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  • Title: Determinants of early breastfeeding initiation and exclusive breastfeeding in Colombia.
    Author: Finnie S, Peréz-Escamilla R, Buccini G.
    Journal: Public Health Nutr; 2020 Feb; 23(3):496-505. PubMed ID: 31587670.
    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.
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