Sociodemographic characteristics
All participants in this study were first time mothers living in Bahir Dar city. From423 eligible first time mothers, 400 were interviewed in this study which made the response rate 95.0%. The mean age of mothers was 26 years with standard deviation of (SD±4.08).More than half of participants (52.2%) were between the age of fifteen and twenty years old. More than two third of mothers were from Orthodox Christianity religion. Majority of study participants (87.3%) were from Amhara ethnic group. Regarding to educational status around one third of mothers (33%) were not educated at all while another one third of mothers (31.5%) were educated at college and above levels. The average household income of respondents who disclosed their household income was 3762 Ethiopian birr per month with standard deviation (SD±2136.48) (Table 1).
Maternal and infant health service utilization characteristics
Almost half of infants (53.5%) were male babies. More than half of infants were aged between 0-90 days. Majority of mothers (90.8%) attended antenatal care follow up and majority of mothers (60.2%) attended in health center. On the other hand, only one hundred thirty three (36.6%) attended more than three antenatal care visits. More than two third of mothers (76.3%) received breastfeeding counseling during their antenatal care visits. Regarding to delivery, majority (93.8%) of mothers delivered in health institution and majority 329(82.2%) of mothers were delivered by normal/spontaneous vaginal delivery (Table2).
Exclusive breastfeeding and related practices
Prevalence of exclusive breastfeeding practice a day (24hrs.) before the survey was 57.3 %( 95%CL: 52.3%, 62%).Among first time mothers who did not exclusively breastfeed, seventy two (18.3%) gave mixed feeding, sixty one (15.3%) gave predominant breastfeeding and thirty eight (9.5%) gave formula feeding to their infant. Majority (91.2%) of mothers gave colostrum to their infant. Among mothers who did not practice exclusively breast feeding, the main reasons mentioned were; lack of information about exclusive breastfeeding 133(33.8%), lack of time due to work demand 101(25.3%), insufficient breastfeeding 72(18%), breast complication 55 (13.5%) and maternal illness 37 (9.3%) (Table3).
Information, knowledge, barriers and supporting systems of exclusive breastfeeding
Regarding to knowledge and information about breastfeeding 316(79%) mothers were found to have adequate knowledge about breastfeeding while 344(86%) were informed about breastfeeding. For mothers who were informed about breastfeeding the main source of information mentioned were: television (49.5%), radio (20.3%), health extension workers (20%), volunteer health workers (5%) and friends/relatives (5.3%).Concerning breast problem, around two third of mothers (51.5%) faced some type of breast problem. Among mothers faced breast problems, the main problems faced were: mastitis (41.4%), abscess (32.9%) and sore/cracked nipples (25.7).Regarding to supporting system of mothers in infant care and breastfeeding, around 357(89.5%) were supported by their husband. Among employed mothers, less than half (44.5%) were supported by their organization .On the other hand, few mothers (13%) had got support from cultural system of their community (Table 4).
Factors associated with exclusive breastfeeding practice
First binary logistic regression analysis was carried out to select variables having association with EBF practice. Then, eight variables were retained for final model analysis. Sex of infant, maternal age, number of antenatal care visits, and husband support, informational status, breast problems and type of family were the independent predictors of exclusive breastfeeding.
From these independent predictors; current marital status, number of ANC visits, husband support, breast problem and type of family were significantly associated with exclusive breastfeeding practice in multivariable logistic regression analysis.
Husband support was significantly associated with exclusive breastfeeding practice. Mothers who were supported by their husband were more likely to practice exclusive breastfeeding (AOR 3.658, 95%CI: 2.132, 6.278) than their counter parts. Similarly, breast problem was significantly associated with exclusive breastfeeding. Mothers who did not face breast problems were more likely to practice exclusive breastfeeding (AOR 3.658, 95% CI: 2.132, 6.278) than mothers who faced breast problems. At the same time, current marital status was significantly associated with exclusive breastfeeding practice. Women who are not currently married were almost three times more likely to practice exclusive breastfeeding (AOR: 2.787,95 %CI 1.083, 7.171) than their counter parts.
Mothers who had four or more antenatal care follow up visits were almost 2.5 times more likely to feed breast milk their infants exclusively (AOR 2.512, 95%CI: 1.494, 4.233) than mothers who had less than three antenatal care follow up visits. In the same way, type of family was associated with exclusive breastfeeding practice. Mothers who had nuclear family were less likely almost by half to practice exclusive breastfeeding (AOR 0.48, 95%CI: 0.231, 1.001) than mothers who had extended family (Table 5).