Suboptimal breastfeeding practices refer to any behaviors or habits that may interfere with a mother's ability to provide her baby with the best possible nutrition. These practices include not breastfeeding exclusively, using a bottle too soon, not latching on correctly, not breastfeeding on demand, or not breastfeeding for a long enough duration. All of these practices can lead to decreased nutrient intake for the baby, leading to poor growth and development [1,2,3] and as a result it is responsible for 45% of neonatal infectious deaths in the world, 30% of diarrheal based mortality and 18% of ARIs deaths [4,5].
WHO recommends that children should commence BF within 1 hour of delivery, and be exclusively breastfed for the 1st 6-months of age, with timely start of optimal, clean and appropriate complementary foods while sustaining breastfeeding for up to 2-years of life or further [6,7].
Non optimal BF practice is identified from the predominant reason child malnutrition in Ethiopia that indicated in studies is only around half (52%) of the infants less than six months old were exclusively breastfed [8,9,10]. This practice is associated with higher rates of acquisition of infections like GIT, ARI diseases, and conditions. Despite its obvious benefits, EBF duration in many countries including Ethiopia is lower than the international recommendation of exclusive breastfeeding for the first six months of life, especially in urban areas [11, 12].
BF provides numerous health benefits through promoting and protecting maternal and child health from several infections. Optimal breastfeeding is one of the very crucial components of child health but ineffectively practiced leading to exposure of diarrheal and respiratory diseases which may kill the child [1, 2, 13]. Globally, sixty percent of the infants and young child mortality happened because of child feeding problems and where 2/3 of these deaths are attributed to sub-optimal breastfeeding actions [2]. These action have a detrimental effect on the child health and development, specifically in LMICs the accessibility and availability of essencial health service is not properly established [3–5]. In Ethiopia, 57% of under-five children death is associated with malnutrition primarily as a result of hunger, poor family and low health care access [4, 6]. Malnourished child that can survive are more frequently get sick and attacked the life-long effects of developmental problems [5]. Child feeding is a complex issue that has implications on nutritional, health, psychological, and developmental issues [2, 7, 8].
According to WHO, EBF mean the practice of breast milk feeding alone (including expressed breast milk), and no other liquids or solids with the exception of drops or syrups consisting of vitamins, mineral supplements or medicine [2, 4]. Globally, several complex interactions of socio-cultural outlooks targeting on the standards of child feeding startegies are observed [2, 3, 9]. The problem between infant BF views and the WHO recommendations is widening in LMICs where socio-cultural, economic, and traditional norms have significant effects on BF and infant caring practices [3, 10, 11]. Early and fast stopping of breastfeeding, and then replacing by a the start of untidy, unsound formula feeding of children with very light milk content is common in LMICs. This is why; under-five children are highly susceptible to infections for the variety of agents since their body nutrient store is not well developed [3, 8, 14]. Evidences showed that traditional and cultural ways of life related to child feeding have bad effects on the practice of breastfeeding recommended in LMICs [9, 12, 13]. In some societies, water, butter & other food contents are given for neonates, while colostrum is avoided as dirty milk, assuming to start BF when the milk becomes clearer after a few days of fore coming milk removal hoping this practice as a preventive measure of neonates against diseases [9, 11, 12]. Globally, less than 35% of mothers give EBF to their child during the first months of life, and the problem is widely rising in SSC [2, 15]. The Ethiopian Demographic and Health Surveys (EDHS 2005, 2016) data showed that 96% of < 5 children (urban & rural), have ever been breastfed in their lives; however, it was found not optimal [4]. Although, in Ethiopia, 69.1% of neonates are given breast milk within one hour of birth, and less than 80% of two months old infants are put on EBF, this proportion rapidly falls to 38% at the age of six months [4,16].
Even though optimal breastfeeding is one of the targets of Primary Health Care (PHC) initiatives of Ethiopia, a wide range of cultural infant feeding practices are seen and documented even after the implementations of IYCF recommendations.
Actions to protect, promote, and support EBF are demanded at the national, health facility and community levels. This study was aimed to determine the magnitude of suboptimal breastfeeding practices and the potential factors attributed to the practice among women having 24–59 months age children in Dessie zuria woreda.