Are infants born in baby-friendly hospitals being exclusively breastfed until 6 months of age?
OBJECTIVE
To objectively measure rates of breast-feeding to infants born in a baby-friendly hospital in Bangalore, India, and to capture home-based compliance to exclusive breastfeeding (EBF).


METHODS
Breast-milk (BM) and non-breast-milk (NBM) water intake were assessed in 50 mother-infant pairs using a deuterium dilution technique at months 1, 3 and 6.


RESULTS
Complementary feeding (CF) was introduced as early as 1 month among 44% of the infants, and only 14.2% remained as exclusively breastfed by month 6. Intake of BM significantly declined from 166 to 87 ml/kg/day and NBM significantly increased from 23 to 51 ml/kg/day from month 1-6 (P<0.01). There was a significant negative correlation between BM and NBM at months 3 (r = -0.59, P<0.001) and 6 (r = -0.61, P<0.001). The most common barrier to EBF was 'a persistently crying infant'. BM intake significantly correlated with weight for age (WAZ; month 1: r = 0.56, P<0.001; month 3: r = 0.60, P<0.001) and weight for height (WHZ; month 1: r = 0.59, P<0.001; month 3: r = 0.57, P<0.001). NBM intake showed a significant negative correlation with WHZ (r = -0.33, P = 0.02) at month 3 and correlated positively with WAZ (r = 0.37, P = 0.01) and height for age (r = 0.30, P = 0.03) at month 6.


CONCLUSIONS
Despite intensive counseling at birth and during the immediate postnatal period in a baby-friendly hospital, early CF was observed at home. Reason for the early introduction of CF was primarily a crying infant. Home- and community-oriented approaches should be designed to address barriers and improve EBF rates.
Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India.
T M
TM
Samuel
T
T
Thomas
S
S
Bhat
A V
AV
Kurpad
D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals; D006801:Humans; D007194:India; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D008895:Milk, Human; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult