Research Article

Breast-feeding initiation and determinants of exclusive breast-feeding – a questionnaire survey in an urban population of western Nepal

TS Chandrashekhar^a1 c1, HS Joshi^a1, VS Binu^a1, PR Shankar^a2, MS Rana^a1 and U Ramachandran^a3

^a1 Department of Community Medicine, Manipal College of Medical Sciences, PO Box 155, ‘Deep Heights’, Pokhara-16, Nepal

^a2 Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal

^a3 Department of Pediatrics, Manipal College of Medical Sciences, Pokhara, Nepal

Abstract

Objective To assess rates of initiation of breast-feeding and exclusive breast-feeding within 2 months after delivery and to determine the factors influencing exclusive breast-feeding.

Design A health worker-administered questionnaire survey was carried out during the time period 1 August–30 September 2005.

Setting Immunisation clinics of Pokhara, a submetropolitan city in western Nepal.

Subjects Three hundred and eighty-five mothers who had delivered a child within the previous 2 months.

Results The rates of initiation within 1 h and within 24 h of delivery were 72.7 and 84.4%, respectively. Within 2 months after delivery, exclusive breast-feeding was practised by 82.3% of the mothers. Breast milk/colostrum was given as the first feed to 332 (86.2%) babies but 17.2% of them were either given expressed breast milk or were put to the breast of another lactating mother. Pre-lacteal feeds were given to 14% of the babies. The common pre-lacteal feeds given were formula feeds (6.2%), sugar water (5.9%) and cow's milk (2.8%). Complementary feeds were introduced by 12.7% of the mothers. By logistic regression analysis, friends' feeding practices, type of delivery and baby's first feed were the factors influencing exclusive breast-feeding practice of the mothers.

Conclusions Despite the higher rates of initiation and exclusive breast-feeding, practices such as pre-lacteal feeds and premature introduction of complementary feeds are of great concern in this urban population. There is a need for promotion of good breast-feeding practices among expectant mothers and also the community, especially the families, taking into account the local traditions and customs.

(Received December 12 2005)

(Accepted July 04 2006)

Keywords

• Infant nutrition;
• Exclusive breast-feeding;
• Complementary food;
• Bottle-feeding;
• Nepal

Correspondence:

^c1 *Corresponding author: Email chandrashekharats@yahoo.com