Early cessation of exclusive breastfeeding and associated factors among mothers of children Aged 6–24 months in South Ethiopia

Abstract

Early cessation of exclusive breastfeeding increases the risk of childhood morbidity, mortality, malnutrition, and poor development. This study assessed the prevalence and determinants of early EBF cessation among mothers in a pastoralist community. A concurrent mixed-methods study was conducted from December 1–30, 2024, among 633 mothers of children aged 6–24 months selected. Quantitative data were collected using a structured questionnaire, while qualitative data were obtained through focus group discussions. The prevalence of early EBF cessation was 42.7% (95% CI: 38.8–46.6%). Higher odds of early cessation were observed among mothers with no religious affiliation (AOR = 5.98, 95% CI: 3.1–11.4), severe (AOR = 4.70, 95% CI: 2.6–8.5) or moderate food insecurity (AOR = 4.00, 95% CI: 2.0–7.7), breastfeeding problems (AOR = 1.85, 95% CI: 1.03–3.3), and primiparity (AOR = 5.72, 95% CI: 2.95–11.1). Factors associated with lower odds of early cessation included primary (AOR = 0.38, 95% CI: 0.2–0.7) and secondary or higher maternal education (AOR = 0.44, 95% CI: 0.2–0.9), higher birth order (second: AOR = 0.35, 95% CI: 0.2–0.6; third: AOR = 0.37, 95% CI: 0.2–0.7; fourth or higher: AOR = 0.19, 95% CI: 0.1–0.9), antenatal (AOR = 0.51, 95% CI: 0.3–0.8) and postnatal EBF counseling (AOR = 0.47, 95% CI: 0.3–0.7), good EBF knowledge (AOR = 0.18, 95% CI: 0.1–0.3), and a positive attitude toward EBF (AOR = 0.60, 95% CI: 0.4–0.9). Qualitative findings showed that cultural beliefs, traditional practices, maternal workload, misconceptions and food insecurity contributed to early EBF cessation. Early cessation of EBF remains common in this pastoralist community. Strengthening maternal education, breastfeeding counseling, and support for first-time mothers, while addressing food insecurity, breastfeeding problems, and sociocultural barriers, may improve EBF practices.