Suboptimal breastfeeding practices are associated with infant illness in Vietnam

International Breastfeeding Journal

Lan Tran Mai¹  Tuan T Nguyen³  Priya Mannava²  Phuong H Nguyen¹  Nemat Hajeebhoy³ 

[1]International Food Policy Research Institute (IFPRI), Hanoi, Vietnam

[2]Independent Public Health Consultant, Hanoi, Vietnam

[3]Family Health International (FHI 360), Hanoi, Vietnam

关键词: Vietnam;    Prelacteal feeding;    Infant;    Diarrhea;    Breastfeeding;    ARI;   

Others  :  1135876
DOI  :  10.1186/1746-4358-9-12

 received in 2014-02-08, accepted in 2014-07-24,  发布年份 2014

【 摘 要 】

Background

Despite evidence supporting the importance of breastfeeding to child health, breastfeeding practices remain suboptimal in Vietnam. There is currently little evidence on the importance of breastfeeding in the prevention of morbidity during infancy in Vietnam. In order to provide country specific data for policy makers to support breastfeeding friendly policies and programs, analysis was undertaken on a cross-sectional dataset to investigate the association between breastfeeding practices and prevalence of diarrhea and acute respiratory infection (ARI) among infants aged 0–5 months.

Methods

Data on socio-demographic characteristics, infant feeding practices and prevalence of diarrhea and ARI were obtained from 6,068 mother-child dyads in 11 provinces of Vietnam in 2011. Multivariate logistic regression was used to examine the associations between breastfeeding practices and child illnesses.

Results

On average, the prevalence of diarrhea and ARI among infants 0–5 months was 5.3% and 24.5%, respectively. Though half of all infants were breastfed within one hour of birth, 73.3% were given prelacteal foods in the first three days after birth. Only 20.2% of children 0–5 months old were exclusively breastfed, while 32.4% were predominantly breastfed and 47.4% partially breastfed. After adjusting for confounders, early initiation of breastfeeding was associated with lower prevalence of diarrhea [adjusted odds ratio (AOR) = 0.74 (95% CI 0.58, 0.93)], while prelacteal feeding was associated with higher prevalence [AOR = 1.53 (95% CI 1.15, 2.03)]. Compared to infants who were exclusively breastfed, infants who were predominantly [AOR = 1.52 (95% CI 1.05, 2.21)] or partially breastfed [AOR = 1.55 (95% CI 1.07, 2.24)] were more likely to have diarrhea. Prelacteal feeding [AOR = 1.16 (95% CI 1.01, 1.33)] and partial breastfeeding [AOR relative to exclusive breastfeeding = 1.24 (95% CI 1.03, 1.48)] were associated with higher prevalence of ARI. While the protective effects of exclusive breastfeeding against diarrhea declined with child age, this effect for ARI appears to have remained constant.

Conclusions

Early initiation and exclusive breastfeeding protects against diarrhea and ARI. Results confirm that interventions to improve early and exclusive breastfeeding would contribute to improving child health and nutrition in Vietnam.

【 授权许可】

   
2014 Hajeebhoy et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Gartner LM, Morton J, Lawrence RA, Naylor AJ, O’Hare D, Schanler RJ, Eidelman AI: Breastfeeding and the use of human milk. Pediatrics 2005, 115(2):496-506.
• [2]Horta BL, Bahl R, Martines JC, Victora CG: Evidence on the long-term effects of breastfeeding: systematic reviews and meta-analysis. Geneva: World Health Organization; 2007.
• [3]Morrow AL, Ruiz-Palacios GM, Jiang X, Newburg DS: Human-milk glycans that inhibit pathogen binding protect breast-feeding infants against infectious diarrhea. J Nutr 2005, 135(5):1304-1307.
• [4]Noguera-Obenza M, Ochoa TJ, Gomez HF, Guerrero ML, Herrera-Insua I, Morrow AL, Ruiz-Palacios G, Pickering LK, Guzman CA, Cleary TG: Human milk secretory antibodies against attaching and effacing Escherichia coli antigens. Emerg Infect Dis 2003, 9(5):545-551.
• [5]Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality Lancet 2000, 355(9202):451-455.
• [6]Kramer MS, Kakuma R: The optimal duration of exclusive breastfeeding: a systematic review. Adv Exp Med Biol 2004, 554:63-77.
• [7]Lamberti LM, Fischer Walker CL, Noiman A, Victora C, Black RE: Breastfeeding and the risk for diarrhea morbidity and mortality. BMC Public Health 2011, 11(Suppl 3):S15.
• [8]Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J: Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep) 2007, 153:1-186.
• [9]Marild S, Jodal U, Hanson LA: Breastfeeding and urinary-tract infection. Lancet 1990, 336(8720):942.
• [10]Pisacane A, Graziano L, Zona G: Breastfeeding and urinary tract infection. Lancet 1990, 336(8706):50.
• [11]Victora CG, Smith PG, Barros FC, Vaughan JP, Fuchs SC: Risk factors for deaths due to respiratory infections among Brazilian infants. Int J Epidemiol 1989, 18(4):918-925.
• [12]Wright AL, Holberg CJ, Martinez FD, Morgan WJ, Taussig LM: Breast feeding and lower respiratory tract illness in the first year of life. Group Health Medical Associates. BMJ 1989, 299(6705):946-949.
• [13]Aniansson G, Alm B, Andersson B, Hakansson A, Larsson P, Nylen O, Peterson H, Rigner P, Svanborg M, Sabharwal H, Svanborg C: A prospective cohort study on breast-feeding and otitis media in Swedish infants. Pediatr Infect Dis J 1994, 13(3):183-188.
• [14]Duncan B, Ey J, Holberg CJ, Wright AL, Martinez FD, Taussig LM: Exclusive breast-feeding for at least 4 months protects against otitis media. Pediatrics 1993, 91(5):867-872.
• [15]Lucas A, Cole TJ: Breast milk and neonatal necrotising enterocolitis. Lancet 1990, 336(8730):1519-1523.
• [16]Butz WP, Habicht JP, DaVanzo J: Environmental factors in the relationship between breastfeeding and infant mortality: the role of sanitation and water in Malaysia. Am J Epidemiol 1984, 119(4):516-525.
• [17]Clemens JD, Sack DA, Harris JR, Khan MR, Chakraborty J, Chowdhury S, Rao MR, van Loon FP, Stanton BF, Yunus M, Ali M, Ansaruzzaman M, Svennerholm A, Holmgren J: Breast feeding and the risk of severe cholera in rural Bangladeshi children. Am J Epidemiol 1990, 131(3):400-411.
• [18]VanDerslice J, Popkin B, Briscoe J: Drinking-water quality, sanitation, and breast-feeding: their interactive effects on infant health. Bull World Health Organ 1994, 72(4):589-601.
• [19]WHO: Global strategy for infant and young child feeding: the optimal duration of exclusive breastfeeding. Geneva: World Health Organization; 2001.
• [20]Lauer JA, Betran AP, Victora CG, de Onis M, Barros AJ: Breastfeeding patterns and exposure to suboptimal breastfeeding among children in developing countries: review and analysis of nationally representative surveys. BMC Med 2004, 2:26.
• [21]Dibley MJ, Senarath U, Agho KE: Infant and young child feeding indicators across nine East and Southeast Asian countries: an analysis of National Survey Data 2000–2005. Public Health Nutr 2010, 13(9):1296-1303.
• [22]Nguyen PH, Menon P, Ruel M, Hajeebhoy N: A situational review of infant and young child feeding practices and interventions in Vietnam. Asia Pac J Clin Nutr 2011, 20(3):359-374.
• [23]Duong DV, Binns CW, Lee AH: Breast-feeding initiation and exclusive breast-feeding in rural Vietnam. Public Health Nutr 2004, 7(6):795-799.
• [24]Hop LT, Gross R, Giay T, Sastroamidjojo S, Schultink W, Lang NT: Premature complementary feeding is associated with poorer growth of Vietnamese children. J Nutr 2000, 130(11):2683-2690.
• [25]Thu HN, Eriksson B, Khanh TT, Petzold M, Bondjers G, Kim CN, Thanh LN, Ascher H: Breastfeeding practices in urban and rural Vietnam. BMC Public Health 2012, 12:964.
• [26]Duong DV, Binns CW, Lee AH: Introduction of complementary food to infants within the first six months postpartum in rural Vietnam. Acta Paediatr 2005, 94(12):1714-1720.
• [27]UNICEF: UNICEF and Nutritional Institute of Nutrition: a review of the nutrition situation in Viet Nam 2009–2010. 2011.
• [28]Baker J, Sanghvi T, Hajeebhoy N, Abrha TH: Learning from the design and implementation of large-scale programs to improve infant and young child feeding. Food Nutr Bull 2013, 34(3 Suppl):S226-S230.
• [29]Baker J, Sanghvi T, Hajeebhoy N, Martin L, Lapping K: Using an evidence-based approach to design large-scale programs to improve infant and young child feeding. Food Nutr Bull 2013, 34(3 Suppl):S146-S155.
• [30]WHO, UNICEF: Diarrhea: why children are still dying and what can be done. Geneva: World Health Organization; 2009.
• [31]WHO: Infection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care. WHO interim guidelines. Geneva: World Health Organization; 2007.
• [32]WHO: Indicators for assessing infant and young child feeding practices. Part 2: Measurements. Geneva: World Health Organization; 2008. http://whqlibdoc.who.int/publications/2010/9789241599290_eng.pdf webcite
• [33]GSO: General Statistics Office of Viet Nam: statistical data: administrative unit, land and climate. 2010. http://www.gso.gov.vn webcite
• [34]Vyas S, Kumaranayake L: Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 2006, 21(6):459-468.
• [35]StataCorp: Stata Statistical Software Release 11. Texas: College Station, Stata Corporation; 2009.
• [36]Przyrembel H: Timing of introduction of complementary food: short- and long-term health consequences. Ann Nutr Metab 2012, 60(Suppl 2):8-20.
• [37]UNICEF: Progress on drinking water and sanitation 2012 update. USA: UNICEF and the World Health Organization; 2012.
• [38]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.
• [39]Mihrshahi S, Kabir I, Roy SK, Agho KE, Senarath U, Dibley MJ: Determinants of infant and young child feeding practices in Bangladesh: secondary data analysis of Demographic and Health Survey 2004. Food Nutr Bull 2010, 31(2):295-313.
• [40]Lopez-Alarcon M, Villalpando S, Fajardo A: Breast-feeding lowers the frequency and duration of acute respiratory infection and diarrhea in infants under six months of age. J Nutr 1997, 127(3):436-443.
• [41]Victora CG, Smith PG, Vaughan JP, Nobre LC, Lombardi C, Teixeira AM, Fuchs SM, Moreira LB, Gigante LP, Barros FC: Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil. Lancet 1987, 2(8554):319-322.
• [42]Arifeen S, Black RE, Antelman G, Baqui A, Caulfield L, Becker S: Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics 2001, 108(4):E67.