Determinants of exclusive breastfeeding in infants of six months and below in Malawi: a cross sectional study

Yusuf M Salim,William Stones

doi:10.1186/s12884-020-03160-y

Abstract

BackgroundUNICEF and WHO recommend that all children should be exclusively breastfed for the first 6 months of life as breastmilk contains all the nutrients an infant needs during this period. In Malawi, exclusive breastfeeding has been declining from 72% (2009), 70.2% (2014) and 61% in the most recent survey (2015–16). We aimed to determine factors associated with exclusive breastfeeding in Malawi.MethodsWe used data from the Malawi Demographic and Health Survey (MDHS) 2015–2016. Survey records for 2059 mothers of children aged 6 months and below were identified and potential factors influencing infant feeding were examined. Logistic regression analysis was carried out to model determinants of exclusive breastfeeding (EBF).ResultsEBF declined in proportion to the age of the infant. Significant associations with continuing EBF were age of the mother, ethnicity of the mother, sex of infant and number of siblings. Members of the Tumbuka (OR = 1.71, CI. 1.13–2.59) and Ngoni (OR = 2.05, CI. 1.38–3.05) communities were more likely to practice EBF. In addition, mothers with female babies (OR = 1.35, CI. 1.08–1.70) and those with 3–4 children (OR = 1.47, CI. 1.04–2.08) were more likely to engage in EBF.ConclusionWe identify important variations in EBF practices among population sub-groups in Malawi that need to be considered when framing health education messaging. Work is needed to assess the impact of more targeted messaging, whether delivered via ‘ten steps’ to successful breastfeeding under Baby Friendly Hospital Initiative (BFHI) programming or other health education and awareness campaigns to sensitize communities on implications of some cultural practices on the lives of babies. The potential role for mass media, targeted Health Surveillance Assistants’ (HSA) home visits and male involvement also require exploration.

Highlights

UNICEF and WHO recommend that all children should be exclusively breastfed for the first 6 months of life as breastmilk contains all the nutrients an infant needs during this period
Exclusive breastfeeding under 6 months of age is defined as the proportion of children, 0–6 months of age, fed only breastmilk, with the exception of oral rehydration solution, vitamins, minerals, and/or medicines [1]
This study assessed determinants of exclusive breastfeeding in children of 6 months of age in Malawi using cross–sectional household Malawi Demographic and Health Survey (MDHS) data collected in 2015–2016

Summary

Introduction

UNICEF and WHO recommend that all children should be exclusively breastfed for the first 6 months of life as breastmilk contains all the nutrients an infant needs during this period. UNICEF and WHO recommend that children should be exclusively breastfed for the first 6 months of life to achieve optimal growth, development and health [2]. This implies that no other foods or liquids are provided, including water. Improving breastfeeding practices could save the lives of more than 800,000 children under 5 every year, the vast majority of whom are under 6 months of age [2] Exclusive breastfeeding confers both short and the longterm benefits to both the child and mother.

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