{ "abstract": "Background\n\nAn important strategy to decrease infant morbidity and mortality is timely initiation of breastfeeding (TIBF), which is defined as putting the newborn to the breast within 1 hour of delivery. Delayed initiation of breastfeeding may contribute to high neonatal and infant mortality in sub-Saharan Africa.Objective\n\nThis study assessed the prevalence of TIBF and associated factors using recent Demographic and Health Survey data from 20 sub-Saharan African countries.Methods\n\nUsing recent Demographic and Health Survey data from sub-Saharan African countries, a cross-sectional study was conducted. Data were accessed on January 27, 2026. The analysis included 177,988 children after application of sampling weights. The hierarchical structure of the data was taken into consideration by conducting a multilevel logistic regression analysis. Results were presented using adjusted odds ratios (AORs) with 95% CIs. To evaluate cluster-level variance, random-effects measures such as the median odds ratio and intraclass correlation coefficient were reported.Results\n\nAmong 177,988 weighted samples, 59.05% (95% CI 58.82%-59.28%) initiated breastfeeding within 1 hour of birth. TIBF was more likely among rural residents (AOR 1.25, 95% CI 1.21-1.28), mothers with primary (AOR 1.48, 95% CI 1.45-1.52), secondary (AOR 1.22, 95% CI 1.19-1.26), and higher education (AOR 1.22, 95% CI 1.15-1.28), institutional delivery (AOR 1.40, 95% CI 1.36-1.43), multiparous (AOR 1.19, 95% CI 1.15-1.23), and grand multiparous mothers (AOR 1.10, 95% CI 1.05-1.14). Lower odds were observed among cesarean births (AOR 0.31, 95% CI 0.30-0.33), twin births (AOR 0.87, 95% CI 0.82-0.92), delayed antenatal care initiation (AOR 0.84, 95% CI 0.82-0.85), female children (AOR 0.90, 95% CI 0.88-0.91), and mothers with a history of child death (AOR 0.90, 95% CI 0.86-0.94).Conclusions\n\nTIBF remains suboptimal in sub-Saharan Africa and is influenced by maternal, obstetric, and health care factors. Enhancing antenatal counseling and postnatal breastfeeding support, particularly after cesarean delivery and among vulnerable groups, may improve timely initiation practices.", "abstract_shown": true, "affiliations": [ "Department of Health Promotion and Behavioral Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, 273, Ethiopia, +251 936987005.", "Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.", "Public Health Department, College of Medicine and Health Science, Debre Markos University, Amhara, Ethiopia.", "School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.", "College of Medicine and Health Science, Debre Markos University, Amhara, Ethiopia.", "Debre Markos University, Debre Markos, Amhara, Ethiopia.", "Injibara University, Injibara, Amhara, Ethiopia.", "Department of Midwifery, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia." ], "article_type": "research article", "arxiv": null, "author_total": 12, "authors": [ { "affs": [ 0 ], "name": "Tadele Derbew Kassie", "orcid": "0000-0003-2211-6090" }, { "affs": [ 1 ], "name": "Getnet Gedif", "orcid": "0000-0002-2193-1248" }, { "affs": [ 2 ], "name": "Mequanent Dessie Bitewa", "orcid": "0009-0002-7239-5104" }, { "affs": [ 2 ], "name": "Atsede Alle Ewunetie", "orcid": "0000-0002-1851-913X" }, { "affs": [ 3 ], "name": "Tewodros Shibabaw", "orcid": "0000-0002-9155-4898" }, { "affs": [ 4 ], "name": "Menberu Gete", "orcid": "0009-0008-4672-633X" }, { "affs": [ 5 ], "name": "Melkamu Siferih", "orcid": "0000-0002-6468-7708" }, { "affs": [ 6 ], "name": "Mikias Getahun Molla", "orcid": "0009-0001-3610-0615" }, { "affs": [ 5 ], "name": "Tirusew Wondie Wodie", "orcid": "0009-0003-4941-8125" }, { "affs": [ 6 ], "name": "Daniel Mulat Eshetu", "orcid": "0009-0007-1201-904X" }, { "affs": [ 7 ], "name": "Abebaw Abeje Muluneh", "orcid": "0000-0002-9877-5212" }, { "affs": [ 2 ], "name": "Aysheshim Asnake Abneh", "orcid": "0009-0003-3884-2529" } ], "bibtex": "https://research.draconitic.com/paper/814zt7rtgthpy.bib", "cited_by": 0, "doi": "10.2196/103827", "fulltext_url": "https://europepmc.org/articles/PMC13679858", "id": "814zt7rtgthpy", "issns": [ "2561-6722" ], "landing_url": "https://europepmc.org/article/MED/42896126", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2713|Breastfeeding Practices and Influences" ] ], "openalex": "W7213059765", "pdf_url": "https://europepmc.org/articles/PMC13679858?pdf=render", "pmcid": "PMC13679858", "pmid": "42896126", "published": "2026-10-19", "publisher": null, "ris": "https://research.draconitic.com/paper/814zt7rtgthpy.ris", "sources": [ { "first_seen": "2026-10-30T12:19:32Z", "native_id": "MED:42896126", "source": "europepmc", "url": "https://europepmc.org/article/MED/42896126" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2713|Breastfeeding Practices and Influences", "subfield": "epidemiology-public-health" } ], "title": "Timely Initiation of Breastfeeding and Associated Factors in 20 Sub-Saharan African Countries: Cross-Sectional Multilevel Analysis of Recent Demographic and Health Surveys.", "title_text": "Timely Initiation of Breastfeeding and Associated Factors in 20 Sub-Saharan African Countries: Cross-Sectional Multilevel Analysis of Recent Demographic and Health Surveys.", "type": "peer-reviewed", "updated_at": "2026-10-30T12:19:32Z", "url": "https://research.draconitic.com/paper/814zt7rtgthpy", "venue": "JMIR pediatrics and parenting", "versions": [] }