Factors associated with exclusive breastfeeding of infants aged 0-6 months among mothers in Namuwongo Slum, Kampala Capital City Authority
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Back ground: Exclusive breast feeding for the first six months plays a great role in preventing infant morbidity and mortality. Mothers stop breast feeding soon after resuming work and they need supportive national policies and incentives to enable them to enable them continue. In Uganda there is variation in the proportions of mothers who exclusively breastfeed their infants between urban communities and rural communities. Furthermore, still within the urban communities there is variation between the urban poor and urban rich communities. Objective: To assess the factors associated with exclusive breastfeeding of infants aged 0-6 months among mothers in Namuwongo slum in order to generate information that can be useful in developing targeted interventions to encourage and improve exclusive breastfeeding in urban slums. Methodology; This retrogressive cross-sectional community based study targeted 280 mothers with children between 7-12 months living in four of the nine zones of Namuwongo slum namely Kanyogoga, Namuwongo A, Kasanvu and Yoka. An interviewer administered semi structured questionnaire was used to assess the mother’s breastfeeding practices as well as demographic, employment characteristics, maternal knowledge and attitude. Modified Poisson regression analysis was done to determine the association between independent factors and exclusive breastfeeding in Stata version 13. Focus group discussions were used to collect information on maternal perceptions on exclusive breastfeeding and analyzed using thematic content analysis Results; nearly all children (96.79%) had ever been breastfed, however only 39.29% were exclusively breastfed. The factors associated with exclusive breastfeeding included being married (PR=4.93, 95%CI 1.66-14.66), being unemployed (PR=2.34 95%CI 2.22-2.47), being paid even during maternity leave (PR=2.46; 95%CI 1.32-4.54), having facilities at work (PR=2.54; 95%CI 1.32-4.54), infant being healthy (PR=1.91; 95%CI 1.10-3.31), having good breastfeeding practices (PR=6.67; 95%CI 3.64-12.21), intention to exclusively breastfeed for 6 months (PR=3.17; 95%CI 2.06-4.89) or more (PR=4.31; 95%CI 2.73-6.79), giving pre-lacteal (PR=12.76; 95%CI 4.85-33.54) and taking child to work. In the focus group discussions mothers also attributed their inability to breastfeed exclusively to children demanding for food, failure to produce adequate milk, excess work demands among others. Conclusion; the prevalence of exclusive breastfeeding among women living in urban slum was lower than the national prevalence and that recommended by WHO. The factors found to be associated with EBF included marital status, employment status, maternity leave being paid, having facilities at work, infants morbidity, breastfeeding practices, intention to exclusively breastfeed for 6 months or more, giving pre-lacteal and taking child to work.