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Gessese GT, Woldeamanuel BT, Demie TG, Diriba Biratu T, Handebo S. Breastfeeding performance index and associated factors among children aged 0-6 months in Ethiopia: Analysis of the 2019 Ethiopia Mini Demographic and Health Survey. Front Nutr 2022; 9:970737. [PMID: 36263306 PMCID: PMC9574351 DOI: 10.3389/fnut.2022.970737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Infants under the age of 6 months are commonly affected by malnutrition globally. The higher the breastfeeding performance index (BPI), the greater the advantage of breastfeeding will be. However, there is a lack of literature in the context of Ethiopia. Therefore, this study is aimed at investigating the magnitude and determinants of the breastfeeding performance index score among mothers of children under the age of 6 months in Ethiopia. Methods This study was conducted using the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) dataset. A stratified, two-stage cluster sampling technique was used in the study. The survey data were weighted using the “svy” function in STATA version 16. Descriptive statistics, bivariable and multivariable logistic regression were employed in the analysis. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported. The results were considered statistically significant if the p-value was < 0.05. The goodness of fit of the model was checked using the Hosmer–Lemeshow test. Results A total of 4,273 mothers with children under the age of 6 months were included in the analysis. Our analysis revealed that the prevalence of low breastfeeding performance index was 79.05% (95% CI: 78.01, 81.59). A unit increase in child age (AOR = 11.56; 95% CI: 6.97, 19.17), the richest wealth quintile (AOR = 2.76; 95% CI: 1.18, 6.5), a higher level of education (AOR = 5.41; 95% CI: 2.08, 14.05), being married or living with partner (AOR = 2.73; 95% CI: 1.18, 6.27), being women from Somali (AOR = 5.11; 95% CI: 2.08, 12.56), Afar (AOR = 3.03; 95% CI: 1.16, 7.91), Oromia (AOR = 1.88; 95% CI: 1.03, 3.41), Diredawa city administration (AOR = 2.89; 95% CI: 1.04, 8.07), and antenatal care (ANC) visit (AOR = 2.05; 95% CI: 1.31, 3.19) were positively associated with the low breastfeeding performance index. Conclusion The prevalence of the low breastfeeding performance index was found to be high. Hence, the findings of the study suggest the need to target interventions aimed at improving breastfeeding performance toward mothers with higher socioeconomic and demographic status and educational status. Antenatal care clients are among the targets of the intervention.
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Affiliation(s)
- Getachew Tilahun Gessese
- Department of Nutrition, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia,*Correspondence: Getachew Tilahun Gessese
| | - Berhanu Teshome Woldeamanuel
- Department of Epidemiology and Biostatistics, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Takele Gezahegn Demie
- Department of Health Education and Health Promotion, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Tolesa Diriba Biratu
- Department of Epidemiology and Biostatistics, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Simegnew Handebo
- Department of Health Education and Health Promotion, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Mulatu T, Yimer NB, Alemnew B, Linger M, Liben ML. Exclusive breastfeeding lowers the odds of childhood diarrhea and other medical conditions: evidence from the 2016 Ethiopian demographic and health survey. Ital J Pediatr 2021; 47:166. [PMID: 34344434 PMCID: PMC8335997 DOI: 10.1186/s13052-021-01115-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 07/14/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Lack of exclusive breastfeeding during the first 6 months of infant life contributes to childhood morbidity and mortality. This study aimed to investigate the association of exclusive breastfeeding and childhood illnesses in Ethiopia. METHODS A secondary data analysis was conducted using data from the 2016 Ethiopian Demographic and Health Survey (EDHS). Descriptive and multivariable logistic regression analyses were carried out. RESULTS A total of 1034 mother-infant pairs were included in the analysis. The overall magnitude of exclusive breastfeeding among infants aged under 6 months was 87.6% (95% CI: 84.3-90.3%). Compared to infants who were non-exclusively breastfed, the odds of having an illness with fever in the last 2 weeks among infants who were exclusively breastfed decreased by 66% (AOR: 0.34; 95% CI: 0.16, 0.75). Similarly, exclusively breastfed infants had lower odds of having an illness with a cough (AOR: 0.38; CI: 0.20, 0.72) and having diarrhea (AOR: 0.33; CI: 0.13, 0.83) compared to non-exclusively breastfed infants. CONCLUSION Exclusive breastfeeding lowers the odds of an illness with fever, illness with cough and diarrhea. The findings of this study implicate the need for promotion of exclusive breastfeeding in the country.
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Affiliation(s)
- Tesfahun Mulatu
- School of Public Health, College of Health Science, Woldia University, P.o.box: 400, Woldia University, Weldiya, Amhara, Ethiopia
| | - Nigus Bililign Yimer
- School of Midwifery, College of Health Science, Woldia University, Weldiya, Amhara, Ethiopia
| | - Birhan Alemnew
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Weldiya, Amhara, Ethiopia
| | - Melese Linger
- School of Public Health, College of Health Science, Woldia University, P.o.box: 400, Woldia University, Weldiya, Amhara, Ethiopia
| | - Misgan Legesse Liben
- School of Public Health, College of Health Science, Woldia University, P.o.box: 400, Woldia University, Weldiya, Amhara, Ethiopia.
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Hailu WS, Bayih MT, Babble NF. Four in every ten infants in Northwest Ethiopia exposed to sub-optimal breastfeeding practice. PLoS One 2020; 15:e0238576. [PMID: 33137137 PMCID: PMC7605653 DOI: 10.1371/journal.pone.0238576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/19/2020] [Indexed: 12/04/2022] Open
Abstract
Background Improper breastfeeding practices significantly impair the health, development, and survival of infants, children, and mothers. A Breastfeeding Performance Index (BPI) is a composite index to describe overall maternal breastfeeding practice with infants under six months of age. To date, there is insufficient evidence on breastfeeding performance index and its associated factors in Ethiopia. Objective To assess the breastfeeding performance index and its associated factors in Sekela District, Northwest Ethiopia, 2019. Methods A community-based cross-sectional study was conducted on 605 randomly selected mothers having infants aged 6 to 12 months from April 02, 2019 to May 13, 2019. Data was collected using a structured interviewer-administered questionnaire. Multivariable logistic regressions were used to identify independent predictors of BPI. Results Two hundred forty-six (40.7%) of mothers had low BPI scores. Mothers who lived alone (AOR = 3.18; 95%CI: 1.15, 8.82), mothers who were merchants (AOR = 2.75; 95%CI:1.05, 7.15), attended three antenatal care (ANC) visits (AOR = 0.42; 95% CI: 0.20, 0.82), attended four antenatal care visits (AOR = 0.35; 95%CI: 0.12, 0.82), received postnatal care (PNC) (AOR = 0.35; 95%CI: 0.19, 0.64), had poor knowledge on breastfeeding (AOR = 3.19;95%CI: 1.14, 8.89) or negative attitudes towards breastfeeding (AOR = 2.70;95%CI: 1.13, 6.45), were independent predictors of low BPI scores. Conclusions The prevalence of sub-optimal breastfeeding practice in northwest Ethiopia was very high. A mother living alone, maternal occupation, ANC visits, PNC, maternal breastfeeding knowledge, and attitude towards breastfeeding were independent predictors of low BPI scores. Nutrition promotion should be implemented by considering the above significant factors to decrease inappropriate breastfeeding practice in Northwest Ethiopia.
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Affiliation(s)
- Workineh Shume Hailu
- Department of Midwifery, Mizan Aman Health Science College, Mizan Teferi, Ethiopia
| | - Mulat Tirfie Bayih
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
| | - Netsanet Fentahun Babble
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Acheampong AK, Ganga-Limando M, Aziato L. Perceived enablers of exclusive breastfeeding by teenage mothers in Ghana. S Afr Fam Pract (2004) 2020; 62:e1-e5. [PMID: 33054255 PMCID: PMC8377796 DOI: 10.4102/safp.v62i1.5108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 03/13/2020] [Indexed: 11/10/2022] Open
Abstract
Background Exclusive breastfeeding for the first 6 months can prevent diseases, boost immunity and improve quality of lives of infants. Ghana implemented programmes aimed at reaching the global target of increasing exclusive breastfeeding for the first 6 months to at least 50% by the year 2025. The country witnessed a decline in the overall rate of exclusive breastfeeding and an increase in the number of teenage mothers. Globally, teenage mothers are less likely to breastfeed than mothers of other age groups. Understanding enablers of exclusive breastfeeding by teenage mothers is important for any intervention aimed at improving exclusive breastfeeding rates and the quality of lives of infants. Method The study used a qualitative, exploratory, descriptive and contextual design, with focus groups. A total of six group discussions were conducted with 30 pregnant teenagers recruited from six public hospitals. Results Seven enablers emerged from the analysis of data. These included positive beliefs about the benefits of breast milk, family history of positive exclusive breastfeeding outcomes, support of the intimate partner, approval of closed-family members, expert opinions of antenatal care staff, teenage-oriented breastfeeding education and community-based breastfeeding education. Conclusion Health professionals and policy makers could learn from these enablers and use them to promote exclusive breastfeeding practices amongst teenage mothers in Ghana.
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Acheampong AK, Aziato L, Marfo M, Amevor P. Breastfeeding and caring for children: a qualitative exploration of the experiences of mothers with physical impairments in Ghana. BMC Pregnancy Childbirth 2020; 20:331. [PMID: 32471372 PMCID: PMC7260762 DOI: 10.1186/s12884-020-03028-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 05/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background Breastfeeding and caring for children demand time, energy and effort. Mothers with physical impairments in Ghana require special needs to be able to achieve optimal motherhood as society demands. Globally, literature on breastfeeding and caring for children among mothers with physical disabilities is limited. Similarly, there is dearth of literature on the experiences of mothers with physical impairments in Ghana. Therefore, this study sought to add to literature by exploring the experiences of mothers with physical impairments with regards to breastfeeding and how they care for their children. Methods Qualitative descriptive exploratory design was used. Twelve mothers with physical impairments who had been purposively sampled gave informed consent before data was collected through in-depth one-on-one interviews. Data was recorded, transcribed and analyzed inductively using the content analysis technique. Results Mothers with physical impairments perceived breastfeeding as difficult and expensive due to issues relating to disruption of sleep, dysfunctional limbs and the need for breastfeeding mothers to eat nutritionally balanced meals. Participants felt prejudged and discriminated at different points in their daily encounters. Conclusion Mothers with physical impairments have challenges. Therefore, attitudinal change should be advocated in the Ghanaian society with respect to issues concerning people living with disabilities.
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Affiliation(s)
| | - Lydia Aziato
- Department of Adult Health, School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana.
| | - Margaret Marfo
- School of Nursing, Wisconsin International University College-Ghana, Accra, Ghana
| | - Philomena Amevor
- School of Nursing, Wisconsin International University College-Ghana, Accra, Ghana
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Nigatu D, Azage M, Motbainor A. Effect of exclusive breastfeeding cessation time on childhood morbidity and adverse nutritional outcomes in Ethiopia: Analysis of the demographic and health surveys. PLoS One 2019; 14:e0223379. [PMID: 31577821 PMCID: PMC6774524 DOI: 10.1371/journal.pone.0223379] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/19/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Though exclusive breastfeeding (EBF) for the first six months is recommended, it remains a debatable issue in both developed and developing countries. Thus, this study investigated the effect of EBF cessation time on childhood morbidity and adverse nutritional outcome in Ethiopia. METHODS We used the 2011 and 2016 Ethiopian Demographic and Health Surveys. The study involved 2,433 children under six months of age. Logistic regression model was applied to determine the effect of EBF cessation time on outcome variables. Population Attributable Fraction was calculated to evaluate the public health impacts of EBF termination in the population. RESULTS Discontinuing EBF at 0-3 months (adjusted odds ratio (AOR): 1.95, 95% confidence interval (CI): 1.08, 3.53)) and 4-6 months (AOR: 3.57, 95% CI: 2.19, 5.83) increased diarrhea occurrence compared to children who continued EBF up to 6 months. Children who had terminated EBF at 4-6 months had increased odds of fever (AOR: 1.73, 95% CI: 1.11, 2.68) and acute respiratory illnesses (ARIs) (AOR: 2.74, 95% CI: 1.61, 4.65). Cessation of EBF earlier than 4 months or between 4-6 months was associated with increased odds of having at least one childhood morbidity. Termination of EBF at 0-3 months and at 4-6 months were associated with increased occurrence of wasting (AOR: 2.32, 95% CI: 1.45, 3.74) and underweight (AOR: 2.30, 95% CI: 1.36, 3.91), respectively. Exclusive breastfeeding can avert 42% of diarrhea, 27% of ARI, 21% of fever, 26% of wasting and 23% of underweight burden among children under six months of age. CONCLUSIONS Termination of EBF before six months was associated with increased occurrence of diarrhea, fever and ARIs. It was also linked with increased occurrence of childhood wasting and underweight. The finding emphasized EBF for the first six months to reduce childhood morbidity and adverse nutritional outcomes.
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Affiliation(s)
- Dabere Nigatu
- Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Muluken Azage
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Achenef Motbainor
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Ethiopia's high childhood undernutrition explained: analysis of the prevalence and key correlates based on recent nationally representative data. Public Health Nutr 2019; 22:2099-2109. [PMID: 30894232 DOI: 10.1017/s1368980019000569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the contribution of child, maternal and household factors in stunting, wasting and underweight among children under 5 years in Ethiopia. DESIGN Quantitative cross-sectional design based on nationally representative data. SETTING Urban and rural areas of Ethiopia.ParticipantsYounger (0-24 months; n 4199) and older age groups (25-59 months; n 5497), giving a total of 9696 children. RESULTS Among the younger age group, 29 % were stunted, 14 % were wasted and 19 % were underweight; and among the older age group, the prevalence of stunting, wasting and underweight was 47, 8 and 28 %, respectively. Being female, intake of multiple micronutrients, household having a piped source of drinking-water, high maternal BMI, higher household wealth and higher maternal education were associated with decreased odds of at least one form of undernutrition in both groups. On the other hand, children who were anaemic, had low birth weight, drank from a bottle, and children of stunted or wasted or working mothers were more likely to be stunted, wasted or underweight in both groups (P<0·05). While most predictors and/or risk factors followed a similar pattern across the two age groups, child factors had higher leverage in the younger than the older group across the three forms of undernutrition. CONCLUSIONS Multiple set of factors predicted childhood undernutrition in Ethiopia. The study underscores the importance of intervening in the first 1000 days through promoting maternal education, maternal-child health services, mother's nutrition and improving intrahousehold food distribution.
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Sehhatie FS, Mirghafourvand M, Havizari S. Effect of prenatal counseling on exclusive breastfeeding frequency and infant weight gain in mothers with previous unsuccessful breastfeeding: a randomized controlled clinical trial. J Matern Fetal Neonatal Med 2019; 33:3571-3578. [PMID: 30720379 DOI: 10.1080/14767058.2019.1579191] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Breastfeeding counseling and mother support provision positively affect the duration of exclusive breastfeeding and infant growth and development. This study aimed to determine the effect of prenatal counseling on the frequency of exclusive breastfeeding and infant weight gain in mothers with previous unsuccessful breastfeeding.Methods: This was a randomized clinical trial on 108 pregnant women who visited the healthcare centers in Tabriz-Iran from November 2017 to May 2018. Participants were randomly allocated either to an intervention or a control group. The intervention group received four breastfeeding counseling sessions in the third trimester, whereas the control group merely received routine care. Counseling was offered to mothers until day 15, 2 months and the end of the month 4 postpartum, in case of experiencing any problem. A researcher-made breastfeeding performance checklist was completed by the groups on three occasions (p < .05 considered as the significance level).Findings: The frequency of exclusive breastfeeding in the intervention group was 75.9, 72.2, and 72.2% on day 15, and 2 and 4 months postpartum, respectively. It was 31.5, 16.7, and 16.7% in the control group, respectively. The probability of exclusive breastfeeding on day 15, month 2, and month 4 was significantly higher in the intervention group. The mean infant weight on day 15 postpartum was significant in the intervention group (mean difference = 112.2; 95% confidence interval = 29.8-194.5; p = .008). No statistically significant difference was observed between the groups in terms of infant weight gain in months 2 (p = .221) and 4 (p = .128) postpartum.Result: The results of the study showed that pregnancy counseling increases the frequency of exclusive breastfeeding in mothers.
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Affiliation(s)
- Fahimeh Shafaei Sehhatie
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shiva Havizari
- Student Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Hussien J, Assefa S, Liben ML. Breastfeeding performance in Afar regional state, northeastern Ethiopia: a cross sectional study. BMC Pediatr 2018; 18:375. [PMID: 30501631 PMCID: PMC6267822 DOI: 10.1186/s12887-018-1353-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 11/21/2018] [Indexed: 01/09/2023] Open
Abstract
Background In Ethiopia fewer than 20% of infants aged less than six months are appropriately fed. This study aimed to identify predictors of poor breastfeeding performance among mother-infant pairs in Samara-Logia city administration, Afar Regional State, Ethiopia. Methods Five hundred and seventy six mothers of infants aged less than six months were recruited to participate in face-to-face structured interviews at their home. Infant feeding practices were measured by breastfeeding performance index (BPI). Infants who scored 0–3 BPI were classified as achieving ‘Low BPI’, 4–5 as ‘Medium BPI’, and 6–7 scores as ‘High BPI’. A pre-tested instrument was used to assess demographic characteristics of mothers and their experiences of infant feeding. EpiData version 3.02 was used to enter, clean and code the data. Then, data were analyzed using SPSS version 20. Results Five hundred thirty six (93.1%) of the study mothers had ever breastfed their infants. About 83% [95% CI: 80.0, 86.0%] of infants had achieved low or medium BPI scores. Being older than 34 years [AOR: 4.55; 95% CI (1.33, 15.73)], having an infant aged 4–5 months [AOR: 2.49; 95% CI (1.08, 5.76)], giving birth at home [AOR: 4.25; 95% CI (1.37, 13.23)] or by caesarean section [AOR: 8.00; 95% CI (2.78, 23.09)] and receiving advice on proper infant feeding practices at postnatal checkup [AOR:0.28; 95% CI (0.13,0.59)] were independent predictors of low/medium BPI scores. Conclusion This study revealed that nearly eight in ten infants aged less than six months achieved low/medium BPI scores. Being older than 34 years, having an infant aged 4–5 months, giving birth at home or by caesarean section and lack of advice on proper infant feeding practices were associated with higher odds of low/medium BPI scores.
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Affiliation(s)
- Jemal Hussien
- Health and Nutrition specialist department, Save the children, Afar, Ethiopia
| | - Selam Assefa
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | - Misgan Legesse Liben
- Department of Public Health, Faculty of Health Sciences, Woldia University, Amhara, Ethiopia.
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Richard SA, McCormick BJJ, Seidman JC, Rasmussen Z, Kosek MN, Rogawski ET, Petri W, Bose A, Mduma E, Maciel BLL, Chandyo RK, Bhutta Z, Turab A, Bessong P, Mahfuz M, Caulfield LE, On Behalf Of The Mal-Ed Network Investigators. Relationships among Common Illness Symptoms and the Protective Effect of Breastfeeding in Early Childhood in MAL-ED: An Eight-Country Cohort Study. Am J Trop Med Hyg 2018; 98:904-912. [PMID: 29380724 PMCID: PMC5930868 DOI: 10.4269/ajtmh.17-0457] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Children in low-income countries experience multiple illness symptoms in early childhood. Breastfeeding is protective against diarrhea and respiratory infections, and these illnesses are thought to be risk factors of one another, but these relationships have not been explored simultaneously. In the eight-site MAL-ED study, 1,731 infants were enrolled near birth and followed for 2 years. We collected symptoms and diet information through twice-weekly household visits. Poisson regression was used to determine if recent illness history was associated with incidence of diarrhea or acute lower respiratory infections (ALRI), accounting for exclusive breastfeeding. Recent diarrhea was associated with higher risk of incident diarrhea after the first 6 months of life (relative risk [RR] 1.10, 95% confidence interval [CI] 1.04, 1.16) and with higher risk of incident ALRI in the 3- to 5-month period (RR 1.23, 95% CI 1.03, 1.47). Fever was a consistent risk factor for both diarrhea and ALRI. Exclusive breastfeeding 0-6 months was protective against diarrhea (0-2 months: RR 0.39, 95% CI 0.32, 0.49; 3-5 months: RR 0.83, 95% CI 0.75, 0.93) and ALRI (3-5 months: RR 0.81, 95% CI 0.68, 0.98). Children with recent illness who were exclusively breastfed were half as likely as those not exclusively breastfed to experience diarrhea in the first 3 months of life. Recent illness was associated with greater risk of new illness, causing illnesses to cluster within children, indicating that specific illness-prevention programs may have benefits for preventing other childhood illnesses. The results also underscore the importance of exclusive breastfeeding in the first 6 months of life for disease prevention.
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Affiliation(s)
- Stephanie A Richard
- Fogarty International Center/National Institutes of Health, Bethesda, Maryland
| | | | - Jessica C Seidman
- Fogarty International Center/National Institutes of Health, Bethesda, Maryland
| | - Zeba Rasmussen
- Fogarty International Center/National Institutes of Health, Bethesda, Maryland
| | | | | | | | | | | | | | | | | | - Ali Turab
- Aga Khan University, Karachi, Pakistan
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