Prevalence and contributing factors of early initiation of breastfeeding (EIBF) in Ethiopia: a systematic review and meta-analysis

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BACKGROUND: Even though the National Infant and Young Child (IYC) Feeding guideline was launched in Ethiopia in 2016, early initiation of breastfeeding is not consistently measured among studies which limit evidence for the development of promotion strategies. METHODS: A weighted inverse-variance random effects model was used to estimate the pooled prevalence and contributing factors of early initiation of breastfeeding (EIBF). Heterogeneity was assessed using the I² statistic, forest plot, and Egger's test. Data from 22 primary studies across all regional states in Ethiopia were analyzed, including 39,316 mother-infant pairs who had given birth and breastfed within the last two years, from December 11, 2023, to January 16, 2024. RESULTS: The pooled prevalence of EIBF was 67.44% (95% CI: 61.31-73.56, I² = 99.40%, P = 0.001). Factors contributing to EIBF included urban residency (OR = 2.7, 95% CI: 2.11-3.30), regular antenatal care (OR = 2.44, 95% CI: 1.72-3.15), absence of prelacteal feeding (OR = 4.26, 95% CI: 2.93-5.60), secondary or higher education (OR = 2.53, 95% CI: 1.39-3.68), highest maternal wealth index (OR = 2.36, 95% CI: 1.62-3.09), health facility delivery (OR = 3.60, 95% CI: 2.58-4.62), receiving health education during antenatal care (OR = 1.62, 95% CI: 1.40-1.84), and breastfeeding support (OR = 3.56, 95% CI: 2.38-4.73). CONCLUSION: The prevalence of early breastfeeding initiation (EIBF) remains below WHO targets. Factors like urban residence, higher education, and access to antenatal care and hospital-based delivery services are positively linked to EIBF. To improve rates, health services should enhance community outreach, promote antenatal care, provide early breastfeeding education, and offer professional support immediately after birth. PROSPERO ID: CRD42024498671.

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