Vaginal Delivery and Maternal Knowledge on Correct Breastfeeding Initiation Time as Predictors of Early Breastfeeding Initiation: Lesson from a Community-Based Cross-Sectional Study

Background. Early initiation of breastfeeding is a recommended practice by the World Health Organization (WHO), but in Ethiopia only 52% of the mothers practiced early initiation of breastfeeding. Hence, this study aimed to assess prevalence of early initiation of breastfeeding and the associated factors among mothers in Bahir Dar City, northwest Ethiopia. Methods. A community-based cross-sectional study was conducted among mothers who delivered 12 months before the study began in Bahir Dar City, northwest Ethiopia. A cluster sampling technique was used to select a sample of 819 participants. Bivariate and multivariate analyses were performed. Results. In this study, the prevalence of early initiation was found to be 87.0%. On multivariate logistic regression, delivering vaginally (AOR = 7.37, 95% CI = 4.24, 13.82) and being knowledgeable on correct initiation time (AOR = 6.08, 95% CI = 3.71, 9.95) were found to be independent predictors of early initiation. Conclusions. Prevalence of early initiation of breastfeeding in Bahir Dar city is relatively good but still lower than the national plan. Delivering vaginally and being knowledgeable on correct initiation time were significantly associated with early initiation. Increasing maternal knowledge on correct initiation and providing adequate pain relief and early assistance for mothers who gave birth by C/S were recommended. 1. Background Breastfeeding (BF) is an unequalled way of providing ideal food for the healthy growth and development of infants [1]. As per the WHO recommendation, breastfeeding should be initiated early and exclusive breastfeeding should be continued for the first six months of life to achieve optimal growth, development, and health [2–4]. A report from Ghana indicated that the risk of death as a result of infection increased with increasing delay in initiation of breastfeeding; overall late initiation was associated with a 2.6-fold risk [5]. Another study also reported the importance of early breastfeeding initiation in reducing neonatal mortality [6]. Additionally, early initiation of breastfeeding and continued EBF for the first six months have been found to have beneficial effect in improving vaccine response [7]. Malnutrition has been responsible for about 45% of 6.6 million deaths annually among children under five worldwide. The vast majority of this malnutrition related deaths are often associated with inappropriate feeding practices [8]. Global risk assessment of suboptimal breastfeeding indicates that 96% of all infant deaths in developing countries that are attributable to