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Trends and predictors of early initiation, exclusive, and continued breastfeeding in Bangladesh (2004-2018): a multilevel analysis of Demographic and Health Survey data
Authors: Md Sabbir Ahmed, Kyly C Whitfield, Fakir Md Yunus
Source: The British Journal of Nutrition, DOI:10.1017/S0007114521004761
Topic(s): Breastfeeding
Child feeding
Country: Asia
Published: DEC 2021
Abstract: The early initiation of breastfeeding (EIBF) within one hour of birth, exclusive breastfeeding (EBF) to 6 months, and continued breastfeeding (CBF) to 2 years are key infant and young child feeding guidelines promoted globally for optimal child health and development. Using publicly available national survey data from the five most recent, consecutive Bangladesh Demographic and Health Surveys (2004, 2007, 2011, 2014, 2017-18), we assessed the trends in these key breastfeeding indicators. Multiple multilevel logistic regression models were built to assess sociodemographic predictors of breastfeeding using the latest 2017-18 dataset. Both EIBF and EBF have increased significantly between 2004 and 2017-18, from 26% to 60% and 36% to 68%, respectively and CBF decreased from 94% to 85%. Caesarean section delivery conferred lower EIBF practice (OR= 0.34, 95% CI: 0.27 to 0.42) compared to vaginal delivery. Women who were currently working had 32% lower odds of EBF (OR= 0.68, 95% CI: 0.48 to 0.95). Compared to delivery at home, women who delivered in a health facility had 81% higher odds of EBF (OR= 1.81, 95% CI: 1.25 to 2.34). Larger family size (=5) also predicted EBF (OR= 1.70, 95% CI: 1.21 to 2.40). Rural residency was associated with 2.39 (95% CI 1.32 to 4.31) times of higher odds of CBF. Administrative region (division) was also predictive of the various breastfeeding indicators. Although Bangladesh currently exceeds the 2019 global prevalence rates for these three breastfeeding indicators, efforts should be made to continue improving EIBF and EBF, and to prevent future decreases in CBF.