Prevalence of Delayed Breastfeeding Initiation and Its Risk Factors Among Reproductive Aged Women in Somalia: A Cross‐Sectional Study Using Somalia Health and Demographic Survey

Background and aims: Although the advantages of breastfeeding are well-documented, many mothers struggle to meet the World Health Organization's recommendation for early initiation of breastfeeding. Improved cognitive development and intelligence in children are linked to early breastfeeding. As far as we are aware, no previous studies have looked at the initiation of breastfeeding in Somalia. Thus, the purpose of this study was to evaluate the prevalence and contributing factors of delayed breastfeeding initiation among women in Somalia. Methods: This study used data from 2020 Somalia Health and Demographic Survey, including a weighted samples of 7,965 mothers of children. Multilevel logistic regression was used to identify factors linked to delayed breastfeeding initiation. Statistical significance was determined using adjusted odds ratios with 95% confidence intervals. Results: The prevalence of delayed breastfeeding initiation was 32.73%. Mother age group 25-34 (AOR = 0.85; 95%CI:0: 0.73, 0.98), cesarean section birth (AOR = 2.45; 95%CI: 1.74, 3.44), ANC visit (AOR = 0.80; 95%CI: 0.71, 0.91), did not have immediate skin to skin contact (AOR = 0.32; 95%CI: 0.28, 0.37), high community media exposure (AOR = 0.73; 95%CI: 0.58, 0.92), having breast feeding counseling (AOR = 0.73; 95%CI: 0.59, 0.89) and large birth size (AOR = 0.65; 95%CI:0.53, 0.79) were factors associated with delayed breastfeeding initiation. Conclusion: In Somalia, the rate of delayed breastfeeding initiation is still high. Maternal age, antenatal care visits, mode of delivery, birth size, breastfeeding counseling, skin-to-skin contact, geographic region, residence, and community media exposure are important factors. Therefore, important interventions to encourage early breastfeeding initiation, including breastfeeding education programs, increasing access to ANC services, offering prompt counseling, and assisting mothers during cesarean deliveres. Moreover, implement facility promoting immediate skin-to-skin contact and expanding community-based education and media campaigns to improve awareness in rural areas are vital interventions to encourage early breastfeeding initiation in Somalia.