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. 2025 May 9;25(1):367.
doi: 10.1186/s12887-025-05495-x.

Determinants of given anything other than breast milk for neonates in Ethiopia: a multilevel modeling complex sample survey data analysis

Nigusie Selomon Tibebu  1 , Tigabu Desie Emiru  2 , Chalie Marew Tiruneh  2 , Gebrehiwot Berie Mokonnen  2 , Birara Aychew Tilaye  2 , Lakachew Yismaw Bazezew  2 , Bisrat Dessie Getu  3 , Moges Wubneh Abate  4 , Adane Birhanu Nigat  4 , Getasew Legas  5 , Belete Gelaw Walle  6 , Mulualem Gete Feleke  7 , Endalk Birrie  8
Affiliations

Determinants of given anything other than breast milk for neonates in Ethiopia: a multilevel modeling complex sample survey data analysis

Nigusie Selomon Tibebu et al. BMC Pediatr. .

Abstract

Background: Giving any things other than breast milk during the first 3 days after birth is a prelacteal feeding. Thus, providing anything other than breast milk to newborns has an impact on the prompt initiation and exclusive breastfeeding but a major issue in the developing countries. Therefore, the aimed to assess the determinants both individual and community level factors of given anything other than breast milk for neonates in Ethiopia.

Methods: This study was a multilevel population-based cross-sectional conducted with total of weighted sample of 24,252 participants. The Ethiopian Demographic and Health Survey 2019 data were the source of secondary data analysis used in the study. The data was hierarchical; therefore we performed a multilevel analysis. In the multivariable analysis, variables with p-value < 0.05 were deemed substantially correlated with given anything other than breast milk for neonates.

Results: In this study, respondents with Catholic religion followers [adjusted odds ratio (AOR) = 0.05; 95%CI: 0.12, 0.28] timely initiation of breast feeding [AOR = 4.44; 95%CI: 2.91, 6.74], Cesarean delivery usage [AOR = 3.94; 95%CI: 2.13, 7.13], and being in communities with pastoralist region [AOR = 6.39; 95%CI: 3.03, 11.62] were significant predictors of given anything other than breast milk for neonates.

Conclusion: This study found that giving anything other than breast milk to newborns was associated with both individual and community level characteristics, particularly among members of the Catholic Church, prompt commencement of breastfeeding, use of cesarean section delivery, and contextual region categories. Therefore, improving maternal health and early breastfeeding services should be strengthen. Furthermore, it is preferable to fairly distribute maternal services among regions and to focus on people living in pastoralist regions.

Keywords: Breast milk; Ethiopia; Multilevel modeling; Neonates.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: All methods were carried out in accordance with relevant guidelines of the Demographic and Health Surveys (DHS) program. Informed consent was waived from the International Review Board of Demographic and Health Surveys (DHS) program data archivists, after the consent paper was submitted to DHS Program, a letter of permission to download the dataset for this study. The dataset was not shared or passed on to other bodies and has maintained its confidentiality. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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