title: Determinants of early initiation of breastfeeding in Amibara district, Northeastern Ethiopia: a community based cross-sectional study.
abstract: BACKGROUND
  Early initiation of breastfeeding has lifetime benefits for the mother and the child. It has a positive impact on the duration of exclusive breastfeeding. Hence, the initiation of breastfeeding within the first hour of life lays the foundation for optimal breastfeeding. This study aimed to assess early and timely initiation of breastfeeding practices and associated factors among mothers of children aged less than 24 months in Amibara district of Northeast Ethiopia during April 2015.
  
  
  METHODS
  A quantitative community based cross-sectional study was employed on 407 mothers of children aged less than 24 months in Amibara district. Descriptive statistics, binary and multivariable logistic regression analysis were employed to identify the factors associated with early initiation of breastfeeding. The strength of the association was measured by odds ratio, and p-value < 0.05 was considered statistically significant.
  
  
  RESULTS
  Three hundred eighty one (94.5 %) of the respondents had ever breastfed their index child. Of those who had ever breastfed, 151, 39.6 % (95 % Confidence Interval [CI] 35.0 %, 45.0 %) of mothers initiated breastfeeding within 1 h after birth. In multivariable logistic regression analysis mothers living in urban areas (Adjusted Odds Ratio [AOR] 3.8; 95 % CI 2.32, 6.06) and who attended formal education (AOR 2.0; 95 % CI 1.21, 3.46) were associated with increased odds of early initiation of breastfeeding. The factors associated with decreased odds of timely initiation of breastfeeding were caesarean section delivery (AOR 0.46; 95 % CI 0.22, 0.97) and mothers with two or three children (AOR 0.59; 95 % CI 0.35, 0.99).
  
  
  CONCLUSIONS
  This study showed that four in ten infants were breastfed within the first hour after birth. Therefore, providing proper support and guidance of health professionals during cesarean section delivery and breastfeeding education programs at the village level for girls and young women without formal education are important interventions to promote early initiation of breastfeeding in the study area.
authors.affiliation: Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, Afar Ethiopia.
authors.forename: Misgan Legesse
authors.initials: ML
authors.lastname: Liben
authors.affiliation: Department of Public Health, College of Medical and Health Sciences, Samara University, Samara, Afar Ethiopia.
authors.forename: Ebrahim Mohammed
authors.initials: EM
authors.lastname: Yesuf
keywords: Afar; Agro-pastoral; Amibara; Early breastfeeding initiation; Ethiopia