Breastfeeding practice in China from 2013 to 2018: a study from a national dynamic follow-up surveillance

Abstract

Background Breastfeeding is important for the physical and psychological health of the mother and child. Basic data on breastfeeding practice in China are out-of-date and vary widely. This study aimed to evaluate the progress of breastfeeding practice in China, as well as to explore the bottlenecks in driving better practice. Methods This was an observational study. We used data from the Under-5 Child Nutrition and Health Surveillance System in China for the period 2013–2018. The prevalence of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) were calculated for each year for subgroups of China. The Cochran-Armitage test was used to explore the time trends. The annual percent of change (APC) were calculated by log-linear regression followed by exp transformation. Results The prevalence of EIBF increased significantly from 44.57% (95% CI: 44.07, 45.07) in 2013 to 55.84% (95% CI: 55.29, 56.38) in 2018 (Ptrend < 0.001), with an APC of 4.67% (95% CI: 3.51, 5.85). And the prevalence of EBF increased rapidly from 16.14% (95% CI: 15.10, 17.18) to 34.90% (95% CI: 33.54, 36.26) (Ptrend < 0.001), with an APC of 14.90% (95% CI: 9.97, 20.04). Increases were observed in both urban and rural areas, with urban areas showing greater APCs for EIBF (6.05%; 95% CI: 4.22, 7.92 v.s. 2.26%; 95% CI: 1.40, 3.12) and EBF (18.21%; 95% CI: 11.53, 25.29 v.s. 9.43%; 95% CI: 5.52, 13.49). The highest EBF prevalence was observed in the East, but the Central area showed the highest APC. The prevalence of EBF decreased with increasing age within the first 6 months, especially after 3 months. Conclusion The prevalence of both EIBF and EBF in China are improving in recent years. The rural and West China could be the key areas in the future actions. More efforts should be made to protect and promote breastfeeding to achieve near- and long-term goals for child health.

Association of Breastfeeding for the First Six Months of Life and Autism Spectrum Disorders: A National Multi-Center Study in China

“…Second, the breastfeeding rate in our study is quite high (48.8%), and one of the explanations for this is that our data were mostly collected in relatively developed areas with better breastfeeding practices and related services in local maternal and child health hospitals. During the study period, the Chinese government implemented national initiatives to promote breastfeeding practices by releasing breastfeeding-related systems [ 55 ]. Diverse types of evaluations, management, and supervision were used to build a friendly environment for breastfeeding, and hospitals were evaluated by the government for their baby-friendly status.…”

Determinants of exclusive breastfeeding for the first six months in China: a cross-sectional study

“…In China, as estimated by a nationally representative survey in 2013, 20.7% of infants under 6 months were exclusively breastfed according to the reported diets during the 24 h [ 7 ]. The Under-5 Child Nutrition and Health Surveillance System shows that the prevalence of exclusive breastfeeding measured by diet recall of the previous 24 h increased from 16.14% in 2013 to 34.90% in 2018 in China, with an annual percent of change of 14.90% [ 8 ].…”

Breastfeeding practices in Northeast China in 2008 and 2018: cross-sectional surveys to explore determinants over a decade

“…In the present study, the rates of exclusive breastfeeding during the first six months in 2008 and 2018 were below the WHO’s target of 50% towards 2025 [ 22 ], and the prevalence of early initiation of breastfeeding was among the ‘poor’ levels according to the WHO standard (poor: <= 29%, medium: 30–49%, good: 50–89%, excellent: >= 90%) [ 23 ]. In comparison with the Chinese national data of U5CNHSS (34.9%) [ 8 ] and regional data of Nanning (37%) [ 11 ] in 2018, exclusive breastfeeding in Northeast China in 2018 (47.6%) was higher. Our result was consistent with the U5CNHSS finding that the prevalence of exclusive breastfeeding was higher in the east (39.3%) than in the west (25.7%) [ 8 ].…”

“…For example, a population-based survey (n = 10,408) conducted in 12 provinces / municipalities in 2017–18 reported that less than 10% of children received early initiation of breastfeeding, and no more than 30% were exclusively breastfed within six months [ 6 , 7 ]. Data from the Under-5 Child Nutrition and Health Surveillance System (U5CNHSS) demonstrated slightly higher coverage, with higher prevalence of exclusive breastfeeding (According to the WHO definition, “exclusive breastfeeding” was taken to mean feeding of infants 0–5 months old with breast milk but neither liquid foods nor solid / semi-solid / soft food during the previous 24 h) observed in the East (39.3%) than the West (25.7%) [ 8 ]; however, the rates still lagged behind the global average. The prevalence and determinants of breastfeeding vary widely across geographical regions in China.…”

“…The prevalence and determinants of breastfeeding vary widely across geographical regions in China. For example, the prevalence of exclusive breastfeeding was higher in the east than in the west region [ 8 ]. The national surveys mentioned above both reported negative associations between maternal education and exclusive breastfeeding [ 9 , 10 ], while data from Nanning city otherwise reported a positive association [ 11 ].…”