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  • Title: Predictors of exclusive breastfeeding in early infancy: operational implications.
    Author: Sachdev HP, Mehrotra S.
    Journal: Indian Pediatr; 1995 Dec; 32(12):1287-96. PubMed ID: 8772886.
    Abstract:
    OBJECTIVES: To evaluate the independent predictors of exclusive breastfeeding in early infancy. DESIGN: Cross sectional multivariate comparison of different breastfeeding categories. SETTING: Urban teaching hospital Outpatient Department. SUBJECTS: Mothers of 501 children between the age group of 0-6 months were questioned in detail on a standardized pretested proforma about various sociodemographic, parental, infant, feeding related, antenatal and perinatal characteristics likely to affect breastfeeding practices. Mother's height and weight and infant's weight were also recorded. RESULTS: The exclusive breastfeeding, predominant breastfeeding, bottle feeding, ever breastfed and timely first suckling rates were 44.9%, 67.8%, 31.5%, 99.4% and 10.4%, respectively. Amongst the 29 factors subjected to univariate analyses, 16 clinically relevant or significant (p < 0.1) variables were included for multiple logistic regression models. The significant (p < 0.05) positive independent association for exclusive and partial breastfeeding were (OR) infant's present weight (1.45 to 9.64); breastmilk as first feed (1.53 to 2.22); and lower age of child (1.02 to 1.05). Additional important predictors for exclusive breastfeeding versus total top feeding) were (OR) breastfeeding propagation (1.34 and 2.99); less educated mother (1.09 and 1.23); normal vaginal delivery (1.60) and taller mother (1.21). CONCLUSIONS: Breastfeeding propagation plays a key role in promoting exclusive breastfeeding. Other independent negative predictors represent a high risk subset for whom intensive propagation is desirable since these factors by themselves may not be amenable to intervention. To identify the correlates of breast feeding practices in the early postpartum period, interviews were conducted with 501 mothers who delivered infants at Lok Nayak Jai Prakash Narain Hospital from August 1993 to July 1994. There were 80-87 infants in each monthly postpartum interval from 0 to 6 months. Exclusive breast feeding until 6 months of age was practiced by 307 mothers (61.3%); 158 infants (31.5%) were partially breast-fed and 36 (7.2%) were receiving no breast milk. Insufficient milk supply, inferred from the infant's crying, was the reason given for breast milk supplementation by 52.3% of mothers who initiated this practice; among mothers who had totally weaned their infant, 28% cited breast rejection by the baby as the cause. Multiple logistic regression analyses identified infant's present weight, breast milk as first feed, and lower age of child as significant (p 0.05) predictors of exclusive breast feeding. Also important to predicting exclusive breast feeding were breast feeding propagation, less-educated mother, normal vaginal delivery, and taller mother. Lower birth weight was an additional significant independent predictor of non-exclusive breast feeding. These findings suggest a need for educational campaigns aimed at supporting breast-feeding mothers, especially those who perceive their milk supply to be inadequate.
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