Infant and young child feeding (IYCF) practices in Ethiopia and Zambia and their association with child nutrition: Analysis of demographic and health survey data

Data from the 2005 Ethiopia Demographic and Health Survey (EDHS) and the 2007 Zambia Demographic Health Survey (ZDHS) were analyzed to examine the association between World Health Organization (WHO) recommended IYCF indicators and nutritional status among children 0- 23 months of age in Ethiopia and Zambia. A total of 1810 and 2512 children within this age group from Ethiopia and Zambia , respectively , were included in the analysis. Exclusive breast -feeding among children 0- 5.9 months of age is low in both Ethiopia (43 % ) and Zambia (51 % ). Timely introduction of complementary food is lower in Ethiopia (61 %) compared to Zambia (90 %). Only 7 percent of children between 6- 23 months of age consumed diets that met the minimum dietary diversity requirement of four or more food groups consumed per day compared to 37 % in Zambia. Multiple linear and logistic regression analyses using appropriate measures to account for the complex survey design were applied to examine the associations between IYCF practices and child anthropometry. Linear regression results show that exclusive breast -feeding (EBF) is positively associated with weight -for -height z -score (WHZ) (effect size (ES) 0.65; p<0.001) and weight -for- age z -score (W AZ) (ES 0.28; p<0.01) in Zambia. In Ethiopia, EBF under 6 months of age is negatively associated with height -for- age z - score (HAZ) (ES 0.81; p<0.01). Timely introduction of complementary food between 6- 8 months of age was positively associated with HAZ (ES 1.19; p<0.01) in Zambia. Higher dietary diversity score was associated with higher HAZ (ES 0.23, p<0.001 in Ethiopia; ES 0.12, p<0.01 in Zambia) and WAZ (ES 0.17, p<0.001 in Ethiopia; ES 0.04, p<0.10 in Zambia) in both countries. The findings demonstrate the need to reinforce age - appropriate IYCF practices to address child undernutrition. Special attention is needed to improve the complementary feeding practices, particularly diet diversity for children 6 -23 months of age , while sustaining a focus on EBF among children under 6 months of age, in order to improve overall nutrition al status of young children in Ethiopia and Zambia.

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The relationships among iron supplement use, Hb concentration and linear growth in young children: Ethiopian Demographic and Health Survey

British Journal Of Nutrition ◽

10.1017/s0007114517002677 ◽

2017 ◽

Vol 118 (9) ◽

pp. 730-736 ◽

Cited By ~ 6

Author(s):

Shimels Hussien Mohammed ◽

Ahmad Esmaillzadeh

Keyword(s):

Young Children ◽

Breast Feeding ◽

Health Survey ◽

Linear Growth ◽

Dietary Diversity ◽

Dietary Factors ◽

Demographic And Health Survey ◽

Supplement Use ◽

Feeding Duration ◽

Hb Concentration

AbstractGrowth faltering and anaemia remain unacceptably high among infants and young children in Ethiopia. In this study, we investigated the relationships among Fe supplement use (ISU), Hb concentration and linear growth, hypothesising positive relationships between ISU and Hb, ISU and linear growth and Hb and linear growth. We used a nationally representative data of 2400 children aged 6–24 months from the Ethiopian Demographic and Health Survey (EDHS) 2011, conducted following a stratified, two-stage cluster sampling. We examined the links by Pearson’s correlation, bivariate and multivariate linear regression analyses and reported adjusted estimates. We found that ISU was not significantly associated with either Hb (β=1·09; 95 % CI −2·73, 5·01, P=0·567) or linear growth (β=0·07; 95 % CI −0·06, 0·21, P=0·217). We found a positive, however, weak, correlation between Hb and linear growth (r 0·09; 95 % CI 0·06, 0·11, P<0·001). Hb predicted linear growth independent of a variety dietary and non-dietary factors (β=0·08; 95 % CI 0·04, 0·11, P<0·001). Although not the primary focus of the study, our analysis showed that age and breast-feeding duration were independently associated with Hb; age, birth type, size at birth, sex, breast-feeding duration, dietary diversity and deworming were independently associated with linear growth, indicating that Hb and linear growth are multifactorial with both nutritional and non-nutritional factors implicated. Further studies, with better design and exposure assessment, are warranted on the relation of ISU with Hb or linear growth.

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Obstetrical care is associated with child’s dietary diversity in Indonesia: analysis from Demographic and Health Survey 2017

Public Health Nutrition ◽

10.1017/s1368980020002396 ◽

2020 ◽

pp. 1-10

Author(s):

Anna Marie Pacheco Young ◽

Yunhee Kang

Keyword(s):

Health Facility ◽

Health Survey ◽

Fruits And Vegetables ◽

Dietary Diversity ◽

Demographic And Health Survey ◽

Food Groups ◽

Cross Sectional ◽

Obstetrical Care ◽

Dietary Diversity Score ◽

Antenatal Visits

Abstract Objective: To explore the influence of obstetrical care factors on dietary diversity and individual food group consumption in Indonesia. Design: Cross-sectional study to assess the association between pregnancy care factors and dietary diversity score, minimum dietary diversity (MDD) and consumption of seven food groups. Setting: Data from the Indonesia Demographic and Health Survey 2017. Participants: A total of 5113 children aged 6–23 months. Results: Dietary diversity score was significantly higher for children whose mothers received four or more prenatal care visits, were delivered at a health facility, had a professionally trained delivery assistant and were delivered by C-section. Children born at a health facility and delivered by a health professional had higher odds of meeting MDD (adjusted OR (AOR) 1·45, 95 % CI 1·18, 1·79 and OR 2·10, 95 % CI 1·54, 2·87, respectively). Four or more antenatal visits, delivering at a health facility and having a professional delivery attendant were associated with higher odds of consumption of lentils (AOR 1·66, 95 % CI 1·23, 2·25, AOR 1·30, 95 % CI 1·02, 1·65 and AOR 1·79, 95 % CI 1·19, 2·69). Four or more antenatal visits, delivering at a health facility and having a professional delivery attendant had higher odds of consumption of other fruits and vegetables (AOR 1·70, 95 % CI 1·23, 2·35, OR 1·23, 95 % CI 1·03, 1·61 and OR 1·90, 95 % CI 1·29, 2·79). Conclusions: Efforts focusing on providing nutritional education during antenatal care and delivery should be encouraged, especially for mothers seeking care outside of a health facility.

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Obstetrical Care Is Associated with Child Dietary Diversity in Indonesia: Analysis from Demographic and Health Survey 2015

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_180 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1108-1108

Author(s):

Anna Marie Young ◽

Yunhee Kang

Keyword(s):

Prenatal Care ◽

Health Facility ◽

Health Survey ◽

Dietary Diversity ◽

Demographic And Health Survey ◽

Food Groups ◽

Obstetrical Care ◽

Dietary Diversity Score ◽

Antenatal Visits ◽

Minimum Dietary Diversity

Abstract Objectives Our study aimed to examine if obstetrical care factors are associated with dietary diversity score, minimum dietary diversity (4 or more out of 7 food group consumption), and consumption of seven food groups among children ages 6–23 months using the Indonesia Demographic and Health Survey 2015. Methods Univariate and multiple logistic regression were performed to assess the association between obstetrical care factors, including number of prenatal care visits, location of delivery, mode of delivery, delivery provider, timing of postnatal visit, and postnatal visit provider, with dietary diversity score, minimum dietary diversity, and consumption of seven food groups. Results Four or more prenatal care visits, delivery in a health facility, delivery assisted by trained professional, or delivery by C-section were positively associated with higher dietary diversity scores of children (All P < 0.05). Delivery in a health facility and delivery assisted by a health professional was associated with higher odds of minimum dietary diversity (OR = 1.45, 95% CI [1.18–1.79] and OR = 2.10, 95% CI [1.54–2.87]). Four or more prenatal care visits was associated with higher odds of consumption of eggs (OR = 1.28, 95% [1.01–1.63]). Four or more antenatal visits, delivering at a health facility, and having a professional delivery attendant was associated with higher odds of consumption of lentils (OR = 1.66, 95% CI [1.23–2.25], OR = 1.30, 95% CI [1.02–1.65], OR 1.79, 95% CI [1.19–2.69], respectively). Four or more antenatal visits, delivery at a health facility, and having a professional delivery attendant was associated with higher odds of consumption of other fruits and vegetables (OR = 1.70, 95% CI [1.23–2.35), OR = 1.23, 95% CI [1.03–1.61], OR = 1.90, 95% CI [1.29- 2.79]). Having a professional delivery attendant was associated with higher odds of consumption of grains, flesh, and eggs (OR 1.72, 95% CI [1.09– 2.71], OR = 1.67, 95% CI [1.26–2.21], OR = 1.71, 95% CI [1.29–2.24]). Conclusions Obstetrical care received from a health facility and professionally trained providers throughout pregnancy is positively associated with dietary diversity in children ages 6–23 months. Efforts focusing on providing nutritional education before and during birth could be encouraged, especially for mothers seeking care outside of a health facility in Indonesia. Funding Sources None.

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Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6–23 Months in Malawi

Nutrients ◽

10.3390/nu13010178 ◽

2021 ◽

Vol 13 (1) ◽

pp. 178

Author(s):

Zizwani Brian Chilinda ◽

Mark L. Wahlqvist ◽

Meei-Shyuan Lee ◽

Yi-Chen Huang

Keyword(s):

Young Children ◽

Dietary Diversity ◽

World Health ◽

Food Groups ◽

Water Access ◽

Direct Role ◽

Cross Sectional ◽

Child Undernutrition ◽

Health Organization ◽

Minimum Dietary Diversity

Along with sanitation and hygiene, water is a well-known driver of child undernutrition. However, a more direct role of household (HH) water access in shaping dietary diversity remains unexplored. We assessed the association between HH water access and achievement of minimum dietary diversity (MDD) among young children. We utilized nationally-representative cross-sectional data from the 2015/16 Malawi Demographic and Health Survey, which included 4727 mother–child dyads, respectively, (26.8 ± 6.8 years, range 15–49 years) and (13.9 ± 4.9 months, range 6–23 months). HH water access was categorized as (1) basic or no access, (2) intermediate, or (3) optimal. MDD was defined as feeding a child, during the previous day, at least four of the food groups defined by the World Health Organization. Only 27.7% of the children achieved MDD standards; most of the children who achieved MDD were from HHs with optimal water access (58.4%, p < 0.001). However, only 5.9% of the mother–child dyads were from HHs with optimal water access. After adjusting for covariates, children from HHs with optimal water access had higher odds of achieving MDD than those from HHs with basic or no water access (aOR = 1.74, CI = 1.24–2.46). Our results highlight the need to incorporate water-based strategies into national nutritional policies to increase dietary diversity among Malawian infants and young children.

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Determinants of inadequate complementary feeding practices among children aged 6–23 months in Ghana

Public Health Nutrition ◽

10.1017/s1368980014000834 ◽

2014 ◽

Vol 18 (4) ◽

pp. 669-678 ◽

Cited By ~ 30

Author(s):

Abukari I Issaka ◽

Kingsley E Agho ◽

Penelope Burns ◽

Andrew Page ◽

Michael J Dibley

Keyword(s):

Risk Factors ◽

Health Survey ◽

Complementary Feeding ◽

Dietary Diversity ◽

Feeding Practices ◽

Demographic And Health Survey ◽

Meal Frequency ◽

Factors Associated ◽

Minimum Dietary Diversity ◽

Breast Fed

AbstractObjectiveTo explore complementary feeding practices and identify potential risk factors associated with inadequate complementary feeding practices in Ghana by using the newly developed WHO infant feeding indicators and data from the nationally representative 2008 Ghana Demographic and Health Survey.DesignThe source of data for the analysis was the 2008 Ghana Demographic and Health Survey. Analysis of the factors associated with inadequate complementary feeding, using individual-, household- and community-level determinants, was done by performing multiple logistic regression modelling.SettingGhana.SubjectsChildren (n 822) aged 6–23 months.ResultsThe prevalence of the introduction of solid, semi-solid or soft foods among infants aged 6–8 months was 72·6 % (95 % CI 64·6 %, 79·3 %). The proportion of children aged 6–23 months who met the minimum meal frequency and dietary diversity for breast-fed and non-breast-fed children was 46·0 % (95 % CI 42·3 %, 49·9 %) and 51·4 % (95 % CI 47·4 %, 55·3 %) respectively and the prevalence of minimum acceptable diet for breast-fed children was 29·9 % (95 % CI 26·1 %, 34·1 %). Multivariate analysis revealed that children from the other administrative regions were less likely to meet minimum dietary diversity, meal frequency and acceptable diet than those from the Volta region. Household poverty, children whose mothers perceived their size to be smaller than average and children who were delivered at home were significantly less likely to meet the minimum dietary diversity requirement; and children whose mothers did not have any postnatal check-ups were significantly less likely to meet the requirement for minimum acceptable diet. Complementary feeding was significantly lower in infants from illiterate mothers (adjusted OR=3·55; 95 % CI 1·05, 12·02).ConclusionsThe prevalence of complementary feeding among children in Ghana is still below the WHO-recommended standard of 90 % coverage. Non-attendance of postnatal check-up by mothers, cultural beliefs and habits, household poverty, home delivery of babies and non-Christian mothers were the most important risk factors for inadequate complementary feeding practices. Therefore, nutrition educational interventions to improve complementary feeding practices should target these factors in order to achieve the fourth Millennium Development Goal.

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Crop diversity is associated with higher child diet diversity in Ethiopia, particularly among low-income households, but not in Vietnam

Public Health Nutrition ◽

10.1017/s1368980021003281 ◽

2021 ◽

pp. 1-12

Author(s):

Erin E Esaryk ◽

Sarah Anne Reynolds ◽

Lia CH Fernald ◽

Andrew D Jones

Keyword(s):

Low Income ◽

Dietary Diversity ◽

Positive Association ◽

Household Wealth ◽

Crop Diversity ◽

Food Groups ◽

Crop Species ◽

Diet Diversity ◽

Household Level ◽

Functional Richness

Abstract Objectives: To examine associations of household crop diversity with school-aged child dietary diversity in Vietnam and Ethiopia and mechanisms underlying these associations. Design: We created a child diet diversity score (DDS) using data on seven food groups consumed in the last 24 h. Generalised estimating equations were used to model associations of household-level crop diversity, measured as a count of crop species richness (CSR) and of plant crop nutritional functional richness (CNFR), with DDS. We examined effect modification by household wealth and subsistence orientation, and mediation by the farm’s market orientation. Setting: Two survey years of longitudinal data from the Young Lives cohort. Participants: Children (aged 5 years in 2006 and 8 years in 2009) from rural farming households in Ethiopia (n 1012) and Vietnam (n 1083). Results: There was a small, positive association between household CNFR and DDS in Ethiopia (CNFR–DDS, β = 0·13; (95 % CI 0·07, 0·19)), but not in Vietnam. Associations of crop diversity and child diet diversity were strongest among poor households in Ethiopia and among subsistence-oriented households in Vietnam. Agricultural earnings positively mediated the crop diversity–diet diversity association in Ethiopia. Discussion: Children from households that are poorer and those that rely more on their own agricultural production for food may benefit most from increased crop diversity.

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Assessment of Barriers to Exclusive Breast Feeding Among Working Saudi Mothers

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i10/1221 ◽

2021 ◽

Vol 6 (10) ◽

pp. 656-663

Author(s):

Nisreen Kh. Aref Albezrah ◽

Haneen Ali Alshehri ◽

Raghad Hilal Alswat ◽

Manal Saeed Almalki ◽

Atheer Mohammed Al fuhayd ◽

...

Keyword(s):

Saudi Arabia ◽

Breast Milk ◽

Breast Feeding ◽

Working Mothers ◽

World Health ◽

Western Region ◽

Full Time ◽

Milk Secretion ◽

Exclusive Breast Feeding ◽

The Western Region

Background: The World Health Organization and the United Nations International Children’s Fund recommend mothers to exclusively breastfeed their infants for the first six months of their life that should be initiated within the first hour after birth. Methods: This cross-sectional study included currently employed Saudi working mothers residing the Western region of Saudi Arabia. A self-administered questionnaire was distributed through email and social media. Each person meeting the inclusion criteria was provided informed consent, explaining the study aim, and ensuring the confidentiality of information. Data were obtained by filling out the designed Questionnaire. Result: This study included 692 working Saudi mothers. The frequency of exclusive breast feeding was 40.2%, which was continued by 29.8% only after returning to the work. Insufficient breast milk secretion (17.5%) and the lack or minimal support from the workplace for EBF (6.6%) were commonly stated by the mothers. There were great deficiencies in the breastfeeding friendly work policies including the absence of breast feeding or breast milk-pumping place (86.4%), absence of breastfeeding hours during work time (80.9%), and the presence of a strict full-time schedule that did not allow freely use of the nursing break. Conclusion: The present study shows low prevalence of exclusive breast feeding among working mothers in the Western region of Saudi Arabia. Multiple barriers to continuing breast feeding have been detected. Insufficient breast milk secretion and the lack of breastfeeding friendly work policies were common reasons.

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Concordance of Mother-Child (6–23 Months) Dietary Diversity and Its Associated Factors in Kucha District, Gamo Zone, Southern Ethiopia: A Community-Based Cross-Sectional Study

Journal of Nutrition and Metabolism ◽

10.1155/2021/8819846 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Tesfaye Guja ◽

Yabsira Melaku ◽

Eshetu Andarge

Keyword(s):

Associated Factors ◽

Dietary Diversity ◽

Cross Sectional Study ◽

World Health ◽

Southern Ethiopia ◽

Food Groups ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Mothers And Children

Meeting minimum standards of dietary quality in mothers and children is a challenge in many developing countries including Ethiopia. Emerging evidence suggests that maternal and child dietary diversity is associated, but little is known about the associated factors of concordance of mother-child dietary diversity in Ethiopia and none is documented in the study area. This study examines the concordance between mother-child (6–23 months) dyads dietary diversity and the associated factors in Kucha District, Gamo Zone, Southern Ethiopia. A community-based cross-sectional study was conducted among 791 mother-child (6–23 months) pairs from 11 selected kebeles on March 6 to April 13, 2017. Multistage cluster sampling technique was used to select the study subjects. The sampling frame was obtained from the family folder of health posts in each kebele. The mother-child pairs were selected by the simple random sampling method. The 7 food groups of the World Health Organization (WHO) for children and the 10 food groups of FANTA/FAO 2016 for mothers were used to analyze the dietary diversity. Cohen’s kappa statistics was calculated to see the strength of concordance. The multivariable logistic regression model was fitted to determine factors affecting mother-child dietary diversity concordance. A good concordance was noted between mother-child dietary diversity scores (Kappa = 0.43). Only 56 (7.1%) mothers were negative deviants, and 133 (16.8%) mothers were positive deviants in dietary diversity consumption. Rural residence (AOR = 3.49; 95% CI: 1.90–6.41), having no formal education (AOR = 1.8; 95% CI: 1.08–3.05), not owning milking cow (AOR = 1.7; 95% CI: 1.10–2.56), children with low dietary diversity (AOR = 8.23; 95% CI: 5.17–13.08), and mothers with low dietary diversity (AOR = 0.46; 95% CI: 0.29–0.74) were found to be factors associated with mother-child dietary diversity concordance. An increase in the percentage of children reaching the minimum dietary diversity was greater with a successive increase in maternal dietary diversity. Despite interesting similarities between mothers and children dietary consumption, more than three-quarters of concordants did not achieve the recommended dietary diversity score (were low concordants). Interventions targeting on rural women’s access to high school education, home-based milking cow rearing, and promoting nutrition-sensitive agriculture to meet the dietary requirements of mothers and children in a sustainable manner and public health efforts to improve child nutrition may be strengthened by promoting maternal dietary diversity due to its potential effect on the entire family.

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Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy?

Public Health Nutrition ◽

10.1079/phn2005912 ◽

2006 ◽

Vol 9 (5) ◽

pp. 644-650 ◽

Cited By ~ 328

Author(s):

NP Steyn ◽

JH Nel ◽

G Nantel ◽

G Kennedy ◽

D Labadarios

Keyword(s):

Sensitivity And Specificity ◽

Dietary Diversity ◽

Pearson Correlation ◽

Child Growth ◽

World Health ◽

Food Groups ◽

Nutrient Adequacy ◽

Z Scores ◽

Food Variety ◽

The Mean

AbstractObjectiveTo assess whether a food variety score (FVS) and/or a dietary diversity score (DDS) are good indicators of nutrient adequacy of the diet of South African children.MethodsSecondary data analyses were undertaken with nationally representative data of 1–8-year-old children (n = 2200) studied in the National Food Consumption Study in 1999. An average FVS (mean number of different food items consumed from all possible items eaten) and DDS (mean number of food groups out of nine possible groups) were calculated. A nutrient adequacy ratio (NAR) is the ratio of a subject's nutrient intake to the estimated average requirement calculated using the Food and Agriculture Organization/World Health Organization (2002) recommended nutrient intakes for children. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a percentage. MAR was used as a composite indicator for micronutrient adequacy. Pearson correlation coefficients between FVS, DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. The relationships between MAR and DDS and between anthropometric Z-scores and DDS were also evaluated.ResultsThe children had a mean FVS of 5.5 (standard deviation (SD) 2.5) and a mean DDS of 3.6 (SD 1.4). The mean MAR (ideal = 100%) was 50%, and was lowest (45%) in the 7–8-year-old group. The items with the highest frequency of consumption were from the cereal, roots and tuber group (99.6%), followed by the ‘other group’ (87.6%) comprising items such as tea, sugar, jam and sweets. The dairy group was consumed by 55.8%, meat group by 54.1%, fats by 38.9%, other vegetables by 30.8%, vitamin-A-rich by 23.8%, other fruit by 22%, legumes and nuts by 19.7% and eggs by 13.3%. There was a high correlation between MAR and both FVS (r = 0.726; P < 0.0001) and DDS (r = 0.657; P < 0.0001), indicating that either FVS or DDS can be used as an indicator of the micronutrient adequacy of the diet. Furthermore, MAR, DDS and FVS showed significant correlations with height-for-age and weight-for-age Z-scores, indicating a strong relationship between dietary diversity and indicators of child growth. A DDS of 4 and an FVS of 6 were shown to be the best indicators of MAR less than 50%, since they provided the best sensitivity and specificity.ConclusionEither FVS or DDS can be used as a simple and quick indicator of the micronutrient adequacy of the diet.

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Exclusive and any breast-feeding rates of Pacific infants in Auckland: data from the Pacific Islands Families First Two Years of Life study

Public Health Nutrition ◽

10.1079/phn2005925 ◽

2006 ◽

Vol 9 (6) ◽

pp. 692-699 ◽

Cited By ~ 10

Author(s):

Philip J Schluter ◽

Sarnia Carter ◽

Teuila Percival

Keyword(s):

New Zealand ◽

Breast Milk ◽

Hospital Discharge ◽

Breast Feeding ◽

Pacific Islands ◽

Discharge Summary ◽

World Health ◽

Feeding Rates ◽

Exclusive Breast Feeding ◽

Life Study

AbstractObjectivesTo present current breast-feeding rates for Pacific infants resident in New Zealand. Reasons for the introduction of complementary liquid foods were also explored.DesignA longitudinal study using hospital discharge summary records and maternal home interviews undertaken at 6 weeks, 12 and 24 months postpartum. Turnbull's non-parametric survival analysis was used to model exclusive breast-feeding rates.SettingAuckland, New Zealand.ResultsThe cohort comprised 1376 infants at 6 weeks, 1223 infants at 12 months and 1142 infants at 24 months. Exclusive breast-feeding rates at hospital discharge, 6 weeks, 3 and 6 months postpartum were 84% (95% confidence interval (CI): 80–88%), 49% (95% CI: 43–55%), 37% (95% CI: 32–42%) and 9% (95% CI: 7–11%), respectively. Significant ethnic difference existed, with Samoan mothers having higher exclusive breast-feeding rates than Tongan mothers (P = 0.002). The percentage of infants receiving any breast milk at hospital discharge, 6 weeks, 12 and 24 months was 96% (95% CI: 94–97%), 95% (95% CI: 94–96%), 31% (95% CI: 28–34%) and 15% (95% CI: 13–17%), respectively. Again ethnic differences emerged. Common reasons cited for discontinuation of exclusive breast-feeding included uncertainty of breast milk supply (56%), problems with breasts (30%) and difficulties breast-feeding in work or educational environments (26%). However, 691 (50%) mothers sought no advice about their breast-feeding concerns within the first six weeks of life.ConclusionsExclusive breast-feeding rates for Pacific infants are ethnically heterogeneous, have declined since the 1990s and fall short of the World Health Organization recommendations. The principal reasons cited for exclusive breast-feeding discontinuation echo those reported over a decade ago.

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