Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya

Abstract

BackgroundThe World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations.MethodsData from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods.ResultsThere was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence).ConclusionsThe study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning.

Factors associated with exclusive breastfeeding in Kenya: a systematic review

“…Maternal level of education has also been reported to influence exclusive breastfeeding by some studies. 18,22 However, other studies did not find a significant association.…”

“…24 In another study in Nairobi informal settlements, child's sex was among the predictors of early introduction of complementary foods. 22 The age of the infant has also been significantly associated with exclusive breastfeeding. In a study carried out in Nyando, the rate of exclusive breastfeeding decreased with an increase in infant age.…”

Knowledge and Practices of Exclusive Breastfeeding among Women in Rural Uttar Pradesh

“…The first section of the interview schedule consisted the questions on the socio-demographic profile, educational status of the respondents which included question about the age of the respondent, religion, caste, migration status of the respondent, Ownership of household, Type of family, Years of education of the respondent, Years of education of the respondent's husband, etc. were asked [31][32][33][34][35].…”

Comparison of infant-feeding practices in two health subdistricts with different baby-friendly status in Mpumalanga province

“…44 On the contrary, factors associated with sub-optimal infant feeding practices in urban informal settlements in Nairobi, Kenya, included the child's gender, perceived size at birth, mother's marital status, ethnicity, education level, family planning (pregnancy desirability), health seeking behaviour (place of delivery) and neighbourhood (slum of residence). 45 Infant feeding practices in the context of HIV differ from that within the general population. A study comparing data from two cross-sectional surveys conducted in Eastern Uganda has demonstrated that EBF of infants under the age of 6 months was more common in the general population (54%) than among the HIV-positive mothers (24%).…”