Prevalence and Associated Factors of Early Cessation of Exclusive Breastfeeding Practice in Noakhali, Bangladesh: A Mixed-Method Study

Purpose: Though the benefits of exclusive breastfeeding (EBF) till the age of six months are unanimously perceived and ubiquitously accepted, there are several factors that impede this great practice all over the world, and Bangladesh is no exception. Design and methods: A clinic-based, mixed-method, cross-sectional study was conducted to investigate the EBF practice and the possible causes of early cessation in Noakhali district, Bangladesh. The Kaplan-Meier survival curve with a log-rank test was used to compare the survival differences of recommended and observed EBF practices. The life table for EBF practice was also presented, and the multivariate cox proportional regression model was used to identify the predictors of EBF duration. Two focus group discussions were conducted to generate qualitative data on EBF cessation. Results: The mean duration of EBF was five months; only 30% of mothers did not complete EBF, and the cumulative survival curve showed a sharp fall after four months of breastfeeding. However, factors such asmother's advanced age (30 years or above; AHR: 0.376, 90% CI: 0.158-0.893) and low level of education increase the risk of the EBF cessation, while being housewife mothers, preceding birth interval of more than 2 years and living in urban areas decreases the risk of EBF termination. Perceived inadequacy of breast milk and some cultural norms were among the cessation factors revealed in qualitative analysis. Conclusions: Although the completion rates of EBF practice seem to be high in this study population, some sociocultural issues remain to be addressed, and further promotional efforts should be made to continue and improve the EBF practice. (C) 2021 Elsevier Inc. All rights reserved.