Exclusive breast-feeding reduces ARI and diarrhoea deaths among infants in

Abstract

Objective: Describe the breast-feeding practices and assess the effect of exclusive breast-feeding in early infancy on the risk of infant deaths, especially those due to acute respiratory infections (ARI) and diarrhoea. Methodology: In a prospective study in the slums of Dhaka city, 1,677 infants were followed up from birth till 12 months of their age. Based on the baseline information at enrollment, the infants were visited 5 more times for anthropometric measurements and infant-feeding information. Verbal autopsy, based on a structured questionnaire, was used for assigning causes to the 180 reported deaths. Proportional hazards regression models were used for estimating the effect of breast-feeding practices, introduced as a time-varying variable, after accounting for other variables. Results: The proportion of infants exclusively breastfed was only 6.2% at enrollment, increasing to 53.1% at 1 month and then gradually declining to 4.8% at 6 months of age. Predominant breast-feeding declined from 65.9% at enrollment to 4.1% at 12 months of age. Very few infants were not breastfed, while the proportion of partially breastfed infants increased with age. The breast-feeding practices did not differ between the low- and the normal birth-weight infants at any age. The overall infant mortality was 114 deaths per 1,000 live-births. Compared to exclusive breast-feeding in the first few months of life, partial or no breast-feeding was associated with 2.30-fold higher risk of infant deaths and 2.48- and 3.96-fold higher risk of deaths due to ARI and diarrhoea respectively. Conclusion: The important role of appropriate breast-feeding practices inthesurvivalof infants is clear from this analysis. The reduction in ARI deaths underscores the broad-based beneficial effect of exclusive breastfeeding beyond its role in reducing dietary contamination as evident here in the strong protection against deaths