Factors associated with exclusive breastfeeding duration among lactating mothers in selected health centers in Nairobi County, Kenya

Abstract

Background: Exclusive breastfeeding (EBF) for six months bestows many benefits to the infant and the mother and is recommended by the WHO. Many infants in Kenya are introduced to mixed feeding earlier than recommended resulting in a low duration of EBF. Broad objective: To assess the duration of exclusive breastfeeding and investigate the factors influencing the duration of EBF amongst mothers with infants between six and nine months of age in Nairobi. Methods: A cross-sectional study design was used. Three health facilities in Nairobi County were sampled. A total of 194 mothers with children six to nine months of age were interviewed using an interviewer administered questionnaire with closed and open ended questions. Data analysis was done using the Statistical Package for Social Sciences software (SPSS) version 21. Descriptive statistics were generated, Chi-square test and Fisher’s exact test was done for relationships of variables. Logistic regression was done to establish the relationship between EBF and various explanatory variables. P value set at < 0.05 was used to interpret the significance of the statistical tests. Results: The mean age of the mothers was 27.2 ±5.2 (95% CI 26.450-28.000). Most mothers (82.5%) were married, while 15.5% had never been married. A majority (79.3%) had attained secondary school and above level of education. The median duration of reported EBF based on continuous breastfeeding since birth to six months, was found to be six months. The prevalence of continuous exclusive breastfeeding since birth to six months was 68.0% (95% CI; 60.800-74.700). In bivariate Chi-square and Fisher’s exact test analysis, maternal knowledge that breast milk alone can sustain the baby for six months (P-value =0.001), breastfeeding problems which had interfered with breastfeeding (P=0.006) and confidence that breast milk alone would be adequate for six months (P=0.007) had significant associations with EBF duration. In multivariate logistic regression analysis, breastfeeding problems which interfered with breastfeeding (OR: 0.151, 95% CI: 0.042-0.542, P=0.004) and confidence that breast milk alone without even water can sustain the baby for six months (OR: 4.885, 95% CI: 1.592-14.985, P=0.006) were significantly associated with EBF duration. After controlling for pre-lacteal feeding, maternal breastfeeding problems that interfered with breastfeeding (AOR: 0.166, P=0.012), and maternal confidence that breast milk alone can sustain the baby for six months (AOR: 17.641, P=0.018) were retained as predictors for a longer EBF duration. Conclusion: The median duration of EBF in this study was found to be six months. The factors that influenced the duration of EBF were maternal knowledge that breast milk alone was adequate for the infant for six months, maternal confidence that breast milk alone without even water can sustain the baby for six months and maternal breast problems that influenced breastfeeding. Recommendations: There is need by health workers in the study area to scale up education of mothers to ensure they fully understand all the EBF practices, it’s adequacy for the infant for six months and all the benefits to continue improving maternal confidence in breast milk and breastfeeding promotion information offered by the Ministry of Health to mothers should include more visual aids and demonstrations for mothers on how to cope with breast complications to reduce their interfering with breast feeding.