Infant feeding practices in Bhaktapur, Nepal: a cross-sectional, health facility based survey

International Breastfeeding Journal

Tor A Strand³  Prakash S Shrestha⁴  Lotta Mellander²  Ram K Chandyo⁵  Manjeswori Ulak¹ 

[1] Centre for International Health, University of Bergen, Norway;Department of Paediatrics, Göteborg University, Sweden;Medical Microbiology, Innlandet Hospital Trust, Lillehammer N-2629, Norway;CHRP, Department of Paediatrics, IOM, Nepal;Department of Community Medicine, Kathmandu Medical College, Nepal

关键词: Nepal;    infant;    mixed feeding;    Exclusive breastfeeding;   

Others  :  801509
DOI  :  10.1186/1746-4358-7-1

 received in 2011-02-07, accepted in 2012-01-10,  发布年份 2012

【 摘 要 】

Background

Promotion of proper breastfeeding practices for the first six months of life is the most cost-effective intervention for reducing childhood morbidity and mortality. However, the adherence to breastfeeding recommendations in many developing countries is not satisfactory. The aims of the study were to determine breastfeeding and infant feeding patterns at nine months of age and to assess factors influencing exclusive breastfeeding practices.

Methods

In Bhaktapur, Nepal, we carried out a cross-sectional survey of 325 infants who came for measles vaccination at the age of nine months. Mothers were interviewed on details regarding feeding of their child and health since birth.

Results

Three quarters of all mothers reported that they did not receive any information on breastfeeding during the antenatal visit. Two hundred and ninety five (91%) mothers gave colostrum and 185 (57%) initiated breastfeeding within one hour of delivery. The prevalence of exclusively breastfeeding at 1, 3 and 6 months were 240 (74%), 78 (24%) and 29 (9%), and partial feeding was initiated in 49 (15%), 124 (38%) and 257 (79%) babies, respectively. The main reason, according to the mother, for introducing other foods before six months of age was insufficient breast milk. In logistic regression analyses, mother's knowledge on how long child should be given only breast milk and not living in joint families were associated positively with exclusive or predominant breastfeeding for four months or beyond.

Conclusions

Despite the high proportion of mothers who initiated breastfeeding immediately after birth, continuation of exclusive breastfeeding for up to six months was not common. Very few mothers received any information on breastfeeding during the antenatal visit, indicating a need for counseling on exclusive breastfeeding. Possible options for this counseling could be during antenatal visits and at regular clinic visits for vaccination.

【 授权许可】

   
2012 Ulak et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]UNICEF: Strategy for improved nutrition of children and women in developing countries. New York; 1990.
• [2]WHO: The optimal duration of exclusive breast feeding: reports of an expert consultation. Geneva, WHO; 2001.
• [3]Oddy WH, Sly PD, de Klerk NH, Landau LI, Kendall GE, Holt PG, Stanley FJ: Breast feeding and respiratory morbidity in infancy: a birth cohort study. Arch Dis Child 2003, 88(3):224-228.
• [4]Kalanda BF, Verhoeff FH, Brabin BJ: Breast and complementary feeding practices in relation to morbidity and growth in Malawian infants. Eur J Clin Nutr 2006, 60(3):401-407.
• [5]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.
• [6]Mullany LC, Katz J, Li YM, Khatry SK, LeClerq SC, Darmstadt GL, Tielsch JM: Breast-feeding patterns, time to initiation, and mortality risk among newborns in southern Nepal. J Nutr 2008, 138(3):599-603.
• [7]de Onis M, Garza C, Onyango AW, Rolland-Cachera MF: [WHO growth standards for infants and young children]. Arch Pediatr 2009, 16(1):47-53.
• [8]Haider R, Ashworth A, Kabir I, Huttly SR: Effect of community-based peer counsellors on exclusive breastfeeding practices in Dhaka, Bangladesh: a randomised controlled trial. Lancet 2000, 356(9242):1643-1647.
• [9]Engebretsen IM, Wamani H, Karamagi C, Semiyaga N, Tumwine J, Tylleskar T: Low adherence to exclusive breastfeeding in Eastern Uganda: a community-based cross-sectional study comparing dietary recall since birth with 24-hour recall. BMC Pediatr 2007, 7:10. BioMed Central Full Text
• [10]Vaahtera M, Kulmala T, Hietanen A, Ndekha M, Cullinan T, Salin ML, Ashorn P: Breastfeeding and complementary feeding practices in rural Malawi. Acta Paediatr 2001, 90(3):328-332.
• [11]Mihrshahi S, Ichikawa N, Shuaib M, Oddy W, Ampon R, Dibley MJ, Kabir AK, Peat JK: Prevalence of exclusive breastfeeding in Bangladesh and its association with diarrhoea and acute respiratory infection: results of the multiple indicator cluster survey 2003. J Health Popul Nutr 2007, 25(2):195-204.
• [12]He YN, Zhai F: [Complementary feeding practice in Chinese rural children]. Wei Sheng Yan Jiu 2001, 30(5):305-307.
• [13]Ministry of Health and Population (MOHP), Nepal, NEW ERA and Macro International Inc: Nepal Demographic Health Survey 2006. Kathmandu, Nepal: Ministry of Health and population, New ERA, and Macro International Inc; 2007.
• [14]CBS: Central Bureau of Statistics (CBS). Government of Nepal. National Planning Commission Secretariat. 2001.
• [15]DPHO: Half Yearly report on EPI coverage in Bhaktapur district. District Public Health Office (DPHO), Bhaktapur; 2008.
• [16]Dean AG, Sullivan KM, Soe MM: OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version 2.3.1. [http://www.OpenEpi.com] webcite
• [17]WHO: Indicators for Assessing Infant and Young Child Feeding Practices: Conclusions of a consensus meeting held 6-8 November 2007 in Washington D.C., USA. 2007.
• [18]Labbok MH, Belsey M, Coffin CJ: A call for consistency in defining breast-feeding. Am J Public Health 1997, 87(6):1060-1061.
• [19]Tiwari R, Mahajan PC, Lahariya C: The determinants of exclusive breast feeding in urban slums: a community based study. J Trop Pediatr 2009, 55(1):49-54.
• [20]Chandrashekhar TS, Joshi HS, Binu V, Shankar PR, Rana MS, Ramachandran U: Breast-feeding initiation and determinants of exclusive breast-feeding - a questionnaire survey in an urban population of western Nepal. Public Health Nutr 2007, 10(2):192-197.
• [21]Agampodi SB, Agampodi TC, de Silva A: Exclusive breastfeeding in Sri Lanka: problems of interpretation of reported rates. Int Breastfeed J 2009, 4:14. BioMed Central Full Text
• [22]Aryal TR: Breastfeeding in Nepal: patterns and determinants. JNMA J Nepal Med Assoc 2007, 46(165):13-19.
• [23]Moffat T: Breastfeeding, wage labor, and insufficient milk in peri-urban Kathmandu, Nepal. Med Anthropol 2002, 21(2):207-230.
• [24]HKI: Breastfeeding and complementary feeding practices are less than adequate among mothers of children 12-23 months in the Baitadi districts of Nepal. In Nepal Nutrition and Food Security Bulletin. Helen Keller International (HKI); 2010.
• [25]Fjeld E, Siziya S, Katepa-Bwalya M, Kankasa C, Moland KM, Tylleskar T: 'No sister, the breast alone is not enough for my baby' A qualitative assessment of potentials and barriers in the promotion of exclusive breastfeeding in southern Zambia. Int Breastfeed J 2008, 3(1):26. BioMed Central Full Text
• [26]Imdad A, Yakoob MY, Bhutta ZA: Impact of maternal education about complementary feeding and provision of complementary foods on child growth in developing countries. BMC Public Health 2011, 11(Suppl 3):S25. BioMed Central Full Text
• [27]Bahl R, Frost C, Kirkwood BR, Edmond K, Martines J, Bhandari N, Arthur P: Infant feeding patterns and risks of death and hospitalization in the first half of infancy: multicentre cohort study. Bull World Health Organ 2005, 83(6):418-426.