Infant feeding practices in rural Meheran, Comilla, Bangladesh

Abstract

Since 1930 breast-feeding has declined worldwide. Differences exist in breast-feeding practices between developed and developing countries and between urban and rural people. In order to define the breast-feeding practices in Bangladesh, we studied longitudally 401 rural children and cross-sectionally 193 urban children. Collections of dietary data and anthropometric measurements were done monthly during the 1st year and quarterly thereafter by trained paramedical staff. One hundred percent rural, 98% urban poor, and 78% urban elite mothers breast-fed their babies at birth. At 1 year 97% rural, 90 urban poor, and 25% elite continued breast-feeding. By 2 years it decreased further. Only some rural children but many of the urban children were provided with cow's milk during breast-feeding. At 10 months, 100% urban elite, 33% of the urban poor, and 6% of rural mothers provided rice and bread to babies. The growth pattern from 4th months of age fell behind the developed countries. Heavier mothers produced heavier children. Mothers should be trained about supplementation of food and the time of supplementation. Breast-feeding is still quite prevalent in the villages of this country. Maternal nutrition and timely supplementation are important for development of children.

PIP: Because of the rapid urbanization of Bangladesh, infant feeding practices in cities have changed. A comparison of this change between urban and rural areas of Bangladesh has not been done, but this study of a rural community was performed to determine the basic feeding pattern of rural infants in order to define a baseline from which alterations in current practices may be measured. To this end, 401 rural children were studied longitudinally and 193 urban children were studied cross-sectionally. Dietary data and anthropometric measurements were collected monthly during the first year of study and quarterly thereafter by paramedical staff. In terms of persistence of breastfeeding practice in Bangladesh, 100% of rural, 98% of urban poor, and 78% of urban elite mothers breastfed their babies at birth. At the end of 1 year, 97% of rural, 90% of urban poor, and 25% of urban elite mothers continued breastfeeding; 2-year follow-up showed even further decreases in breastfed infants. Few rural children vs. many urban children had their breastfeedings supplemented with cow's milk during the lactation period. At 10 months, 100% of urban elite, 33% of urban poor, and 6% of rural mothers had fed rice and bread supplements to the infants. In all socioeconomic groups, growth pattern after 4 months of age lagged behind those found in developed nations. Maternal weight was correlated with infant body weight, with heavier mothers producing heavier children. The need for locally produced baby food based on locally cultivatable cereals is noted, and suggested time for beginning supplementation to breastfeeding is from 4-6 months, where adequate supplemental foods are available.