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.

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. Identify factors contributing early cessation of breastfeeding in a single centre of Eastern province Sri Lanka. 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. 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). 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.

Ranasinghe JC ，Madushika DS ，Abeysundara SP ，Agampodi SB ... -  《-》

Determinants of early cessation of exclusive breastfeeding practices among rural mothers from Jaffna District of Sri Lanka.

Sri Lanka is an upper-middle-income country with excellent health statistics. However, 2016 Demographic and Health Survey data have shown 82% and 64% of mothers exclusively breastfed infants aged 0-6 months and 4-5 months, respectively. The short duration of exclusive breastfeeding (EBF) has an impact on the growth and development of babies. Since no studies have been reported on EBF practices of the rural mothers in Jaffna District, an administrative district among 25 districts of Sri Lanka, this study aimed to assess the factors influencing the early cessation of EBF. For this community-based cross-sectional study, 338 mother-child pairs were selected from 2013-14. EBF was defined as children not receiving any food or drink, including complementary foods, formula milk or milk products except for medicines and vitamins or mineral drops, other than breast milk since birth. Socio-economic and demographic factors, the influence of the mode of delivery, and knowledge on EBF were obtained using an interviewer-administered questionnaire. The details of EBF and reasons for the cessation of breastfeeding before six months were obtained from a subgroup of mothers (n = 208). Multivariate analysis was performed to explore the correlates of breastfeeding. In this study, 71.2% (95% CI 64.5, 77.2) had practiced EBF for six months. Early discontinuation of EBF was practiced by employed mothers (AOR 4.3; 95% CI 1.3, 13.9), mothers of low birth weight babies (AOR 3.6; 95% CI 1.6, 8.2) and those who experienced Cesarean section birth (AOR 2.9; 95% CI 1.2, 6.9). The EBF practiced by mothers of rural Jaffna was not associated with the gender of the babies, type of family, number of children in a family, religion of the household, knowledge on EBF, or family income. The prevalence of EBF up to six months was low in rural Jaffna, and it was influenced by employment, birthweight of the babies, and the mode of delivery. To enhance EBF, the Regional Directorate of Health Service, Jaffna, should take necessary action with policymakers to increase maternity leave for at least six months, reduce the Cesarean section rate, and provide nutritional support to pregnant mothers.

Karthigesu K ，Balakumar S ，Arasaratnam V 《International Breastfeeding Journal》

Barriers for early initiation and exclusive breastfeeding up to six months in predominantly rural Sri Lanka: a need to strengthen policy implementation.

Agampodi TC ，Dharmasoma NK ，Koralagedara IS ，Dissanayaka T ，Warnasekara J ，Agampodi SB ，Perez-Escamilla R ... -  《International Breastfeeding Journal》

Effect of maternal employment on exclusive breastfeeding practice among mothers of infants 6-12 months old in Wolkite town, Ethiopia: a comparative cross-sectional study.

Exclusive breastfeeding (EBF) means providing only breast milk for infants for up to six months without the addition of solid or liquid matter. Even though EBF had great benefits for infants and mothers, the rate of EBF is so limited below the global target. In Ethiopia, the overall EBF practice is 59%. This low EBF practice had a great unexplained variation among employed and unemployed mothers. Therefore, this study aimed to compare EBF practice and associated factors among employed and unemployed mothers of infants aged 6-12 months in Wolkite town, Southern Ethiopia, 2020. A community-based comparative cross-sectional study was conducted in March 2020. A total sample of 485 (241 employed and 244 unemployed) study subjects was involved in the study. A simple random sampling technique was used to recruit study subjects. A pre-tested structured interviewer-administered questionnaire was used. Multivariable logistic regression was used to identify associated factors of EBF practice for the whole study participants and then for employed and unemployed mothers independently. The pooled prevalence of exclusive breastfeeding practice was 63.9% [95% CI (59.8-68.2%)]. Exclusive breastfeeding practice was 54.8% [95% CI (48.5-61.4%)] and 73% [95% CI (66.8-78.7%)] among employed and unemployed mothers respectively. Three or more years of a birth interval [AOR = 4.03; 95% CI (1.80-8.99)], three or more ANC visits [AOR = 5.39; 95% CI (1.49-19.45)], and having PNC service [AOR = 4.56; 95% CI (2.0-9.4)] significantly associated to exclusive breastfeeding practice among employed mothers. No history of breastfeeding counseling during ANC visits [AOR = 0.15; 95% CI (0.06-0.41)], had history of breast disease [AOR = 0.28; 95% CI (0.08-0.99)], three or more ANC visits [AOR = 5.11; 95% CI (1.66-15.8)], and having social support [AOR = 3.05; 95% CI (1.23-7.6)] significantly associated to EBF practice among unemployed mothers. Employment among mothers was found to discourage EBF practice. The predictors of exclusive breastfeeding practice are different for employed and unemployed. Therefore Policymakers and program planners are called to come together and create a conducive environment for lactating employees, and appropriate intervention at respective predictor variables is needed to enhance EBF practice.

Zewdie A ，Taye T ，Kasahun AW ，Oumer A ... -  《BMC Womens Health》

Maternal Perception of Adequacy of Mother's Milk Among Mothers Giving Birth at a Teaching Hospital in Sri Lanka.

Rodrigo R ，Rodrigo A ，Liyanage N ，Hatahagoda W ，Hewavitharana U ... -  《-》