Trends, spatial distribution and determinants of bottle feeding among children 0-23 months in Ethiopia, 2024; Evidence from EDHS (2005-2019)

Background; The act of giving baby liquids (including breast milk) or semi-solid food through a bottle using a nipple or teat is known as bottle feeding. The 2018 WHO report showed that 59% of infants worldwide and 85% of infants in Australia practiced bottle feeding. Bottle feeding is associated with high rates of child morbidity and mortality. Bottle feeding of newborn infants has essential implications for their immediate and future health. Objective ; To assess trends, spatial distribution, and determinants of bottle feeding among children 0–23 months using EDHS (Ethiopian demographic and health survey) 2005–2019 data in Ethiopia, 2024 Method; A Cross-sectional study was conducted using the EDHS 2005–2019 data. Data was downloaded and extracted from the DHS website. Stata version 17, Arc-GIS version 10.1, and Sat-Scan 10.1.2 software were used for analysis. Global Moran's I statistics were used to assess the spatial distribution of bottle feeding. Getis-Ord Gi* statistical analysis was used to show hot spot areas for bottle feeding. A multilevel mixed-effect logistic regression model was fitted to identify factors associated with bottle feeding. An adjusted odds ratio with a 95% confidence interval was used to report the association. Result ; The Trend of bottle feeding increased from 14.2% in 2005 to 22.74% in 2019. Spatial variation of bottle feeding was non-random across all the surveys. Women with secondary and above education [AOR = 1.87; 95% CI (1.30, 2.70)], Middle[AOR = 1.80; 95% CI (1.18, 2.78)] and rich [AOR = 2.05; 95% CI (1.35, 3.11)] mothers, Children aged 6–11 months [AOR = 3.95 95% CI (2.74, 5.70)] and 12–23 months [AOR = 2.80; 95% CI(2.01,3.90)of age] and region had higher odds of bottle feeding. Children not delivered by CS [AOR = 0.60; 95% CI (0.38, 0.96)] had low odds of bottle feeding. Conclusion and recommendation; The Trend of bottle feeding has increased over time. Bottle feeding has shown significant spatial variation in all four EDHS surveys(2005–2019). Maternal educational level, wealth index, CS delivery, child age in months, and region were determinant factors of bottle feeding. Addis Ababa, Diredawa, Hareri, and Somali regions were hot spot areas of bottle feeding in all four surveys. Increasing awareness and strengthening effective strategies to hinder the growing pattern of bottle feeding are recommended.