title: Determinants of breastfeeding practices: an analysis of the Sri Lanka Demographic and Health Survey 2006-2007.
abstract: Identification of factors that predict a woman's infant feeding choice is important for breastfeeding promotion programmes. We analysed a subsample of children under 2 years of age from the most recent Sri Lanka Demographic and Health Survey (SLDHS) to assess breastfeeding practices and factors associated with suboptimal practices. SLDHS 2006-2007 used a stratified two-stage cluster sample of ever-married women aged 15-49 years. Breastfeeding indicators were estimated for the last-born children (n = 2735). Selected indicators were examined against independent variables through cross-tabulations and multivariate analyses. Of the sample, 83.3% initiated breastfeeding within 1 h of birth. Continuation rates declined from 92.6% in first year to 83.5% in second year. Exclusive breastfeeding (EBF) rate under 6 months of age was 75.8%, with median duration being 4.8 months. Delayed initiation of breastfeeding was associated with low birthweight [odds ratio (OR) = 2.24] and caesarean delivery (OR = 3.30), but less likely among female infants (OR = 0.75), mothers from 'estate' sector (OR = 0.61) or richer wealth quintile (OR = 0.60). Non-EBF was associated with children from urban areas (OR = 1.72) and estate sector (OR = 4.48) and absence of post-natal visits by a public health midwife (OR = 1.89). A child was at risk for not currently breastfeeding if born in a private hospital (OR = 3.73), delivered by caesarean section (OR = 1.46) or lived in urban areas (OR = 2.80) or estate sector (OR = 3.23). Those living in estates (OR = 11.4) and not receiving post-natal home visits (OR = 2.62) were more likely to discontinue breastfeeding by 1 year. Breastfeeding indicators in Sri Lanka were higher compared with many countries and determined by socio-economic and health care system factors.
authors.affiliation: Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka. upul.senarath@yahoo.com
authors.forename: Upul
authors.initials: U
authors.lastname: Senarath
authors.forename: Indika
authors.initials: I
authors.lastname: Siriwardena
authors.forename: Sanjeeva S P
authors.initials: SS
authors.lastname: Godakandage
authors.forename: Hiranya
authors.initials: H
authors.lastname: Jayawickrama
authors.forename: Dulitha N
authors.initials: DN
authors.lastname: Fernando
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dibley
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data*; D002585:Cesarean Section / Q000706:statistics & numerical data; D016000:Cluster Analysis; D003710:Demography; D005247:Feeding Behavior; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D012923:Social Class; D012959:Socioeconomic Factors; D013188:Sri Lanka; D055815:Young Adult