1.0 INTRODUCTION/BACKGROUND

1.1 Introduction

Milk is the primary source of nutrition for newborns before able being to digest other foods other than milk (UNICEF, 2006). Breast milk is the milk produced by the breast (or mammary glands) of the human female for her infant offspring. Breast feeding offer health benefits to mother and child when exclusively breast fed. Among the benefits of exclusive breastfeeding to Infants are lower risk of infant Death Syndrome, Increased intelligence, decrease, Cold and flu resistances, lower risk of childhood onset diabetes, risk of asthma and eczema, decrease like hood of contracting middle ear infection, dental problem, Obesity in life, risk of autism, risk of childhood leukemia developing psychological disorders, particularly in adopted children and exclusive breast feeding, reduces the risk of HIV transmission from mother to child (UNICEF, 2006).

Breastfeeding for a period of two years is more cost-effective than the alternative method of feeding the baby particularly in the first six months (WHO, 2010). Breastfeeding might even protect mothers against breast cancer as well as some types of ovarian cancers and used as natural method of family planning (Akbari, et al., 2011; WHO, 2011).

UNICEF recommended exclusive breastfeeding for 6 months of life and continued breastfeeding up to two years of age or beyond (UNICEF, 2006). An appropriate feeding practice is important in survival, growth and development of the child(Kumar, 2006). Withdrawing the process of breastfeeding before the time recommended to children will be a high risk of infections to infant (AED, 2004). Stunting prevalence worldwide is about 52%, and indicated as one of the factor coursed by inadequate exclusive breastfeeding for six months of life (UNICEF, 2008).

The Ministry of Health and Social Welfare (MOHSW) recommended that infants should exclusively breast feed for the first six months, thereafter followed with appropriate complementary foods while on breast milk, up to two year of age (MOH; 2004). Adequate nutrition at the stage of infant and early childhood is essential to insure the growth, health and development of the children to their full potential (WHO; 2009). The Millennium development goal described the exclusive breast feeding (EBF) for six months is among effective interventions to achieve Millennium Development Goal number 4 which is deal with reduction of the child mortality rate (Bryce. et al. 2006).

The Breast milk provides required nutrients to infants, the human milk is endogenous nutrient store contains all nutrients (WHO, 2011). It provides all the energy and nutrients that is needed for growth and development for the first months of life up to two years of age (WHO, 2011).

About 60% of under-five mortality is caused by malnutrition either directly or indirectly, whereby more than 2/3 of those associated with inappropriate breastfeeding practices during infancy (Gupta, 2006). Breastfeeding practice can save many as 1.5 million infants’ lives every year as it provides significant protection against diseases (WHO, 2003). Orphans child is more likely to die before reach age of two years than child whose mother survival (UNICEF, 2007, Sloan et al., 2008, WHO, 2011).

35% of infants worldwide are exclusively breastfeeding during their first four months of life although the rates differ from one country to another (WHO, 2009). Brazil 58%, Bangalore 40%, Iran 69%, Lebanon 10.1%, Nigeria 20%, Bangladesh 34.5%, and Jordan 77% (Batal et al., 2005). In Sub-Sahara and Africa countries exclusive breast feeding rate for six months is about 30% (UNICEF. 2006), 47% in Ethiopia, 13% in Kenya (Koima, 2010) and 50% in Tanzania (UNICEF, 2006. TDHS, 2010. Setegn et al., 2012). Although the CDC reported that, the breastfeeding is rising by 2% (CDC, 2012). One of the study indicated that, the race, maternal age, maternal occupation, parent's educational level, social-economic status, insufficient milk supply, infant health problems, maternal obesity, smoking, parity, method of delivery, maternal interest, social culture, and lack of knowledge were among factors that cause inadequate exclusive breastfeeding (Roudbari, et al. 2009).