title: Breastfeeding practices and child growth outcomes in Haiti: an analysis of data from Demographic and Health Surveys.
abstract: Haiti's national nutrition policy prioritises breastfeeding, but limited data are available to inform strategy. We examined national trends in early initiation of breastfeeding (ErIBF) and exclusive breastfeeding (EBF) over a 10-year period using data from three Haitian Demographic and Health Surveys (1994-1995, 2000 and 2005-2006). We used multivariate regression methods to identify determinants of ErIBF and EBF in the 2005-2006 data set and to examine relationships to growth. There was no change in ErIBF across surveys [1994-1995: 36.6%, 95% confidence interval (CI) 29.9-43.9; 2000: 49.4%, 95% CI 44.1-54.8; 2005-2006: 43.8%, 95% CI 40.5-47.1]. EBF among 0-5-month-olds increased sharply (1994-18995: 1.1%, 95% CI 0.4-3.2; 2000: 22.4%, 95% CI 16.5-29.5; 2005-2006: 41.2%, 95% CI 35.4-47.2). The proportion of breastfeeding children 0-5 months who received soft, solid or semi-solid foods decreased (1994-1995: 68.5%, 95% CI 57.3-77.9; 2000: 46.3%, 95% CI 39.3-53.4; 2005-2006: 30.9%, 95% CI 25.9-36.5). Child age at time of survey [odds ratio (OR) 1.73; P = 0.027], lower maternal education (OR = 2.14, P = 0.004) and residence in the Artibonite Department (OR 0.31; P = 0.001) were associated with ErIBF among children 0-23 months. Age group and department were significant predictors of EBF among children 0-5 months. ErIBF was associated with higher weight-for-age z-scores [effect size (ES) 0.22; P = 0.033] and height-for-age z-scores (ES 0.20; P = 0.044). There was no statistically significant relationship between EBF and growth. The 10-year ErIBF and EBF trends in Haiti echo global and regional trends. ErIBF and EBF are related practices but with different determinants in the Haitian context. These differences have implications for intervention delivery.
authors: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors: Rebecca
authors: R
authors: Heidkamp
authors: Nutrition Section, UNICEF Country Office, Port-au-Prince, Haiti.
authors: Mohamed Ag
authors: MA
authors: Ayoya
authors: Nutrition Section, UNICEF Country Office, Port-au-Prince, Haiti.
authors: Ismael Ngnie
authors: IN
authors: Teta
authors: Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA.
authors: Rebecca J
authors: RJ
authors: Stoltzfus
authors: National Food and Nutrition Program Coordination Unit, Ministry of Public Health and Population, Port-au-Prince, Haiti.
authors: Joseline Pierre
authors: JP
authors: Marhone
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data* / Q000639:trends; D002657:Child Development; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006205:Haiti; D006306:Health Surveys; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: breastfeeding; breastfeeding initiation; child growth; health policy; infant and child nutrition; low-income countries
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