Determinants of early initiation of breastfeeding in Somalia: A population based study using the 2020 demographic and health survey data

Background Early initiation of breastfeeding (EIBF) within one hour of birth is essential for neonatal survival, yet evidence from Somalia is limited. This study examined determinants of EIBF using nationally representative data. Methods A secondary analysis of the 2020 Somali Demographic and Health Survey (SDHS) was conducted among 2,020 women with children aged 0–23 months. Sampling weights were applied. EIBF was analyzed as a binary outcome using bivariate and multivariate logistic regression. Statistical significance was set at p ≤ 0.05. Analyses were performed using SPSS version 27. Results Overall, 75% of newborns were breastfed within the first hour after birth. In the multivariate analysis, mothers aged 30–39 years were more likely to initiate breastfeeding early compared with those aged 15–19 years (AOR = 1.65; 95% CI: 1.01–2.70). Urban residence was positively associated with EIBF (AOR = 1.31; 95% CI: 1.02–1.68), while nomadic residence was negatively associated (AOR = 0.52; 95% CI: 0.40–0.68). Mothers without radio exposure (AOR = 0.68; 95% CI: 0.47–1.00), unemployed mothers (AOR = 0.17; 95% CI: 0.04–0.85), and those whose husbands were unemployed (AOR = 0.75; 95% CI: 0.63–0.91) had lower odds of EIBF. Facility delivery significantly increased the likelihood of EIBF (AOR = 1.44; 95% CI: 1.03–2.00). Conclusion EIBF in Somalia is influenced by maternal, socioeconomic, and health service related factors. Strengthening facility-based deliveries and expanding health education through mass media may improve EIBF practices.