Abstract
Background: Early initiation of breastfeeding (EIBF) is defined as starting breastfeeding within the first hour of birth. It has clinical importance to reduce neonatal morbidity and mortality. Previously studies have been conducted in Ethiopia to identify factors associated with EIBF. However, those studies hadn’t investigated the variation of factors within rural versus urban populations. Therefore, this study is aimed to investigate the differences in factors associated with the early initiation of breastfeeding in rural-urban populations.Methods: This study was used Ethiopian Demographic and Health Survey data, 2016. A total of 3662 children aged less than 24 months were included in the study. Thus,2897 children were disaggregated into rural and the rest 765 of them were into urban. A multivariable logistic regression model was fitted to identify the determinant of EIBF. Finally, a statistically significant association was declared at a p-value of ≤0.05.Results: In rural populations, the study found that the age of mothers 15-24 years (AOR=1.50, 95%CI: 1.13,2.00), mothers not working (AOR=1.38,95%CI: 1.12,1.69), large birth size (AOR=1.44,95%CI:1.12,1.85), and participation of mothers in making health care decisions (AOR=1.43, 95%CI: 1.17,1.75) were positively associated with EIBF. Rural mothers having ≤2 children(AOR=0.55,95%CI: 0.45,0.67), living in larger to center regions (AOR=0.13,95%CI: 0.06, 0.27), and small peripheral regions (AOR=0.12,95%CI:0.06, 0.24) were negatively associated with EIBF. Irrespective of residence, the odds of EIBF were higher in vaginal delivery (RuralAOR= 4.38,95%CI:1.81,10.59; urban AOR= 3.19,95%CI:1.86, 5.48 ).In the urban population, having frequent ANC follow-ups was associated with a higher odds of EIBF.Conclusions: The study concludes that the age of mothers, working status of mothers, birth sizes, mothers participation in making health care decisions, numbers of children in the households, living in large to center regions and small peripheral regions were determinants of early initiation of breastfeeding, only rural residence. Mode of delivery was associated with EIBF, Irrespective of the residence. In the urban population, having frequent ANC follow-ups was associated with a higher odds of EIBF. Special emphases to mothers living in rural large to center and small peripheral regions should be given. Regardless of the residence, appropriate guidance and supports should be given for babies delivered through cesarean section.