Factors associated with exclusive breastfeeding among mothers of children under two years of age in Dalit community, Rajbiraj Municipality, Saptari, Nepal

Abstract

AbstractThe prevalence of exclusive breastfeeding (EBF) is suboptimal in Nepal and very low in Madhesh province. Dalits are generally known for being economically exploited, politically voiceless, socially degraded, educationally backward, classified as untouchables, and deprived of human dignity and social justice. This study aimed to assess the proportion of Dalit Mothers who practice exclusive breastfeeding and the factors associated with it.The study utilized an analytical, cross-sectional design by using a semi-structured questionnaire to 156 Dalit mothers of Rajbiraj Municipality, Saptari, Nepal. For the analysis involving testing for the association of independent variables with dependent variables, bivariate analysis (chi-square statistics and a p-value at <0.05) was used. Those that are significant in the bivariate analysis were further preceded by multivariate logistic regression.In the present study, the prevalence of exclusive breastfeeding was (43.6%). Mother’s occupation (AOR = 5.724; CI = 1.726 -18 977), Mothers education (adjusted odds ratio [AOR] = 5.724; CI = 1.726 -18 977), smoking habit (AOR = 2.785; CI = 1.073 – 7.228), colostrum milk feeding (AOR = 14.199; CI = 3.508 – 57.474), number of times visit the health center for ANC (AOR = 2.852; CI = 1.210 – 6.726) were positively associated with exclusive breastfeeding whereas sex of the child, type of family, knowledge about breastfeeding, mothers receive counselling on EBF in ANC or PNC visit was also associated with exclusive breastfeeding. Among the respondents who did not practice exclusive breastfeeding, the common reasons cited were trouble initiating milk flow (23.7%), insufficient breast milk production (21.7%), Breast milk not satisfying the baby (20.9%), too many household duties (12%), difficulties with infant sucking or latching (6.4%), and the baby becoming sick and not being able to breastfeed (4.8%).The study demonstrates that, nearly half (43.6%) of the infants were breastfed exclusively hence the need for targeted interventions and support to promote EBF among Dalit mothers. Factors such as maternal education, occupation, colostrum milk feeding, and antenatal care visits were identified as important influencers of exclusive breastfeeding. Healthcare professionals, policymakers, and community leaders can utilize these insights to design effective strategies that encourage and support exclusive breastfeeding among Dalit mothers, ultimately improving the health and well-being of infants in this marginalized community.