A Community-Based Prospective Cohort Study of Exclusive Breastfeeding in Central Nepal

Background: Existing information on breastfeeding in low income countries such as Nepal has been largely derived from cross-sectional demographic health surveys. This study investigated exclusive breastfeeding rates, and compared the duration of exclusive breastfeeding between rural and urban mother...

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Main Authors: Karkee, R., Lee, Andy, Khanal, Vishnu, Binns, Colin
Format: Journal Article
Published: BioMed Central Ltd 2014
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/47919
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author Karkee, R.
Lee, Andy
Khanal, Vishnu
Binns, Colin
author_facet Karkee, R.
Lee, Andy
Khanal, Vishnu
Binns, Colin
author_sort Karkee, R.
building Curtin Institutional Repository
collection Online Access
description Background: Existing information on breastfeeding in low income countries such as Nepal has been largely derived from cross-sectional demographic health surveys. This study investigated exclusive breastfeeding rates, and compared the duration of exclusive breastfeeding between rural and urban mothers in central Nepal using an alternate cohort methodology. Methods: A community-based prospective cohort study was conducted among 639 recently delivered mothers representative of the Kaski district of Nepal. Breastfeeding information was obtained at birth (n = 639), 4 weeks (n = 639), 12 weeks (n = 615; 96.2%) and 22 weeks (n = 515; 80.6%) through repeated interviews using validated questionnaires. Risk of cessation of exclusive breastfeeding was assessed by Cox regression analysis. Results: The great majority of women received breastfeeding information (74%) and were encouraged to breastfeed by health personnel or family members (81%). Although nearly all mothers (98%) breastfed up to six months, the reported exclusive breastfeeding rate declined rapidly from 90.9% at birth to 29.7% at 22 weeks. Urban women experienced significantly shorter (p = 0.02) exclusive breastfeeding duration (mean 104.5, 95% CI 95.8 to113.1 days) and were more likely to cease exclusive breastfeeding (hazard ratio (HR) 1.28, 95% CI 1.03 to 1.60) than their rural counterparts (mean 144.7, 95% CI 132.3 to 157.1 days). Breastfeeding problem (HR 2.07, 95% CI 1.66 to2.57) and caesarean delivery (HR 1.88, 95% CI 1.36 to 2.62) were also significantly associated with exclusive breastfeeding cessation.Conclusions: Despite the almost universal practice of breastfeeding, the reported exclusive breastfeeding rates declined substantially over time. Exclusive breastfeeding up to six months was more common in rural than urban areas of central Nepal. Urban mothers also exclusively breastfed shorter than rural mothers.
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spelling curtin-20.500.11937-479192017-10-02T02:27:58Z A Community-Based Prospective Cohort Study of Exclusive Breastfeeding in Central Nepal Karkee, R. Lee, Andy Khanal, Vishnu Binns, Colin Exclusive breastfeeding Nepal risk factors Background: Existing information on breastfeeding in low income countries such as Nepal has been largely derived from cross-sectional demographic health surveys. This study investigated exclusive breastfeeding rates, and compared the duration of exclusive breastfeeding between rural and urban mothers in central Nepal using an alternate cohort methodology. Methods: A community-based prospective cohort study was conducted among 639 recently delivered mothers representative of the Kaski district of Nepal. Breastfeeding information was obtained at birth (n = 639), 4 weeks (n = 639), 12 weeks (n = 615; 96.2%) and 22 weeks (n = 515; 80.6%) through repeated interviews using validated questionnaires. Risk of cessation of exclusive breastfeeding was assessed by Cox regression analysis. Results: The great majority of women received breastfeeding information (74%) and were encouraged to breastfeed by health personnel or family members (81%). Although nearly all mothers (98%) breastfed up to six months, the reported exclusive breastfeeding rate declined rapidly from 90.9% at birth to 29.7% at 22 weeks. Urban women experienced significantly shorter (p = 0.02) exclusive breastfeeding duration (mean 104.5, 95% CI 95.8 to113.1 days) and were more likely to cease exclusive breastfeeding (hazard ratio (HR) 1.28, 95% CI 1.03 to 1.60) than their rural counterparts (mean 144.7, 95% CI 132.3 to 157.1 days). Breastfeeding problem (HR 2.07, 95% CI 1.66 to2.57) and caesarean delivery (HR 1.88, 95% CI 1.36 to 2.62) were also significantly associated with exclusive breastfeeding cessation.Conclusions: Despite the almost universal practice of breastfeeding, the reported exclusive breastfeeding rates declined substantially over time. Exclusive breastfeeding up to six months was more common in rural than urban areas of central Nepal. Urban mothers also exclusively breastfed shorter than rural mothers. 2014 Journal Article http://hdl.handle.net/20.500.11937/47919 10.1186/1471-2458-14-927 BioMed Central Ltd fulltext
spellingShingle Exclusive breastfeeding
Nepal
risk factors
Karkee, R.
Lee, Andy
Khanal, Vishnu
Binns, Colin
A Community-Based Prospective Cohort Study of Exclusive Breastfeeding in Central Nepal
title A Community-Based Prospective Cohort Study of Exclusive Breastfeeding in Central Nepal
title_full A Community-Based Prospective Cohort Study of Exclusive Breastfeeding in Central Nepal
title_fullStr A Community-Based Prospective Cohort Study of Exclusive Breastfeeding in Central Nepal
title_full_unstemmed A Community-Based Prospective Cohort Study of Exclusive Breastfeeding in Central Nepal
title_short A Community-Based Prospective Cohort Study of Exclusive Breastfeeding in Central Nepal
title_sort community-based prospective cohort study of exclusive breastfeeding in central nepal
topic Exclusive breastfeeding
Nepal
risk factors
url http://hdl.handle.net/20.500.11937/47919