Undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia: A community-based study

Background: An exclusive breastfeeding period is a time when the infant's feeding depends on only breast milk. Inadequate maternal nutrition during this period could lead to insufficient infant feeding, which can further lead to childhood undernutrition and developmental restrictions. Evidently, the burden of maternal undernutrition was higher in resource-limited countries, including Ethiopia.Objectives: This study aimed to assess the proportion of undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia.Design: The study used a community-based cross-sectional design.Methods: The study was conducted among 442 nursing mothers from 10 to 30 June 2022. The participants were selected using multistage sampling techniques. An interviewer-administered structured questionnaire was used to collect information. Statistical software EpiData version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. The factors associated with undernutrition were identified using a binary logistic regression analysis. In the bivariable analysis, a p-value of less than 0.25 was used to include the variable in the multivariable analysis, whereas p-value less than 0.05 was an odds ratio used to declare an independent association at a 95% confidence interval.Results: The proportion of undernutrition among the participants was found to be 24.8% in the study area. Poor intake of extra meals (adjusted odds ratio = 2.104; 95% confidence interval: 1.208, 3.664), poor dietary diversity habits (adjusted odds ratio = 3.605; 95% confidence interval: 2.112, 6.153), a lack of nutrition information (adjusted odds ratio = 1.853; 95% confidence interval: 1.070, 3.212), and household food insecurity (adjusted odds ratio = 4.424; 95% confidence interval: 2.639, 7.417) were identified as factors enhancing undernutrition among exclusive breastfeeding mothers in the area.Conclusion: A quarter of exclusive breastfeeding mothers were undernourished in the area. Poor dietary diversity habits, poor intake of extra meals, a lack of nutrition information, and household food insecurity were found to be the factors determining undernutrition. Hence, it is important to reinforce nutrition intervention programs, including maternal nutrition education and counseling. A study identified undernutrition among exclusive breastfeeding mothers in Southwest EthiopiaAdequate nutrition for a nursing mother is crucial for the health of both the baby and the mother. Frequent breastfeeding, especially in exclusive breastfeeding (EBF) mothers, increases the physiological demand for nutrients. Consequently, inadequate nutrition during this period can lead to undernutrition. Undernutrition during this crucial period can result in the detriment of a newborn's growth and development. The problem is common in resource-limited settings, including Ethiopia. The study was conducted to assess the magnitude of undernutrition in the general nursing period. However, this problem, in particular the EBF period, was poorly studied before including the study area. A community-based cross-sectional study was conducted to assess the prevalence of undernutrition and its associated factors among EBF mothers in southwest Ethiopia. Accordingly, of the total of 435 participants involved in the study, about 108 (24.8%) of EBF mothers were undernourished. The participants' poor intake of extra meals (adjusted odds ratio (AOR) = 2.104; 95% confidence interval (CI): 1.208, 3.664), poor dietary diversity habits (AOR = 3.605; 95% CI: 2.112, 6.153), a lack of nutrition information (AOR = 1.853; 95% CI: 1.070, 3.212), and household food insecurity (AOR = 4.424; 95% CI: 2.639, 7.417) were identified as factors enhancing undernutrition among EBF mothers in the area. Generally, the study identified about one-fourth of EBF mothers as undernourished in the area. Hence, the concerned bodies need to strengthen nutritional information dissemination to the community. Moreover, food supplementation should be planned for food-insecure households in the area.