Abstract
BackgroundAlthough breastfeeding is common in Democratic Republic of the Congo, the proportion of women who exclusively breastfeed their babies up to 6 months remains low. This study aimed at identifying predictors of discontinuing exclusive breastfeeding before six months among mothers in Kinshasa.MethodsA prospective study was carried out from October 2012 to July 2013 among 422 mother-child pairs recruited shortly after discharge from twelve maternities in Kinshasa and followed up to six months. Interviews were conducted at each woman’s house during the first week after birth, and at one, two, three, four, five and six months. Collected data included history of child’s feeding and mother’s socio-demographic and psychosocial characteristics. The Cox Proportional Model was used to identify predictors of discontinuing exclusive breastfeeding before six months.ResultsThe median duration of exclusive breastfeeding was 10.9 weeks (Inter Quartile Range 4.3 to 14.9). At six months, 2.8 % of infants were exclusively breastfed. The factors independently associated with the discontinuation of exclusive breastfeeding before six months were: not confident in the ability to breastfeed [Adjusted hazard ratio (AHR) = 3.90; 95 % CI 1.66, 9.16)], no plan on the duration of EBF (AHR = 2.86; 95 % CI 1.91, 4.28), breastfeeding problems during the first week (AHR = 1.54; 95 % CI 1.13, 2.11), low level of breastfeeding knowledge (AHR = 1.52; 95 % CI 1.08, 2.15), and experienced less than five Baby-friendly practices during the maternity stay (AHR = 1.47; 95 % CI 1.05, 2.06).ConclusionsConfidence in the ability to breastfeed and intention to exclusively breastfeed were the most important predictors of discontinuing exclusive breastfeeding before six months. To have a greater impact on the duration of exclusive breastfeeding, interventions should focus on these factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s13006-015-0044-7) contains supplementary material, which is available to authorized users.
Highlights
Breastfeeding is common in Democratic Republic of the Congo, the proportion of women who exclusively breastfeed their babies up to 6 months remains low
In 2010, among children younger than five years, suboptimal breastfeeding was responsible for 8 % of all deaths and 7.6 % of all childhood Disability Adjusted Life Years (DALYs) [7]
To promote the practice of exclusive breastfeeding (EBF), the country had implemented various strategies including the extension of the Baby Friendly Hospital Initiative (BFHI) in health facilities located in provinces, the establishment of Baby Friendly Communities and the implementation of the national code of the marketing of breast milk substitutes
Summary
Breastfeeding is common in Democratic Republic of the Congo, the proportion of women who exclusively breastfeed their babies up to 6 months remains low. 5 % of developing countries, including the Democratic Republic of the Congo (DRC), had an increase in absolute number of DALYs attributable to suboptimal breastfeeding [7]. To promote the practice of EBF, the country had implemented various strategies including the extension of the Baby Friendly Hospital Initiative (BFHI) in health facilities located in provinces, the establishment of Baby Friendly Communities and the implementation of the national code of the marketing of breast milk substitutes. In spite of those interventions, no significant change was noted in 2010. The result from the 2010 Multiple Indicator Cluster Surveys (MICS) showed that most mothers initiated breastfeeding, 37 % of children younger than six months were exclusively breastfed, 65 % of children from two to three months old were receiving complementary feeding and, only 5 % of children were exclusively breastfed at six months [11]
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