Levels of Exclusive Breastfeeding and Correlates at 10weeks Post-Delivery in a Rural Setting

Background Sustaining a high rate of adherence to exclusive breastfeeding may be challenging in resource constrained setting. This study established the levels of exclusive breastfeeding, alternate feeding patterns, health and growth impacts, among 10 weeks old infants in a remote, understudied village in East Africa. Subject and methods This was a secondary cross-sectional analysis of a prospective cohort data. Data of 457 out of the 529 mother- newborn pairs recruited from birth were obtained and analysed at 10 weeks post-delivery in the postnatal clinic. Infant feeding patterns were recorded and anthropometry were measured and assessed using NICE criteria for static weight growth. Mothers were interviewed using the Edinburgh postpartum depression score to assess emotional status. Both parametric and non-parametric statistics and binary logistic regression model were applied to examine the relationship between maternal/infant characteristics, feeding patterns and infant weight growth. The results were presented in p-values, Odds ratio and 95% confidence interval. Results Clinic attendance had declined below and prevalence of infant weight faltering had increased above the 6 weeks records. The prevalence of infant weight faltering was 3.7% on NICE criteria, higher than the 2.8% with WHO criteria, but there was 93% concordance between the 2 growth assessment tools. Exclusive breastfeeding rate was still high at 96.3%, however, 10.3% of these infants were being breastfed infrequently. The 3 infants that were not exclusively breastfed were offered infant formula (1) using bottle, maize (1) and millet porridge (1) using cup. Infrequent breastfeeding was the major predictor of infant weight faltering, OR 5.59; 95%CI 1.94, 16.14; p=0.001. For every unit increase in frequency of breastfeeding, the infant weight-for-age z-score is likely to increase by 0.15 z-score. To maintain the infant weight z-score at 0 (median), baby should be breastfed on the average of 10times a day consistently. The head circumference and then length were more deficient than the weight in this cohort, despite high level of EBF rate. Maternal depression score was high in the groups of infants that were adequately breastfed and weight thriving, compared to their counterparts. Conclusion Both the practice of EBF and the daily frequency of breastfeeding should be closely monitored; infant head circumference and length assessments should be integrated into the routine growth monitoring programs in these rural MCH clinics. Lactational and mental support programs should be strengthened in the rural MCH systems, to assist mothers to achieve full exclusive breastfeeding easily. The factors contributing to decline in clinic visits need to be identified and mitigated. Home visits should be intensified for infants lost to follow up. KEY WORDS: weight faltering, frequency of breastfeeding, exclusive breastfeeding, post-partum maternal depression score.