Newborn infant feeding practices have significant effects on both the child's current and future health. Infectious infections and inadequate newborn feeding account for 60% of all child deaths globally; in the poor world, where inadequate breastfeeding is the norm for around two-thirds of the population, this percentage is significantly higher. This inadequate breastfeeding accounts for 40% of infant fatalities from infections, 30% of infant deaths from diarrhea, and 18% of infant deaths from acute respiratory problems [1, 2].
The first 1000 days of a child's life are crucial because good nutrition during this time reduces chronic illness risk, lowers morbidity and mortality, and promotes overall better development [3]. The widespread use of breast milk replacements with bottle feeding, which has an adverse effect on effective breastfeeding and suitable supplemental feeding, should be avoided. The World Health Organization (WHO) advises against bottle-feeding for infants and young children because it interferes with supplemental feeding that is appropriate and optimal for breastfeeding and because bottles with a nipple are more likely to be contaminated [4].
Bottle feeding is the act of giving an infant any type of food or drink, including breast milk, infant formula, semisolid cereals, tea, juice, etc., from a bottle with a nipple/teat [5]. The rate of bottle-feeding differs by country, ranging from 15% in Nigeria [6] to 64% in Iraq [7]. Furthermore, a higher prevalence of bottle-feeding was reported in various studies, for example in Yemen, it is about 55% [8]. The prevalence of BTLF for West Africa, East Africa, Central Africa, and Southern Africa was 8.17%, 14.32%, 17.01%, and 30.05% respectively [9]. In Ethiopia, bottle feeding prevalence and rates vary by sociodemographic factors. This practice is predominantly associated with Socio-demographic characteristics like age [11, 13], level of maternal education [19, 20], maternal economic and employment status [12, 13, 21–23], marital status [11], the residence of the mothers [20, 24], and obstetric and health facility-related factors [11, 20]. Additionally, many studies also addressed the reasons for practicing bottle-feeding like easiness for feeding the child, assumption of insufficient breast milk, breast or nipple condition and the child did not cry when they gave bottle, are among others [13, 25, 26]. Other studies indicated that mother’s illness, breast-related health issues as well as perceived issues (i.e. perception of insufficiency of mother's milk) are also the reasons to provide bottle-feeding [27, 28]. According to the World Health Organization, the best practices for feeding infants and young children include starting breastfeeding as soon as possible after birth, continuing breastfeeding for at least 6 months while introducing complementary feeding, and continuing breastfeeding for up to 2 years or longer. Even beyond six months, it is advised to feed the infant all liquids from a cup rather than a bottle.
The EDHS 2011 states that one child of every ten uses a bottle with a nipple [10]. Furthermore, other studies done in different parts of Ethiopia showed that the prevalence of bottle feeding in towns like Holeta [11], Shashemene [12], and Agaro town of Jimma Zone is 20.9%, 19.6%, and 93.2% respectively [13]. According to the 2011 Ethiopian Demographic and Health Survey [14], 13% of 0–23 months old infants and young children and 16% of infants under 6 months were fed using a bottle with a nipple [15].
Despite what would appear to be relatively low rates of bottle feeding, which may not accurately reflect the country as a whole, the manner it is done makes bottle feeding more difficult. Furthermore, this practice is especially prevalent in developing nations due to low levels of education among women, limited financial resources, a lack of clean water, unclean environments, and other factors. Inadequate and/or inferior bottles and teats are widely available, which exacerbates the situation in developing countries. One of the dangers of bottle-feeding breast milk to infants is overdilution of the milk, which results in malnutrition. Additionally, bottle-feeding increases the risk of gastrointestinal tract (GIT) disorders such dental caries, ear infections, and others. [6, 7, 16–18].
In general, there is a large shift from breastfeeding to bottle feeding in the urban areas of developing countries [10, 28, 29] and in Ethiopia, the problem of malnutrition, infectious diseases, and mortality among children under the age of 5 years are substantially high [30, 31]. Additionally, bottle feeding is more common in Ethiopia, with rates as high as 38% in some regions like Oromia. According to data from two successive demographic and health surveys, there is also a trend toward more people in the country using bottles to feed their babies (11 to 13%). Even though bottle-feeding is a prevalent practice in Ethiopia, issues relating to it are rare, especially in Addis Abeba's municipal administration. In order to determine the impact of bottle feeding on undernutrition in children aged 6 to 23 months in Bole Sub-City Health Centers of Addis Ababa City Administration of Ethiopia, this study's objective is to evaluate this effect.