Predictors of exclusive breastfeeding in early infancy: operational implications.

ABSTRACT

OBJECTIVES: To evaluate the independent predictors of exclusive breastfeeding in early infancy. DESIGN: Cross sectional multivariate comparison of different breastfeeding categories. SETTING: Urban teaching hospital Outpatient Department. SUBJECTS: Mothers of 501 children between the age group of 0-6 months were questioned in detail on a standardized pretested proforma about various sociodemographic, parental, infant, feeding related, antenatal and perinatal characteristics likely to affect breastfeeding practices. Mother's height and weight and infant's weight were also recorded. RESULTS: The exclusive breastfeeding, predominant breastfeeding, bottle feeding, ever breastfed and timely first suckling rates were 44.9%, 67.8%, 31.5%, 99.4% and 10.4%, respectively. Amongst the 29 factors subjected to univariate analyses, 16 clinically relevant or significant (p < 0.1) variables were included for multiple logistic regression models. The significant (p < 0.05) positive independent association for exclusive and partial breastfeeding were (OR) infant's present weight (1.45 to 9.64); breastmilk as first feed (1.53 to 2.22); and lower age of child (1.02 to 1.05). Additional important predictors for exclusive breastfeeding versus total top feeding) were (OR) breastfeeding propagation (1.34 and 2.99); less educated mother (1.09 and 1.23); normal vaginal delivery (1.60) and taller mother (1.21). CONCLUSIONS: Breastfeeding propagation plays a key role in promoting exclusive breastfeeding. Other independent negative predictors represent a high risk subset for whom intensive propagation is desirable since these factors by themselves may not be amenable to intervention.