Concordance with the WHO guidelines for early child feeding through the first six months of life in a sample of infants of the Guatemalan highlands

Abstract

BackgroundThe WHO recommends exclusive breastfeeding (EBF) through the first 6 mo of life. EBF is defined as having received only breast milk during the previous day. Predominant breast feeding (PBF) allows the infant to receive certain liquids such as water, juices and ritual fluids.ObjectiveTo evaluate EBF and PBF rates in a sample of infants from a low‐income, urban Guatemalan population using 3 different interview methods.MethodsMothers of 154 infants (77 boys) in their 6th mo of life, attending a public health center, were recruited and interviewed on a single occasion regarding previous day (as suggested by the WHO), current, and past (since birth) feeding practices.ResultsUsing the previous day recall, EBF was reported by 86 (56%) of the mothers. Estimated EBF rates were much lower when based on current feeding practice questions (20%) and even lower when based on feeding practices since birth (9%). Using the less stringent recommendation allowing certain liquids, we observed PBF rates of 58%, 49% and 31% based on previous day, current and past reported feeding practices, respectively.ConclusionThe WHO method overestimates the EBF rate compared to the recall since birth. Overall, adherence to the WHO guidelines for feeding in the first semester of infancy was much less than ideal and in need of strengthening.Funded by the Nestlé Foundation, Switzerland