Breastfeeding in Tigray and Gonder, Ethiopia, with special reference to exclusive/almost exclusive breastfeeding beyond six months
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Published on: September 22, 2023
Zewditu Getahun1, Veronika Scherbaum, Yonas Taffese
1Institute of Biological Chemistry and Nutrition, Garbenstrasse 30, University Hohenheim, Germany.
Insights
Exclusive breastfeeding (Ex/AEx-BF) supports infant growth better than partial breastfeeding (P-BF). Nutrition education is crucial for Ethiopian mothers to improve infant health outcomes and combat malnutrition.
Area of Science:
- Maternal and Child Health
- Nutritional Epidemiology
- Pediatric Nutrition
Background:
- Breastfeeding practices vary significantly in Ethiopia, impacting infant growth and maternal nutritional status.
- Initiation of breastfeeding and the duration of exclusive/almost exclusive breastfeeding (Ex/AEx-BF) are critical factors for infant well-being.
- Maternal malnutrition (low body mass index - BMI) and infant malnutrition are prevalent issues in the studied regions.
Purpose of the Study:
- To assess the initiation and duration of exclusive/almost exclusive breastfeeding (Ex/AEx-BF) versus partial breastfeeding (P-BF) in Ethiopian infants up to 12 months.
- To examine the relationship between breastfeeding practices, infant growth, and maternal BMI in Tigray and Gonder regions.
- To identify factors influencing breastfeeding duration and provide recommendations for improving infant nutrition.
Main Methods:
- A comparative study involving 471 infants in Tigray and 596 infants in Gonder, Ethiopia.
- Assessment of breastfeeding initiation within 1 hour of birth and continued practices up to 12 months.
- Analysis of infant growth faltering and malnutrition rates in relation to feeding modes and maternal BMI.
Main Results:
- Breastfeeding initiation within 1 hour was more common in Tigray; Gonder had higher rates of delayed initiation and prelacteal feeding.
- At six months, over 50% of mothers practiced Ex/AEx-BF; over 25% continued until eight months, and 15-16% until one year.
- Infant growth faltered less in Ex/AEx-BF infants compared to P-BF infants; malnutrition became evident after eight months.
- Malnourished mothers with malnourished infants were more frequent in mixed-feeding groups compared to Ex/AEx-BF groups.
Conclusions:
- Early initiation and sustained exclusive/almost exclusive breastfeeding are associated with better infant growth outcomes.
- Perceived insufficient breastmilk is a key driver for early introduction of complementary foods, necessitating targeted nutrition education.
- Interventions, including health packages and nutrition education, are vital to reach rural populations and address maternal and infant malnutrition, especially where long-term breastfeeding is practiced.
Abstract:
This study assesses the initiation and duration of exclusive/almost exclusive breastfeeding (Ex/AEx-BF) versus partial breastfeeding (P-BF) and its relationship to infant growth and maternal body mass index (BMI) in Ethiopian infants up to 12 months of age (Tigray n = 471; Gonder n =596). Initiation of breastfeeding within 1 hr after birth was 1.7 times more common in Tigray. In Gonder 19% of the mothers started breastfeeding on the third day of delivery and consequently, a significant higher proportion of newborns were offered prelacteal feeds (P<0.001). At six months, 52.2% and 61.5% of mothers in Tigray and Gonder respectively practised Ex/AEx-BF. Perceived lack of breastmilk was a major factor for offering complementary foods before six months. More than 25% of infants in both regions were Ex/AEx-BF up to the eighth month and 16.4% and 15.7% of infants in Tigray and Gonder were still Ex/AEx-BF at the end of the first year. Growth faltered before six months of age but less frequently in Ex/AEx-BF compared to P-BF infants. Malnutrition became obvious after eight months in both groups. Malnourished mothers (BMI < 18.5) offering mixed feeding to their malnourished children (<-2 z-score) below six months of age was higher in both regions compared to the Ex/AEx-BF group (in Gonder 25% vs 5.9%; in Tigray 42.9% vs 33.3%). Nutrition education to raise awareness of mothers regarding initiation of exclusive breastfeeding directly after birth, the value of colostrum and avoidance of pre-postlacteal feeds, needs to be implemented. A new health package to be implemented could be a proper vehicle to reach the rural population, which doesn't have access to health services. The relationship between infant growth, mode of feeding and mothers nutritional status should be further investigated, particularly in populations with a high prevalence of maternal and infant nutrition and where long term breastfeeding is practiced.
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