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Abstract
BackgroundThe prevalence of early initiation of breastfeeding and exclusive breastfeeding (EBF) at 6 months remain low in the Philippines. To help meet the 90% early initiation of breastfeeding target and to improve infant and young child feeding practices in the Philippines, the Millennium Development Goals - Fund 2030 Joint Programme (JP) on Ensuring Food Security and Nutrition for Children 0–24 months old was implemented. We aimed to determine the effectiveness of visits by peer counselors during pregnancy and after delivery, and membership in breastfeeding support groups in promoting these optimal breastfeeding practices.MethodsWe used data from the Endline Survey of the JP to study the effects of prenatal and postnatal peer counselor visits, and membership in breastfeeding support groups, and their possible interactions with initiation of breastfeeding within 1 hour of birth among children aged 0 to 24 months and EBF at 6 months among children aged 6 to 24 months, while adjusting for confounding. We used logistic regression methods for survey data to assess these associations.ResultsOf the 2343 mother-infant pairs, only 1500 (63.1%) practiced early initiation of breastfeeding. Of the 1865 children aged 6 months or older, only 621 (34.7%) were exclusively breastfed at 6 months. After adjusting for confounding variables, there was no strong evidence that peer counselor visits were associated with early initiation or EBF at 6 months. However, members of breastfeeding support groups had 1.49 times higher odds of early initiation of breastfeeding (95% CI [Confidence Interval] 1.12, 1.98) and 1.65 times higher odds of EBF (95% CI 1.20, 2.24) compared to those who were not members of breastfeeding support groups. There was no interaction between the different exposure variables and early initiation and EBF at 6 months.ConclusionsOur findings suggest breastfeeding support groups may be institutionalized to promote both early initiation of breastfeeding and EBF in the Philippines, while the role of peer counselors in promoting optimal breastfeeding behaviors should be further reviewed. Our suggestion to integrate non-healthcare professionals to promote early initiation of breastfeeding and EBF could be tested in future intervention studies.
Highlights
The prevalence of early initiation of breastfeeding and exclusive breastfeeding (EBF) at 6 months remain low in the Philippines
After adjusting for confounders, we report that there was no strong evidence that visits by peer counselors during pregnancy as well as visits after delivery were associated with EBF
While there is no strong evidence that visits by a peer counselor during pregnancy and after delivery are associated with early initiation of breastfeeding and EBF, there is strong evidence that membership in breastfeeding support groups is positively associated with both early initiation of breastfeeding and EBF
Summary
The prevalence of early initiation of breastfeeding and exclusive breastfeeding (EBF) at 6 months remain low in the Philippines. Initiation of breastfeeding, defined as breastfeeding within 1 h of birth, and exclusive breastfeeding (EBF), defined as giving the infant breastmilk only, without supplementary food or water or medicines, during the first 6 months of life, are optimal breastfeeding behaviors that improve child health and survival [1,2,3,4,5]. Initiation of breastfeeding stimulates the production of breastmilk, provides antibody protection, and reduces postpartum hemorrhage [6] It is linked with successful practice of other optimal breastfeeding behaviors, such as EBF for 6 months after birth, and continued breastfeeding for at least 2 years with complementary feeding after 6 months [5, 7, 8]. In the long term, breastfeeding increases postpartum weight loss, decreases visceral adiposity, and reduces risk of cardiovascular diseases, diabetes, and breast and ovarian cancers [12]
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