Breastfeeding rates of children under two years old in nine cities of China from 1985 to 2015:a comparison between urban and suburban areas / 中华围产医学杂志

ABSTRACT

Objective To analyze the breastfeeding rate of children under two years of age in nine cities of China in 2015 and variations in breastfeeding patterns from 1985 to 2015. Methods All data were collected from a series of national cross-sectional surveys "National Growth Survey of Children under Seven Years Old in Nine Cities of China" (urban and suburban areas of Beijing, Haerbin, Xi'an, Wuhan, Nanjing, Shanghai, Guangzhou, Fuzhou and Kunming) conducted from each May to October in 1985, 1995, 2005 and 2015. Stratified cluster sampling was used to select healthy children at least 150 in each subpopulation. Feeding patterns within 24 h prior to investigation were analyzed through face-to-face interviews using a self-made questionnaire. The rates of exclusive breastfeeding, mixed feeding and formula feeding were described as composition ratios. The difference between urban and suburban areas was analyzed by Chi-square test and the weaning age was calculated with a Probit model. Results (1) In 2015, the exclusive breastfeeding rate for infants under six months of age was 48.8% (9 143/18 722) in urban areas and 48.4% (8 652/17 878) in suburban areas, and the breastfeeding rates at one and two years old were 36.1% (1 351/3 746) and 5.8% (211/3 668) in urban areas and 29.9% (1 128/3 776) and 4.3% (157/3 683) in suburbs. The differences of breastfeeding patterns in ≥1-<2, ≥2-<3, ≥ 3-<4, ≥ 5-<6, ≥ 10-<12, ≥ 12-<15, ≥ 18-<21 and ≥ 21-<24 months of age were all significantly between suburbs and urban areas (χ2=8.575-36.299, all P<0.01). The age at weaning age was 9.4 months and 9.3 months in urban and suburban areas, respectively. (2) From 1985 to 2005, breastfeeding rates showed a decreasing trend, especially in suburban areas where the exclusive breastfeeding rate for infants under six months of age decreased from 60.2% (8 898/14 780) to 42.5% (6 487/15 261) and the continuous breastfeeding rate decreased from 60.1% (2 164/3 600) to 27.6% (783/2 838) at the age of one and from 8.9% (320/3 600) (in 1995) to 3.0% (85/2 850) in 2015 at the age of two. However, from 2005 to 2015, breastfeeding rates were on the rise, especially in urban areas in which the exclusive breastfeeding rate for infants under six months of age increased from 32.8% (5 176/15 782) to 48.8% (9 143/18 722) and the continuous breastfeeding rates at one and two years old respectively increased from 17.0% (499/2 940) to 36.1% (1 351/3 746) and from 1.2% (34/2 856) to 5.8% (211/3 668). Conclusions There are great changes in breastfeeding patterns for Chinese children in the nine cities from 1985 to 2015. In the first two decades, breastfeeding rates decreased and the duration of breastfeeding was shortened, while the last decade have seen increased breastfeeding rates and longer breastfeeding duration. The exclusive breastfeeding rate for infants under six months of age is similar in urban and suburban areas and both have reached about to 50% in 2015, which indicates fruitful results have achieved through the implementation of infant feeding strategies and related measures in China.