Importance of breastfeeding and complementary feeding for management and prevention of childhood diarrhoea in low- and middle-income countries

Abstract

Background Early and exclusive breastfeeding have been shown to protect young infants from all-cause and diarrhoea-related mortality. Ideally breastfeeding should be initiated within the first hour of birth. Despite efforts to increase rates of early and exclusive breastfeeding in low- and middle-income countries (LMICs), challenges with uptake remain. This analysis reviews trends in early and exclusive breastfeeding, and the impact of infant feeding interventions in reducing childhood diarrhoea. Methods We conducted a detailed review of articles written in English between 1990 and 2020 on the impact and efficacy of breastfeeding and complementary feeding on diarrhoea in children aged 0-2 years in LMICs. Using data from 86 countries and all WHO global regions collected from the mid-1980s through 2018 obtained from publicly available Demographic Health Surveys, we assessed trends in five-year intervals of timing of breastfeeding initiation, exclusive breastfeeding, median and mean duration of exclusive breastfeeding, and complementary feeding. Results The literature search identified ten articles that described variable rates of early initiation of breastfeeding from 20% in Pakistan to 76% in Egypt. An analysis of 288 DHS studies found that the proportion of women who reported initiating breastfeeding within an hour of birth increased from 32% in the early 1990s to 55% between 2016 and 2020. Exclusive breastfeeding increased from 20% in the late 1980s to 48% between 2016 and 2020 and the mean duration of exclusive breastfeeding of 2-to-4-month-old infants doubled. Early initiation of breastfeeding and exclusive breastfeeding was associated with reductions in diarrhoea prevalence in the South East Asian, Western Pacific, Eastern Mediterranean, and African regions. Eight studies evaluating the effectiveness of different maternal education interventions, health care worker training, and media campaigns demonstrated improvements in exclusive breastfeeding, and most resulted in reductions in the incidence or duration of diarrhoea. Conclusions During the last two decades, early and exclusive breastfeeding have increased. Nevertheless, the uptake of this basic, low-cost intervention remains suboptimal across all global regions. Given the potential benefits the in reduction of diarrhoea and diarrhoea-associated mortality, interventions for improving the uptake of early and exclusive breastfeeding in different sociological contexts need to be designed, implemented, and evaluated.

The role of breastfeeding as a protective factor against the development of the immune-mediated diseases: A systematic review

“…It has been shown that beginning breastfeeding as soon as possible and continuing it exclusively protects new-born babies against death due to diarrhea ( 43 ). A self-limiting characteristic of the human body that is usually caused by gastroenteritis is termed “diarrhoea.” It is characterized by having loose stools abnormally frequently in a single day ( 44 ).…”

Complementary Feeding: Tradition, Innovation and Pitfalls

“…Adequate timing and characteristics of CF are fundamental for infants worldwide. In low- and middle-income countries, correct CF is closely linked to parents’ and caregivers’ educational level, and it also represents a milestone in infants’ diarrhea and disease prevention [ 4 ]. Moreover, in a review analyzing CF practices in 80 low- and middle-income countries, the authors concluded that monitoring CF indicators across the world and implementing policies and programs to reduce wealth-related inequalities are essential to achieving children’s nutritional standards [ 5 ].…”

Infant and Young Child Feeding Knowledge among Caregivers of Children Aged between 0 and 24 Months in Seshego Township, Limpopo Province, South Africa

“…Malnutrition, vitamin deficiencies, and delayed motor and cognitive development in infants and young children are all health problems that can be further worsened by poor complementary feeding methods, which can also impede a child’s growth [ 18 ]. Inadequate breastfeeding and delayed introduction of complementary foods, increase the risk of childhood mortality and morbidity [ 19 , 20 ]. To prevent child malnutrition and death, breastfeeding must begin within an hour of delivery, be exclusive for the first six months with the introduction of timely and adequate quality complementary food, and last for at least two years [ 21 ].…”