BackgroundBreastfeeding offers incredible health benefits to both child and mother. It is suggested by World Health Organization that an able mother should practice and maintain exclusive breastfeeding for first six months of her infant’s life. The objective of this study was to determine the prevalence and factors associated with exclusive breastfeeding for first six months of an infant’s life in Bangladesh.MethodsData was extracted from Bangladesh Demographic and Health Survey (BDHS-2014). BDHS-2014 collected data from 17,863 Bangladeshi married women in reproductive age from the entire country using two stages stratified cluster sampling. We included only mothers having at least one child currently aged not less than 6 months. Mothers who did not have child to breastfeed, some incomplete information and missing samples were excluded from the data set and consequently 3541 mothers were considered in the present study. Chi-square test, binary logistic regression models were used in this study.ResultsThe prevalence of exclusive breastfeeding (EBF) for first six months of an infant’s life in Bangladesh was 35.90%. Binary multivariable logistic regression model demonstrated that relatively less educated mothers were more likely to exclusively breastfeed their children than higher educated mothers.(AOR = 2.28, 95% CI: 1.05–4.93; p < 0.05). Housewife mothers were more likely to be EBF than their counterparts (AOR = 1.20, 95% CI: 1.02–1.42; p < 0.05). Higher rate of EBF was especially found among mothers who were living in Sylhet division, within 35–49 years old, and had access to mass media, had more than 4 children, had delivered at home and non-caesarean delivery, took breastfeeding counseling, antenatal and postnatal cares.ConclusionsStepwise regression model exhibited that most of the important predictors were modifiable factors for exclusive breastfeeding. Authorities should provide basic education on EBF to educated mothers, and organize more general campaign on EBF.

To assess the risk factors for acute malnutrition (weight-for-height z-score (WHZ) < −2), a case-control study was conducted during June–September 2012 in 449 children aged 6–59 months (178 with WHZ < −2 and 271 comparing children with WHZ ≥ −2 and no edema) admitted to the Dhaka Hospital of icddr,b in Bangladesh. The overall mean ± SD age was 12.0 ± 7.6 months, 38.5% (no difference between case and controls). The mean ± SD WHZ of cases and controls was −3.24 ± 1.01 versus −0.74 ± 0.95 (P < 0.001), respectively. Logistic regression analysis revealed that children with acute malnutrition were more likely than controls to be older (age > 1 year) (adjusted OR (AOR): 3.1, P = 0.004); have an undernourished mother (body mass index < 18.5), (AOR: 2.8, P = 0.017); have a father with no or a low-paying job (AOR: 5.8, P < 0.001); come from a family having a monthly income of <10,000 taka, (1 US$ = 80 taka) (AOR: 2.9, P = 0.008); and often have stopped predominant breastfeeding before 4 months of age (AOR: 2.7, P = 0.013). Improved understanding of these characteristics enables the design and targeting of preventive-intervention programs of childhood acute malnutrition.

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We examined the rate of weight gain and absolute weight gain of underweight children (weightfor-age Z score < −2) aged between 6-24 months living in a slum of Dhaka city, in response to two different regimens of supplementary feeding. Comparison was also made with the weight gain of a healthy group of children from the same locality. In total 161 children, including 68 healthy children representing the control group, were enrolled for the 5 months supplementation. The two regimens of feeding were either ready-to-use therapeutic food (RUTF, Plumpy'Nut) or locally made cereal-based supplementary food Pushti packet which was recommended in the National Nutritional Program. No food supplementation was provided to control children. All children received vitamin A as part of the six-monthly national program, albendazole for deworming, immunization, and health and nutrition education. Multiple micronutrient powder (MNP) was provided only to Pushti packet and control children. The rate of weight gain on RUTF was 1.69 g/kg/day during the first month and gradually declined to 0.9 g/kg/day at the final month of the trial, whereas, the rate of weight gain on Pushti packet was 0.77 g/kg/day during the first month declining to 0.70 g/kg/day at the end of the trial. Rate of weight gain in the control group was steady between 0.47-0.50 g/kg/day. Absolute weight gains of 1085 g, 790 g and 730 g were observed in the RUTF, Pushti packet and the control groups, respectively which were significantly higher in the RUTF group. There was no statistically significant difference between the RUTF and Pushti packet groups in terms of rate of weight gain. Overall, weight gain was unsatisfactory for both supplementation groups. Better absolute weight gain was observed with RUTF supplementation compared to Pushti packet which prevented further deterioration in weight among the malnourished children.

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