Individual- and community-level factors associated with early initiation of breastfeeding in Mozambique: evidence from the 2022-2023 Demographic and Health Survey.

Background: Early initiation of breastfeeding is defined as giving breast milk to the newborn within one hour of birth. It strengthens the link between mother and child, promotes cognitive development, and lowers the chance of obesity and non-communicable diseases during the prime years of life. Nowadays, only 50% of newborns worldwide receive breast milk within their first hour of life. This study examined the prevalence and individual- and community-level factors associated with early initiation of breastfeeding using the Demographic and Health Survey data and offers suggestions that can enhance the practice in Mozambique.

Methods: Data from the nationally representative Mozambique Demographic and Health Survey were used in this cross-sectional analysis. The study included a weighted sample of 3,548 children born in the two years prior to the survey. Software for statistical analysis, STATA/SE version 14.0, was used to clean, recode, and analyze the data. Utilizing multilevel logistic regression, the factors associated with the outcome variable were identified. Statistical significance was attained by variables having a p-value less than 0.05.

Results: The prevalence of early initiation of breastfeeding in Mozambique was 75.03% (95% CI: 73.58%, 76.43%). Factors like non-working [AOR = 0.62; 95% CI (0.50, 0.78)], wanted last pregnancy [AOR = 1.68; 95% CI (1.33, 2.12)], antenatal care attendance [AOR = 0.63; 95% CI (0.43, 0.93)], vaginal birth [AOR = 2.30; 95% CI (1.58, 3.36)], size of the child at birth [AOR = 1.77; 95% CI (1.26, 2.48)], urban residence [AOR = 2.99; 95% CI (1.90, 4.72)], community-level antenatal care utilization [AOR = 0.52; 95% CI (0.35, 0.77)], and community poverty level [AOR = 0.34; 95% CI (0.20, 0.58)] were significantly associated with early initiation of breastfeeding.

Conclusions: About three out of four newborn babies in Mozambique have an early initiation of breastfeeding. It is critical to concentrate on developing policies that support the early initiation of breastfeeding, particularly for mothers who have small children, unplanned pregnancies, non-vaginal deliveries, and reside in rural areas.