How do high ambient temperatures affect infant feeding practices? A prospective cohort study of postpartum women in Bobo-Dioulasso, Burkina Faso

Chérie Part; Véronique Filippi; Jenny A Cresswell; Rasmané Ganaba; Shakoor Hajat; Britt Nakstad; Nathalie Roos; Kadidiatou Kadio; Matthew Chersich; Adelaide Lusambili; Seni Kouanda; Sari Kovats

doi:10.1136/bmjopen-2022-061297

How do high ambient temperatures affect infant feeding practices? A prospective cohort study of postpartum women in Bobo-Dioulasso, Burkina Faso

BMJ Open. 2022 Oct 5;12(10):e061297. doi: 10.1136/bmjopen-2022-061297.

Authors

Affiliations

¹ Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK cherie.part@lshtm.ac.uk.
² Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
³ Agence de Formation de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté), Bobo-Dioulasso, Burkina Faso.
⁴ Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
⁵ Division of Child and Adolescent Health, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁶ Department of Pediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana.
⁷ Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.
⁸ Departement Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso.
⁹ Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.
¹⁰ Department of Population Health, Medical College, Aga Khan University, Nairobi, Kenya.

Abstract

Objective: To examine the effects of high ambient temperature on infant feeding practices and childcare.

Design: Secondary analysis of quantitative data from a prospective cohort study.

Setting: Community-based interviews in the commune of Bobo-Dioulasso, Burkina Faso. Exclusive breastfeeding is not widely practised in Burkina Faso.

Participants: 866 women (1:1 urban:rural) were interviewed over 12 months. Participants were interviewed at three time points: cohort entry (when between 20 weeks' gestation and 22 weeks' postpartum), three and nine months thereafter. Retention at nine-month follow-up was 90%. Our secondary analysis focused on postpartum women (n=857).

Exposure: Daily mean temperature (°C) measured at one weather station in Bobo-Dioulasso. Meteorological data were obtained from publicly available archives (TuTiempo.net).

Primary outcome measures: Self-reported time spent breastfeeding (minutes/day), exclusive breastfeeding of infants under 6 months (no fluids other than breast milk provided in past 24 hours), supplementary feeding of infants aged 6-12 months (any fluid other than breast milk provided in past 24 hours), time spent caring for children (minutes/day).

Results: The population experienced year-round high temperatures (daily mean temperature range=22.6°C-33.7°C). Breastfeeding decreased by 2.3 minutes/day (95% CI -4.6 to 0.04, p=0.05), and childcare increased by 0.6 minutes/day (0.06 to 1.2, p=0.03), per 1°C increase in same-day mean temperature. Temperature interacted with infant age to affect breastfeeding duration (p=0.02), with a stronger (negative) association between temperature and breastfeeding as infants aged (0-57 weeks). Odds of exclusive breastfeeding very young infants (0-3 months) tended to decrease as temperature increased (OR=0.88, 0.75 to 1.02, p=0.09). There was no association between temperature and exclusive breastfeeding at 3-6 months or supplementary feeding (6-12 months).

Conclusions: Women spent considerably less time breastfeeding (~25 minutes/day) during the hottest, compared with coolest, times of the year. Climate change adaptation plans for health should include advice to breastfeeding mothers during periods of high temperature.

Keywords: Community child health; EPIDEMIOLOGY; NUTRITION & DIETETICS; PUBLIC HEALTH.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Breast Feeding*
Burkina Faso
Child
Cohort Studies
Female
Humans
Infant
Postpartum Period*
Prospective Studies
Temperature