Breastfeeding in infancy: identifying the program-relevant issues in Bangladesh
Rukhsana Haider1, Sabrina Rasheed, Tina G Sanghvi
1Training and Assistance for Health & Nutrition (TAHN) Foundation, Bangladesh. rukhsana.haider@gmail.com.
International Breastfeeding Journal
|December 2, 2010
Summary
Despite decades of promotion, breastfeeding practices in Bangladesh remain poor. Key gaps exist in early initiation, colostrum feeding, and exclusive breastfeeding due to lack of awareness and insufficient support from health workers.
Area of Science:
- Public Health
- Maternal and Child Health
- Nutrition Science
Background:
- Numerous breastfeeding promotion programs in Bangladesh since the late 1980s have yielded limited improvements in infant feeding practices.
- Significant disparities persist between recommended breastfeeding behaviors and actual practices among mothers in Bangladesh.
Purpose of the Study:
- To identify program-relevant issues hindering optimal breastfeeding practices in Bangladesh.
- To analyze the gaps in key breastfeeding behaviors and the factors contributing to these deficiencies.
Main Methods:
- Quantitative household data (n=356) and qualitative data (n=97) including interviews, focus groups, and observations were collected in rural Chittagong and urban Dhaka.
- Trials of Improved Practices (TIPs) (n=26) were conducted across multiple sites to inform intervention design.
- Analysis focused on WHO-recommended practices: early initiation, colostrum/no prelacteal feeds, on-demand feeding, no bottle use, and exclusive breastfeeding for six months.
Main Results:
- Major gaps identified in early initiation (76%), colostrum/no prelacteal feeds (54%), and exclusive breastfeeding (90%).
- Mothers cited lack of knowledge on benefits/risks and "insufficient milk" perception as primary reasons.
- Health worker engagement was minimal (8% antenatal/immunization, 34% sick child visits); grandmothers were key information sources (28%).
Conclusions:
- Substantial gaps in breastfeeding behaviors are driven by insufficient awareness of benefits, risks, and practicalities.
- Low interaction rates between health workers and mothers impede breastfeeding support.
- Targeted counseling by health facility staff and community workers at all contact points is crucial to reinforce key infant feeding messages.
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