Determinants of infant breastfeeding practices in Nepal: a national study

Abstract

Background Optimal breastfeeding practices, reflected by early initiation and feeding of colostrum, avoidance of prelacteal feeds, and continued exclusivity or predominance of breastfeeding, are critical for assuring proper infant nutrition, growth and development. Methods We used data from a nationally representative survey in 21 district sites across the Mountains, Hills and Terai (southern plains) of Nepal in 2013. Determinants of early initiation of breastfeeding, feeding of colostrum, prelacteal feeding and predominant breastfeeding were explored in 1015 infants < 12 months of age. Prelacteal feeds were defined as food/drink other than breast milk given to newborns in first 3 days. Predominant breastfeeding was defined as a child < 6 months of age is mainly breastfed, not fed solid/semi-solid foods, infant formula or non-human milk, in the past 7 days. Adjusted prevalence ratios (APR) and 95% confidence intervals (CI) were estimated, using log Poisson regression models with robust variance for clustering. Results The prevalence of breastfeeding within an hour of birth, colostrum feeding, prelacteal feeding and predominant breastfeeding was 41.8, 83.5, 32.7 and 57.2% respectively. Compared to infants not fed prelacteal feeds, infants given prelacteal feeds were 51% less likely to be breastfed within the first hour of birth (APR 0.49; 95% CI 0.36, 0.66) and 55% less likely to be predominantly breastfed (APR 0.45; 95% CI 0.32, 0.62). Infants reported to have received colostrum were more likely to have begun breastfeeding within an hour of birth (APR 1.26; 95% CI 1.04, 1.54) compared to those who did not receive colostrum. Infants born to mothers ≥ 20 years of age were less likely than adolescent mothers to initiate breastfeeding within 1 hour of birth. Infants in the Terai were 10% less likely to have received colostrum (APR 0.90; 95% CI 0.83, 0.97) and 2.72 times more likely to have received prelacteal feeds (APR 2.72; 95% CI 1.67, 4.45) than those in the Mountains. Conclusions Most infants in Nepal receive colostrum but less than half initiate breastfeeding within an hour of birth and one-third are fed prelacteal feeds, which may negatively affect breastfeeding and health throughout early infancy. Electronic supplementary material The online version of this article (10.1186/s13006-019-0208-y) contains supplementary material, which is available to authorized users.

Breastfeeding practices within the first six months of age in mid-western and eastern regions of Nepal: a health facility-based cross-sectional study

“…This rate was similar to 67% observed by Karkee et al in central Nepal [21] but more than the national average of 54.9% reported by NDHS 2016 [2]. and 41.8% reported by Bhandari et al [16] Rate of early initiation of breastfeeding varied widely among countries, ranging from 17.7 to 98.4% with a mean of 57.6% [22].…”

“…However, the full breastfeeding rate, including predominant breastfeeding, was 51.4% when predominant breastfeeding is added. Bhandari et al reported the rate of predominant breastfeeding, defined as mainly breastfed, not fed solid/ semisolid foods, infant formula, or non-human milk to be 57.2% in Nepal [16]. The global exclusive breastfeeding rate currently stands at 40%, based on data from 129 countries.…”

Magnitude and associated factors of prelacteal feeding practices among mothers of under one-year-old children in Rural Pastoralist Communities of Afar, North Eastern Ethiopia: A community based cross-sectional study.

“…However, the current study includes both urban and rural areas. Again this magnitude was higher than magnitude reported from studies conducted in South Sudan [25], India [26], Nepal [27] which was 53%, 22.4%, 32.7%, respectively. This might stem from differences in cultural beliefs and practices, study setting, health and nutrition policy, and strategies.…”

A quality improvement study on breastfeeding initiation rate within 1 hour of life in inborn neonates in a tertiary care centre

“…3,9 The introduction of breastfeeding within the first hour of life reduced deaths in Nepal by 19% and in Ghana by 22%. 10,11 Knowing the consequences of delayed initiation of breastfeeding, team approach with small simple measures which will have a high impact with almost nil cost can be achieved with quality improvement initiative. 12 This will also help us practice evidence-based medicine translating research to practical application making bench to bedside practice.…”