title: Breast-feeding initiation and determinants of exclusive breast-feeding - a questionnaire survey in an urban population of western Nepal.
abstract: OBJECTIVE
  To assess rates of initiation of breast-feeding and exclusive breast-feeding within 2 months after delivery and to determine the factors influencing exclusive breast-feeding.
  
  
  METHODS
  A health worker-administered questionnaire survey was carried out during the time period 1 August-30 September 2005.
  
  
  METHODS
  Immunisation clinics of Pokhara, a submetropolitan city in western Nepal.
  
  
  METHODS
  Three hundred and eighty-five mothers who had delivered a child within the previous 2 months.
  
  
  RESULTS
  The rates of initiation within 1 h and within 24 h of delivery were 72.7 and 84.4%, respectively. Within 2 months after delivery, exclusive breast-feeding was practised by 82.3% of the mothers. Breast milk/colostrum was given as the first feed to 332 (86.2%) babies but 17.2% of them were either given expressed breast milk or were put to the breast of another lactating mother. Pre-lacteal feeds were given to 14% of the babies. The common pre-lacteal feeds given were formula feeds (6.2%), sugar water (5.9%) and cow's milk (2.8%). Complementary feeds were introduced by 12.7% of the mothers. By logistic regression analysis, friends' feeding practices, type of delivery and baby's first feed were the factors influencing exclusive breast-feeding practice of the mothers.
  
  
  CONCLUSIONS
  Despite the higher rates of initiation and exclusive breast-feeding, practices such as pre-lacteal feeds and premature introduction of complementary feeds are of great concern in this urban population. There is a need for promotion of good breast-feeding practices among expectant mothers and also the community, especially the families, taking into account the local traditions and customs.
authors.affiliation: Department of Community Medicine, Manipal College of Medical Sciences, PO Box 155, Deep Heights, Pokhara-16, Nepal. chandrashekharats@yahoo.com
authors.forename: T S
authors.initials: TS
authors.lastname: Chandrashekhar
authors.forename: H S
authors.initials: HS
authors.lastname: Joshi
authors.forename: Vs
authors.initials: V
authors.lastname: Binu
authors.forename: P R
authors.initials: PR
authors.lastname: Shankar
authors.forename: M S
authors.initials: MS
authors.lastname: Rana
authors.forename: U
authors.initials: U
authors.lastname: Ramachandran
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000453:epidemiology* / Q000523:psychology; D003126:Colostrum; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009390:Nepal; D012423:Rural Health; D011795:Surveys and Questionnaires; D014886:Weaning