title: Prevalence of timely breastfeeding initiation and associated factors in Dembecha district, North West Ethiopia: a cross-sectional study.
abstract: BACKGROUND
  Early initiation of breastfeeding is a simple and cost effective intervention to advance the health of mothers and newborn babies. A large number of neonatal deaths could be prevented if infants were breastfed. However, there is poor practice related to breastfeeding initiation within the first one hour of birth, and the factors affecting it are not well understood. This study was conducted to assess the prevalence of timely breastfeeding initiation and associated factors in Dembecha district, North West Ethiopia.
  
  
  METHODS
  A cross-sectional study design was conducted from August to September 2015. Multistage sampling techniques were used to select a total of 739 mothers who had children under 2 years of age. A pretested structured questionnaire was used to collect data. Descriptive analysis, bivariate and multiple logistic regression analysis were performed.
  
  
  RESULTS
  The level of timely initiation of breastfeeding was 73.1 %. The magnitude of prelacteal feeding and colostrum feeding in this study was 11.9 and 76.2 % respectively. Timely initiation of breastfeeding was significantly associated with the presence of four and above antenatal appointments during the last pregnancy (Adjusted Odds Ratio [AOR] 3.1; 95 % Confidence Interval [CI] 1.2, 8.0), access to mass media such as radio or television (AOR 1.54; 95 % CI 1.10, 2.20), and mothers who were attended by traditional birth attendant during their last birth (AOR 0.23; 95 % CI 0.07, 0.75).
  
  
  CONCLUSIONS
  The level of timely initiation of breastfeeding was relatively good compared with previous studies in Ethiopia, although more than quarter of mothers didn't start breastfeeding within the first one hour of birth. Timely initiation of breastfeeding was significantly associated with the presence of four and above antenatal care during the last pregnancy, access to mass media (e.g. radio, television), and last child attended by traditional birth attendant. Programs should encourage mothers to use skilled birth attendants at birth, emphasise the importance of feeding colostrum and to initiate breastfeeding within one hour after childbirth.
authors.affiliation: Save the Children International, Bahirdar, Ethiopia.
authors.forename: Abebe
authors.initials: A
authors.lastname: Bimerew
authors.affiliation: Public Health Department, Medicine and Health Sciences College, Debre Markos University, Debre Markos, Ethiopia.
authors.forename: Muluken
authors.initials: M
authors.lastname: Teshome
authors.affiliation: Midwifery Department, Medicine and Health Sciences College, Debre Markos University, Debre Markos, Ethiopia.
authors.forename: Getachew Mullu
authors.initials: GM
authors.lastname: Kassa
keywords: Breastfeeding; Child health; Ethiopia; Timely initiation of breastfeeding