Traditional foods and herbal preparations to improve the perceived insufficiency of breast milk among lactating women in the Dire Dawa Administration, eastern Ethiopia, 2022

Background: Perceptions of insufficient breast milk quantity and the use of some traditional food items and local herbs to increase it are a common phenomenon worldwide, particularly in low-resource countries like Ethiopia. But the food items and herbs used are variable and inconsistent in different areas. So far, studies are scarce nationally and in the study area, and therefore, this study was aimed at assessing the use of traditional food items and local herbs for the perceived benefit of breast milk increment and its associated factors. Methodology : A community-based mixed study was conducted from October 01–30, 2022 in the Dire Dawa administration, eastern Ethiopia. A systematic random sampling technique was used to select 722 participants for the quantitative study and purposive sampling for the qualitative study. Data were collected through face-to-face interviews using a pre-tested structured questionnaire and semi-structured questions for focus group discussion. Quantitative data were entered and cleaned by Epi DATA (Version 3.1) and analyzed using SPSS (Version 22). A P-value < 0.25 at bivariate to select variables for multivariate and ≤ 0.05 at multivariate with 95% confidence intervals was considered statistically significant. Qualitative data were analyzed using thematic analysis using open-source software. Results 722 women for quantitative and nine focus group discussants for qualitative were included and the overall traditional food and local herbs use to increase perceived insufficient breast milk was 32.8% (95% CI: 29.4–36.6%). A higher age group (AOR = 2.31, 95%CI: 1.37–3.90), rural residence (AOR = 1.98, 95%CI: 1.21–3.23), no formal education (AOR = 2.25, 95%CI: 1.16–4.36), primary level education (AOR = 2.02, 95%CI: 1.18–3.46), presence of medical illness (AOR = 4.73, 95%CI: 1.96–11.43), prior use experience (AOR = 2.81, 95% CI: 1.78–4.46) and a lack of postnatal counseling (AOR = 1.80, 95% CI: 1.20–2.70) were associated with a higher likelihood of traditional food and local herbs use. Traditional food items and local herbs were the main identified themes in the qualitative results. Conclusion The extent of traditional food and local herbs use to increase perceived insufficient breast milk was a common practice and associated with women’s age, education, resident area, presence of medical illness, prior use experience, and a lack of postnatal counseling. Stakeholders were recommended to increase postnatal counseling and awareness while taking women's residence and education level into account, as well as conduct additional community-based research.