| dc.description.abstract | Background: Exclusive breastfeeding (EBF), feeding only breastmilk during the first six months, has many short- and long-term benefits for infants, mothers and society. In 2019, the Ethiopian EBF-rate was 59% far below the national target of 72%. In Ethiopia, 85% of the population depends on agriculture. Together with climate change Household Food Insecurity (HFI) has, and will, have a large impact on the country. Limited studies (12) have explored the influence of HFI on EBF intention and practice. Previous studies originated from various areas globally and found mixed results. Objective: To investigate the role of HFI on EBF intention and practice, while considering other theorized predictors of EBF, among all pregnant women (≥ 18) in their second or third trimester residing in the rural district of Dedo Ethiopia. Methods: A selection of variables was obtained from the Mega Project (2017), a prospective cohort (n = 417). Bivariate analyses, logistic regressions and negative binominal regressions were performed. The dependent variable for intention was agree vs. strongly agree to EBF. The dependent variable for practice was either EBF vs. mixed breastfeeding or EBF cessation counted in months. Stepwise predictors were added to the analyses creating multiple models. The predictors included were maternal age, education, intention to EBF, socioeconomic position, ANC visits, place of delivery, early initiation, parity, and sex of newborn. Results: 410 women were included of which 23 were lost to follow up. 98.8% agreed or strongly agreed with EBF while 58.78% practiced EBF. HFI was not significantly associated to EBF intention or practice in any of the analyses. However, the direction of the effect indicates that (severe) food insecure women practice EBF longer. Positive effects to practice EBF (longer) were found for having an education, being multiparous, low socioeconomic position, 1-3 ANC visits, giving birth in a facility, and early initiation of breastfeeding. All these effects were small and insignificant. Conclusion: The current data could not conclusively show the influence of HFI on EBF intentions and practices; however, the effect was in the hypothesized direction. Improving the setting of mothers, including HFI, is important for the successful practice of EBF. | eng |