review · International Breastfeeding Journal
Exclusive breastfeeding provides infants with solely breast milk during their first six months of life, excluding all other food or water aside from medicines and supplements. A systematic review and meta-analysis of forty-five observational studies conducted in Ethiopia between 2015 and 2020 evaluated exclusive breastfeeding rates and maternal employment. The analysis established a pooled exclusive breastfeeding prevalence of 60.42 percent among mothers in Ethiopia. Full-time maternal employment showed a clear negative association with the practice, with employed mothers being 57 percent less likely to exclusively breastfeed their infants compared to mothers without paid employment. Overall rates remain below international targets. Addressing this shortfall requires governmental and non-governmental organisations to establish supportive workplace environments, including measures such as mandatory paid maternity leave to help working mothers sustain exclusive breastfeeding.
Exclusive breastfeeding is critical for infant health and nutrition during early life. By demonstrating that full-time employment substantially reduces exclusive breastfeeding in Ethiopia, these findings highlight a direct conflict between maternal work obligations and infant care. The evidence supports public health leaders and employers seeking to establish policy reforms, such as extended paid maternity leave, that protect child nutrition alongside female workforce participation.
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BACKGROUND: Exclusive breastfeeding is defined as the practice of providing only breast milk for an infant for the first 6 months of life without the addition of any other food or water, except for vitamins, mineral supplements, and medicines. Findings are inconsistent regarding the prevalence of exclusive breastfeeding in Ethiopia. Full-time maternal employment is an important factor contributing to the low rates of practice of exclusive breastfeeding. Empowering women to exclusively breastfeed, by enacting 6 months' mandatory paid maternity leave can increase the rate of exclusive breastfeeding in the first 6 months of life up to 50%. The purpose of this review was to estimate the pooled prevalence of exclusive breastfeeding and its association with full-time maternal employment in the first 6 months of life for infants in the context of Ethiopia. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used in this systematic review and meta-analysis. All observational studies reporting the prevalence of exclusive breastfeeding and its association with maternal employment in Ethiopia were considered. The search was conducted from 6 November 2020 to 31 December 2020 and all papers published in the English language from 1 January 2015 to 31 December 2020 were included in this review. RESULTS: Forty-five studies were included in the final analysis after reviewing 751 studies in this meta-analysis yielding the pooled prevalence of EBF 60.42% (95% CI 55.81, 65.02) at 6 months in Ethiopia. Those full-time employed mothers in the first 6 months were 57% less likely to practice exclusive breastfeeding in comparison to mothers not in paid employment in Ethiopia (OR 0.43; 95% CI 0.31, 0.61). CONCLUSIONS: Full-time maternal employment was negatively associated with the practice of exclusive breastfeeding in comparison to unemployed mothers. The prevalence of exclusive breastfeeding in Ethiopia is low in comparison to the global recommendation. The Ethiopian government should implement policies that empower women. The governmental and non-governmental organizations should create a conducive environment for mothers to practice exclusive breastfeeding in the workplace.
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DOI: 10.1186/s13006-021-00432-x
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