Determinants of infant and young child feeding practices in Sri Lanka: secondary data analysis of Demographic and Health Survey 2000.
BACKGROUND
Poor feeding practices in early childhood contribute to the burden of childhood malnutrition and morbidity.


OBJECTIVE
To estimate the key indicators of breastfeeding and complementary feeding and the determinants of selected feeding practices in Sri Lanka.


METHODS
The sample consisted of 1127 children aged 0 to 23 months from the Sri Lanka Demographic and Health Survey 2000. The key infant feeding indicators were estimated and selected indicators were examined against a set of individual-, household-, and community-level variables using univariate and multivariate analyses.


RESULTS
Breastfeeding was initiated within the first hour after birth in 56.3% of infants, 99.7% had ever been breastfed, 85.0% were currently being breastfed, and 27.2% were being bottle-fed. Of infants under 6 months of age, 60.6% were fully breastfed, and of those aged 6 to 9 months, 93.4% received complementary foods. The likelihood of not initiating breastfeeding within the first hour after birth was higher for mothers who underwent cesarean delivery (OR = 3.23) and those who were not visited by a Public Health Midwife at home during pregnancy (OR = 1.81). The rate of full breastfeeding was significantly lower among mothers who did not receive postnatal home visits by a Public Health Midwife. Bottlefeeding rates were higher among infants whose mothers had ever been employed (OR = 1.86), lived in a metropolitan area (OR = 3.99), or lived in the South-Central Hill country (OR = 3.11) and were lower among infants of mothers with secondary education (OR = 0.27). Infants from the urban (OR = 8.06) and tea estate (OR = 12.63) sectors were less likely to receive timely complementary feeding than rural infants.


CONCLUSIONS
Antenatal and postnatal contacts with Public Health Midwives were associated with improved breastfeeding practices. Breastfeeding promotion strategies should specifically focus on the estate and urban or metropolitan communities.
Senarath
Upul
U
Department of Community Medicine, University of Colombo, Sri Lanka. upul.senarath@yahoo.com
Dibley
Michael J
MJ
Godakandage
S S P
SS
Jayawickrama
Hiranya
H
Wickramasinghe
Aravinda
A
Agho
Kingsley E
KE
D000328:Adult; D000375:Aging; D001903:Bottle Feeding / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000706:statistics & numerical data; D002585:Cesarean Section; D004522:Educational Status; D005247:Feeding Behavior; D005260:Female; D006293:Health Promotion; D006306:Health Surveys; D006792:House Calls; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000706:statistics & numerical data; D007231:Infant, Newborn; D008297:Male; D008880:Midwifery; D009035:Mothers; D012424:Rural Population; D013188:Sri Lanka; D014505:Urban Population; D014931:Women, Working