Association between exclusive breastfeeding practice and maternal knowledge of the lactational amenorrhea method and its associated factors among postpartum mothers in Northeast Ethiopia

Abstract

INTRODUCTION: Exclusive breastfeeding during the first six months postpartum is essential for preventing unintended pregnancy. Lactational amenorrhea method (LAM) is a safe and effective natural family planning method that provides up to 98% protection when its three criteria are met. Inadequate knowledge of LAM and poor exclusive breastfeeding practices increase the risk of unintended pregnancy. This study assessed the association between exclusive breastfeeding practice and maternal knowledge of LAM and its associated factors among postpartum mothers in Northeast Ethiopia, 2023/24. METHOD: An institution-based cross-sectional study design was employed. The study was conducted in four hospitals in Northeast Ethiopia. A total of 607 participants were included, and the study period was from March 2023 to June 30, 2023. Data were collected using standardized, interviewer-administered questionnaires. Multivariable logistic regression model was employed using SPSS version 26. Multicollinearity, sensitivity analysis and Hosmer-Lemeshow goodness-of-fit test were assessed. Variables with p-values less than 0.25 in the bivariable analysis were entered into multivariable logistic regression model to control for potential confounders. Finally, variables with p-values less than 0.05 at 95% CI were considered statistically significant. RESULT: The prevalence of good exclusive breastfeeding practice was 68.4% (95% CI: 64.0-72.8%), while good maternal knowledge of the lactational amenorrhea method was 56.0% (95% CI: 50.7-61.2%). Maternal knowledge of LAM was significantly associated with exclusive breastfeeding practice (χ² = 5.378, p = 0.02). Factors significantly associated with exclusive breastfeeding practice included marital status (AOR: 0.5; 95% CI: 0.2-0.9), educational level (AOR: 2.0; 95% CI: 1.3-3.0), and reason for hospital visit (AOR: 0.45; 95% CI: 0.28-0.73). Factors associated with maternal knowledge of LAM were marital status (AOR: 4.0; 95% CI: 1.83-9.0), educational status (AOR: 1.8; 95% CI: 1.16-2.76), age (AOR: 0.42; 95% CI: 0.28-0.63), and hospital level (AOR: 1.5; 95% CI: 1.02-2.17). CONCLUSION: Two-thirds of participants had good exclusive breastfeeding practices, and 56% were knowledgeable about LAM. Marital status, educational level, and reason for hospital visit were significantly associated with exclusive breastfeeding practice. Structured postnatal education should be provided across all hospitals to improve exclusive breastfeeding practice. CLINICAL TRIAL NUMBER: Not applicable.