiation of breastfeeding in Amibara district, Northeastern Ethiopia: a community based cross-sectional study. Int Breastfeed J. 2016;11:1-7.
Lakew Y, Tabar L, Haile D. Socio-medical determinants of timely breastfeeding initiation in Ethiopia: evidence from the 2011 nation wide demographic and health survey. Int Breastfeed J. 2015;10:1-6.
Beyene MG, Geda NR, Habtewold TD, Assen ZM. Early initiation of breastfeeding among mothers of children under the age of 24 months in Southern Ethiopia. Int Breastfeed J. 2017;12:1-9.
Berhe H, Mekonnen B, Bayray A, Berhe H. Determinants of breast feeding practices among mothers attending public health facilities, Mekelle, Northern Ethiopia; a cross sectional study. Int J Pharm Sci Res. 2013;4:650-660.
Alemayehu M, Abreha K, Yebyo H, Zemichael K, Gebremichael H. Factors associated with timely initiation and exclusive breast feeding among mothers of Axum town, Northern Ethiopia. Science Journal of Public Health. 2014;2:394-401.
Ekubay M, Berhe A, Yisma E. Initiation of breastfeeding within one hour of birth among mothers with infants younger than or equal to 6 months of age attending public health institutions in Addis Ababa, Ethiopia. Int Breastfeed J. 2018;13:1-7.
John JR, Mistry SK, Kebede G, Manohar N, Arora A. Determinants of early initiation of breastfeeding in Ethiopia: a population-based study using the 2016 demographic and health survey data. BMC Pregnancy Childbirth. 2019;19:1-10.
Derso T, Biks GA, Tariku A, et al. Correlates of early neonatal feeding practice in Dabat HDSS site, Northwest Ethiopia. Int Breastfeed J. 2017;12:1-7.
Gultie T, Sebsibie G. Determinants of suboptimal breastfeeding practice in Debre Berhan town, Ethiopia: a cross sectional study. Int Breastfeed J. 2016;11:1-8.
Adugna DT. Women's perception and risk factors for delayed initiation of breastfeeding in Arba Minch Zuria, Southern Ethiopia. Int Breastfeed J. 2014;9:1-8.
Tilahun G, Degu G, Azale T, Tigabu A. Prevalence and associated factors of timely initiation of breastfeeding among mothers at Debre Berhan town, Ethiopia: a cross-sectional study. Int Breastfeed J. 2016;11:1-9.
Musa SA. Vaginal delivery and maternal knowledge on correct breastfeeding initiation time as predictors of early breastfeeding initiation: Lesson from a community-based cross-sectional study. ISRN Epidemiology. 2014;2014:1-7.
Tariku A, Biks GA, Wassie MM, Worku AG, Yenit MK. Only half of the mothers practiced early initiation of breastfeeding in Northwest Ethiopia, 2015. BMC Res Notes. 2017;10:1-7.
Regassa N. Infant and child feeding practices among farming communities in Southern Ethiopia. Kontakt. 2014;16:e215-e222.
Tewabe T. Timely initiation of breastfeeding and associated factors among mothers in Motta town, East Gojjam zone, Amhara regional state, Ethiopia, 2015: a cross-sectional study. BMC Pregnancy Childbirth. 2016;16:1-7.
Hoche S, Meshesha B, Wakgari N. Sub-optimal breastfeeding and its associated factors in rural communities of Hula district, Southern Ethiopia: a cross-sectional study. Ethiop J Health Sci. 2018;28:49-62.
Hailemariam TW, Adeba E, Sufa A. Predictors of early breastfeeding initiation among mothers of children under 24 months of age in rural part of West Ethiopia. BMC Public Health. 2015;15:1-6.
Bimerew A, Teshome M, Kassa GM. Prevalence of timely breastfeeding initiation and associated factors in Dembecha district, North West Ethiopia: a cross-sectional study. Int Breastfeed J. 2016;11:1-8.
Acharya P, Khanal V. The effect of mother’s educational status on early initiation of breastfeeding: further analysis of three consecutive Nepal demographic and health surveys. BMC Public Health. 2015;15:1-12.
Patel A, Banerjee A, Kaletwad A. Factors associated with prelacteal feeding and timely initiation of breastfeeding in hospital-delivered infants in India. J Hum Lact. 2013;29:572-578.
Senarath U, Dibley M, Agho K. Breastfeeding practices and associated factors among children under 24 months of age in Timor-Leste. Eur J Clin Nutr. 2007;61:387-397.
Ogbo FA, Eastwood J, Page A, et al. The impact of sociodemographic and health-service factors on breast-feeding in Sub-Saharan African Countries with high diarrhoea mortality. Public Health Nutr. 2017;20:3109-3119.
Silveira RBD, Albernaz E, Zuccheto LM. Fatores associados ao início da amamentação em uma cidade do sul do brasil. Rev Bras Saude Mater Infant. 2008;8:35-43.
Esteves TMB, Daumas RP, Oliveira MICd, Andrade CAdFd, Leite IC. Factors associated to breastfeeding in the first hour of life: systematic review. Rev Saude Publica. 2014;48:697-708.
Joshi C, Torvaldsen S, Hodgson R, Hayen A. Factors associated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data. BMC Pregnancy Childbirth. 2014;14:1-11.
Gibson-Davis CM, Brooks-Gunn J. The association of couples’ relationship status and quality with breastfeeding initiation. Journal of Marriage and Family. 2007;69:1107-1117.
Li R, Darling N, Maurice E, Barker L, Grummer-Strawn LM. Breastfeeding rates in the United States by characteristics of the child, mother, or family: the 2002 national immunization survey. Pediatrics. 2005;115:e31-e37.
Seltzer JA. Families formed outside of marriage. J Marriage Fam. 2000;62:1247-1268.
Mallik S, Dasgupta U, Naskar S, Sengupta D, Choudhury K, Bhattacharya S. Knowledge of breast feeding and timely initiation of it amongst post natal mothers: an experience from a baby friendly teaching hospital of a metropolitan city. IOSR J Dent Med Sci. 2013;4:25-30.
Li R, Scanlon KS, Serdula MK. The validity and reliability of maternal recall of breastfeeding practice. Nutr Rev. 2005;63:103-110.
World Health Organization, UNICEF. Global Strategy for Infant and Young Child Feeding. Geneva, Switzerland: World Health Organization;2003;1-37.

Keywords: Ethiopia; breastfeeding; breastfeeding initiation; breastmilk; meta-analysis; systematic review

Date Created: 20200403 Date Completed: 20210514 Latest Revision: 20220531

20250114

10.1111/apa.15278

32239528