Trends and Factors Associated with Changes in Early Initiation of Breastfeeding: Analysis of the Tanzania Demographic and Health Surveys 2004-2016

Background: Despite WHO recommendations on the benefits of early initiation of breastfeeding for both the mother and child, only 53.5% of newborns in Tanzania are breastfed within the first hour of life. The trend for early initiation of breastfeeding shows little progress and Tanzania is still far behind reaching the global recommended rate of 70% of early initiation of breastfeeding. This study aims to determine trends and factors associated with changes in the early initiation of breastfeeding in Tanzania from 2004-2016. Methodology: This was an analytical cross-sectional study utilizing secondary data from the Tanzania Demographic and Health Surveys (TDHS) for the years 2004-2005, 2010, and 2015-2016. Data analysis was performed using Stata 15. Frequencies and proportions were used to summarize categorical variables. A Modified Poisson regression model was used to determine factors associated with the early initiation of breastfeeding. Multivariable Poisson decomposition analysis was used to assess factors associated with changes in the early initiation of breastfeeding across surveys. Results: Trends in early initiation of breastfeeding decreased from 59.53% in 2004/2005 to 46.72% in 2010, and then increased to 51.94% in 2015/2016. Only 5.9% of the overall change in early initiation of breastfeeding was contributed by the difference in characteristics such as mode of delivery and working status. The difference in coefficients contributed to a 94% decrease in early initiation of breastfeeding mostly due to a decrease in early initiation of breastfeeding among caesarean section delivery patients. Conclusion: The prevalence of early initiation of breastfeeding in Tanzania decreased between 2004 and 2016, then increased from 2010-2016. Interventions and health policies need to target factors that had significant effects on the early initiation of breastfeeding such as increasing health facility delivery and promoting the initiation of breastfeeding soon after caesarean section delivery.