How multiple episodes of exclusive breastfeeding impact estimates of exclusive breastfeeding duration

Report from the eight‐site MAL‐ED birth cohort study

Bibliographic Data

ID15535759
AuthorsRamya Ambikapathi (0000-0002-2013-2516, National Institutes of Health), Margaret N Kosek (Center for Human Nutrition, Department of International Health The Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA), Margaret Kosek (0000-0001-6340-4852, Johns Hopkins University), Gwenyth O Lee (0000-0002-7889-3852, Johns Hopkins University), TC Mahopo (0000-0003-0186-1438, University of Venda), Cloupas Mahopo (Department of Nutrition, School of Health Sciences University of Venda Thohoyandou Limpopo Province South Africa), Crystal L Patil (0000-0003-4536-4599, Illinois Department of Children and Family Services), Bruna LL Maciel (0000-0002-0724-1961, Universidade Estadual do Ceará), Ali Turab (0000-0002-5445-9728, Aga Khan University), M Munirul Islam (0000-0002-8780-8760, International Centre for Diarrhoeal Disease Research), Manjeswori Ulak (0000-0002-6193-4849, Tribhuvan University), Anuradha Bose (christian medical college, vellore), Maribel Paredes Olórtegui (0000-0001-9943-8157, Prisma), Laura L Pendergast (0000-0003-1985-2548, Temple University), Laura E Murray-Kolb (0000-0002-5836-9471, Pennsylvania State University), Laura E Murray‐Kolb (Department of Nutritional Sciences The Pennsylvania State University State College Pennsylvania USA), Dennis Lang (National Institutes of Health), Benjamin J J Mccormick (Fogarty International Center National Institutes of Health Bethesda Maryland USA), Benjamin JJ McCormick (0000-0002-8060-0502, National Institutes of Health), Laura E Caulfield (0000-0001-7152-1004, Johns Hopkins University, corresponding author)
Year2016
Volume12
Issue4
Pages740-756
Publication date2016-08-08
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMaternal and Child Nutrition (JOURNAL)
Journal identifiersISSN: 1740-8695 • E-ISSN: 1740-8709
PublisherWiley (PUBLISHER • GB)
DOI10.1111/mcn.12352
OpenAlexW2516101288
LanguageEN
Citations received7
References cited47

The duration of exclusive breastfeeding (EBF) is often defined as the time from birth to the first non‐breast milk food/liquid fed (EBFLONG), or it is estimated by calculating the proportion of women at a given infant age who EBF in the previous 24 h (EBFDHS). Others have measured the total days or personal prevalence of EBF (EBFPREV), recognizing that although non‐EBF days may occur, EBF can be re‐initiated for extended periods. We compared breastfeeding metrics in the MAL‐ED study; infants' breastfeeding trajectories were characterized from enrollment (median 7 days, IQR: 4, 12) to 180 days at eight sites. During twice‐weekly surveillance, caretakers were queried about infant feeding the prior day. Overall, 101 833 visits and 356 764 child days of data were collected from 1957 infants. Median duration of EBFLONG was 33 days (95% CI: 32–36), compared to 49 days based on the EBFDHS. Median EBFPREV was 66 days (95% CI: 62–70). Differences were because of the return to EBF after a non‐EBF period. The median number of returns to EBF was 2 (IQR: 1, 3). When mothers re‐initiated EBF (second episode), infants gained an additional 18.8 days (SD: 25.1) of EBF, and gained 13.7 days (SD: 18.1) (third episode). In settings where women report short gaps in EBF, programmes should work with women to return to EBF. Interventions could positively influence the duration of these additional periods of EBF and their quantification should be considered in impact evaluation studies. © 2016 John Wiley & Sons Ltd

Breast feeding · Breast milk · Breastfeeding · Cohort · Cohort study · Infant formula · Psychological intervention · Breastfeeding Practices and Influences · Child Nutrition and Water Access · Demography · Food Security and Health in Diverse Populations · Medicine · Internal Medicine · Pediatrics

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