Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018

Bhattacharjee, Natalia V.; Hay, Simon I.

doi:10.1038/s41562-021-01108-6

Cited by 38 publications

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“…Breast milk is the sole natural and primary source of optimum sustenance for newborn babies’ physical and neurological growth and cognitive development [ 40 ]; it also boosts the child’s immune system at an early age [ 41 – 43 ]. However, it may be challenging for women to stick to EBF for six months, especially in low and lower-middle income countries like Bangladesh, where maternal malnutrition is frequent, leading to reduce breast milk production [ 44 – 48 ]. In addition, a lack of information about the benefits of EBF practice, insufficient workplace supports for mothers, and insufficient healthcare system support all contribute to mothers discontinuing the EBF practice before the recommended six-month period [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Likelihood of infectious diseases due to lack of exclusive breastfeeding among infants in Bangladesh

Abdulla¹,

Karimuzzaman

Ali

et al. 2022

PLoS ONE

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Background Bangladesh is a South Asian developing country trying to achieve the Sustainable Development Goals (SDG)-3 and the objective of the Rural Electrification Board (REB) regarding child mortality. Infectious diseases are leading causes of child mortality, and lack of exclusive breastfeeding (EBF) among infants aged 0–6 months increases child morbidity and mortality from various infectious diseases in developing countries. However, as per existing literature, no study has been conducted yet to determine the lack of EBF practice effect on child mortality in Bangladesh. With this backdrop, the authors intend to measure the likelihood of infectious diseases due to the lack of EBF of infants aged 0–6 months in Bangladesh. Materials and methods This study used Bangladesh Demographic and Health Survey (BDHS) data over 1996–97 to 2017–18. The mothers of infants aged 0–6 months who were willingly participated in the BDHSs were considered to include in our analysis. Initially, there were 9,133 cases in the combined dataset. After filtering, there were 5,724 cases in the final dataset. We have considered diarrhea (D), acute respiratory infection (ARI) separately as well as the presence of either D or ARI or both and named as CoDARI as outcome variables. This study used both graphical and statistical techniques (Chi-square test, Wald test, and logistic regression) to analyze the data. The odds ratio (OR) and 95% confidence interval (CI) were used to quantify the likelihood of infectious diseases due to lack of EBF practice and its elasticity, respectively. Results The EBF practice got a conspicuous increasing trend, but the prevalence of infectious diseases was declined from 0 to 3 months of age of infants, whereas an inverse scenario is observed between 4–6 months. The significance of that inverse relationship was confirmed by p-value corresponding to the chi-square test and the Wald test of the adjusted regression coefficients after adjusting the associated factor’s effect on infectious diseases. The adjusted ORs also concluded that the lack of EBF practice up to six months of age could enhance the risk of D, ARI, and CoDARI by 2.11 [95% CI: 1.56–2.85], 1.43 [95% CI: 1.28–1.60], and 1.48 [95% CI: 1.32–1.66] times higher, respectively. Conclusion Findings of this study emphasize the importance of EBF up to six months of age of infants against diarrhea and ARI specific morbidity and mortality. Our results also agreed to the recommendation of the World Health Organization (WHO), United Nations International Children’s Emergency Fund (UNICEF), American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), and National Nutrition Programme of Ethiopia (NNPE) that the EBF practice for the first six months of age could be a best, cost-effective, long-lasting natural preventive way to reduce the child morbidity and mortality due to infectious diseases in developing countries. Therefore, findings would help policymakers ensuring the achievement target of REB and SDG-3 associated with the health sector in Bangladesh.

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Section: Discussionmentioning

confidence: 99%

Likelihood of infectious diseases due to lack of exclusive breastfeeding among infants in Bangladesh

Abdulla¹,

Karimuzzaman

Ali

et al. 2022

PLoS ONE

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“…Previous research has shown that proportion of exclusively breastfed children remains low in many lower- and middle-income countries ( 7 ). However, according to a recent geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 low-middle-income countries (LMICS), the total prevalence of EBF increased from 27% to 39% across all countries (2000–2018) ( 8 ). It is estimated to be extrapolated to 43% by 2025 ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, according to a recent geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 low-middle-income countries (LMICS), the total prevalence of EBF increased from 27% to 39% across all countries (2000–2018) ( 8 ). It is estimated to be extrapolated to 43% by 2025 ( 8 ). Although this could be positive progress, it falls short of the 70% goal ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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Feeding Patterns, Mother-Child Dietary Diversity and Prevalence of Malnutrition Among Under-Five Children in Lebanon: A Cross-Sectional Study Based on Retrospective Recall

2022

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BackgroundDespite demonstrated benefits, most countries fall short of meeting international targets for breastfeeding patterns, optimal complementary feeding, mother-children's quality diet, and malnutrition among under-five children.RationaleSince mothers usually play the most vital role in the healthcare of their children, research is needed to illuminate maternal factors that might promote a child's health and nutritional status.AimThe purpose of this study is to retrospectively (1) examine the under-five children's (0–59 months) feeding habits including exclusive breastfeeding, exclusive bottle feeding, continued breastfeeding, and complementary feedings, (2) investigate the mother-child's dietary diversity, and (3) identify any factors that cause less optimal nutrition due to a lack of food diversity in children aged 6 to 59 months. Moreover, (4) the prevalence of wasting, stunting, underweight, and overweight in the under-five offspring living in households located in the main two provinces in Lebanon (Beirut and Mount Lebanon) was determined.MethodsThe data for this analysis were collected from a representative sample of 384 households [384 mothers (21–49 years old) and children (0–59 months)] between February 2019 and June 2019. A questionnaire was used to inquire mothers of children ages 0–23 months about exclusive breastfeeding (EBF), continuous breastfeeding (CBF), exclusive bottle feeding (EBOT), mixed feeding (MF), and complementary feeding patterns. Moreover, additional questions regarding dietary diversity were asked to mothers of children aged 6 to 59 months. This score was calculated based on the 24 h recall of the mother and her child's consumption of 7 food groups, during the 24 h prior to the survey. Moreover, stunting, wasting, overweight, and underweight were calculated using the z-score for height-for-age (HAZ), weight-for-height (WHZ), and weight-for-age (WAZ), respectively. Binary logistic regression was used to explore the dietary diversity among children (ages 6–59 months) adjusting for covariates at maternal and household levels.ResultsAround 44% of children (0–59 months) had normal body weight. In addition, 9.3% were underweight (WAZ < -2SD to −3SD), 6.5% were at risk of being overweight, 24.45% were overweight, 9.3% were stunted (HAZ < -2SD to −3SD), and 6.25% (WHZ < -2SD to −3SD) were wasted. In total, among under-five children, the prevalence of EBF at 40 d and 6 months was 27 and 30%, respectively. The prevalence of CBF was 23%. Around 60% of mothers breastfed their offspring between 0 and 6 months and half of them introduced infant formula at earlier stages between 0–6 months. Furthermore, 78.4% of mothers introduced food to their children between 4 and 6 months (of which 40% before 6 months) and 62.5% of them introduced sugary drinks before 6 months. As for dietary diversity (DD), one out of two mothers and one out of three children (ages 6–59 months) had a low DD score (DDS) (46 and 32%, respectively). The children's and mother's DD were strongly found to be correlated (p-value = 0.034). Regression analysis showed that children's DD increased around 2 times [AOR = 1.7; 95% CI (1.042–2.914)] in context of high maternal DDS, and about 12 times [AOR = 11.7; 95% CI (1.2–111)] when a member of the highest-income households.ConclusionsOur findings demonstrated low rates of EBF and CBF, high prevalence of EBOT, and early introduction of complementary foods among children ages 0–59 months. Furthermore, for children ages 6–59 months, there was poor mother-child dietary diversity and a high prevalence of overweight and stunted children in the main two Lebanese provinces. This suggests the alarming need for continuous nutrition intervention to improve infant feeding patterns and dietary diversity to reduce the malnutrition rates.

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“…India has been slow in adopting recommended IYCF practices ( 8 ) , and the performance of MDD in India has been poor for various reasons ( 4 , 7 , 9 , 10 ) . According to the Global Burden of Disease Study, India had an estimated 19⋅1 % of children (equivalent to an estimated 5 351 900 infants under 6 months of age) who were not exclusively breastfed in 2018 ( 11 ) . Children with MDDF had low fruit, vegetable and protein-rich food consumption, and many children who met MDD also had low protein-rich food consumption ( 9 ) .…”

Section: Introductionmentioning

confidence: 99%

Factors associated with minimum dietary diversity failure among Indian children

Kumar

Kumar²,

Kumar³

2022

J Nutr Sci

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Recognising the importance of infant and young child feeding practices during the first 2 years of life, the World Health Organization's Global Nutrition Monitoring Framework developed a minimum dietary diversity (MDD) indicator for feeding children aged 6–23 months. MDD is defined as the consumption of food items from five or more groups out of a total of eight food groups. Food intake from less than five food groups is considered minimum dietary diversity failure (MDDF). Using the nationally representative National Family Health Survey (NFHS) dataset, the present study assessed the trend in MDDF between 2005–6 and 2015–16 and the factors associated with MDDF among children aged 6–23 months during 2015–16. The NFHS conducted in 2005–6 and 2015–16 covered a sample of 14 419 and 74 078 children aged 6–23 months, respectively. Overall, the MDDF reduced from 87⋅4 % (95 % confidence interval (95 % CI) 86⋅8 %, 87⋅9 %) in 2005–6 to 80⋅6 % (95 % CI 80⋅1 %, 81⋅0 %) in 2015–16. Multivariable logistic regression analysis revealed that increased child's age, second and third birth order children, higher maternal age and education, mass media exposure of mothers and more than four antenatal care visits had a negative association with the MDDF. Children living in rural areas and residing in high-focus states of India were observed with higher odds of experiencing MDDF. Exposure to community healthcare services was negatively associated with MDDF, and anaemic children were more likely to have MDDF. Socioeconomic status of mothers and children and encouragement of maternal and child healthcare use could be helpful in devising context-specific intervention to mitigate MDDF.

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Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018

Cited by 38 publications

References 34 publications

Likelihood of infectious diseases due to lack of exclusive breastfeeding among infants in Bangladesh

Likelihood of infectious diseases due to lack of exclusive breastfeeding among infants in Bangladesh

Feeding Patterns, Mother-Child Dietary Diversity and Prevalence of Malnutrition Among Under-Five Children in Lebanon: A Cross-Sectional Study Based on Retrospective Recall

Factors associated with minimum dietary diversity failure among Indian children

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