Despite benefits of exclusive breastfeeding (EBF) and its strategic place in the national guidelines for infant and young child feeding, its practice remains insufficient in Cote d’Ivoire. It is therefore important to identify its early stopping associated factors. We aimed to (i) assess the extent of children’s exposure to exclusive breastfeeding and the associated explanatory factors for discontinuation before six months, and (ii) to profile non-exclusively breastfed children and interrelationships between these factors. A secondary analysis of data from the 2016 Cote d’Ivoire Fifth Multi Indicator Cluster Survey (MICS5) of 980 children under six months of age was conducted in this study. Data were analyzed using the actuarial method of survival hazard estimation combined with the Wilcoxon (Gehan) test, discrete time proportional hazards regression models, and Multiple Correspondence Analysis (MCA) to profile the children. Maternal exposure to counseling session, age at delivery, and child sex were significantly associated with the likelihood of discontinuing exclusive breastfeeding before the first six months of life. Children deprived of EBF resided in urban areas, in high and very high economic welfare households. Their mothers had a secondary education or higher and had three or fewer children. Logistic analysis showed that health status and sex of the child were significantly associated (P < 0.001) with exclusive breastfeeding. An extremely important and rarely studied factor is that children who were sick in weeks prior to the survey were more likely to remain exclusive breastfeeding (adjusted OR 1.80; 95% Confidence Interval (CI) 1.452, 2.234). Girls are less likely to be exclusively breastfed than boys (adjusted OR 1.48; 95% CI 1.22, 1.798). Low standard of living was associated with early cessation of EBF (adjusted OR 2.15; CI 1.325, 3.499). The duration of the exclusive breastfeeding was significantly longer among mothers with high exposure to medical discourse (adjusted OR 0.74; CI 0.595, 0.91). Improving the practice of exclusive breastfeeding in Cote d’Ivoire requires strengthening the capacities of health professionals in terms of advice and assistance to mothers for the practice of exclusive breastfeeding and its maintenance until six months of age, regardless of the health status and sex of the child.

中文翻译：

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科特迪瓦六个月以下儿童纯母乳喂养的相关因素

尽管纯母乳喂养（EBF）有诸多好处，并且在国家婴幼儿喂养指南中具有战略地位，但科特迪瓦的实践仍然不够。因此，确定其早期停止的相关因素非常重要。我们的目的是（i）评估儿童接受纯母乳喂养的程度以及六个月前停止母乳喂养的相关解释因素，以及（ii）分析非纯母乳喂养的儿童以及这些因素之间的相互关系。本研究对 2016 年科特迪瓦第五次多指标类集调查 (MICS5) 的数据进行了二次分析，调查对象为 980 名 6 个月以下儿童。使用生存风险估计精算方法结合 Wilcoxon (Gehan) 检验、离散时间比例风险回归模型和多重对应分析 (MCA) 来分析数据，以对儿童进行分析。母亲接受咨询、分娩年龄和儿童性别与在出生后六个月前停止纯母乳喂养的可能性显着相关。被剥夺了 EBF 的儿童居住在城市地区的高经济福利家庭和极高经济福利家庭。他们的母亲受过中等或以上教育，有三个或更少的孩子。Logistic分析显示，孩子的健康状况和性别与纯母乳喂养显着相关（P<0.001）。一个极其重要且很少研究的因素是，调查前几周内生病的儿童更有可能继续纯母乳喂养（调整后 OR 1.80；95% 置信区间 (CI) 1.452, 2.234）。女孩纯母乳喂养的可能性低于男孩（调整后 OR 1.48；95% CI 1.22，1.798）。低生活水平与早期停止 EBF 相关（调整后 OR 2.15；CI 1.325，3.499）。经常接触医学话语的母亲纯母乳喂养的持续时间明显更长（调整后 OR 0.74；CI 0.595，0.91）。在科特迪瓦改善纯母乳喂养的做法需要加强卫生专业人员的能力，为母亲提供纯母乳喂养的建议和协助，并将其维持到六个月大，无论母亲的健康状况和性别如何孩子。