Impact of multiple exclusive breastfeeding episodes on estimates of exclusive breastfeeding duration

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Topic(s): Nutrition Health & Wellness Obesity Nutrition & Disease Management

Association between multiple exclusive breastfeeding episodes and estimates of exclusive breastfeeding duration

The World Health Organization recommends exclusive breast feeding (EBF) for the first 6 months of an infant’s life since EBF is crucial for an infant’s optimal well-being. The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development birth cohort study published in the journal Maternal and Child Nutrition compared various breastfeeding metrics.

The study characterised infants’ breastfeeding trajectories from the time of enrolment to 180 days. Three different metrics for the estimation of the median duration of EBF were compared. First, the EBF duration was defined as the duration from birth to first study visit, wherein the status was not designated EBF, and the median duration collected longitudinally (EBFLONG) was identified. Second, the proportion of infants who were EBF for 24 hours was estimated using the DHS interpolation (EBFDHS) method. Third, the personal prevalence of EBF was estimated, taking into account the practice of re-initiation of EBF (EBFPREV).

A total of 356,764 child days of data were recorded from 1957 infants. The median duration of EBFLONG, EBFDHS and EBFPREV was 33 days, 49 days and 66 days, respectively. The differences can be attributed to the re-initiation of EBF after a period of non-EBF. Re-initiation of EBF was seen in 64.2% of women across all sites in the study. The median number of EBF re-initiation was 2 (IQR: 1, 3). The gain in EBF days associated with second and third episodes of EBF re-initiation within 6 months was 18.8 days and 13.7 days, respectively. Better socio-economic status, good maternal reasoning ability and shorter period of EBF (<2 months) increased the probability of re-initiation.

Interventional programmes to encourage women to return to EBF and positively support EBF re-initiations need to be carried out in settings where short gaps in EBF is reported.

News Source: Ambikapathi R, Kosek M, Lee G, et al. How multiple episodes of exclusive breastfeeding impact estimates of exclusive breastfeeding duration: report from the eight-site MAL-ED birth cohort study. Maternal & Child Nutrition. 2016.