Breast feeding of infants between 0-6 months old in 20 provinces, municipalities and autonomous regions in the People's Republic of China. National Coordinating Working Group for Breastfeeding Surveillance

Breastfeeding in China: a review

This review aims to describe changes in breastfeeding and summarise the breastfeeding rates, duration and reasons of discontinuing 'any breastfeeding' or 'exclusive breastfeeding' in P.R. China. Breastfeeding rates in China fell during the 1970s when the use of breast milk substitutes became widespread, and reached the lowest point in the 1980s. As a result many efforts were introduced to promote breastfeeding. The breastfeeding rate in China started to increase in the 1990s, and since the mid-1990s 'any breastfeeding' rates in the majority of cities and provinces, including minority areas, have been above 80% at four months. But most cities and provinces did not reach the national target of 'exclusive breastfeeding' of 80%. The 'exclusive breastfeeding' rates in minority areas were relatively lower than comparable inland provinces. The mean duration of 'any breastfeeding' in the majority of cities or provinces was between seven and nine months. The common reasons for ceasing breastfeeding, or introducing water or other infant food before four months, were perceived breast milk insufficiency, mother going to work, maternal and child illness and breast problems. Incorrect traditional perceptions have a strong adverse influence on 'exclusive breastfeeding' in less developed areas or rural areas. China is a huge country, geographically and in population size, and there is considerable ethnic diversity. Therefore breastfeeding rates in different parts of China can vary considerably.

Infant feeding practices in Xinjiang Uygur Autonomous Region, People's Republic of China

Aims

To document infant feeding methods in the first six months of life in Xinjiang Uygur Autonomous Region, People's Republic of China, 2003–2004. Some problems with breast-feeding in the area are explained.

Methods

A longitudinal study of infant feeding practices was undertaken. A total of 1219 mothers who delivered babies during 2003 and 2004 were interviewed in five hospitals or institutes, and after discharge were contacted in person or by telephone at approximately monthly intervals to obtain details of infant feeding practices. Multivariate logistic regression analysis was used to explore factors associated with breast-feeding initiation.

Results

‘Any breast-feeding’ rates at discharge and at 0.5, 1.5, 2.5, 3.5, 4.5 and 6 months were 92.2, 91.3, 89.9, 88.8, 87.7, 86.0 and 73.0%, respectively. ‘Exclusive breast-feeding’ rates at discharge and at 0.5, 1.5, 2.5, 3.5, 4.5 and 6 months were 66.2, 47.6, 30.1, 25.8, 22.1, 13.0 and 6.2%, respectively. The main problem of breast-feeding in Xinjiang was the early introduction of formula or water. The average duration of ‘exclusive breast-feeding’ was 1.8 months (95% confidence interval (CI) 1.7–2.0), of ‘full breast-feeding’ 2.8 months (95% CI 2.7–2.9) and of ‘any breast-feeding’ 5.3 months (95% CI 5.2–5.4).

Conclusions

Infant feeding methods in Xinjiang were documented in this study and the main problems with infant feeding in Xinjiang are discussed. Further studies are needed to identify factors associated with ‘exclusive breast-feeding’ and duration.

A decade of change in breastfeeding in China's far north-west

BACKGROUND

There have been considerable changes in breastfeeding practices in China over the past forty years. However China is a very large country, and breastfeeding rates in different parts of China vary considerably. The objective of this paper is to identify and compare breastfeeding types and rates between 1994-1996 and 2003-2004 in Shihezi, Xinjiang Uygur Autonomous Region, PR China.

METHODS

In 1994-1996, a study of breastfeeding (n = 2197) was undertaken in Shihezi, Xinjiang, PR China. A decade later in 2003-2004, a longitudinal study (n = 545) of infant feeding practices was undertaken in the same area.

RESULTS

The 'any breastfeeding' rates at 1, 4 and 6 months were 94%, 82% and 78% respectively in the early 1990s. A decade later, breastfeeding at 1 month was lower, but rates at 4 and 6 months remained the same. In 2004 the 'full breastfeeding' rate at one month was significantly higher (57%) than a decade earlier (38%), but after 3 months there was a rapid decline. This reflected a shift in the way complementary foods are introduced: the initial introduction was later, but by a higher proportion of mothers.

CONCLUSION

The rate of breastfeeding at one month is significantly lower in 2003-2004 when compared to 1994-1996. The 'full breastfeeding' rates were initially higher, but after 3 months were then lower. The Chinese national breastfeeding targets were not reached in either period of the study. These studies show the need to further promote full or exclusive breastfeeding and further longitudinal studies are necessary to provide the detailed knowledge about risk factors required for health promotion programs.

Early Feeding Practices and the Nutrition Status of Preschool Children in Rural Hubei Province, China

A nutrition surveillance survey was conducted in June 1990 in four poor rural counties of Hubei Province, China, that included 25 villages and 3,564 children, to determine early feeding practices and the nutrition status of preschool children. Data were collected through interviews, anthropometric measurements, analysis of haemoglobin values, and physical examinations. More than 90% of the infants under 6 months of age were being breast-fed, as were approximately 75% of those 12 months old and 26% of those 24 months old. A trend to introducing solid foods into children's diets at younger ages appeared to have occurred between 1984 and 1988; only 15% of the children ate solid food at 6 months of age and 58% at 12 months in 1984, compared with 23% and 78% respectively in 1988. The children's anthropometric measurements were comparable to international standards for the first months of life, and then weight-forage and height-for-age Z scores deviated negatively. Physical examinations suggested that several micronutrient deficiencies might be present The data also indicated that during a time of sweeping economic changes and expanded health care availability, breast-feeding was maintained, food was introduced into the diets of children at younger ages, and acute malnutrition was not common.

Breastfeeding practices in Chengdu, Sichuan, China

Barriers to increased breastfeeding rates in Chengdu, Sichuan were investigated in 1992 and 1993. Responses of focus groups showed that ignorance about breastfeeding and belief that the mother's milk was inadequate, and lack of support from their families, places of employment, and the health system acted as barriers to the women's breastfeeding their infants up to the age of four to six months. Subsequently, 363 mothers of 4- to 12-month-old Chengdu infants were surveyed. Although most mothers in both studies said breastmilk was the best food for their infant up to age of four to six months, only about half of the mothers breastfed for longer than one month. Both studies showed that infants who roomed with their mothers after birth were more likely to have been put to their mother's breast earlier, fed colostrum, breastfed somewhat longer, and exclusively breastfed for a somewhat longer period, although their mothers' infant feeding knowledge did not differ. The researchers conclude that Chengdu health workers should teach parents and parents-to-be more about breastfeeding, and that rooming-in be expanded in Chengdu hospitals.