Exclusive breastfeeding practices among mothers in urban slum settlements: pooled analysis from three prospective birth cohort studies in South India

International Breastfeeding Journal - Tập 12 - Trang 1-7 - 2017
Vasanthakumar Velusamy1, Prasanna S. Premkumar1, Gagandeep Kang1
1Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India

Tóm tắt

The World Health Organization (WHO) recommends six months of exclusive breastfeeding. Despite documented health, social and economic benefits, the practice of exclusive breastfeeding is quite low and information on influencing factors is limited especially from slum settlements. Our goal is to assess the prevalence and evaluate factors associated with early cessation of exclusive breastfeeding in the first six months of life among mothers in urban slums of Vellore, Southern India. We pooled data from three similar birth cohort studies (n = 1088) conducted between 2002 and 2009. Breastfeeding information was obtained soon after birth and then from follow-up home visits conducted once every two weeks by the field workers. Multivariable Cox regression analyses were used to assess factors associated with early cessation of exclusive breastfeeding. The prevalence of exclusive breastfeeding for the first six months was 11.4%, based on prospective data since birth. Results from multivariable analyses revealed maternal education (Adjusted Hazard Ratio [AHR] 1.18 , 95% CI 1.03, 1.35), pucca type of house (AHR 1.25 , 95% CI 1.10, 1.43), two or more number of children in the family (AHR 1.26 , 95% CI 1.10, 1.43), joint family structure (AHR 1.20 , 95% CI 1.02, 1.40) and birth during summer (AHR 1.16, 95% CI 1.01, 1.31) were associated with early cessation of exclusive breastfeeding in the first six months. Our results indicate that exclusive breastfeeding rates are well below the recommended levels. Educational interventions providing comprehensive breastfeeding information to mothers and their families can be evaluated to assess its effect on improving infant feeding practices.

Tài liệu tham khảo

Victora CG, Bahl R, AJD B, GVA F, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet. 2016;387:475–90. Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices. The Lancet. 2016;387:491–504. Patel A, Badhoniya N, Khadse S, Senarath U, Agho KE, Dibley MJ, et al. Infant and young child feeding indicators and determinants of poor feeding practices in India: secondary data analysis of National Family Health Survey 2005–06. Food Nutr Bull. 2010;31:314–33. International Institute for Population Sciences. India National Family Health Survey (NFHS-3), 2005–06. International Institute for Population Sciences. 2007. Noor S, Rajesh AH, Babu GK. A study on breast feeding practices among mothers of urban slums of Rourkela. IOSR-J Dent Med Sci (IOSR-JDMS). 2015;1:77–80. Roy S, Dasgupta A, Pal B. Feeding practices of children in an urban slum of Kolkata. Indian J Community Med. 2009;34:362. Boccolini CS, Carvalho ML, Oliveira MI. Factors associated with exclusive breastfeeding in the first six months of life in Brazil: a systematic review. Rev Saude Publica. 2015;49:91. Madhiwalla N. Healthcare in urban slums in India. Natl Med J India. 2007;20:113–4. Census of India. Available at http://www.censusindia.gov.in/2011census/dchb/3304_PART_B_DCHB_VELLORE.pdf. Accessed 10 Dec 2016. Gladstone BP, Muliyil JP, Jaffar S, Wheeler JG, Le Fevre A, Iturriza-Gomara M, et al. Infant morbidity in an Indian slum birth cohort. Arch Dis Child. 2008;93:479–84. Sarkar R, Sivarathinaswamy P, Thangaraj B, Sindhu KN, Ajjampur SS, Muliyil J, et al. Burden of childhood diseases and malnutrition in a semi-urban slum in southern India. BMC Public Health. 2013;13:87. Kattula D, Sarkar R, Sivarathinaswamy P, Velusamy V, Venugopal S, Naumova EN, et al. The first 1000 days of life: prenatal and postnatal risk factors for morbidity and growth in a birth cohort in southern India. BMJ Open. 2014;4:e005404. World Health Organization. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. 2009. Agampodi SB, Agampodi TC, De Silva A. Exclusive breastfeeding in Sri Lanka: problems of interpretation of reported rates. Int Breastfeed J. 2009;4:14. Raheem RA, Binns CW, Chih HJ, Sauer K. Determinants of the introduction of prelacteal feeds in the Maldives. Breastfeed Med. 2014;9:473–8. Karkee R, Lee AH, Khanal V, Binns CW. A community-based prospective cohort study of exclusive breastfeeding in central Nepal. BMC Public Health. 2014;14:927. Abdel-Hady DM, El-Gilany A-H. Calculating, Exclusive breastfeeding rates: comparing dietary “24-hour recall” with recall “since birth” methods. Breastfeed Med. 2016;11:514–8. Barennes H, Empis G, Quang TD, Sengkhamyong K, Phasavath P, Harimanana A, et al. Breast-milk substitutes: a new old-threat for breastfeeding policy in developing countries. A case study in a traditionally high breastfeeding country. PloS One. 2012;7:e30634. Senarath U, Dibley MJ, Agho KE. Factors associated with nonexclusive breastfeeding in 5 east and southeast Asian countries: a multilevel analysis. J Hum Lact. 2010;26:248–57. Khassawneh M, Khader Y, Amarin Z, Alkafajei A. Knowledge, attitude and practice of breastfeeding in the north of Jordan: a cross-sectional study. Int Breastfeed J. 2006;1:17. Holbrook KE, White MC, Heyman MB, Wojcicki JM. Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study. Int Breastfeed J. 2013;8:7. Ulak M, Chandyo RK, Mellander L, Shrestha PS, Strand TA. Infant feeding practices in Bhaktapur, Nepal: a cross-sectional, health facility based survey. Int Breastfeed J. 2012;7:1. Das A, Chatterjee R, Karthick M, Mahapatra T, Chaudhuri I. The influence of seasonality and community-based health worker provided counselling on exclusive breastfeeding - findings from a cross-sectional survey in India. PloS One. 2016;11:e0161186. Samuelsson U, Ludvigsson J. Seasonal variation of birth month and breastfeeding in children with diabetes mellitus. J Pediatr Endocrinol Metab. 2001;14:43–6. Sellen DW. Weaning, complementary feeding, and maternal decision making in a rural east African pastoral population. J Hum Lact. 2001;17:233–44. Simondon KB, Simondon F. Mothers prolong breastfeeding of undernourished children in rural Senegal. Int J Epidemiol. 1998;27:490–4.