Concordance of the Deuterium Dose to Mother Method and 24-Hour Recall to Measure Exclusive Breastfeedingat 6 Weeks Postnatally in Rural/Urban Setting in Jamaica.

Abstract

The 2030 health agenda for the United Nations Sustainable Development Goals promote exclusive breastfeeding (EBF) for the first 6months of life as a central step towards ensuring the survival of infants. As Jamaica attempts to achieve this goal, monitoring the rates of EBF is desirable. Currently, EBF rate is measured by questionnaires which are subject to recall and social desirability biases. We determined the rate of EBF using the Deuterium-oxide dose-to-mother (DTM) method and 24-h recall. The concordance of both methods and urban-rural differences of EBF were evaluated. Additionally, thegrowth of infants who were exclusively breastfed was compared to the infants who were mixed-fed. Sixty-one healthy mother-child pairs were followed from birth. EBF was measured at 6weeks. Growth was determined using standard anthropometric measurements. Differences in means were assessed by independent t-test or ANOVA. The agreement between the DTM and 24-h recall method was assessed with the kappa statistic. Differences in anthropometry and location were determined using a repeated measure model approach. Thirty (49%) women exclusively breastfed their infants with mean breast milk intake of 1024.3 ± 256.9g/day. There was moderate agreement between the methods (Agreement 69%, kappa 0.37, p = 0.002). Rural women (65%) were more likely to practice exclusive breastfeeding. There was no significant difference between the growth of the exclusively breastfed infant and mixed-fed infants. EBF rate was successfully measured using the DTM method. Women from urban settings are less likely to practice EBF. Further research may be needed to gain an in-depth understanding of the factors affecting breastfeeding practices in urban Jamaica.