Trends in infant and young child feeding practices in Bangladesh, 1993–2011

Abstract

BackgroundOptimal infant and young child feeding practices are crucial to improving the health and nutritional status of children. Bangladesh Breastfeeding Foundation, UNICEF and several other organizations are working in the country for the promotion of healthy feeding practices. This article presents trends in breastfeeding and complementary feeding practices in Bangladesh from 1993–2011, based on data in Bangladesh Demographic and Health Surveys. The following Bangladesh Demographic and Health Surveys were studied: BDHS 93–94, BDHS 96–97, BDHS 99–00, BDHS 04, BDHS 07 and BDHS 11. Values of indicators for infant and young child feeding proposed by WHO, along with their 95% confidence intervals, were calculated, and trends were assessed.FindingsAmong the core indicators, early initiation of breastfeeding, exclusive breastfeeding under six months, introduction of solid, semi-solid and soft foods, and consumption of iron-rich foods have improved, while continued breastfeeding at one year does not display a statistically significant development. Of the optional indicators, the prevalence of age-appropriate breastfeeding and children ever breastfed improved, while the prevalence of predominant breastfeeding under six months witnessed a decline. Median duration of breastfeeding declined, and there was no change in the other optional indicators (continued breastfeeding at two years and bottle feeding). Developments in the other optional indicators were not statistically significant. The ratings of early initiation of breastfeeding and complementary feeding have gone up from poor to fair, those of exclusive breastfeeding under six months from fair to good, while those of bottle-feeding are fair.ConclusionThe developments in breastfeeding and complementary feeding practices in the country have been considerable, but there is still substantial scope for improvement.

A systematic review of complementary feeding practices in South Asian infants and young children: the Bangladesh perspective

“…Dietary diversity was explored in 11 studies [6,8,[13][14][15][16][17][18][19][20][21], with 4 using the seven WHO IYCF food groups to quantify MDD [14][15][16]19]. Their data suggests a declining trend in MDD achievement between 2007 and 2011, with current attainment around 25%.…”

“…The 2007 BDHS combined groups M and E into a single "meat, fish, and eggs" group; this figure may therefore underestimate the true value. In the 2011 BDHS the reported rate had fallen to 25% [19]. A large cohort study conducted in rural subdistricts in 2011 provides an even lower number; Owais et al (Weight of Evidence = High (WOE = H)) interviewed 2073 mother-child pairs over 9 months, and found that just 16% of children received the necessary four food groups per day to satisfy MDD [15].…”

“…Whilst raising awareness on MDD by improving knowledge is likely to be beneficial, the delivery mode of such an intervention needs to be established [6]. With evidence of an increasing prevalence of iron deficiency anaemia within 3 months of CF initiation, supporting mothers' use of iron rich or fortified foods is essential with some advocating the use of universal distribution of iron fortified foods for low households [13,18,19,47]. Levels of maternal education have been identified as an influence on CFP.…”

Early newborn ritual foods correlate with delayed breastfeeding initiation in rural Bangladesh

“…Early initiation of breastfeeding (within an hour of birth) is also recommended by WHO [9] and delayed initiation has been associated with increased risk of infant mortality [10–14]. However, despite exclusive breastfeeding advocacy efforts and evidence that breastfeeding improves infant outcomes in Bangladesh [15], early and exclusive breastfeeding remains low [16–18]. A comprehensive study found a 47.1% prevalence of early breastfeeding and 64.1% prevalence of exclusive breastfeeding until six months in 2011 in Bangladesh [16].…”

“…However, despite exclusive breastfeeding advocacy efforts and evidence that breastfeeding improves infant outcomes in Bangladesh [15], early and exclusive breastfeeding remains low [16–18]. A comprehensive study found a 47.1% prevalence of early breastfeeding and 64.1% prevalence of exclusive breastfeeding until six months in 2011 in Bangladesh [16]. Additionally, early complementary feeding continues to occur [19, 20].…”