Bottle-feeding practice and its associated factors among mothers of children aged 0 to 23 months in sub-Saharan Africa: a multi-level analysis of demographic and health surveys (2015-2022).
Avoidance of bottle feeding is recommended as it interferes with optimal suckling behavior, is difficult to keep clean, and is an important route for the transmission of pathogens. However, there is a current shift towards breastfeeding for a short period and the introduction of bottle feeding in both the developed and developing worlds. Bottle-feeding practice and its individual- and community-level determinants are not addressed in sub-Saharan Africa. Therefore, this study aimed to fill this gap and assess the pooled prevalence and associated factors of bottle feeding among mothers of children less than 23 months of age.
Data from the recent demographic and health surveys of 20 countries in sub-Saharan Africa conducted between 2015 and 2022 were used. A total weighted sample of 86,619 mother-child pairs was included in the current study. Multilevel mixed-effects logistic regression was used to determine the factors associated with the outcome variable. Intra-class correlation coefficient, likelihood ratio test, median odds ratio, and deviance (-2LLR) values were used for model comparison and fitness. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant.
The overall pooled prevalence of bottle feeding among mothers of children aged 0 to 23 months in sub-Saharan Africa was 13.74% (95% CI: 13.51%, 13.97%). Factors like maternal age [AOR = 1.09; 95% CI (1.04, 1.14)], educational status [AOR = 2.83; 95% CI (2.58, 3.10)], marital status [AOR = 1.16; 95% CI (1.09, 1.24)], maternal occupation [AOR = 0.76; 95% CI (0.73, 0.79)], media exposure [AOR = 0.80; 95% CI (0.76, 0.85)], wealth index [AOR = 1.21; 95% CI (1.15, 1.29)], sex of the household head [AOR = 1.17; 95% CI (1.12, 1.24)], family size [AOR = 1.06; 95% CI (1.01, 1.12)], number of under-five children [AOR = 1.11; 95% CI (1.04, 1.19)], place of delivery [AOR = 1.06; 95% CI (1.00, 1.12)], mode of delivery [AOR = 1.41; 95% CI (1.31, 1.52)], counseling on breastfeeding [AOR = 0.88; 95% CI (0.84, 0.92)], age of the child [AOR = 1.65; 95% CI (1.57, 1.75)], and residence [AOR = 1.64; 95% CI (1.56, 1.72)] were significantly associated with bottle-feeding practices.
Nearly one out of seven children aged 0 to 23 months received bottle feeding in sub-Saharan African countries. Older mothers, higher mothers' educational status, unmarried women, richest families, non-working mothers, exposed to media, female-headed households, large family size, having one under-five children, home delivery, cesarean delivery, children aged 6-11 months, and urban residence were significantly associated with an increased risk of bottle feeding. Breastfeeding promotion programs are advised to target mothers who are older, educated, working, rich, gave birth at home, have a large family size, are delivered by cesarean section, have children aged 6-11 months, and reside in urban areas to achieve a significant decrease in bottle feeding rates in sub-Saharan Africa.
Mekonen EG
《BMC PUBLIC HEALTH》
Prevalence and factors associated with prelacteal feeding in Western Nepal.
Newborn infants are often given prelacteal feeds in Nepal despite government policies encouraging exclusive breastfeeding for the first six months of life.
This study investigated the prevalence, reasons, types and factors associated with prelacteal feeding in the south-western region of Nepal.
Information on prelacteal feeding was obtained from 735 recently delivered women who were recruited for a prospective community-based cohort study conducted during 2014 in the Rupandehi district of Nepal. Factors associated with prelacteal feeding were assessed using logistic regression analysis.
A total of 225 (30.6%) mothers reported giving prelacteal feeds to their infants. The most popular prelacteal food was formula milk (41.7%), followed by cow or buffalo milk (26.6%), and sugar/glucose water (12.4%). Caesarean delivery (17.3%), cultural preference (16.4%) and being tired after childbirth (10.6%) were the most commonly cited reasons. Almost half (48%) of the mothers were advised by their mother/mother-in-law on prelacteal feeding method. Higher parity (adjusted odds ratio (OR) 2.05; 95% confidence interval (CI) 1.18-3.54), low birthweight (OR 1.97; 95% CI 1.23-3.16), caesarean delivery (OR 3.70; 95% CI 2.37-5.80) and wealthy status (OR 2.49; 95% CI 1.52-4.06) were associated with prelacteal feeding.
Nearly one-third of the infants in this study were given prelacteal feeds. Future breastfeeding promotion programmes should focus on the mothers with low birthweight infants, of high parity, from a wealthy family and those who had caesarean delivery.
Khanal V
，Lee AH
，Karkee R
，Binns CW
... -
《-》
ResearchGate
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