In this study, we use data from the Demographic and Health Surveys to examine the relationship between household structure and childhood immunization in Niger and Nigeria. We show that household structure is an important determinant of childhood immunization in Nigeria: Children from nuclear, elementary polygynous, and three-generational households are worse-off than those from laterally extended households. However, the lower odds of full immunization among children from three-generational and elementary polygynous households are attributable to low economic status and low maternal education levels, respectively. In Niger, household structure does not have a significant effect on children's likelihood of being fully immunized.
BackgroundDurations of exclusive breastfeeding (EBF) and predominant breastfeeding (PBF) from two different assessments, among the same mother-infant population, were investigated to determine the degree to which the assessments yielded overlapping results.MethodsThirty Ugandan mother-infant pairs were followed up weekly from birth to three months of age with weekly short-time feeding recall: the 24-hour recall asked prior to the 1-week recall. In addition, at week 6 and 12 dietary recalls since-birth were conducted. Variables for the duration of EBF and PBF were created from the short-time feeding recalls and the dietary recalls since-birth, respectively. Mean durations of EBF and PBF from the two assessments were compared with Kaplan Meier analysis at week 6 and 12. Reproducibility of dietary recall instruments was also assessed.ResultsAt six weeks postpartum the mean durations of EBF were 0.50 weeks (95% CI: 0, 1.02) according to the weekly short-time recalls and 1.51 weeks (95% CI: 0.66, 2.35) according to the recall since-birth (Mantel-Cox test, p = 0.049). The mean durations of PBF were 4.07 weeks (95% CI: 3.38, 4.77) according to the frequent short-time recalls and 4.50 weeks (95% CI: 3.93, 5.07) according to the recall since-birth, (Mantel-Cox-test, p = 0.82). At twelve weeks the mean durations of EBF were 0.5 weeks (95% CI: 0, 1.1) according to the weekly short-time recalls and 1.4 weeks (95% CI: 0.1, 2.7) according to the recall since-birth (Mantel-Cox-test, p = 0.15). The mean durations of PBF were 5.2 weeks (95% CI: 3.9, 6.5) according to the weekly short-time recalls and 6.6 weeks (95% CI: 5.4, 7.8) according to recall since-birth (Mantel-Cox-test, p = 0.20). Reports of feeding categories and early feeding practices showed high reproducibility.ConclusionComparing duration of EBF and PBF in this group of mother-infant pairs showed overlapping results from the weekly short-time assessment and the recall since-birth at twelve weeks, with the latter yielding slightly longer duration of the respective feeding modalities. The retrospective recall since-birth could be assessed as a cost-reducing tool compared to the frequent follow-up addressing duration of respective infant feeding modalities for evaluation of programmes promoting safer infant feeding practices.Trial registrationThe study was part of formative studies for the ongoing study PROMISE EBF registered at http://clinicaltrials.gov, NCT00397150.
Breast milk has a high concentration of secretory immunoglobulin and potentially could serve as a source of passive antibody protection of infants against systemic invasion by Haemophilus influenzae type b. Specific antibody to the capsular polysaccharide of this organism was detected in the colostrum and all subsequent milk samples in 11 of 12 women with a radioactive antigen binding assay. The geometric mean concentrations of antibody were 1.99 microgram/ml in colostrum and 0.18 microgram/ml in breast milk at six weeks and after four and one-half to six months of lactation. Antibody levels in colostrum correlated positively with those in subsequent milk samples; levels after six weeks of lactation correlated highly with those present after four and one-half to six months of lactation. IgA was the predominant immunoglobulin class of anticapsular antibody in the colostrum and milk samples as detected by an enzyme-linked immunosorbent assay.
This paper uses data from 22 national surveys in developing countries to estimate the use of bottles for feeding of infants under 6 months of age. These data were collected in the context of the Demographic and Health Surveys programme (DHS) between 1986 and 1989. Bottle use appears to be very common in most countries. Only six of the 22 countries had levels of bottle use of less than 20 per cent, and all these countries are in sub-Saharan Africa. The policy implications are discussed briefly.
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