Predictors of discontinuing exclusive breastfeeding before six months among mothers in Kinshasa: a prospective study

Abstract

BackgroundAlthough breastfeeding is common in Democratic Republic of the Congo, the proportion of women who exclusively breastfeed their babies up to 6 months remains low. This study aimed at identifying predictors of discontinuing exclusive breastfeeding before six months among mothers in Kinshasa.MethodsA prospective study was carried out from October 2012 to July 2013 among 422 mother-child pairs recruited shortly after discharge from twelve maternities in Kinshasa and followed up to six months. Interviews were conducted at each woman’s house during the first week after birth, and at one, two, three, four, five and six months. Collected data included history of child’s feeding and mother’s socio-demographic and psychosocial characteristics. The Cox Proportional Model was used to identify predictors of discontinuing exclusive breastfeeding before six months.ResultsThe median duration of exclusive breastfeeding was 10.9 weeks (Inter Quartile Range 4.3 to 14.9). At six months, 2.8 % of infants were exclusively breastfed. The factors independently associated with the discontinuation of exclusive breastfeeding before six months were: not confident in the ability to breastfeed [Adjusted hazard ratio (AHR) = 3.90; 95 % CI 1.66, 9.16)], no plan on the duration of EBF (AHR = 2.86; 95 % CI 1.91, 4.28), breastfeeding problems during the first week (AHR = 1.54; 95 % CI 1.13, 2.11), low level of breastfeeding knowledge (AHR = 1.52; 95 % CI 1.08, 2.15), and experienced less than five Baby-friendly practices during the maternity stay (AHR = 1.47; 95 % CI 1.05, 2.06).ConclusionsConfidence in the ability to breastfeed and intention to exclusively breastfeed were the most important predictors of discontinuing exclusive breastfeeding before six months. To have a greater impact on the duration of exclusive breastfeeding, interventions should focus on these factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s13006-015-0044-7) contains supplementary material, which is available to authorized users.

Knowledge, Attitude and Practice towards Exclusive Breastfeeding among Lactating Mothers, Mizan Aman Town, Southwestern Ethiopia: Descriptive Cross Sectional Study

“…Our EBF findings were similar to a study in Addis Ababa, Ethiopia which found 29.3 % prevalence of EBF under six months [9], while it was higher than a study in Abha female educational district, Saudi Arabia in which EBF for 6 months was reported only by 8.3 % of participants (n = 32) [6] and a study in Kinshasa, Congo that found only 2.8 % of infants were exclusively breastfed (n =12) [7].…”

“…In Saudi Arabia only by 8.3 % (n = 32) of the 384 participants EBF for 6 months [6]. In a study in Congo, 87.5 % of infants were EBF during the maternity stay, but by six months, only 2.8 % (n = 12) of infants were exclusively breastfed [7]. In a study done in Nigeria, the majority (88.0 %) of the respondents had heard about EBF and hospital was the source of information, and more than 50 % of the women had a positive attitude towards breastfeeding [8].…”

Addressing barriers to exclusive breast-feeding in low- and middle-income countries: a systematic review and programmatic implications

“…Definitions of maternal knowledge of EBF varied across studies and included: maternal report of EBF definition and related benefits, recommendations and/or best practices. Only three studies found a significant association between maternal knowledge and EBF practices (12,23,24) . In Ethiopia, a large cross-sectional study found that mothers with low knowledge of breast-feeding 'best practices' had 3·4 times higher odds of non-EBF than mothers with high knowledge of breast-feeding best practices (12) .…”

“…Arusei et al (29) 151 Kenya Longitudinal X Aubel et al (57) 260 Senegal Mixed methods Babakazo et al (24) 422 DRC Cohort Chandrashekhar et al (11) 385…”

“…300 Nigeria and Ghana Cross-sectional X X X Afiyanti and Juliastuti (52) 18 Indonesia Qualitative X X X Aluko-Arowolo and Adekoya (30) 110 Nigeria Qualitative X Arusei et al (29) 151 Kenya Longitudinal Aubel et al (57) 260 Senegal Mixed methods X Babakazo et al (24) 422 DRC Cohort X Chandrashekhar et al (11) 385…”