Determinants of early breastfeeding initiation and exclusive breastfeeding in Colombia

Public Health Nutr. 2020 Feb;23(3):496-505. doi: 10.1017/S1368980019002180. Epub 2019 Oct 7.

Abstract

Objective: To identify modifiable risk factors associated with early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) in Colombia.

Design: Cross-sectional study from the 2010 Colombia nationally representative Demographic Health Survey (DHS). Studied exposures were categorized into five hierarchical blocks of increasing proximity to the outcomes: household, maternal, health systems, child, and early feeding characteristics. The two outcomes examined were delayed breastfeeding initiation among infants <24 months and interruption of EBF among infants <6 months. Prevalence ratios were computed using Poisson regression analysis with robust error variance, adjusted for sampling weights, following a hierarchical modelling approach.

Setting: Nationally representative cross-sectional survey from Colombia.

Participants: The EIBF analytical sample included 6592 and the EBF sample 1512 women with young children.

Results: EIBF prevalence was 65·6 % in children under 24 months and EBF was 43 % in infants under 6 months. Modifiable risk factors associated with delayed breastfeeding initiation were: C-section (PR = 2·08, CI 95 % = 1·92, 2·25), maternal overweight/obesity (PR = 1·09, CI 95 % = 1·01, 1·17), lack of skilled attendant at birth (PR = 1·09, CI 95 % = 1·01, 1·18). Modifiable risk factors for EBF interruption were C-section (PR = 1·12, CI 95 % = 1·02, 1·23) and prelacteal feeding (PR = 1·51, CI 95 % = 1·37, 1·68). Non-pregnancy intention was a protective factor for EBF interruption (PR = 0·82, CI 95 % = 0·72, 0·93).

Conclusions: C-section, lack of skilled attendant at birth, prelacteal feeding, maternal nutritional status, and pregnancy intention were modifiable factors associated with suboptimal breastfeeding practices in Colombia.

Keywords: Breastfeeding; Early breastfeeding initiation; Exclusive breastfeeding; Infant and young child feeding.

MeSH terms

  • Adult
  • Breast Feeding / statistics & numerical data*
  • Cesarean Section*
  • Child
  • Child, Preschool
  • Colombia
  • Cross-Sectional Studies
  • Female
  • Health Surveys
  • Humans
  • Infant
  • Mothers / statistics & numerical data*
  • Pregnancy
  • Prevalence
  • Risk Factors