Infant feeding practices and determinants of poor breastfeeding behavior in Kinshasa, Democratic Republic of Congo: a descriptive study

International Breastfeeding Journal

Frieda Behets⁴  Miriam Labbok²  Jean Lambert Chalachala³  Marcel Yotebieng¹ 

[1] Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, The University of North Carolina at Chapel Hill, Chapel Hill NC, USA;School of Public Health, The University of Kinshasa, Kinshasa, DR, Congo;School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

关键词: DR Congo;    Kinshasa;    Infant feeding practices;    Exclusive breastfeeding;    Breastfeeding;   

Others  :  801019
DOI  :  10.1186/1746-4358-8-11

 received in 2013-01-21, accepted in 2013-09-28,  发布年份 2013

【 摘 要 】

Background

Although breastfeeding is almost universally accepted in the Democratic Republic (DR) of Congo, by the age of 2 to 3 months 65% of children are receiving something other than human milk. We sought to describe the infant feeding practices and determinants of suboptimal breastfeeding behaviors in DR Congo.

Methods

Survey questionnaire administered to mothers of infants aged ≤ 6 months and healthcare providers who were recruited consecutively at six selected primary health care facilities in Kinshasa, the capital.

Results

All 66 mothers interviewed were breastfeeding. Before initiating breastfeeding, 23 gave their infants something other than their milk, including: sugar water (16) or water (2). During the twenty-four hours prior to interview, 26 (39%) infants were exclusively breastfed (EBF), whereas 18 (27%), 12 (18%), and 10 (15%) received water, tea, formula, or porridge, respectively, in addition to human milk. The main reasons for water supplementation included “heat” and cultural beliefs that water is needed for proper digestion of human milk. The main reason for formula supplementation was the impression that the baby was not getting enough milk; and for porridge supplementation, the belief that the child was old enough to start complementary food. Virtually all mothers reported that breastfeeding was discussed during antenatal clinic visit and half reported receiving help regarding breastfeeding from a health provider either after birth or during well-child clinic visit. Despite a median of at least 14 years of experience in these facilities, healthcare workers surveyed had little to no formal training on how to support breastfeeding and inadequate breastfeeding-related knowledge and skills. The facilities lacked any written policy about breastfeeding.

Conclusion

Addressing cultural beliefs, training healthcare providers adequately on breastfeeding support skills, and providing structured breastfeeding support after maternity discharge is needed to promote EBF in the DR Congo.

【 授权许可】

   
2013 Yotebieng et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Estimates of under-five mortality rates by country, the 2011 release. [http://www.childmortality.org/ webcite]
• [2]Building a future for women and children. The 2012 Report [http://www.countdown2015mnch.org/reports-and-articles/2012-report webcite]
• [3]Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, et al.: Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. The Lancet 2012, 379(9832):2151-2161.
• [4]Mosley WH, Chen LC: An analytical framework for the study of child survival in developing countries. Bull World Health Organ 2003, 81(2):140-145.
• [5]Ministère du Plan avec la collaboration du Ministère de la Santé Kinshasa RDdCaMIIC. Maryland, USA: Congo Democratic Republic: DHS, 2007 - Final Report (French); 2008.
• [6]Resultat Preliminaires [http://www.childinfo.org/files/MICS_RDC_2010.pdf]
• [7]WHO/UNICEF: Progress on sanitation and drinking-water 2010 update. World Health Organization; 2010.
• [8]WHO: Global strategy for infant and young child feeding, the optimal duration of exclusive breastfeeding. 2001. [Provisional agenda item 13.1] [http://apps.who.int/gb/archive/pdf_files/WHA54/ea54id4.pdf webcite]
• [9]Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J: Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008, 371(9608):243-260.
• [10]Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS: How many child deaths can we prevent this year? Lancet 2003, 362(9377):65-71.
• [11]Edmond KM, Zandoh C, Quigley MA, Amenga-Etego S, Owusu-Agyei S, Kirkwood BR: Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics 2006, 117(3):e380-e386.
• [12]Bhutta ZA, Chopra M, Axelson H, Berman P, Boerma T, Bryce J, Bustreo F, Cavagnero E, Cometto G, Daelmans B, et al.: Countdown to 2015 decade report (2000–10): taking stock of maternal, newborn, and child survival. Lancet 2010, 375(9730):2032-2044.
• [13]WHO/UNICEF: Baby-friendly hospital initiative: revised, updated and expanded for integrated care. 2009. [http://whqlibdoc.who.int/publications/2009/9789241594967_eng.pdf webcite]
• [14]Abrahams SW, Labbok MH: Exploring the impact of the Baby-Friendly Hospital Initiative on trends in exclusive breastfeeding. Int Breastfeed J 2009, 4:11. BioMed Central Full Text
• [15]Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, Haider BA, Kirkwood B, Morris SS, Sachdev HP, et al.: What works? Interventions for maternal and child undernutrition and survival. Lancet 2008, 371(9610):417-440.
• [16]Coutinho SB, de Lira PI, de Carvalho LM, Ashworth A: Comparison of the effect of two systems for the promotion of exclusive breastfeeding. Lancet 2005, 366(9491):1094-1100.
• [17]Coghlan B, Brennan RJ, Ngoy P, Dofara D, Otto B, Clements M, Stewart T: Mortality in the Democratic Republic of Congo: a nationwide survey. Lancet 2006, 367(9504):44-51.
• [18]Coghlan B, Ngoy P, Mulumba F, Hardy C, Bemo VN, Stewart T, Lewis J, Brennan RJ: Update on mortality in the Democratic Republic of Congo: results from a third nationwide survey. Disaster Med Public Health Prep 2009, 3(2):88-96.
• [19]Monitoring the Status of Women and Children. Area Graph, DRC [http://www.childinfo.org/breastfeeding_dprcongo.html webcite]
• [20]Labbok MH, Pérez-Escamilla R, Peterson A, Coly S: Breastfeeding and Child Spacing - Country Profiles. Washington DC: Institute of Reproductive Health. Georgetown University; 1997.
• [21]Infant Feeding Practices Study II. The Questionnaires [http://www.cdc.gov/ifps/questionnaires.htm webcite]
• [22]DHS Model Questionnaires. [http://www.measuredhs.com/publications/publicationsearch.cfm?type=35 webcite]
• [23]McLeroy KR, Bibeau D, Steckler A, Glanz K: An ecological perspective on health promotion programs. Health Educ Q 1988, 15(4):351-377.
• [24]Labbok MH: Community interventions to promote optimal breastfeeding: Review of studies on early initiation, any breastfeeding, exclusive breastfeeding, and continued breastfeeding. Washington, DC: The Infant & Young Child Nutrition Project (IYCN); 2012.
• [25]Salhab WA, Wyckoff MH, Laptook AR, Perlman JM: Initial hypoglycemia and neonatal brain injury in term infants with severe fetal acidemia. Pediatrics 2004, 114(2):361-366.
• [26]Cornblath M, Hawdon JM, Williams AF, Aynsley-Green A, Ward-Platt MP, Schwartz R, Kalhan SC: Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics 2000, 105(5):1141-1145.
• [27]de Rooy L, Hawdon J: Nutritional factors that affect the postnatal metabolic adaptation of full-term small- and large-for-gestational-age infants. Pediatrics 2002, 109(3):E42.
• [28]Hoseth E, Joergensen A, Ebbesen F, Moeller M: Blood glucose levels in a population of healthy, breast fed, term infants of appropriate size for gestational age. Arch Dis Child Fetal Neonatal Ed 2000, 83(2):F117-F119.
• [29]Li R, Fein SB, Chen J, Grummer-Strawn LM: Why mothers stop breastfeeding: mothers' self-reported reasons for stopping during the first year. Pediatrics 2008, 122(Suppl 2):S69-S76.
• [30]Gatti L: Maternal perceptions of insufficient milk supply in breastfeeding. J Nurs Scholarsh 2008, 40(4):355-363.
• [31]Britton C, McCormick FM, Renfrew MJ, Wade A, King SE: Support for breastfeeding mothers. Cochrane Database Syst Rev 2007., 1CD001141
• [32]Chung M, Ip S, Yu W, Raman G, Trikalinos T, DeVine D, Lau J: Interventions in primary care to promote breastfeeding: a systematic review. Edited by Agency for Healthcare Research and Quality. Rockville (MD), USA; 2008. [vol. Evidence Syntheses, No. 66]