Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya


Kimani-Murage, Elizabeth, Madise, Nyovani J., Fotso, Jean-Christophe, Kyobutungi, Catherine, Mutua, Martin K., Gitau, Tabither and Yatich, Nelly (2011) Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health, 11, (396) (doi:10.1186/1471-2458-11-396). (PMID:21615957).

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Description/Abstract

Background
The World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations.

Methods
Data from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods.

Results
There was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence).

Conclusions
The study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning.

Item Type: Article
ISSNs: 1471-2458 (print)
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions: Faculty of Social and Human Sciences > Social Sciences > Social Statistics & Demography
ePrint ID: 337024
Date Deposited: 16 Apr 2012 13:10
Last Modified: 19 May 2014 09:07
Projects:
Urbanisation, poverty and health dynamics in sub-Saharan Africa
Funded by: Wellcome Trust (078530/C/05/Z)
2005 to 2010
URI: http://eprints.soton.ac.uk/id/eprint/337024

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