Early Initiation of Breastfeeding and Associated Factors Among Mothers in Dire Dawa Hospitals, Eastern Ethiopia:

Institutional Based Comparative Study

Abstract

Background: Early initiation of breastfeeding is putting the newborn to the breast within one hour after birth. There is still a discrepancy in early initiation and no noticeable difference between vaginal and cesarean delivery mothers on early initiation of breastfeeding, despite there being bits of evidence on the proportion and associated factors of early initiation of breastfeeding in different parts of the country. So, the purpose of this study was to examine the extent of early breastfeeding initiation and its contributing factors between women who gave birth vaginally and by cesarean section.

Methods: An institutional-based comparative cross-sectional study was employed in Dire Dawa health facilities from December 2022 to January 2023. A total of 646 (323 vaginal and 323 cesareans delivered) mothers were selected using the systematic random sampling method. Data were collected using a pretested interviewer-administered questionnaire and entered into Epi Data version 3.1, and then exported to SPSS v. 23.0. Bi-variable and multivariable logistic regression analyses with a 95% confidence interval were employed. Variables with p<0.05 were identified as significant factors to the outcome variable.

Results: Early initiation of breastfeeding was higher among mothers who underwent vaginal delivery (83.5%, 95%CI: 79.0%-88.0%) than cesarean section (40.1%, 95%CI: 35.0%-46.0%) and it was positively associated with mothers from urban areas (AOR=2.50, 95%CI: 1.55-4.02), who had professional guidance to early initiation of breastfeeding (AOR=3.12, 95%CI: 1.79-3.51), had good knowledge (AOR=2.30, 95%CI:1.39-3.82), had husband support (AOR=5.19, 95%CI:3.06, 8.80), had labor pain less than 12 hours (AOR=3.21, 95%CI:1.80-5.39), and who did not fear COVID 19 (AOR=3.13, 95%CI:1.54, 6.37).

Conclusion: Early initiation of breastfeeding was more common among vaginally delivered mothers as compared to cesarean delivered mothers. Residence, professional guidance, knowledge, husband support, labor pain, and fear of COVID-19 were significantly associated with EIBF among vaginally and cesarean-delivered mothers. Community-based breastfeeding education and counseling to pregnant mothers and encouraging partner involvement in breastfeeding are recommended.