Exclusive breast feeding is the strongest predictor of infant survival in Northwest Ethiopia: a longitudinal study

Abstract

Despite the overall national success in reducing infant mortality rate in Ethiopia, infant mortality rate is still high in northwest Amhara region. This study is conducted in one of the high mortality areas with the aim of identifying risk factors that are associated with infant mortality in Northwest Amhara Region, Ethiopia. A prospective open cohort study involving 1752 infants (1472.4518 person years of follow-up) was undertaken from November 2009 to August 2011. Kaplan-Meier Survival analysis was used to estimate infant mortality rate. Risk factors associated with infant mortality were assessed using multivariate Poisson regression. The overall infant mortality rate was 88 per 1000 person-years (95% CI: 74.3, 104.9). After controlling other important predictors in multivariate Poisson regression, infants not exclusively breastfed [IRR = 7.86, 95% CI: (5.11, 12.10), )], breast milk initiated after 24 hours of birth [IRR = 4.84,95% CI: (2.94,7.99)], mothers not washing hands with soap after visiting toilet and before feeding child [IRR = 4.61, 95% CI: (2.24, 9.48)], being rural residents [IRR = 2.33, 95% CI: (1.12, 4.88)], infants born within 24 months for the previous birth [IRR = 2.79, 95%CI: (1.88, 4.15)], have increased the risk of infant mortality. In conclusion, exclusive breast feeding is the strongest predictor of infant survival in this predominantly rural setting where hygienic standards are poor. Supporting mothers to exclusively breast feeding which is cost effective, safe and feasible strategy, can help reduce infant mortality in the study setting.

Exclusive breastfeeding and associated factors among mothers in Gozamin district, northwest Ethiopia: a community based cross-sectional study

“…In the study in Dabat, family income was not a significant predictor for EBF practice [19], while it was statistically associated with EBF according to a study done in Awi Zone, northwest Ethiopia [21]. …”

Childhood Mortality: Trends and Determinants in Ethiopia from 1990 to 2015—A Systematic Review

“…Mothers who did not use soap for hand washing had higher infant death than those who used soap [39]. Infants whose mothers were not washing their hands with soap after visiting toilet and before feeding child had high mortality rate than their counterparts [IRR = 4.61, 95% CI: (2.24, 9.48)] [32]. In terms of etiological fractions, a greater number of U5M could be ascribed to parental compared to environmental conditions, with relatively more infants being affected than children [19].…”

“…The likelihood of death among children who were not breastfed was 6 times higher compared to their counterparts [23]. Infants not exclusively breastfed and given breast milk after 24 hours of birth had higher mortality than their counterparts with IRR = 7.86, 95% CI: (5.11, 12.10) and IRR = 4.84, 95% CI: (2.94, 7.99), respectively [32]. A community based study done using verbal autopsy method in Gondar revealed that malnutrition is one of the causes of childhood mortality [33].…”

Knowledge and attitudes of puerperal women relating to breastfeeding in a university hospital

“…Thus, the discussion of these variables can reveal cultural trends of a population group as regards BF (SILVA, 2013;BIKS, 2015;SALUSTIANO, 2012).…”