Across-country comparisons of selected infant and young child feeding indicators and associated factors in four South Asian countries

Abstract

Background: Information on infant and young child
feeding is widely available in Demographic and Health
Surveys and National Family Health Surveys for countries
in South Asia; however, infant and young child
feeding indicators from these surveys have not been
compared between countries in the region.
Objective. To compare the key indicators of breastfeeding
and complementary feeding and their determinants
in children under 24 months of age between four South
Asian countries.

Methods: We selected data sets from the Bangladesh
Demographic and Health Survey 2004, the India
National Family Health Survey (NFHS-03) 2005–06, the
Nepal Demographic and Health Survey 2006, and the
Sri Lanka 2000 Demographic and Health Survey. Infant
feeding indicators were estimated according to the key
World Health Organization indicators.

Results: Exclusive breastfeeding rates were 42.5%
in Bangladesh, 46.4% in India, and 53.1% in Nepal.
The rate of full breastfeeding ranged between 60.6%
and 73.9%. There were no factors consistently associated
with the rate of no exclusive breastfeeding across
countries. Utilization of health services (more antenatal
clinic visits) was associated with higher rates of exclusive
breastfeeding in India but lower rates in Nepal. Delivery
at a health facility was a negative determinant of exclusive
breastfeeding in India. Postnatal contacts by Public
Health Midwives were a positive factor in Sri Lanka. A
considerable proportion of infants under 6 months of age
had been given plain water, juices, or other nonmilk liquids.
The rate of timely first suckling ranged from 23.5%
in India to 56.3% in Sri Lanka. Delivery by cesarean
section was found to be a consistent negative factor that
delayed initiation of breastfeeding. Nepal reported the
lowest bottle-feeding rate of 3.5%. Socioeconomically
privileged mothers were found to have higher bottlefeeding
rates in most countries.

Conclusions: Infant and young child feeding practices
in the South Asia region have not reached the expected
levels that are required to achieve a substantial reduction
in child mortality. The countries with lower rates of
exclusive breastfeeding have a great potential to improve
the rates by preventing infants from receiving water and
water-based or other nonmilk liquids during the first 6
months of life.