title: Prevalence and determinants of exclusive breastfeeding among adolescent mothers from Quito, Ecuador: a cross-sectional study.
abstract: BACKGROUND
  Exclusive breastfeeding (EBF) is the optimal way to feed children during their first six months of life, having important benefits for them and their mothers. However, the proportion of Ecuadorian mothers who continue to exclusively breastfeed their infants during the recommended six-month period has been reported to remain below the World Health Organization's goal set of 90 %. Little is known regarding factors influencing adolescent mothers to decide whether to practice EBF or not. Furthermore, there is no data about the EBF rates among adolescent mothers in Quito, Ecuador.
  
  
  METHODS
  This cross-sectional study took place from April to November 2013 in the largest maternity ward in Quito, Ecuador (Hospital Gineco Obstétrico Isidro Ayora). Adolescent mothers parenting an infant between 6 and 24 months of age (n = 375) were interviewed using a structured questionnaire about EBF knowledge, beliefs and practices. Bivariate and multivariate analyses were used to identify the independent predictors of EBF.
  
  
  RESULTS
  In our sample, 62.9 % of adolescent mothers raising infants between 6 to 24 months of age chose EBF. Knowledge about the maternal benefits of breastfeeding and awareness of appropriate time frame for EBF were statistically associated with increasing the likelihood of choosing EBF. Adolescent mothers who were acquainted with the recommended duration of EBF were more likely to practice EBF (adjusted odds ratio (AOR) = 1.73; 95 % confidence interval (CI) 1.003, 2.98) as well as those who knew that breastfeeding is a protective factor against breast cancer (AOR = 5.40; 95 % CI 1.19, 24.56).
  
  
  CONCLUSIONS
  Although adolescent mothers may be more prone to discontinuing EBF before their infants reach six months of age, the prevalence of EBF among adolescent mothers interviewed was higher than the rate reported for Ecuadorian mothers in other age groups. Our data underscores the importance of emphasizing the correct practice of BF and its benefits in breastfeeding education programs provided to Ecuadorian mothers, in order to promote the extension of breastfeeding duration to the recommended levels.
authors.affiliation: Escuela de Medicina, Facultad de Ciencias Médicas de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito, Ecuador.
authors.forename: Miguel Á
authors.initials: MÁ
authors.lastname: Jara-Palacios
authors.affiliation: Escuela de Medicina, Facultad de Ciencias Médicas de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito, Ecuador.
authors.forename: Angélica C
authors.initials: AC
authors.lastname: Cornejo
authors.affiliation: Escuela de Medicina, Facultad de Ciencias Médicas de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito, Ecuador.
authors.forename: Gabriela A
authors.initials: GA
authors.lastname: Peláez
authors.affiliation: Escuela de Medicina, Facultad de Ciencias Médicas de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito, Ecuador.
authors.forename: Jenny
authors.initials: J
authors.lastname: Verdesoto
authors.affiliation: Escuela de Ciencias Físicas y Matemáticas, Universidad de las Américas, Quito, Ecuador.
authors.forename: Andrés A
authors.initials: AA
authors.lastname: Galvis
keywords: Adolescent mothers; Ecuador; Exclusive breastfeeding; Quito