Infant feeding modalities addressed in two different ways in Eastern Uganda

Abstract

BackgroundDurations of exclusive breastfeeding (EBF) and predominant breastfeeding (PBF) from two different assessments, among the same mother-infant population, were investigated to determine the degree to which the assessments yielded overlapping results.MethodsThirty Ugandan mother-infant pairs were followed up weekly from birth to three months of age with weekly short-time feeding recall: the 24-hour recall asked prior to the 1-week recall. In addition, at week 6 and 12 dietary recalls since-birth were conducted. Variables for the duration of EBF and PBF were created from the short-time feeding recalls and the dietary recalls since-birth, respectively. Mean durations of EBF and PBF from the two assessments were compared with Kaplan Meier analysis at week 6 and 12. Reproducibility of dietary recall instruments was also assessed.ResultsAt six weeks postpartum the mean durations of EBF were 0.50 weeks (95% CI: 0, 1.02) according to the weekly short-time recalls and 1.51 weeks (95% CI: 0.66, 2.35) according to the recall since-birth (Mantel-Cox test, p = 0.049). The mean durations of PBF were 4.07 weeks (95% CI: 3.38, 4.77) according to the frequent short-time recalls and 4.50 weeks (95% CI: 3.93, 5.07) according to the recall since-birth, (Mantel-Cox-test, p = 0.82). At twelve weeks the mean durations of EBF were 0.5 weeks (95% CI: 0, 1.1) according to the weekly short-time recalls and 1.4 weeks (95% CI: 0.1, 2.7) according to the recall since-birth (Mantel-Cox-test, p = 0.15). The mean durations of PBF were 5.2 weeks (95% CI: 3.9, 6.5) according to the weekly short-time recalls and 6.6 weeks (95% CI: 5.4, 7.8) according to recall since-birth (Mantel-Cox-test, p = 0.20). Reports of feeding categories and early feeding practices showed high reproducibility.ConclusionComparing duration of EBF and PBF in this group of mother-infant pairs showed overlapping results from the weekly short-time assessment and the recall since-birth at twelve weeks, with the latter yielding slightly longer duration of the respective feeding modalities. The retrospective recall since-birth could be assessed as a cost-reducing tool compared to the frequent follow-up addressing duration of respective infant feeding modalities for evaluation of programmes promoting safer infant feeding practices.Trial registrationThe study was part of formative studies for the ongoing study PROMISE EBF registered at http://clinicaltrials.gov, NCT00397150.

Factors associated with delayed initiation of breastfeeding: a survey in Northern Uganda

“…From these estimates, we note that there was no major difference in recall for this variable based on time. A validation study done in Eastern Uganda showed high consistency between infant feeding questions asked at birth and those asked at 3 months [44], further research is needed to assess the consistency after 1 year or more. That said, a 2-year recall period is the recommended standard by the World Health Organization [23] and is also the standard used by the demographic and Health surveys which makes it a meaningful period to use for comparative purposes.…”

Breastfeeding and HIV: experiences from a decade of prevention of postnatal HIV transmission in sub-Saharan Africa

“…'s paper from Uganda where both exclusive breastfeeding and exclusive formula feeding were deemed inappropriate and unsatisfactory by the study participants [45]. The paper describes the deep-seated cultural significance of breast milk as the only culturally appropriate way to feed an infant.…”

“…This message was communicated in talks where men were active participants in the debates about the feeding of their children. The paper, however, reveals the lack of appropriate arenas for men to engage in such debates, the PMTCT field being dominated by a 'mother and child' approach (inherent in the name) [45]. Such lack of partner involvement in the infant health sphere has emerged as perilous in an HIV context where modification of infant feeding regimes is highly dependent upon male support.…”

Exclusive breastfeeding promotion by peer counsellors in sub-Saharan Africa (PROMISE-EBF): a cluster-randomised trial

“…We also noted some questionnaire fatigue in the Ugandan site-ie, reluctance to fully engage in answering similar questions after a few interviews. 18 Overall, a fairly low-intensity peer-counselling intervention to promote EBF for infants aged up to 6 months in Burkina Faso, Uganda, and South Africa resulted in an increase in EBF prevalence ratios at age 12 weeks and 24 weeks. With the success of increasing EBF prevalence elsewhere, 2 our findings suggest that the prevalence of EBF can be increased in many sub-Saharan African settings.…”

“…[14][15][16][17] The questionnaires were piloted in Uganda in 2005. 18 Data were gathered in the mothers' homes from 2006 to 2008 by trained data gatherers. In Burkina Faso and Uganda, data were gathered with hand-held computers by use of EpiHandy (version 165.528-142 RC; webappendix p 15).…”