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Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality
Felix A Ogbo1,2, Kingsley Agho3, Pascal Ogeleka4
1Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, New South Wales, Australia.
Insights
Optimal infant feeding, including early and exclusive breastfeeding, significantly reduces diarrhoea risk in high-mortality regions of sub-Saharan Africa. These practices are crucial for child survival and achieving global health goals.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Diarrhoea remains a leading cause of child mortality in many developing nations.
- Optimal infant feeding practices are known to mitigate diarrhoea, but data from high-mortality regions are scarce.
- This study addresses the knowledge gap concerning infant feeding and diarrhoea in sub-Saharan Africa.
Purpose of the Study:
- To investigate the association between infant feeding practices and diarrhoea incidence.
- To provide evidence for interventions aimed at reducing child mortality in sub-Saharan Africa.
- To inform public health strategies for improving infant nutrition.
Main Methods:
- Utilized recent Demographic and Health Survey data from nine sub-Saharan African countries with high diarrhoea mortality.
- Employed multilevel logistic regression models to analyze associations.
- Adjusted for cluster effects and sampling weights for robust analysis.
Main Results:
- Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with a lower risk of diarrhoea (OR=0.81 and OR=0.50, respectively).
- Predominant breastfeeding also showed a protective effect against diarrhoea.
- Conversely, introduction of complementary foods and continued breastfeeding at one year were linked to a higher risk of diarrhoea.
Conclusions:
- Early and exclusive breastfeeding are protective against diarrhoea in sub-Saharan African countries facing high child mortality.
- Improving optimal infant feeding practices requires integrated, multi-agency partnerships.
- These interventions are vital for reducing diarrhoea mortality and achieving Sustainable Development Goals.
Background:
The impacts of optimal infant feeding practices on diarrhoea have been documented in some developing countries, but not in countries with high diarrhoea mortality as reported by the World Health Organisation/United Nations Children's Fund. We aimed to investigate the association between infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality.
Method:
The study used the most recent Demographic and Health Survey datasets collected in nine sub-Saharan African countries with high diarrhoea mortality, namely: Burkina Faso (2010, N = 9,733); Demographic Republic of Congo (2013; N = 10,458); Ethiopia (2013, N = 7,251); Kenya (2014, N = 14,034); Mali (2013, N = 6,365); Niger (2013, N = 7,235); Nigeria (2013, N = 18,539); Tanzania (2010, N = 5,013); and Uganda (2010, N = 4,472). Multilevel logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between infant feeding practices and diarrhoea in these nine African countries.
Results:
Diarrhoea prevalence was lower among children whose mothers practiced early initiation of breastfeeding, exclusive and predominant breastfeeding. Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with lower risk of diarrhoea (OR = 0.81; 95% confidence interval (CI): 0.77-0.85, P<0.001 and OR = 0.50; 95%CI: 0.43-0.57, respectively). In contrast, introduction of complementary foods (OR = 1.31; 95%CI: 1.14-1.50) and continued breastfeeding at one year (OR = 1.27; 95%CI: 1.05-1.55) were significantly associated with a higher risk of diarrhoea.
Conclusion:
Early initiation of breastfeeding and exclusive breastfeeding are protective of diarrhoea in sub-Saharan African countries with high diarrhoea mortality. To reduce diarrhoea mortality and also achieve the health-related sustainable development goals in sub-Saharan African, an integrated, multi-agency strategic partnership within each country is needed to improve optimal infant feeding practices.
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