Journal Article

Determinants of infant breastfeeding practices in Nepal: a national study

Bhandari, Shiva, Nonyane, Bareng Aletta Sanny, Thorne-Lyman, Andrew L., West, Keith P., Neupane, Sumanta, Shrestha, Binod, Klemm, Rolf D. W., Manohar, Swetha

2019

Overview

Background Optimal breastfeeding practices, reflected by early initiation and feeding of colostrum, avoidance of prelacteal feeds, and continued exclusivity or predominance of breastfeeding, are critical for assuring proper infant nutrition, growth and development. Methods We used data from a nationally representative survey in 21 district sites across the Mountains, Hills and Terai (southern plains) of Nepal in 2013. Determinants of early initiation of breastfeeding, feeding of colostrum, prelacteal feeding and predominant breastfeeding were explored in 1015 infants < 12 months of age. Prelacteal feeds were defined as food/drink other than breast milk given to newborns in first 3 days. Predominant breastfeeding was defined as a child < 6 months of age is mainly breastfed, not fed solid/semi-solid foods, infant formula or non-human milk, in the past 7 days. Adjusted prevalence ratios (APR) and 95% confidence intervals (CI) were estimated, using log Poisson regression models with robust variance for clustering. Results The prevalence of breastfeeding within an hour of birth, colostrum feeding, prelacteal feeding and predominant breastfeeding was 41.8, 83.5, 32.7 and 57.2% respectively. Compared to infants not fed prelacteal feeds, infants given prelacteal feeds were 51% less likely to be breastfed within the first hour of birth (APR 0.49; 95% CI 0.36, 0.66) and 55% less likely to be predominantly breastfed (APR 0.45; 95% CI 0.32, 0.62). Infants reported to have received colostrum were more likely to have begun breastfeeding within an hour of birth (APR 1.26; 95% CI 1.04, 1.54) compared to those who did not receive colostrum. Infants born to mothers ≥ 20 years of age were less likely than adolescent mothers to initiate breastfeeding within 1 hour of birth. Infants in the Terai were 10% less likely to have received colostrum (APR 0.90; 95% CI 0.83, 0.97) and 2.72 times more likely to have received prelacteal feeds (APR 2.72; 95% CI 1.67, 4.45) than those in the Mountains. Conclusions Most infants in Nepal receive colostrum but less than half initiate breastfeeding within an hour of birth and one-third are fed prelacteal feeds, which may negatively affect breastfeeding and health throughout early infancy.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: adolescent mothers / Adult / Age / Analysis / Babies / Baby foods / Birth / Breast feeding / Breast Feeding - psychology / Breast Feeding - statistics & numerical data / Breast milk / Breastfeeding / Breastfeeding & lactation / Child development / Child nutrition / children / Children & youth / Colostrum / Colostrum - metabolism / confidence interval / Data analysis / Data collection / feeds / Female / Food / Health Surveys / Households / Humans / infancy / Infant / infant formulas / Infant nutrition / Infant Nutritional Physiological Phenomena / Infant, Newborn / Infants / Interviews / Male / Maternal and Child Health / Medicine / Medicine & Public Health / milk / Mothers / Mothers - statistics & numerical data / Mountains / national surveys / Neonates / Nepal / Newborn infants / Nutrition / Pregnancy / Prelacteal feeding / Public health / Questionnaires / Regression analysis / Surveys / Teenagers / Time Factors / variance / Young Adult