Factors associated with exclusive breastfeeding in Accra, Ghana

Objective: To assess factors associated with exclusive breast-feeding (EBF) in Accra, Ghana. Design, subjects, setting: Data on current and past infant feeding patterns, sociodemographic, biomedical and biocultural factors were collected using a cross-sectional design, from a sample of 376 women with infants 0-6 months, attending maternal and child health (MCH) clinics in Accra. EBF was defined in two ways: (a) based on a 24-h recall, and (b) based on a recall of liquids or foods given since birth. Results: Although 99.7% of mothers were currently breastfeeding (BF), only half (51.6%) of them EBF their infants. About 98% of participants had heard about EBF, and 85.6% of them planned to EBF on delivery. Based on 'since birth' EBF, planned EBF on delivery was associated with higher likelihood of EBF (OR=2.56; 95% Cl, 1.06-6.17) and delivery at a hospital/polyclinic was associated with a two times higher likelihood of EBF (OR=1.96; 95% Cl, 1.08-3.54). Women living in their own houses were more likely to EBF (OR=3.96; 95% Cl, 1.02-15.49) than those living in rented accommodations and family houses. Those with a more positive attitude towards EBF were more likely to EBF (OR=2.0; 95% Cl, 1.11-3.57) than their counterparts with more negative attitudes. The '24-h recall' EBF model yielded similar results. Conclusions: In this population, EBF was associated with delivery at hospital/polyclinic, having secondary school education, intention to EBF prior to delivery, owning a home and having a positive attitude to EBF. Sponsorship: Funded by a University of Connecticut Research Foundation grant awarded to Dr Rafael Perez-Escamilla, and the LINKAGES program, Accra, Ghana.