Evolution of breastfeeding indicators and early introduction of foods in Latin American and Caribbean countries in the decades of 1990, 2000 and 2010

Abstract

Background Early introduction of liquid/solid food before 6 months of age is one of the major barriers to exclusive breastfeeding. Our objective was to analyze the evolution of infant feeding practices for infants under 6 months of age in Latin American and Caribbean countries in the decades of 1990, 2000 and 2010. Method Cross-sectional time series study with data from Demographic and Health Surveys carried out between 1990 and 2017 in six Latin America and Caribbean countries: Bolivia (1994 to 2008), Colombia (1995 to 2010), Dominican Republic (1996 to 2013), Guatemala (1995 to 2015), Haiti (1994/1995 to 2016/2017), Peru (1996 to 2018). Pooled sample comprised of 22,545 infants under the age of 6 months. Surveys were grouped in three decades: 1990s for surveys from 1990 to 1999, 2000s for surveys from 2000 to 2009, and 2010s for surveys from 2010 to 2017. Exclusive breastfeeding (EBF), predominant breastfeeding (PBF), mixed breastfeeding (mixed BF), supplemented breastfeeding (supplemented BF) and non-breastfeeding (non-BF), and individual foods (water, liquids, milk, infant formula, semi-solid/solid) were analyzed. Prevalence of breastfeeding and food indicators were calculated in pooled sample, according to the infant monthly age groups, decade of survey and residence area(rural/urban). Results Between 1990s and 2010s, there was an increase in the exclusive breastfeeding prevalence (1990s = 38.1%, 2010s = 46.6%) and a reduction in the PBF prevalence (1990s = 51.7%, 2010 s = 43.1%). There was a decrease in the liquids (1990s = 40.7%, 2010s = 15.8%) and milk prevalence (1990s = 20.4%, 2010s = 8.3%) and an increase in water (1990s = 32.3%, 2010s = 37.6%), and infant formula (1990s = 16.6%, 2010s = 25.5%) prevalence. All breastfeeding indicators, except exclusive breastfeeding, progressively increased according to the monthly age group in three decades, and EBF prevalence sharply decreased from 2 to 3 months of age in all decades. Exclusive breastfeeding prevalence was higher in rural area in the three decades (1990s rural = 43.8%, 1990s urban = 32.4%, 2010s rural = 51.1%, 2010s urban = 42.4%) and infant formula prevalence was higher in urban area (1990s rural = 8.6%, 1990s urban = 24.6%, 2010s rural = 15.9%, 2010s urban = 34.1%). Conclusions In the last three decades, in all age groups, there was an increase in exclusive breastfeeding prevalence, as well as a significant reduction in liquids and milk. In the rural area, EBF prevalence remains higher than in urban. Increased water and infant formula feeding are the main barriers to achieving the Global Nutrition Target 2025 for exclusive breastfeeding.

Psychosocial and context factors associated with breastfeeding and complementary feeding changes in Belize: a mixed methods approach

“…In rural areas, mothers practiced more EBF for the rst six months, compared to mothers in urban areas. These ndings are consistent ndings from Latin American and Caribbean countries (Meira et al, 2022).…”

Factors Associated with Adequate Breastfeeding: Evidence from the Peruvian Demographic and Health Survey, 2019

“…Regarding the current position (employed or unemployed), mothers without a job had a higher proportion of ABF. Likewise, the same association has been reported in other Latin American countries and in the United States [ 26 , 32 , 33 ]. This could be attributed to the fact that mothers without a job (formal or informal) would have the autonomy of their schedules to ensure exclusive breastfeeding for more months, while employed women needed to return to work early and would have less time to feed their children directly.…”

“…Similar to our finding, in Colombia a prevalence of IUF of 65.6% has been recorded; however, in their study they acknowledge that Colombia has been working for several years to create a breastfeeding-friendly environment [ 25 ]. In terms of EBF, we determined a frequency of 68.2%, which was higher than that reported worldwide (43%) in 2015 [ 23 ], and that reported in six Latin America and Caribbean countries, including Bolivia, Colombia, Dominican Republic, Guatemala, and Peru in 2010 (~50%) [ 26 ]. However, contrasting with more recent data from Latin American countries, our figures would be similar.…”

Association between breastfeeding, host genetic factors, and calicivirus gastroenteritis in a Nicaraguan birth cohort

“…However, Nicaraguan women are guaranteed eight weeks of paid maternity leave after delivery, which may preclude exclusive breastfeeding for the recommended six months as mothers return to the workforce [31]. Cultural and social factors may also impact breastfeeding practices among young mothers in urban areas, as they are uncomfortable breastfeeding in public or believe that prolonged breastfeeding will negatively affect breast shape or volume [32,33]. Given the limited duration of exclusive breastfeeding in our population (median of 2 weeks), future studies should be conducted in a different population where exclusive breastfeeding is practiced more widely and for longer duration, or as part of a clinical trial that provided lactation support personnel who would constantly advise and encourage new mothers enrolled in the study to continue exclusive breastfeeding.…”