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.

Keywords:

• Addis Ababa
• hazard ratio
• postnatal care
• survival analysis
• time to cessation of EBF

Abbreviations and acronyms

EBF, Exclusive Breast Feeding, ENA, Emergency Nutrition Assessment, EPI, Expanded Program for Immunization, FANTA, Food and Nutrition Technical Assistance, IYC, Infants and Young Children, IYCF, Infant and Young Child Feeding, UNICEF, United Nations Children Fund, WHO, World Health Organization.

Data Sharing Statement

The datasets used or analysed during the current study are available from the corresponding author upon reasonable request.

Acknowledgment

We thank Jimma University for giving us this opportunity. Our gratitude also goes to the Addis Ababa Kirkos sub-city health office, health facilities staff, and study participants.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests in this work.