Infant feeding practices and child health in Bolivia.

ABSTRACT

PIP: This study assesses, in two models, the effects of infant feeding practices on stunted growth and diarrhea incidence among breast fed children aged 3-36 months in Bolivia. Data were obtained from the 1989 Demographic and Health Survey, which included 1143 breast-fed children. About 38% of the children were stunted. Stunting increased with age and parity. In the bivariate analysis, breast feeding increased stunting, and maternal characteristics were related. Stunting increased with maternal age and indigenous ethnicity. Stunting was associated with blue collar and agricultural households and households in the rural Altiplano and Valles regions. About 33% of the children had experienced an episode of diarrhea. Bivariate analysis revealed that only maternal education and having waste removal were related to the occurrence of diarrhea. Logistic models show that the positive effects of breast feeding were more prominent in impoverished environments. Cessation of breast feeding among infants 6 months or less and living in households with extreme rural poverty increased the risk of stunting fourfold. Children with birth intervals of 2-3 years were at 1.5 times lower risk. Children in rural areas were less likely to be stunted than children in urban areas, when socioeconomic status was controlled. Children who had diarrhea were 40% more likely to be stunted. Diarrhea decreased with maternal education. Diarrhea increased with the number of household members. Food supplementation introduced at about 6-9 months, when most infants are fed solids, increased the risk of stunting by about 75%. Introduction earlier or later had no significant impact on child growth. Only 30% of infants received solids before the age of 4 months. Personal living conditions or socioeconomic status were key explanatory factors in stunting and diarrhea.