Time to cessation of exclusive breastfeeding and associated factors among women with children aged 6-24 months in Kilimanjaro region, northern Tanzania: A community-based cross-sectional study

PLoS One. 2021 Oct 28;16(10):e0259041. doi: 10.1371/journal.pone.0259041. eCollection 2021.

Abstract

Background: Exclusive breastfeeding (EBF) up to six months is sub-optimal globally. Tanzania has surpassed the World Health Assembly (WHA) target of increasing the rate of exclusive breastfeeding among children below six months to at least 50% by the year 2025 the median age of cessation of EBF is only three months.

Objective: To determine the time to cessation of exclusive breastfeeding and its associated factors among women with children aged 6-24 months in Kilimanjaro region, Northern Tanzania.

Methods: This was a secondary analysis of data from a community-based cross-sectional study conducted between April 2016 and April 2017 in Kilimanjaro region, northern Tanzania. In the parent study, a multistage sampling technique was used to select study participants and interviewed using a questionnaire. Data for 1291 mother-child pairs were analyzed using STATA version 15. Kaplan-Meier method with the log-rank test estimated and compared the survivor functions across covariate levels. Cox regression proportional hazards models estimated the hazard ratios (HR) and their 95% confidence intervals (CI) for factors associated with time to cessation of exclusive breastfeeding.

Results: The prevalence of cessation of exclusive breastfeeding before six months was 68.7%, with a median age of cessation of four months (95% CI: 3, 4). In comparison to women living in Siha district, women living in Moshi Municipal (HR = 1.61; 95% CI = 1.24, 2.09), Same (HR = 1.32; 95% CI = 1.06, 1.65) and Mwanga (HR = 1.53; 95% CI = 1.20, 1.96) districts, had higher hazards of cessation of exclusive breastfeeding before six months. Women who received breastfeeding counselling at antenatal care had a lower hazard to cease EBF (HR = 0.76, 95% CI 0.65, 087) compared to those who did not receive breastfeeding counselling.

Conclusion: The median age of cessation of EBF is unsatisfactory but at least higher (four months) than the national level estimate of three months. District specific interventions and breastfeeding counselling at antenatal care are essential for improving time to cessation of exclusive breastfeeding. Promotion of adequate ANC visits remains one of the critical interventions to improve BF practices and other reproductive health outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breast Feeding / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • Health Behavior*
  • Humans
  • Infant
  • Mothers*
  • Tanzania
  • Time Factors
  • Young Adult

Grants and funding

The funding to conduct the study was received from Kilimanjaro Christian Medical University College (KCMUCo) under the Institute of Public Health as part of the doctor of medicine training program. Sia E. Msuya was THRiVE-2 faculty and partially supported by the DELTAS Africa Initiative grant number DEL-15-011 to THRiVE-2. The funders did not have any role or influence in the design of the study, data collection, analysis, or interpretation of the results and the development of the manuscript.