Association of age and colostrum discarding with exclusive breastfeeding in Ethiopia: systematic review and meta-analyses

Abstract Introduction Even though optimal breastfeeding is important, significantly low percentage of mothers’ initiate breastfeeding timely and maintain exclusive breastfeeding for 6 months. The aim of this meta-analyses and systematic review was to investigate whether maternal/caregivers’ age, infant age (0-6 months) and discarding colostrum affects timely initiation of breastfeeding (TIBF) and exclusive breastfeeding (EBF) in Ethiopia. Methods A systematic search of PubMed, SCOPUS, EMBASE, CINHAL, Web of Science and WHO Global Health Library electronic databases was done for all English published articles from 2000 to January 2018, supplemented by manual search of identified articles and grey literatures bibliographies. Two reviewers independently screened, extracted and graded the quality studies using Newcastle–Ottawa Scale (NOS). Heterogeneity was assessed using the I2 and Cochran Chi-square statistics. A weighted inverse variance random-effects model meta-analysis was done. Result A total of 37 articles (i.e., 14 studies on TIBF and 23 on EBF) were included. TIBF was associated with colostrum discarding (Odds ratio (OR) = 0.38, 95% CI = 0.21-0.68) but not with maternal/caregivers’ age (OR = 0.98, 95% CI = 0.83-1.15). In addition, colostrum discarding (OR = 0.56, 95% CI = 0.37-0.84) and infant age (OR = 1.86, 95% CI = 1.45-2.39) were significantly associated with EBF but not maternal/caregivers’ age (OR = 1.07, 95% CI = 0.81-1.40). Conclusion This meta-analyses indicated absence of association between maternal/caregivers’ age and breastfeeding practice. Colostrum discarding was associated with both EBF and TIBE. This evidence could be helpful to counsel all reproductive age mothers and who discard colostrum.