Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition

Location: Hall D

Poster Board Number: 272

P13-014 - Determinants of early breastfeeding practices among children under 12 months in Nepal

Sunday, Jun 10
8:00 AM – 6:00 PM

Objective: To identify determinants of optimal early breastfeeding practices in a national sample of households with preschool-aged children in Nepal.

Methods: Breastfeeding practices were explored in 1,011 infants <12 months of age, by retrospective parental interview during a nationally representative, cross-sectional study in 21 district sites across the Mountains, Hills and Terai (southern plains) of Nepal in 2013 (PoSHAN Community Studies). Dichotomous outcomes included breastfeeding within an hour of birth, receipt of colostrum, feeding prelacteals and predominant breastfeeding through 6 months. Adjusted prevalence ratio’s (APR’s) and 95% confidence intervals (C.I.) were estimated using log Poisson regression models with robust variance. Risk factors assessed during the survey were also explored for each outcome.

Results: The proportion of infants breastfed within an hour of birth, fed colostrum, fed prelacteals, and predominantly breastfed were 42%, 83%, 33% and 57%, respectively. Infants who received prelacteals were less likely to be breastfed within an hour (APR: 0.49, 95% C.I.: 0.36-0.65) or predominantly breastfed through 6 months of age (APR: 0.45, 95% C.I.: 0.32-0.63) than infants not given prelacteals. Infants fed colostrum were 25% more likely to be breastfed within an hour of birth (APR: 1.25, 95% C.I.: 1.02-1.52). Children born to older mothers were less likely to initiate breastfeeding within 1 hour of birth than teenage mothers. Infants in the Terai were 10% less likely to receive colostrum (APR: 0.90, 95% C.I.: 0.83-0.97) and 2.72 times more likely to receive pre-lacteal feeds (APR: 2.72, 95% C.I.: 1.67-4.45) than those in the Mountain region. Women who reported >1 antenatal care (ANC) visit were more likely to predominantly breastfeed (APR: 1.27, 95% C.I.: 1.07-1.50) relative to women with no ANC visit.

Conclusions: Most infants in Nepal are fed colostrum but breastfeeding practices are not optimal, with less than half breastfed within an hour of birth and one-third fed prelacteals, a dominant practice in the Terai which negatively affects breastfeeding throughout early infancy. Antenatal care may help prepare mothers to breastfeed their infants.



Funding Source:

USAID Feed the Future Nutrition Innovation Lab, The US Agency for International Development (USAID), Washington DC, under the Cooperative Agreement AID-OAA-L-10-00005.

CoAuthors: Andrew Thorne-Lyman – Johns Hopkins Bloomberg School of Public Health; Binod Shrestha – Nutrition Innovation Lab/Johns Hopkins University; Sumanta Neupane – Nutrition Innovation Lab/Johns Hopkins University; Bareng Nonyane – Johns Hopkins Bloomberg School of Public Health; Swetha Manohar – Johns Hopkins Bloomberg School of Public Health; Rolf Klemm – Johns Hopkins Bloomberg School of Public Health; Keth West – Johns Hopkins Bloomberg School of Public Health

Shiva Bhandari

PhD Student
University of South Carolina
Columbia, South Carolina