Breastfeeding Practices among Adolescent Mothers and Associated Factors in Bangladesh (2004-2014).

Kingsley Agho,Felix Ogbo,Chundung Miner,Catharine Fleming,Mansi Dhami,Raphael Torome,Tahmeed Ahmed

doi:10.3390/nu13020557

Abstract

Optimal breastfeeding practices among mothers have been proven to have health and economic benefits, but evidence on breastfeeding practices among adolescent mothers in Bangladesh is limited. Hence, this study aims to estimate breastfeeding indicators and factors associated with selected feeding practices. The sample included 2554 children aged 0–23 months of adolescent mothers aged 12–19 years from four Bangladesh Demographic and Health Surveys collected between 2004 and 2014. Breastfeeding indicators were estimated using World Health Organization (WHO) indicators. Selected feeding indicators were examined against potential confounding factors using univariate and multivariate analyses. Only 42.2% of adolescent mothers initiated breastfeeding within the first hour of birth, 53% exclusively breastfed their infants, predominant breastfeeding was 17.3%, and 15.7% bottle-fed their children. Parity (2–3 children), older infants, and adolescent mothers who made postnatal check-up after two days were associated with increased exclusive breastfeeding (EBF) rates. Adolescent mothers aged 12–18 years and who watched television were less likely to delay breastfeeding initiation within the first hour of birth. Adolescent mothers who delivered at home (adjusted OR = 2.63, 95% CI:1.86, 3.74) and made postnatal check-up after two days (adjusted OR = 1.67, 95% CI: 1.21, 2.30) were significantly more likely to delay initiation breastfeeding within the first hour of birth. Adolescent mothers living in the Barisal region and who listened to the radio reported increased odds of predominant breastfeeding, and increased odds for bottle-feeding included male infants, infants aged 0–5 months, adolescent mothers who had eight or more antenatal clinic visits, and the highest wealth quintiles. In order for Bangladesh to meet the Sustainable Development Goals (SDGs) 2 and 3 by 2030, breastfeeding promotion programmes should discourage bottle-feeding among adolescent mothers from the richest households and promote early initiation of breastfeeding especially among adolescent mothers who delivered at home and had a late postnatal check-up after delivery.

Highlights

In many low- and middle-income countries (LMICs), approximately 13 million adolescent girls give birth annually [1,2], and Bangladesh has the highest adolescent pregnancy rate in Asia
Our results indicated that exclusive breastfeeding (EBF) and EIBF rates among adolescent mothers were suboptimal because less than half of adolescent mothers had EIBF, and that only half of the adolescent mothers EBF their infants aged less than 6 months and need further improvement in order to gain the full benefits of breastfeeding including health and nutritional status of their children
We found that adolescent mothers who had no antenatal clinic (ANC) visits during pregnancy were less likely to bottle-feed their children compared to those adolescent mothers who had eight or more Antenatal Clinic (ANC) visits during pregnancy

Summary

Introduction

In many low- and middle-income countries (LMICs), approximately 13 million adolescent girls give birth annually [1,2], and Bangladesh has the highest adolescent pregnancy rate in Asia. An estimated 12% of adolescent Bangladeshi girls fall pregnant before the age of 19 years, and this is largely driven by the high rate of child marriage [3]. This early age of marriage and subsequent pregnancy has huge implications for both the mother and baby, as pregnancy and childbirth-related issues were the leading causes of death in adolescent girls in 2017 [4,5], while babies born to adolescent mothers have an increased risk of dying compared to those born to older mothers [6]. Appropriate breastfeeding practices increase child survival and maternal health. Key factors associated with appropriate breastfeeding practices among Bangladeshi mothers of all age groups included non-prelacteal feeding practices [15], a lack of intimate partner violence and/or child abuse [14], access to mass media, home birthing [16], non-caesarean birthing, and receipt of breastfeeding counselling, antenatal and postnatal care [16,18]

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