Breastfeeding in Mexico Was Stable, on Average, but Deteriorated among the Poor, whereas Complementary Feeding Improved: Results from the 1999 to 2006 National Health and Nutrition Surveys

Abstract

We present: 1) indicators of infant and young child feeding practices (IYCFP) and median age of introduction of foods analyzed by geographic and socioeconomic variables for the 2006 national probabilistic Health Nutrition Survey (ENSANUT-2006); and 2) changes in IYCFP indicators between the 1999 national probabilistic Nutrition Survey and ENSANUT-2006, analyzed by the same variables. Participants were women 12-49 y and their <2-y-old children (2953 in 2006 and 3191 in 1999). Indicators were estimated with the status quo method. The median age of introduction of foods was calculated by the Kaplan-Meier method using recall data. The national median duration of breastfeeding was similar in both surveys, 9.7 mo in 1999 and 10.4 mo in 2006, but decreased in the vulnerable population. In 1999 indigenous women breastfed 20.8 mo but did so for only 13.0 mo in 2006. The national percentage of those exclusively breastfeeding <6 mo also remained stable: 20% in 1999 and 22.3% in 2006. Nevertheless, exclusively breastfeeding <6 mo changed within the indigenous population, from 46% in 1999 to 34.5% in 2006. Between surveys, most breastfeeding indicators had lower values in vulnerable populations than in those better-off. Complementary feeding, however, improved overall. Complementary feeding was inadequately timed: median age of introduction of plain water was 3 mo, formula and non-human milk was 5 mo, and cereals, legumes, and animal foods was 5 mo. Late introduction of animal foods occurred among vulnerable indigenous population when 50% consumed these products at 8 mo. Mexican IYCFP indicate that public policy must protect breastfeeding while promoting the timely introduction of complementary feeding.

Early feeding patterns among Mexican babies: findings from the 2012 National Health and Nutrition Survey and implications for health and obesity prevention

“…Late feeding of complementary foods and/or reliance on poor quality foods increases an infant's risk of malnutrition, poor growth, and micronutrient deficiencies [64] and is a major cause of preventable mortality in young children [50]. National surveys in Mexico have shown the coexistence of early and late complementary feeding patterns [35]. Complementary feeding begins as early as age 3 to 5 months among some Mexican infants [34], and up to 92 % of Mexican infants are fed complementary foods before age 6 months [35].…”

“…National surveys in Mexico have shown the coexistence of early and late complementary feeding patterns [35]. Complementary feeding begins as early as age 3 to 5 months among some Mexican infants [34], and up to 92 % of Mexican infants are fed complementary foods before age 6 months [35]. Yet, WHO indicators for measuring dietary diversity or late complementary feeding practices have shown improvement after age 6 months in Mexico [34,35].…”

“…In Mexico, the trends from national surveys have reported deterioration in the rates of breastfeeding [34], inadequate timing of complementary feeding [35], low adherence to recommendations for fruit and vegetable intake [36,37], and excessive consumption of sugarsweetened beverages [38], a problem that prompted the Mexican Ministry of Health to develop recommendations for beverage intake [4] and the Mexican government to institute a 10 % excise tax on sugar-sweetened beverages. Whereas most public policies have focused on prevention of undernutrition, these efforts addressing excessive consumption of sugar-sweetened beverages target the widespread prevalence of obesity in Mexico, which is now recognized as an epidemic [1].…”

‘Life does not make it easy to breast-feed’: using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico

“…In Mexico, EBF under 6 months deteriorated among the poor (33·5 % to 16·6 %), rural (32·7 % to 18·5 %) and indigenous (46 % to 27·5 %) populations from 1999 to 2012 (7,8) . Breast-feeding rates in Mexico are one of the lowest of Latin America with 14·4 % of EBF under 6 months of age (1) .…”

“…In the analysis of inequalities in breast-feeding, Cattaneo (11) identified three phases of breast-feeding prevalence: (i) an initial one with high prevalence and duration of breast-feeding across all population groups (stage 1); (ii) a transformation phase with prevalence and duration falling first among the urban elite, then among the urban and rural poor (stages 2-5); and (iii) a third phase of resurgence, in a sort of inverse pattern (stages [6][7][8]. According to this scheme, Mexico would be between stages 4 and 6 because Mexico (7)(8)(9) traditionally had significantly higher breastfeeding rates in rural (EBF under 6 months of age 32·7 % v. 14·8 % urban), indigenous (46·0 % v. 17·5 % nonindigenous) and low socio-economic (33·5 % v. 14·7 % high socio-economic) populations (1999) but that has been changing and breast-feeding has decreased to 18·5 % in rural areas, 27·5 % in indigenous and 16·6 % in low-income populations (2012). Mexico seems to be in the latter stages of the transformation phase where breast-feeding rates are decreasing among the rural poor and the third phase (resurgence) is emerging with the 'sort of inverse pattern' when breast-feeding rates increase first among the urban elite because there has been an increase in women with higher v. lower education (21·8 % v. 12·8 % in 2012).…”