Exclusive breastfeeding (EBF) is defined as “an infant’s consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk, and no foods) except for vitamins, minerals, and medications until six months” [1]. EBF for six months is important for both infant and maternal health. Infants who are not exclusively breastfeeding are more likely to develop gastrointestinal infections, not only in developing but also in industrialized countries. The risk of mortality due to diarrhea and other infections can increase many-fold in infants who are either partially breastfed or not breastfed at all [1]. During the first two months of life, infants who are not breastfed are nearly six times more likely to die from infectious diseases than infants who are breastfed; between 2 and 3 months, non-breastfed infants are 4 times more likely to die compared to breastfed infants [2, 3].
Infant and young child feeding practices directly affect the nutritional status of children under two years of age and, ultimately, impact child survival. Worldwide, more than nine million children under five years of age die each year [4]. One in every 17 Ethiopian children die before the first birthday and one in every 11 children dies before their fifth birthday [5].
Over two-thirds of these deaths are associated with inappropriate feeding practices and occur in the first year of life. Optimal breastfeeding (early and exclusive breastfeeding) has the potential to prevent over 800,000 deaths (13 % of all deaths) in children under five in the developing world. Whereas, complementary feeding interventions alone were estimated to prevent almost one fifth of deaths in children aged years [4, 5].
Rates of EBF are suboptimal in many countries. In Saudi Arabia only by 8.3 % (n = 32) of the 384 participants EBF for 6 months [6]. In a study in Congo, 87.5 % of infants were EBF during the maternity stay, but by six months, only 2.8 % (n = 12) of infants were exclusively breastfed [7]. In a study done in Nigeria, the majority (88.0 %) of the respondents had heard about EBF and hospital was the source of information, and more than 50 % of the women had a positive attitude towards breastfeeding [8].
Ethiopian context
The duration of breastfeeding in Ethiopia is long, but EBF during the first six months after birth is not widely practiced. Currently, mothers exclusively breastfeed approximately half of children less than six months (52 %). Among sub-groups the percentage of young children who are exclusively breastfed decreases sharply from 70 % of infants age 0–1 month to 55 % of those aged 2–3 months, and further, to 32 % among infants 4–5 months. In addition to breast milk, 19 percent of infants less than six months are given plain water only, while 14 percent receive milk in addition to breast milk, and four percent are given non-milk liquids and juice [5].
A study in Addis Ababa, Ethiopia found the prevalence of EBF under six months was 29.3 % [9]. A study in Arbaminch, Ethiopia showed that 55.6 % exclusively breastfed their children for six months. Three-hundred forty one (89 %) mothers gave colostrum, however a small number of mothers considered colostrum to be expired breast milk and discarded it [10]. A study in Bedele, Ethiopia found that the majority of mothers, 91.8 %, knew the importance of EBF, and 87.3 % of mothers had a positive attitude and strongly agreed that the EBF is advantageous for infants aged less than six months. Only 43.6 % of mothers practiced EBF for the first six months after delivery [11]. A study in Southern Ethiopia found that 56.7 % of mothers living with HIV (Human Immunodeficiency Virus) had a favorable attitude towards EBF and nearly half (48.2 %) of mothers exclusively breastfeed their infants [12]. A study in Harar, Ethiopia indicated EBF was 51.8 % [13]. A study in Gondar showed EBF rate of 35.9 %. Among the respondents, nearly half (49.4 %) exclusively breastfed for only 3 months or less [14]. In a study done in Debre Birhan Ethiopia 68.6 % of mothers practiced EBF to six months, 83.4 % of mothers were knowledgeable of recommended duration of EBF and about 97.5 % of mothers had a positive attitude towards EBF practice [15]. In a study done in Ambo Ethiopia, the prevalence of EBF was 82.2 %, and 90.8 % of mothers were knowledgeable about EBF [16].
The aim of the study was to assess Knowledge, Attitude and Practice (KAP) towards EBF among lactating mothers in Mizan Aman Town, South West Ethiopia, who had a child less than two years during April 2015. The findings will help to describe EBF practice and reveal areas for further study and will assist health care professionals, health extension workers and community health promoters to understand EBF practice in the study area and help them to prioritize and focus their efforts. Additionally, since there is a limited research in the study area, this study can be used as a benchmark for further studies.