Determinants of suboptimal breast-feeding practices in Pakistan

Abstract

Objective: Exclusive breast-feeding is estimated to reduce infant mortality in lowincome countries by up to 13 %. The aim of the present study was to determine the risk factors associated with suboptimal breast-feeding practices in Pakistan. Design: A cross-sectional study using data extracted from the multistage cluster sample survey of the Pakistan Demographic and Health Survey 2006-2007. Setting: A nationally representative sample of households. Subjects: Last-born alive children aged 0-23 months (total weighted sample size 3103). Results: The prevalences of timely initiation of breast-feeding, bottle-feeding in children aged 0-23 months, exclusive breast-feeding and predominant breastfeeding in infants aged 0-5 months were 27?3 %, 32?1 %, 37?1 % and 18?7 %, respectively. Multivariate analysis indicated that working mothers (OR 5 1?48, 95 % CI 1?16, 1?87; P 5 0?001) and mothers who delivered by Caesarean section (OR 5 1?95, 95 % CI 1?30, 2?90; P 5 0?001) had significantly higher odds for no timely initiation of breast-feeding. Mothers from North West Frontier Province were significantly less likely (OR 5 0?37, 95 % CI 0?23, 0?59; P , 0?001) not to breast-feed their babies exclusively. Mothers delivered by traditional birth attendants had significantly higher odds to predominantly breast-feed their babies (OR 5 1?96, 95 % CI 1?18, 3?24; P 5 0?009). The odds of being bottle-fed was significantly higher in infants whose mothers had four or more antenatal clinic visits (OR 5 1?93, 95 % CI 1?46, 2?55; P , 0?001) and belonged to the richest wealth quintile (OR 5 2?41, 95 % CI 1?62, 3?58; P , 0?001). Conclusions: The majority of Pakistani mothers have suboptimal breast-feeding practices. To gain the full benefits of breast-feeding for child health and nutrition, there is an urgent need to develop interventions to improve the rates of exclusive breast-feeding.

Exclusive breastfeeding practices in relation to social and health determinants: a comparison of the 2006 and 2011 Nepal Demographic and Health Surveys

“…This might leave mothers less time to exclusively breastfeed their child. The geographic differences have been shown to have an impact on EBF practices in Sri Lanka [43] and other countries [12,34]. This study also found that female infants were less likely to be EBF.…”

Association between women’s empowerment and infant and child feeding practices in sub-Saharan Africa: an analysis of Demographic and Health Surveys

“…The benefit of increased income and control over income v. the cost of reduced time is often recognized as a trade-off between maternal employment and child care. Existing evidence suggests that the cost is more likely to outweigh the benefit during early infancy because working mothers may not be able to initiate breastfeeding (29,46) , to practise exclusive breast-feeding (30) or to breast-feed as long or frequently as needed (47)(48)(49) . Older children seemed to benefit more from their economically empowered mothers as seen from their better nutritional status compared with their counterparts of unemployed (50) or less financially autonomous mothers (51) .…”

Immediate or early skin‐to‐skin contact after a Caesarean section: a review of the literature

“…A Cochrane review found that SS is likely to improve breastfeeding outcomes after a vaginal birth (Moore et al 2012). It is important to find ways to improve breastfeeding rates after a Caesarean section because surgical birth is known to reduce initiation of breastfeeding (Dashti et al 2010;Zanardo et al 2010;Hauck et al 2011;Thu et al 2012), increase the length of time before the first breastfeed (Örün et al 2010;Pandey et al 2010;Patel et al 2010;Senarath et al 2010;Prior et al 2012;Zanardo et al 2012;Hazir et al 2013), reduce the incidence of exclusive breastfeeding (Dashti et al 2010;Thu et al 2012;Zanardo et al 2012), significantly delay the onset of lactation (Scott et al 2007) and increase the likelihood of supplementation (Parry et al 2013). This review provided some evidence about the benefits of immediate or early SS after a Caesarean section including an increase in initiation, a decreased time to initiation and a reduction of formula supplementation in hospital (Nolan & Lawrence 2009;Gouchon et al 2010).…”