Zewdu Frieselam, Mekonnen Solomon, Atenafu Azeb
Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Nutrition Unit, University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.
Int Breastfeed J. 2025 Apr 8;20(1):27. doi: 10.1186/s13006-025-00718-4.
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.
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.
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.
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.
尽早开始母乳喂养和纯母乳喂养是世界卫生组织认可的最佳母乳喂养方式，有助于降低儿童发病率和死亡率。然而，在全球范围内，不到一半的母亲采取了尽早开始母乳喂养和纯母乳喂养的方式，其中初产妇尤其需要更多关注，因为她们决定尽早并纯母乳喂养第一个孩子，会增加对后续孩子也采取同样方式的可能性。本研究旨在评估埃塞俄比亚西北部贡德尔镇政府妇幼保健诊所的初产妇中尽早开始母乳喂养和纯母乳喂养的情况及相关因素。
2021年2月24日至5月27日，对885名通过两阶段抽样选取的初产妇进行了基于机构的横断面定量研究，并对23名有目的选择的参与者进行了现象学定性研究。定量研究采用预先测试的结构化问卷，并进行二元逻辑回归分析数据。定性研究采用深入访谈，并对数据进行主题分析。
在本研究中，74.7%（95%可信区间71.8, 77.5）的母亲尽早开始母乳喂养，而46.8%（95%可信区间43.5, 50.1）的母亲进行纯母乳喂养。阴道分娩（调整后比值比5.63，95%可信区间3.64, 8.71）、不进行初乳前喂养（调整后比值比5.54，95%可信区间3.50, 8.78）和进行初乳喂养（调整后比值比2.89，95%可信区间1.85, 4.52）是尽早开始母乳喂养的预测因素。另一方面，在医疗机构分娩（调整后比值比3.13，可信区间1.58, 6.18）、产后访视次数[1次（调整后比值比1.88，可信区间1.27, 2.77）、2 - 3次（调整后比值比1.97，可信区间1.25, 3.12）和≥4次（调整后比值比3.61，可信区间1.53, 8.54）]、不进行初乳前喂养（调整后比值比2.14，可信区间1.32, 3.48）、丈夫的支持（调整后比值比2.34，可信区间1.13, 4.83）和医护人员的支持（调整后比值比4.34，可信区间1.98, 9.53）被发现是纯母乳喂养的决定因素，定性研究中也有体现。
尽早开始母乳喂养和纯母乳喂养的比例低于国家目标和全球普遍覆盖的建议，而且大多数重要因素是与妇幼保健服务相关的因素。因此，加强这些服务至关重要，主要重点应放在初产妇身上。
