Breast‐Milk Substitutes and Associated Factors Among Mothers With Infants Younger Than Six Months of Age in North Shewa District, Oromia, Ethiopia, 2023. A Cross‐Sectional Study

ABSTRACT Background Breast milk substitutes (BMS) use is discouraged during the first 6 months, as exclusive breastfeeding is the optimal feeding practice. However, breast milk exclusivity is uncertain, particularly in communities of developing countries, including Ethiopia as information from community claims. Besides, studies are scarce about breast milk substitutes in Ethiopia. Aim The aim of this study was to assess the prevalence of breast‐milk substitutes use and associated factors among mothers with infants younger than 6 months of age. Methods A health facility‐based cross‐sectional study was conducted in the North Shewa district of Oromia from March, 7 to April 7, 2023. The study involved 338 mothers who had infants aged 6 months or younger, selected through a simple random sampling technique. Pre‐tested semi‐structured questionnaires were used to collect the data. While the Hosmer‐Lemeshow test (p = 0.27) is used to assess model fitness. Descriptive statistics and logistic regression analysis were performed. Variables with a p‐value less than 0.05 in the final model were reported as having a statistically significant association with breast milk substitute use. Results The study's response rate was 94.4%. The prevalence of breast milk substitutes use among mothers with infants aged ≤ 6 months was 59.8%. Being housewife (AOR = 0.50,95% CI: 0.2–0.9), being single mother (AOR = 0.11, 95% CI: 0.0–0.9), mothers with poor attitude towards BMS use (AOR = 0.35, 95% CI: 0.2,0.6), mothers whose infants received kangaroo care (AOR = 2.4, 95% CI: 1.1, 5.2), mothers with only primary education (AOR = 2.6, 95% CI: 1.1–6.2), mothers who can not read and write (AOR = 3.1, 95% CI: 2.5, 4.3), colostrum discarding (AOR = 1.8, 95% CI: 1.0–3.2), and antenatal care less than 4 visits (AOR = 2.0, 95% CI: 1.1–3.6) were significantly associated with BMS use. Conclusion Nearly two‐thirds of mothers were providing breast milk substitutes for their infants younger than 6 months. Being a housewife, having a poor attitude towards BMS, and being a single mother were identified as protective factors against BMS use. Conversely, factors that increased the likelihood of BMS use included having only primary education or being unable to read and write, discarding colostrum, having infants who received kangaroo care, and attending fewer than four antenatal care visits. Providing and strengthening counseling on BMS use for husbands and mothers, and strengthening mothers' use of antenatal health care services till delivery.