title: Prevalence and associated factors of timely initiation of breastfeeding among mothers at Debre Berhan town, Ethiopia: a cross-sectional study.
abstract: BACKGROUND
  Timely initiation of breastfeeding is defined as putting the newborn to breast within one hour of birth. It serves as the starting point for continuum of care for the newborn health and development. In Ethiopia, there is a considerable variation on timely initiation of breastfeeding among regions. The main aim of this study was to determine prevalence rate and investigate factors associated with timely initiation of breastfeeding practice among mothers in Debre Berhan town, Ethiopia.
  
  
  METHODS
  A community based cross-sectional study was conducted at Debre Berhan town from April 1 to 30, 2013. A total of 416 mothers who had given birth within the last six months were selected by using simple random sampling technique. Descriptive statistics, bivariable and multivariable logistic regression analysis were employed to identify factors associated with timely initiation of breastfeeding.
  
  
  RESULTS
  The prevalence rate of timely initiation of breastfeeding was 62.6 %. The odds of timely initiation of breastfeeding was high among mothers who have monthly income of greater than 1969 Ethiopian Birr (ETB) (adjusted odds ratio [AOR] 2.77; 95 % Confidence Interval [CI] 1.21, 6.32). Having extended family (AOR 0.5; 95 % CI 0.27, 0.95), not being counseled about timely initiation of breastfeeding during antenatal care (AOR 0.40; 95 % CI 0.18, 0.88), delivered by cesarean section (AOR 0.11; 95 % CI 0.04, 0.33), delivery attended by traditional birth attendants or relatives (AOR 0.22; 95 % CI 0.05, 0.87), and not feeding colostrum (AOR 0.07; 95 % CI 0.02, 0.23) were negatively associated with timely initiation of breastfeeding.
  
  
  CONCLUSIONS
  The practice of timely, also known as early, initiation of breastfeeding was suboptimal. Nearly 40 % of the mothers did not start breastfeeding within one hour after delivery. Findings suggest that in order to improve timely initiation of breastfeeding practice, interventions need to target mothers with extended family, poor socioeconomic status and caesarean delivery. Moreover, mothers who discard colostrum and those who do not deliver under the assistance of health care professional need attention and emphasis has to be given for the breastfeeding counseling service given at antenatal service outlets.
authors.affiliation: Institute of Medicine and Health Sciences, College of Health Sciences, Department of Public Health, Debre Berhan University, Debre Berhan, Ethiopia.
authors.forename: Getachew
authors.initials: G
authors.lastname: Tilahun
authors.affiliation: Public Health at College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
authors.forename: Getu
authors.initials: G
authors.lastname: Degu
authors.affiliation: College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
authors.forename: Telake
authors.initials: T
authors.lastname: Azale
authors.affiliation: Regional Quality Coordinator at Ethiopian Commodity Exchange, Addis Ababa, Ethiopia.
authors.forename: Askal
authors.initials: A
authors.lastname: Tigabu
keywords: Breastfeeding; Infant feeding; Optimal breastfeeding; Prevalence; Timely initiation