Early infant feeding practices in three African countries: the PROMISE-EBF trial promoting exclusive breastfeeding by peer counsellors

Engebretsen, Ingunn Marie S.; Nankabirwa, Victoria; Doherty, Tanya; Diallo, Abdoulaye Hama; Nankunda, Jolly; Ekström, Eva‐Charlotte; Ramokolo, Vundli; Méda, Nicolas; Sommerfelt, Halvor; Jackson, Debra; Tylleskär, Thorkild; Tumwine, James

doi:10.1186/1746-4358-9-19

Cited by 43 publications

(44 citation statements)

References 36 publications

(57 reference statements)

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“…Similar findings were reported from Ethiopia [36], Burkina Faso and Uganda [37]. In addition, evidence from Bangladesh and Tanzania revealed that breastfeeding counselling increases maternal knowledge on optimal infant feeding [38,39].…”

Section: Discussionsupporting

confidence: 72%

Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey

Tongun

Sebit

Ndeezi

et al. 2018

Global Health Action

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Background: Pre-lacteal feeding (PLF) is a barrier to optimal breastfeeding and increases the risk of diarrhoea and acute respiratory tract infections in infants.The prevalence and predictors of PLF are not well studied in South Sudan. Understanding the predictors of PLF is crucial in designing interventions to increase exclusive breastfeeding (EBF) rates. Objective: To assess the prevalence and factors associated with PLF in Jubek State, South Sudan. Method: This was a community based cross-sectional study of 810 mothers of children under two years of age in Jubek State, South Sudan. Mothers were interviewed in their homes using a semi-structured questionnaire to collect data on PLF, socio-demographic and birth characteristics. Multivariable analysis was used to identify factors independently associated with PLF. Results: A total of 426/810 (53 %), 95% confidence interval (CI) [48 %, 59 %] mothers had given pre-lacteal feeds to their infants. The commonest pre-lacteal feeds included glucose solution (54%), water (26%), and infant formula (14%). Having received antenatal breastfeeding counselling decreased the odds of PLF [adjusted odds ratio (AOR) 0.60; 95% CI (0.43, 0.82)]; while discarding of colostrum increased the use of pre-lacteal feeds [AOR 1.57; 95% CI (1.17, 2.11)]. Conclusion: The prevalence of PLF in South Sudan is high. Predictors of PLF included lack of breastfeeding counselling and discarding of colostrum. Infant feeding counselling should be given to all pregnant women in the health facilities and communities. The counselling should emphasize the health benefits of colostrum and discourage the practice of discarding it.

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Section: Discussionsupporting

confidence: 72%

Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey

Tongun

Sebit

Ndeezi

et al. 2018

Global Health Action

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“…Burkina Faso had the highest proportion of women giving prelacteal feeds (>16%). The same feeding patterns were found in the PROMISE-EBF study in Burkina Faso site with <4 and 11% of participants initiating breastfeeding within the first hour and giving prelacteal feeding, respectively [41]. In Burkina Faso, however, women breastfed longer compared to the other countries, for which we have no clear explanation.…”

Section: Discussionsupporting

confidence: 69%

Breastfeeding patterns and its determinants among mothers living with Human Immuno-deficiency Virus -1 in four African countries participating in the ANRS 12174 trial

et al. 2016

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BackgroundHIV-1 transmission rates have been reduced over the last decade, an estimated 2 million new infections per year arise, including 220,000 paediatric cases. The main post-natal HIV exposure is through breastfeeding, where both its duration and modality (exclusive or not) are associated with postnatal transmission. The ANRS 12174 trial compared HIV-1 postnatal transmission of 2 prophylaxis drugs for infants during lactation (lamivudine and lopinavir-ritonavir). Our objective has been to examine the feeding practices and the determinants of exclusive/ predominant (EPBF) or any breastfeeding among the participants of this trial in Burkina Faso, South Africa, Uganda and Zambia.MethodsMothers infected with HIV-1 and their uninfected offspring were followed from day 7 after birth for 50 weeks, keeping monthly records of their feeding patterns. Feeding was classified into 3 categories: 1) exclusive breastfeeding during the first six months, only breast-milk being given to infant for 6 months, 2) predominant breastfeeding, breast-milk with liquid-based items being given, and 3) mixed feeding, other non-breast milk or solid food being given in addition to breast milk with or without liquid-based items. The categories were merged into 2 groups: EPBF applying to infants aged <6 months and mixed feeding applying to infants of any age. The feeding patterns have been given as Kaplan-Meier curves. A flexible parametric multiple regression model was used to identify the determinants of the mothers’ feeding behaviour.ResultsA total of 1,225 mother-infant pairs provided feeding data from Burkina Faso (N = 204), South Africa (N = 213), Uganda (N = 274) and Zambia (N = 534) between November 2009 and March 2013. The mean maternal age was 27.4 years and the mean BMI was 24.5. 57.7 and 93.9% of mothers initiated breastfeeding within the first hour and first day, respectively. Overall, the median durations of any form of breastfeeding and EPBF were 40.6, and 20.9 weeks, respectively. Babies randomized to the lopinavir/ritonavir group in South Africa tended to do less EPBF than those in the lamivudine group.Overall the group of mothers aged between 25 and 30 years, those married, employed or multiparous tended to stop early EPBF. Mothers living in Uganda or Zambia, those aged between 25 -30 years, better educated (at least secondary school level), employed or having undergone C-section stopped any breastfeeding early.ConclusionsThere is a need to improve breastfeeding and complementary feeding practices of children, particularly those exposed to HIV and anti-retrovirals, taking into account context and socio-demographic factors.Trial registrationClinical trial registration: NCT00640263.Electronic supplementary materialThe online version of this article (doi:10.1186/s13006-017-0112-2) contains supplementary material, which is available to authorized users.

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“…The rates in Africa are generally low, and the World Nutrition Report from 2015 revealed that 50% initiated breastfeeding early on the African continent, compared to 39% in the West African region [12]. In a study by Engebretsen et al, early initiation of breastfeeding was ranging from 3.6 to 13.4% in low income countries such as Burkina Faso and Uganda up to 47.1% in middle income countries such as South Africa [30]. The proportion of women who initiated breastfeeding early in our study was 64.9%, which compared to the study mentioned above and the international rates of 40% may be considered quite high, although it is far from optimal.…”

Section: Discussionmentioning

confidence: 99%

Infant feeding practices in the Saharawi refugee camps Algeria, a cross-sectional study among children from birth to six months of age

et al. 2016

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BackgroundAppropriate breastfeeding and infant feeding practices are crucial to a child’s growth and development. The objective of this paper is to describe breastfeeding and general feeding practices and the nutrition status among children from birth to 6 months of age, in the Saharawi refugee camps located in Algeria.MethodsA cross-sectional study was carried out among 111 lactating mothers with infants from birth to 6 months of age. Data regarding breastfeeding practices and a 24 h dietary recall for the infants were collected to assess the World Health Organization’s (WHO) indicators for infant and young child feeding. For exclusive and predominant breastfeeding, age disaggregation for each month was applied to the data. Background characteristics from the mothers and infants were collected, together with anthropometrical measures. We explored predictors for breastfeeding and nutrition status in multiple regression models.ResultsIn total 13.8%, 8.2% and 16.5% of the infants were stunted, wasted and underweight, respectively. Approximately 65% initiated breastfeeding within 1 h after birth and 11.7 and 21.6% were exclusively or predominantly breastfed less than 6 months. The most commonly given solid foods were dates (27.0%) and bread (10.8%). In multiple regression models, initiation of breastfeeding within 1 h after birth gave increased probability of exclusive or predominant breastfeeding. Giving birth at home as opposed to in a hospital and increasing number of children gave increased probability of initiating breastfeeding early. Exclusive or predominant breastfeeding seemed to protect against underweight and wasting.ConclusionsExclusively or predominant breastfeeding was low among Saharawi refugee infants. Wasting and underweight was common and more likely to occur if the infants were not exclusively or predominantly breastfed. These findings support the current international breastfeeding recommendations, and suggest that there is an urgent need for promoting infant feeding practices in the Sahara refugee camps.

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Early infant feeding practices in three African countries: the PROMISE-EBF trial promoting exclusive breastfeeding by peer counsellors

Cited by 43 publications

References 36 publications

Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey

Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey

Breastfeeding patterns and its determinants among mothers living with Human Immuno-deficiency Virus -1 in four African countries participating in the ANRS 12174 trial

Infant feeding practices in the Saharawi refugee camps Algeria, a cross-sectional study among children from birth to six months of age

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