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Determinants of suboptimal breastfeeding in Haryana - An analysis of national family health survey-4 data
Authors: Jyoti Sharma, Shivam Pandey, and Preeti Negandhi
Source: Indian Journal of Public Health, Volume 64, Issue number 3; DOI: 10.4103/ijph.IJPH_406_19
Topic(s): Antenatal care
Body Mass Index (BMI)
Child feeding
Postnatal care
Wealth Index
Country: Asia
Published: SEP 2020
Abstract: Background: Infant and child feeding practices are a prevalent challenge in Haryana. Objectives: The present study aimed to determine factors associated with non-initiation of breastfeeding within 1 h of birth, no exclusive breastfeeding (EBF) and no continued breastfeeding in Haryana. Methods: National Family Health Survey-4 data for the state of Haryana was used for analysis. The outcomes were non-initiation of breastfeeding within 1 h of birth, no EBF, and no continued breastfeeding. Independent variables were categorized as sociodemographic, maternal, and child level factors. Each category of factors was added step-by-step to the logistic regression model for multivariable analysis. Results: Delayed initiation of breastfeeding was higher among poorer wealth quintiles. Home deliveries (adjusted odds ratio [AOR] = 1.90, 95% confidence interval [CI]-1.27–2.84), cesarean section (AOR = 2.22, 95% CI-1.46–3.40), body mass index (BMI) >25 kg/m2 (AOR = 1.62, 95% CI-1.13–2.33), and not receiving postnatal check-up (AOR 1.36, 95% CI-1.40–1.78) increases likelihood of delayed initiation of breastfeeding beyond 1 h of birth. Increased risk of non-EBF was associated with no postnatal check-ups and BMI >25 kg/m2. Risk of discontinuation of breastfeeding was significantly high with birth interval of <2 years (AOR = 1.52, 95% CI-1.08–2.14) and if babies did not receive postnatal check-up (AOR = 1.54, 95% CI-1.04–2.27). Conclusion: The study highlighted need for focused approach to counsel overweight/obese mothers, cesarean section, and home delivered mothers. Community awareness, adequate birth spacing, and postnatal visits are vital for improving exclusive and continued breastfeeding practices. Communities and health-care providers should provide adequate support to mothers for breastfeeding during the antenatal and postnatal periods.