Authors: T.S. Chandrashekhar (1), H.S. Joshi (1), P.R. Shankar (2), V.S. Binu (1), M.S. Rana (1), and U. Ramachandran (3)
(1) Department of Community Medicine, (2) Department of Pharmacology, and (3)Department of Pediatrics, PO Box 155, "Deep Heights", Manipal College of Medical Sciences, Pokhara, Nepal
Breastfeeding practices have wide sociocultural connections and vary according to geographic regions. Published literature on breastfeeding initiation and exclusive breastfeeding is not available for urban population of western Nepal.
The study was conducted to assess rates of breastfeeding initiation and exclusive breastfeeding within 2 months after delivery and to determine the factors influencing exclusive breastfeeding.
A cross-sectional survey was conducted in Pokhara municipality, western Nepal, during August-September 2005. Mothers, attending immunization clinics, who were having babies aged less than 2 months were included. Two trained health workers interviewed the mothers using a pretested semistructured questionnaire after obtaining consent. Exclusive breastfeeding was defined as mother reporting that nothing else but breastmilk was being given from birth till the time of the interview. Data were analyzed using the SPSS package. Descriptive statistics and univariate statistics were applied to compare the demographic factors of exclusive breastfeeding and non-exclusive breastfeeding groups. Univariate and logistic regression analyses were done to explore the factors influencing the decision of the mothers to exclusively breastfeed.
In total, 385 mothers were interviewed. The rates of initiation within one hour and within 24 hours were 72.7% and 84.4% respectively. Exclusive breastfeeding was practised by 82.3% of the mothers. Breastmilk/colostrum was given as first feed to 332 (86.2%) babies, but 17.2% of them were either given expressed breastmilk or were put to breast of other lactating mothers. Prelacteal feeds were given to 14% of the babies. The common prelacteal feeds given were formula feeds (6.2%), sugar water (5.9%), and cow’s milk (2.8%). Complementary feeds were introduced by 12.7% of the mothers. By logistic regression analysis, friends’ feeding practices, type of delivery, and baby’s
first feed were the factors influencing exclusive breastfeeding practice of the mothers.
Despite the higher rates of initiation and exclusive breastfeeding, practices, such as prelacteal feeds and premature introduction of complementary feeds, are of great concern in this urban population. There is a need for promotion of good breastfeeding practices among expectant mothers and also the community, especially the family taking into the account the local traditions and customs.
The authors are grateful to the staff of UNICEF and Pokhara Municipal Corporation for their cooperation during the study. The authors also thank all the mothers who willingly participated in the study. The authors also thank Ms Renu Rana Bhat for work in conducting and supervising the interviews during the data-collection period.