Validating self-reported exclusive breastfeeding in Eswatini using stable isotope techniques.

Area of Science:

• Nutritional Science
• Biomedical Engineering
• Public Health

Background:

• Exclusive breastfeeding (EBF) is vital for infant health and preventing malnutrition.
• Population-level EBF assessment often relies on maternal recall, susceptible to biases.
• Objective methods are needed to accurately measure EBF and inform interventions.

Purpose of the Study:

• To compare EBF prevalence measured by maternal recall versus the deuterium oxide dose-to-mother (DTM) technique in Eswatini.
• To evaluate the strengths and limitations of both methods for assessing infant feeding practices.
• To understand the implications for malnutrition research and public health strategies.

Main Methods:

• A study involving 102 mother-infant pairs in Eswatini.
• EBF assessed via maternal recall (WHO 24-hour method) and the DTM stable isotope technique.
• Measurements taken at three infant age intervals: 6 weeks to 2.4 months, 2.5 to 4.0 months, and 4.1 to 5.5 months.

Main Results:

• Maternal recall consistently overestimated EBF prevalence compared to the DTM method across all age groups.
• Kappa statistics indicated minimal agreement between maternal recall and DTM measurements.
• DTM technique showed significantly lower EBF prevalence, highlighting recall bias.

Conclusions:

• The deuterium oxide dose-to-mother (DTM) technique provides a more accurate and objective measure of EBF.
• Maternal recall data should be interpreted with caution due to substantial overreporting.
• Objective methods like DTM are essential for reliable infant feeding assessments, especially in malnutrition studies.