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

Abstract

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.

Child Feeding Practices of Childbearing Mothers and Their Household Food Insecurity in a Coastal Region of Bangladesh

“…Mother’s age, birth rank of the child, colostrum feeding of children, breastfeeding initiation and frequency of breastfeeding also have shown strong relation (univariate analysis) with exclusive breastfeeding practice and timely initiation of complementary feeding practice. 33 The profound influence of household food security on dietary intake and health and nutritional status of children is supported by a substantial body of research. 41 As far as we know, very few studies have investigated the association between household food insecurity and child feeding practices in Bangladesh.…”

How is parental education associated with infant and young child feeding in Bangladesh? A systematic literature review

“…Our ndings are consistent with the ndings from other South Asian countries. Parental education was found to be negatively associated with optimal breastfeeding in studies conducted in India and Pakistan (97,(100)(101)(102)(103). The common reason behind this scenario is that educated mothers are more likely to have employment than uneducated mothers; however, unsupportive working environments with no or limited breastfeeding opportunities could explain poor breastfeeding practices (104).…”

“…The common reason behind this scenario is that educated mothers are more likely to have employment than uneducated mothers; however, unsupportive working environments with no or limited breastfeeding opportunities could explain poor breastfeeding practices (104). In contrast to the negative associations, other studies also found that parental education was positively associated with breastfeeding in South Asian countries (100,103,(105)(106)(107)(108)(109)(110). According to these studies, the reason is probably because educated mothers are more likely to access healthcare messages, aware of healthy and timely feeding of children, and more capable of making informed health related decisions (106,107).…”

Modeling the Ranked Antenatal Care Visits Using Optimized Partial Least Square Regression

“…Advancements in health research generate public health data having many covariates, where some or all may be correlated. Several studies have been conducted to identify influential factors of different public health concerns using multiple statistical tools and techniques [9][10][11][12][13]. The partial least square (PLS) regression model has been the concern of interest as a statistical method for modeling data having multicollinearity during the last few decades.…”