Factors Affecting Breastfeeding Practices in Sindh Province, Pakistan: A Secondary Analysis of Cross-Sectional Survey Data

Noh, Jin‐Won; Kim, Young Mi; Akram, Nabeel; Yoo, Keunje; Cheon, Jooyoung; Lee, Lena J.; Kwon, Young Dae; Stekelenburg, Jelle

doi:10.3390/ijerph16101689

Cited by 12 publications

(14 citation statements)

References 30 publications

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“…Another study identified several important demographic and socioeconomic factors; these factors were breastfeeding status, age, number of living children, residence, education, wealth, information sources about breastfeeding practices, assistance during delivery, and place of delivery. The study used a multiple logistic regression analysis to highlight the significant factors for breastfeeding practices in Pakistan, whereas this study uses comprehensive and comparative statistical measures to study a range of demographic and socio-economic factors and their relationship with breastfeeding practices [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Factors influencing exclusive breastfeeding duration in Pakistan: a population-based cross-sectional study

Arif¹,

Khan

Aslam

et al. 2021

BMC Public Health

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Background Breastfeeding has the most profound impact on infant health and wellness, and also have significant implications for the mother. The duration of the breastfeeding determines the infant’s protection from malnutrition and other common infectious diseases; consequently, the World Health Organization (WHO) recommends exclusive breastfeeding (EBF) six months, followed by gradual weaning and breastfeeding until the baby is two years old. In Pakistan, the practice of breastfeeding is heavily dependent upon certain demographic, economic, social, and biological factors, which ultimately impact the quality of care provided to the infant and their health. The aim of this paper, therefore, is to measure the impact of these factors on the exclusive breastfeeding duration in Pakistan. Methods The data for the study has been collected from Pakistan Demographic and Health Survey (PDHS) for the year 2017–18. Binary logistic regression model and survival analysis are used to determine the relationship between the independent and dependent variables. Results We use a binary logistic regression to estimate the effect of each factor on the duration of EBF. The binary logistic regression finds significant relationships between region, maternal education, wealth index, size of a child, watching television, delivery by cesarean, and maternal age and EBF. We then use log-likelihood, AIC, BIC criteria to determine if a parametric or non-parametric model would provide a better fit; based on these results we fit an Inverse Gaussian (Weibull) distribution for the survival analysis. These results show that there are more significant factors associated with EBF duration in parametric survival analysis than in the binary logistic regression results. Thus, the survival analysis is a better method for predicting the relationship between the duration of EBF and its factors. Furthermore, logically EBF is designated to be done for six months which would not be properly gauged with a binary response variable. Conclusions The results of this study provide proof that exclusive breastfeeding is a common practice among women in Pakistan, and to improve the quality of post-natal care, health policy in the country needs to focus on the existing demographic and social factors which are found significant in this study.

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Section: Discussionmentioning

confidence: 99%

Factors influencing exclusive breastfeeding duration in Pakistan: a population-based cross-sectional study

Arif¹,

Khan

Aslam

et al. 2021

BMC Public Health

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“…3 Available Literature on research conducted on Pakistani mothers of different social strata has shown a decreased incidence of early initiation of breastfeeding and continuation of breastfeeding. [4][5][6] The education of the community regarding breastfeeding needs to be improved to reduce the high infant mortality rates.…”

Section: Introductionmentioning

confidence: 99%

Breastfeeding practices in nursing mothers during COVID-19 pandemic: Dual center study in Karachi, Pakistan

Bham

Khan²,

Munaver³

et al. 2023

Pak J Med Sci

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Objective: To identify the breastfeeding practices in nursing mothers during the COVID-19 pandemic. Methods: This descriptive cross-sectional study was conducted in the Pediatrics and Gynecology & Obstetrics departments at two of the tertiary care hospitals in Pakistan from September 2020 to February 2021. Recently delivered mothers and mothers of children till two years of age on breastfeeding/formula feed were consecutively enrolled. Results: Of 484 participants, breastfeeding was practiced by 180 (37.2%) participants, formula-fed by 85 (17.6%), and mix feed by 219 (45.2%) participants. Out of 185 mothers who had to breastfeed previous babies, 80.2% of mothers still opted to breastfeed their newborns despite the COVID-19 pandemic. Breastfeeding practices exhibited higher incidence in illiterate mothers (aOR 0.229 95% CI 0.05-0.95, p- 0.042), housewives (aOR 0.35 95% CI 0.13-0.95 p-0.040) and shorter length of stay (aOR 0.290 95% CI 0.15-0.57, p- 0.001) while formula /mixed feeding was found higher in mothers with exposure to formula feeding in previous babies (aOR 17.842, 95% CI 8.33-38.19, p- 0.001) and mothers with pain after delivery (aOR 4.526, 95% CI 2.11-9.71, p-<0.001). Conclusion: Mothers who had to breastfeed their babies in a previous pregnancy, who were less educated, and housewives with a shorter stay in hospital have shown a stronger association with breastfeeding whereas mothers who had previous exposure to formula milk and pain after delivery have shown association to formula feed or mixed feed. doi: https://doi.org/10.12669/pjms.39.2.6707 How to cite this: Bham SQ, Khan KMA, Munaver SA, Sharif UHA. Breastfeeding practices in nursing mothers during COVID-19 pandemic: Dual center study in Karachi, Pakistan. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.6707 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…These studies either had a limited number of participants enrolled from hospital settings or focused on working mothers from urban areas [10][11][12][13]. Moreover, previous studies in the Sindh province of Pakistan have reported associations based on survey data and did not provide an in-depth understanding of perceptions about EBF from various stakeholders at the household and community levels [14]. A qualitative study from Rajanpur district of Punjab province has reported breastfeeding practices and behavior of parents [15], but did not account for diverse views which can possibly come from mothers-in-law and LHWs since their influence in decision making at household and community level has been documented previously [12,16,17].…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study

et al. 2022

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Background Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study aimed to explore barriers to EBF in a rural context of Pakistan. Methods The study was conducted in the rural district Matiari of Sindh, Pakistan, during Jan-March 2020. We used a qualitative exploratory study design and conducted 36 focus group discussions (FGDs). Participants were purposively selected mothers who had not practiced EBF during their previous childbirth, their spouses and mothers-in-law, and lady health workers (LHWs) serving in the study catchment. FGDs were audio-recorded, transcribed, and translated into English from the local language and analysed using thematic content analysis. Results Barriers to EBF included low awareness and cultural practices of prelacteal feeds, insufficient breast milk production, undernutrition of mothers, mothers’ occupation as fieldworkers, less birth spacing, low awareness about the correct technique of breastfeeding, maternal and child ailments, abnormal breasts, and influence of in-laws to start top-up feeds. Several facilitators were identified: family support, appropriate maternal diet, maternal awareness, and support in the neighborhood. Conclusion Barriers to EBF are multifaceted in rural areas, and interventions aiming to improve adherence to EBFshould be multipronged. Awareness-raising alone might not be sufficient, and other interventions should be designed to address the barriers of maternal malnutrition, insufficient milk production, and socio-cultural practices. In addition, safe alternatives to breast milk may be necessary if breastfeeding is truly not feasible. Lack of breast milk substitutes is particularly challenging for poor rural women who cannot afford infant formula milk.

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Factors Affecting Breastfeeding Practices in Sindh Province, Pakistan: A Secondary Analysis of Cross-Sectional Survey Data

Cited by 12 publications

References 30 publications

Factors influencing exclusive breastfeeding duration in Pakistan: a population-based cross-sectional study

Factors influencing exclusive breastfeeding duration in Pakistan: a population-based cross-sectional study

Breastfeeding practices in nursing mothers during COVID-19 pandemic: Dual center study in Karachi, Pakistan

Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study

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