Predictors of exclusive breastfeeding cessation among employed mothers in Mogadishu, Somalia: A cross-sectional study

BACKGROUND: Exclusive breastfeeding (EBF) is critical for infant health and development during the first six months of life. However, employed mothers often face workplace-related challenges that contribute to EBF cessation before the recommended six months. Evidence specifically examining predictors of EBF cessation among employed mothers in Somalia remains limited. This study aimed to assess the prevalence and predictors of EBF cessation among employed mothers in Mogadishu, Somalia. METHODS: A quantitative, descriptive cross-sectional study was conducted in Mogadishu, Somalia, from August 20, 2024, to October 20, 2024, among 303 employed mothers with children aged 6-24 months. Participants were selected using stratified random sampling across four occupational categories. Data were collected through face-to-face interviews using a structured questionnaire adapted from World Health Organization infant and young child feeding tools and the Somalia Health and Demographic Survey. Bivariable and multivariable logistic regression analyses were performed, and crude odds ratios (CORs) and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. RESULTS: The prevalence of EBF cessation was 76.2% (231/303; 95% CI: 70.3%-81.2%). Among mothers with available cessation timing data, the largest proportion stopped EBF in the third month (109/229; 47.6%). In multivariable analysis, flexible working time was associated with lower odds of EBF cessation (AOR = 0.47; 95% CI: 0.23-0.96), and family support was strongly protective (AOR = 0.07; 95% CI: 0.03-0.16). Receiving paid maternity leave showed higher odds of EBF cessation but did not reach statistical significance after adjustment (AOR = 2.52; 95% CI: 0.97-6.54). Lactation breaks showed a non-significant protective trend (AOR = 0.53; 95% CI: 0.24-1.19). CONCLUSION: EBF cessation was highly prevalent among employed mothers in Mogadishu. Flexible working time and family support were protective, while paid maternity leave showed a positive but non-significant association with cessation after adjustment, possibly reflecting short leave duration and early return to full-time work. Workplace policies that extend practical maternity protection, improve work flexibility, provide breastfeeding spaces, and strengthen family and employer support are needed.