Socioeconomic inequalities in early initiation and exclusive breastfeeding practices in Bangladesh: findings from the 2018 demographic and health survey

Abstract

Background Optimal breastfeeding practices including early initiation of breastfeeding and exclusive breastfeeding (EBF) are associated with positive health outcomes. Socioeconomic inequalities in key breastfeeding indicators may play a role in the prevalence of breastfeeding practices. The objective of this study was to examine the socioeconomic inequalities in early initiation of breastfeeding and EBF practices in Bangladesh based on the 2018 Bangladesh Demographic and Health Survey (BDHS). Methods This was a secondary data analysis of the nationally representative 2018 BDHS. Data on 4950 women of reproductive age who had ever given birth and 924 children aged 0–5 months were extracted, for early initiation of breastfeeding and EBF. Early initiation of breastfeeding was determined from children who were put to the breast within the first hour of birth. Exclusive breastfeeding was estimated from children aged 0–5 months who were exclusively breastfed. Results The weighted prevalence of early initiation of breastfeeding and EBF were 60.8% (95% CI; 59.0, 62.6%) and 66.8% (95% CI; 63.1, 70.3%), respectively. The estimated prevalence of early initiation among the poorest, poorer, middle, richer and richest households were 67.8, 66.3, 58.4, 56.3 and 54.4%, respectively. Similarly, early initiation prevalence of 64.4, 65.0, 61.1 and 52.3% were estimated among women with no formal education, primary, secondary and higher education, respectively. The estimated prevalence of EBF among the poorest, poorer, middle, richer and richest households were 63.0, 65.2, 67.7, 66.7 and 69.9%, respectively. Similarly, the estimated EBF prevalence were 62.5, 66.0, 66.3 and 68.9% among women with no formal education, primary, secondary and higher education, respectively. Early initiation of breastfeeding was higher among lower household wealth (Conc. Index = − 0.049; SE = 0.006) and lower educational attainment groups (Conc. Index = − 0.035; SE = 0.006). Conclusions Improving optimal breastfeeding practices in Bangladesh should be given utmost priority. A need to address the socioeconomic inequalities in breastfeeding practices was also identified.

Socioeconomic determinants and inequalities in exclusive breastfeeding among children in Peru

“…Based on the CC evaluated in the present study, it was found that EBF was concentrated among women with a poorer socioeconomic status. This finding is different from that described in studies conducted in Bangladesh, Nigeria, Norway, and the United States ( 11 , 12 , 53 , 54 ), which reported that EBF was concentrated in women with a higher economic income. In accordance with the biomedical literature, there is a positive correlation between formal education and socioeconomic status ( 55 ).…”

“…More than 30 million children in LMICs do not receive EBF due to socioeconomic, cultural and individual determinants that affect EBF practice decisions and behaviors (10). These determinants are related to the woman's age, maternal education, maternal employment, maternal nutritional status, number of antenatal care visits, place and route of delivery, newborn characteristics, social influence and traditional practices that affect the onset and duration of EBF (11)(12)(13), which vary between and within countries, accentuating health inequalities (8). These inequalities are present in most countries, where poorer and less educated mothers have a higher frequency and duration of EBF than their counterparts (1).…”

Correlates of early initiation of breast feeding and prelacteal feeding: a cross-sectional study in Sindh province of Pakistan

“…7 However, the prevalence of early initiation of breast feeding was slightly higher in the present study, which could be because this study was conducted in primarily rural districts of Sindh where women are mostly housewives and have ample time to attend to their newborns, and may not afford milk substitutes like formula milk. [27][28][29][30] The prevalence of prelacteal feeding in our study was also about 32%. It is not surprising that families prefer to give a prelacteal feeding before breast milk, because a prelacteal food is considered a sacred concoction and is part of a value system where it is customary to feed a wide range of foods to newborns immediately after birth.…”

The impact of intrapartum and immediate post‐partum complications and newborn care practices on breastfeeding initiation in Ethiopia: A prospective cohort study

“…Globally, it has been shown that breastfeeding has prodigious benefits for both mothers and newborns. It supports the child's growth, protects the child against infections and the mother from post‐partum haemorrhage and breast and ovarian cancers (Ekholuenetale et al, 2021 ; Mallick et al, 2021 ; Rollins et al, 2016 ; Victora et al, 2016 ). It is estimated that breastfeeding can save up to a million deaths in children under age five each year (Victora et al, 2016 ).…”