Abstract
Background
According to the World Breastfeeding Trends Initiative, Sri Lanka ranked as number one and only country to achieve green status. Exclusive breastfeeding (EBF) for six months is current practice with a rate of 75.5% among 0–5 months.
Aim
Identify factors contributing early cessation of breastfeeding in a single centre of Eastern province Sri Lanka.
Methods
A descriptive cross-sectional study conducted in Sammanthurai Medical officer of Health area. Consecutive mother-infant days with the infant ageing < 6 months were included from 25 public health midwife areas using an interviewer administered questionnaire. Missing values imputed using ‘missForest’ algorithm.
Results
The mean age of the sample was 28.4(SD ± 5.6). Of the 257 mothers recruited, 15(5.8%) were teenagers and 42(16.3%) > 35 years. 251(97.6%) had children 1–5 and 86(33.5%) were first born. 140 (54.5%) had tertiary education, 28 (10.9%).31(12.1%) were employed. EBF rates 0–6 months was 79.8% (n = 205). 239(93.0%) started breastfeeding within an hour. EBF was not associated with maternal age, birth order or income. 18 employed mothers and 186 unemployed mothers continued EBF. Regarding the factors associated with EBF, having a tertiary education (p < .001), being employed (p = .004) and having less than 3 children (p = .03) were associated with non-exclusive breastfeeding. Tertiary education was the significant predictor of non-exclusive breastfeeding in this population with an odds ratio of 4.50 (95% CI 1.331–15.215).
Conclusion
Employment identified as a risk factor for early cessation of EBF needs well planned further research to overcome this practical issue. Also might need revision of workplace policies, establishment of lactation areas in office premises to overcome some of these issues.
Significance
It was noted that early cessation of exclusive breastfeeding is a long term problem in this community. One fifth started complementary food before the recommended 6 months of age. Maternal employment, level of education, and use of pacifiers were identified as clear risk factors for early cessation of breastfeeding. The national policy planning to amalgamate disparities of EBF and duration of maternity leave, changes in newborn care guidelines tailored to specific areas considering local cultural beliefs, breastfeeding at the workplace policies, regulations on breast feeding hour, establishment of lactation areas in office premises, needs to be addressed by the policy makers.
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Data Availability
All data reported in the manuscript.
Code Availability
Not applicable.
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Acknowledgements
We acknowledge Public health midwives in MOH Sammanthurai and Dr M M M Shabeer, Dr A Risfan from Base Hospital Sammanthurai. Dr Emmie Causion for support with manuscript preparation.
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JCR: Conceptualization, Investigation, Methodology, Project Administration, Resources, Supervision, Writing—Review & Editing, Approved final manuscript. MDS and Data Curation, software, Resources, Validation, Visualization, Approved final manuscript. ASP: Data Curation, Formal Analysis, review and editing final manuscript, Approved final manuscript. SBA: Conceptualization, Investigation, Methodology, Project Administration, Supervision, Writing—Review & Editing, Approved final manuscript.
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Ranasinghe, J.C., Madushika, D.S., Abeysundara, S.P. et al. Challenges of Continuation of Exclusive Breast Feeding up to 6 Months in a Setting with High Exclusive Breast Feeding Rates Reported. Experience from Eastern Province of Sri Lanka. Matern Child Health J 27, 1996–2001 (2023). https://doi.org/10.1007/s10995-023-03724-2
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DOI: https://doi.org/10.1007/s10995-023-03724-2