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Infant feeding survival and Markov transition probabilities among children under age 6 months in Uganda

Lumbwe Chola1, Lars T Fadnes, Ingunn M S Engebretsen

  • 1Centre for International Health, University of Bergen, Bergen, Norway. lumbwechola@hotmail.com

American Journal of Epidemiology
|February 7, 2013
PubMed

Insights

Exclusive breastfeeding is better sustained with interventions. A study in Uganda found that peer counseling significantly reduced the risk of stopping exclusive breastfeeding, highlighting the benefits of targeted infant feeding support.

Area of Science:

  • Public Health
  • Biostatistics
  • Maternal and Child Health

Background:

  • Infant feeding studies often use single-event models, neglecting the dynamic transitions between feeding states.
  • Understanding infant feeding duration requires analyzing multiple feeding events and transitions.

Purpose of the Study:

  • To analyze the determinants of infant feeding duration using both single- and multiple-event Cox regression models.
  • To compare Cox models with parametric survival models for estimating feeding-state transition probabilities.

Main Methods:

  • Utilized data from a community randomized trial in Uganda (2005-2008) promoting exclusive breastfeeding (EBF).
  • Employed single- and multiple-event Cox regression and parametric survival models to analyze feeding transitions.
  • Peer counselors provided antenatal and postnatal support to intervention mothers.

Main Results:

  • Children in the intervention group had a significantly lower risk of ceasing exclusive/predominant breastfeeding (hazard ratio = 0.33).
  • Children in rural areas also showed a reduced risk of EBF/PBF cessation (hazard ratio = 0.79).
  • Parametric models demonstrated a better fit than the Cox model based on the Akaike Information Criterion.

Conclusions:

  • The study highlights the effectiveness of interventions in sustaining exclusive breastfeeding.
  • A multi-event analytical approach provides a more comprehensive understanding of infant feeding dynamics.
  • Findings can inform policy-making for improved infant feeding practices and support programs.

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