Prevalence of exclusive breastfeeding and associated factors among mothers working in the informal sector in Kampala District in Uganda.

Abstract

Background: Exclusive breastfeeding for the first six months plays a great role in preventing infant morbidity and mortality. Mothers stop breastfeeding soon after returning to work and they need supportive national polices and incentives to enable them to continue. In Uganda, the existing policies are mainly enjoyed by women in the formal sector while those in the informal hardly access such work benefits. Objective: To determine the prevalence and factors associated with exclusive breastfeeding among mothers working in the informal sector in Kampala. Methods: The study targeted 428 mothers with children <6 months. An interviewer administered semi-structured questionnaire was used to assess the mother’s breastfeeding practices as well as the demographic, employment characteristics, maternal knowledge and attitude. Modified poison regression analysis was done to determine independent factors associated with exclusive breastfeeding in STATA version 13. Focus group discussions were used to collect information on maternal perceptions on exclusive breastfeeding and analyzed using thematic content analysis. Results: Nearly all children (96%) were still breastfeeding, however only 42.8% were exclusively breastfeed and 4.2% were not breastfed at all at the time of the study. The remainder were mixed fed. The factors associated with exclusive breastfeeding included attending antenatal care atleast 4 times (APR=1.24; 95% CI: 1.01-1.51), intention to breastfeed exclusively for 6 months (APR=1.26; 95% CI: 1.01-1.57) or longer (APR=1.38; 95% CI: 1.06-1.76), proper breastfeeding practices (APR=4.12; 95% CI: 2.88-5.90), age of the infant and position at work. In the Focus group discussions, mothers also attributed their inability to breastfeed exclusively to excess work demands and the child demanding for food. They identified the need for increased support from their spouses and breastfeeding breaks as supportive to exclusive breastfeeding. Conclusion: The prevalence of exclusive breastfeeding among women in the informal sector was lower than the national prevalence and that recommended by WHO. The factors found to be associated with EBF included age of the infant, number of antenatal care attendance, and intention to exclusively breastfeed, breastfeeding practices and Position at work. The qualitative findings also revealed that work constraints were barriers. Further research is needed to assess how mothers can be supported to breastfeed exclusively even after returning to work.