our study revealed that Breastfeeding practices were sub-optimal in the study setting due to the delayed initiation of breast feeding. The prevalence of timely initiation breast feeding in Mizan-Aman town is found to be 64.5%. This figure is consistent with study findings which were conducted in Debre Berhan town, Kenya, Lesotho and Jamaica (62.6%, 62.2%, 65.3% and 64.7% respectively) [16, 11, 17, 21].
The practice of early initiation of breast feeding in our study area was higher than study from in Zimbabwe (58.3%) ,south Gondar (54.7%),Axum Town (41.6%) and Goba district (52.4%) respectively[17, 18, 19, 20].this difference could be due to study setting, some of them were from rural side, population character, when the study subjects are those mother of children more than 6 months of age they might not recall well when to start to initiate breast feeding, information and health service utilization and socio economic difference between the referenced subject and the study place.
Higher rate of timely initiation of breast feeding was reported from Malawi (76.9%) [21], Bahirdar city (75.4%) [22], Debre Tabor town (76.8%) [23] and Motta town (76.8%) respectively [21, 22, 23, 24]. the difference might be due to methodological difference, socioeconomic, cultural difference and access to health service.
Mothers’ income level between 1001–1500 Eth Birr were two times (AOR: 95% CI: 1.115, 4.368) more likely initiated breast feeding within one hour than mothers’ income > 1500 Eth Birr. While, this study is contradicted with Debre Berhan town [16], those mothers’ income level > 1969 Eth Birr were more likely initiated early breast feeding. This difference might be due to having higher income and being sophisticated city women, empowers the women to make medical decision. they can afford and prefers elective Cesarean section delivery in order to avoid labor pain. This in turns leads to delayed initiation of breast feeding. Indeed, this is supported by evidence in this study, gov’t employee and merchant mother by occupation, the majority of them have gotten > 1500 ETH Birr/month, were 0.074 (AOR: 95% CI: .006, .867) and 0.079 (AOR: 95% CI: .007, .933) less likely to initiate breast feeding within one hour.
Our study revealed that the odds of timely initiation of breast feeding among primipara mothers were two times (AOR = 2.002 ,95% CI: 1.241, 3.229) higher than their counterpart. This is similar with report from Malawi [21], while contradicted with report from south Gondar [16]. Since primipara mothers are less experienced, might fear of complication. Therefore, for the sake of their infant health, they might seek frequent medical advice from the care providers. This implies that having good level of information about newborn care will result putting their newborn to breast early.
Our study showed that the odds of early initiation of breast feeding among home delivered mothers were nearly three times (AOR = 2.755, 95% CI: 1.237, 6.135) higher than as compared as had institutional delivery. This is contradicted with report from Gurage zone Gunchere woreda [25], Arsi Tiyo woreda [26], Malawi [21], Bahirdar city [22] and Motta town [24], respectively. This might be due to more births take place in health institutions with skilled providers doesn’t mean necessarily will result optimal breast-feeding practice. Rather, missed opportunities, having less committed skilled attendant and having not appropriately trained staff with essential newborn care will result negative effect between institutional delivery and early initiation of breast feeding. This implies that quality of care should be improved in order to have positive relation between institutional delivery and putting newborns to breast within one-hour practice.
Strength and limitation of the study
This study is a community based and tried to represent and made generalization by involving relatively adequate number of study subject. Tried to reduce recall bias by involving only those mother of infant age less than 6 months. But it will share the cross-sectional design limitations.