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Estimating the prevalence of exclusive breastfeeding with data from household surveys: Measurement issues and options

Thomas W Pullum1, Karleen Gribble2, Seema Mihrshahi3

  • 1ICF International, The Demographic and Health Surveys Program, Rockville, MD, United States.

Frontiers in Nutrition
|April 10, 2023
PubMed

Insights

This study introduces improved methods to assess exclusive breastfeeding rates up to six months. These new measures offer a more accurate evaluation of the World Health Organization's infant feeding recommendations.

Area of Science:

  • Public Health
  • Pediatrics
  • Nutrition Science

Background:

  • Exclusive breastfeeding until six months is a key World Health Organization (WHO) recommendation for infant and maternal health.
  • Current standard indicators may not fully capture adherence to this crucial infant feeding guideline.
  • Accurate measurement is vital for effective public health interventions and policy development.

Purpose of the Study:

  • To propose and evaluate supplementary measures for assessing exclusive breastfeeding rates.
  • To provide a more precise estimation of adherence to the WHO recommendation of exclusive breastfeeding until six months of age.
  • To refine the assessment of infant feeding practices using existing survey data.

Main Methods:

  • Development of two supplementary indicators for exclusive breastfeeding assessment.
  • Estimation of exclusive breastfeeding at the precise age of six months.
  • Adjustment for prelacteal feeding practices in the analysis.
  • Application of proposed measures to Demographic and Health Surveys data from 31 low- and middle-income countries (LMICs).

Main Results:

  • The proposed supplementary measures offer a more accurate assessment compared to the standard indicator.
  • Significant variation in the impact of these modifications was observed across different countries.
  • The refined indicators provide a better understanding of exclusive breastfeeding achievement in LMICs.
  • Analysis revealed nuances in breastfeeding adherence not captured by current metrics.

Conclusions:

  • The proposed supplementary measures enhance the accuracy of evaluating exclusive breastfeeding adherence.
  • These easily calculable adjustments provide a more robust assessment of the WHO recommendation.
  • Findings highlight the need for refined indicators to guide infant and maternal health strategies.
  • The study underscores the importance of precise data for improving global infant feeding practices.

Keywords:
IYCF indicatorsWHO EBF recommendationdemographic and health survey dataexclusive breastfeedinginfant feeding

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