Exclusive Breastfeeding Continuation and Associated Factors Among Employed Women in North Ethiopia: A Cross-sectional Study
Abstract Background: Exclusive Breastfeeding (EBF) can prevent up to 13% of under-five mortality in developing countries. In Sub-Saharan Africa the rate of EBF at six months remains very low at 36%. Different types of factors such as maternal, family-related and work-related factors are responsible for the low rate of EBF among employed women. This study aimed to assess the prevalence of EBF continuation and associated factors among employed women in North Ethiopia. Methods: A community-based, cross-sectional study was conducted in two towns of Tigray region, North Ethiopia. Employed women who had children between 6 months and 2 years were surveyed using multistage, convenient sampling. Women filled a paper-based validated questionnaire adopted from Breastfeeding and Employment Study toolkit. The questions were grouped into four parts of sociodemographic characteristics, maternal characteristics, family support and work-related factors. Factors associated with EBF continuation as a binary outcome (yes/no) were determined using multivariate logistic regression. Results: Four-hundred and forty-nine women participated in this study with a mean (SD) age 30.4 (4.2) years. Two hundred and fifty-four (56.4%) participants exclusively breastfed their children for six months or more. The main reason for discontinuation of EBF was the requirement of women to return to paid employment (31.5%). Four-hundred and forty (98.2%) participants believed that breastfeeding has benefits either to the infant or to the mother. Three hundred and seventy-one (82.8%) of the participants received support from their family at home to assist with EBF most commonly from their husbands and mothers. Having family support (adjusted odds ratio [AOR]= 2.1, 95%, CI 1.2-3.6; P = 0.005), having frequent breaks at work (AOR= 2.6, 95% CI, 1.4-4.8; P = 0.002) and the possibility of buying or borrowing required equipment for expressing breast milk (AOR= 1.7, 95% CI, 1.0-3.0; P = 0.033) were statistically associated with increasing chance of EBF. Conclusion: Although returning to work was reported by the study participants as the main reason for discontinuation of EBF, families and managers’ support have significant roles in EBF continuation which in the absence of six-month maternal leave for employed women in Ethiopia would be of benefit to mothers and their child.