Abstract
BackgroundBreastfeeding has the most profound impact on infant health and wellness, and also have significant implications for the mother. The duration of the breastfeeding determines the infant’s protection from malnutrition and other common infectious diseases; consequently, the World Health Organization (WHO) recommends exclusive breastfeeding (EBF) six months, followed by gradual weaning and breastfeeding until the baby is two years old. In Pakistan, the practice of breastfeeding is heavily dependent upon certain demographic, economic, social, and biological factors, which ultimately impact the quality of care provided to the infant and their health. The aim of this paper, therefore, is to measure the impact of these factors on the exclusive breastfeeding duration in Pakistan.MethodsThe data for the study has been collected from Pakistan Demographic and Health Survey (PDHS) for the year 2017–18. Binary logistic regression model and survival analysis are used to determine the relationship between the independent and dependent variables.ResultsWe use a binary logistic regression to estimate the effect of each factor on the duration of EBF. The binary logistic regression finds significant relationships between region, maternal education, wealth index, size of a child, watching television, delivery by cesarean, and maternal age and EBF. We then use log-likelihood, AIC, BIC criteria to determine if a parametric or non-parametric model would provide a better fit; based on these results we fit an Inverse Gaussian (Weibull) distribution for the survival analysis. These results show that there are more significant factors associated with EBF duration in parametric survival analysis than in the binary logistic regression results. Thus, the survival analysis is a better method for predicting the relationship between the duration of EBF and its factors. Furthermore, logically EBF is designated to be done for six months which would not be properly gauged with a binary response variable.ConclusionsThe results of this study provide proof that exclusive breastfeeding is a common practice among women in Pakistan, and to improve the quality of post-natal care, health policy in the country needs to focus on the existing demographic and social factors which are found significant in this study.
Highlights
Breastfeeding has the most profound impact on infant health and wellness, and have significant implications for the mother
Exclusive breastfeeding (EBF) provides improves survival odds for infants, where children who are breastfed are fourteen times more likely to survive when compared to children who have not been breastfed, and prevents diarrhea and pneumonia, which are the two leading causes of infant death [2]
In Pakistan, only 18% of women start the process of initial breastfeeding and only 37.7% of the women continue the practice of exclusive breastfeeding [3]
Summary
Breastfeeding has the most profound impact on infant health and wellness, and have significant implications for the mother. Within the South Asian region, the conditions regarding infant health are dire, and some of the most common inflictions on infant and child health in this region include malnutrition, stunting, and pneumonia Such problems are exacerbated using artificial feeding for infants and lead towards long-term complications such as obesity, diabetes, and higher blood pressure [1]. Exclusive breastfeeding (EBF) provides improves survival odds for infants, where children who are breastfed are fourteen times more likely to survive when compared to children who have not been breastfed, and prevents diarrhea and pneumonia, which are the two leading causes of infant death [2] Despite this favorable evidence, there is a marked reluctance and underuse of exclusive breastfeeding practices in Pakistan.
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