Exclusive Breastfeeding Practice and Associated Factors among Mothers Having Infants (Aged 0-6 Months) in the Pastoral Community of Sawena District, Bale Zone Oromia, Ethiopia, 2023

Abstract Background : Breastfeeding is the easiest, healthiest, and most cost-effective feeding method forinfants. Despite the promotion of exclusive breastfeeding, its importance is poorly understood in pastoral communities. Little information is available on the practices and factors underlyingexclusive breastfeeding, especially in pastoral communities in the Sawena district, Bale zone, Oromia region, and Ethiopia. Objective: This study aimed to assess the prevalence of and factors associated with exclusive breastfeeding among mothers with infant (aged 0-6 months) in pastoral communities in the Sawena district, Bale Zone, Oromia Region, SoutheastEthiopia, 2023. Method: A community-based cross-sectional study design was employed from March 01 to April 2023. A total of 631 women were selected using simple random sampling. The data were collected through face-to-face interviews. The collected data were entered into Epi Data software version 4.6 and subsequently exported into SPSS version 26 for analysis. Variables with a P value < 0.25 in the bivariate analysis were included in the multivariable logistic regression model. The degree of association was expressed using adjusted odds ratios (AOR) with a 95% confidence interval (CI) of < 0.05. Results: Out of 631 eligible mothers, 625 participated in this study, for a response rate of 99.0%. The prevalence of exclusive breastfeeding (EBF) practices among mothers in the study area was 53.8% (95% CI; 49.8%–57.4%). Household food security status AOR=1.6, 95% CI (1.1-2.2), ANC follow-up during pregnancy, AOR = 5.3, 95% CI (2.4-11.9), counselling about EBF during ANC visitsAOR=5; 95% CI (2.1-11.7), number of children AOR =1.6, 95% CI (1.1-2.3) and attitudes toward EBF AOR= 1.8; 95% CI (1.4-2.6) were significantly associated with EBF. The majority of interviewees explained that there were various reasons why exclusive breastfeeding was not practiced, including beliefs that breast milk was insufficient, giving babies water would reduce colic, and fears of food refusal. Conclusion: The prevalence of exclusive breastfeeding practices in the study area was lower than the country-recommended level. Household food security status, ANC follow-up during pregnancy, counselling about breastfeeding during ANC, number of children and attitude toward EBF practice were significantly associated with EBF. BF counselling during ANC services can be provided to mothers to improve their BF knowledge and subsequently improve their EBF practices.