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. 2017 Aug 1:12:36.
doi: 10.1186/s13006-017-0126-9. eCollection 2017.

A single 24 h recall overestimates exclusive breastfeeding practices among infants aged less than six months in rural Ethiopia

Esete Habtemariam Fenta  1 , Robel Yirgu  1 , Bilal Shikur  1 , Seifu Hagos Gebreyesus  1
Affiliations

A single 24 h recall overestimates exclusive breastfeeding practices among infants aged less than six months in rural Ethiopia

Esete Habtemariam Fenta et al. Int Breastfeed J. .

Abstract

Background: Exclusive breastfeeding (EBF) to six months is one of the World Health Organization's (WHOs) infant and young child feeding (IYCF) core indicators. Single 24 h recall method is currently in use to measure exclusive breastfeeding practice among children of age less than six months. This approach overestimates the prevalence of EBF, especially among small population groups. This justifies the need to look for alternative measurement techniques to have a valid estimate regardless of population characteristics.

Method: The study involved 422 infants of age less than six months, living in Gurage zone, Southern Ethiopia. The study was conducted from January to February 2016. Child feeding practices were measured for seven consecutive days using 24 h recall method. Recall since birth, was used to measure breastfeeding practices from birth to the day of data collection. Data on EBF obtained by using single 24 h recall were compared with seven days repeated 24 h recall method. McNemar's test was done to assess if a significant difference existed in rates of EBF between measurement methods.

Result: The mean age of infants in months was 3 (SD -1.43). Exclusive breastfeeding prevalence was highest (76.7%; 95% CI 72.6, 80.8) when EBF was estimated using single 24 h recall. The prevalence of EBF based on seven repeated 24 h recall was 53.2% (95% CI: 48.3, 58.0). The estimated prevalence of EBF since birth based on retrospective data (recall since birth) was 50.2% (95% CI 45.4, 55.1). Compared to the EBF estimates obtained from seven repeated 24 h recall, single 24 h recall overestimated EBF magnitude by 23 percentage points (95% CI 19.2, 27.8). As the number of days of 24 h recall increased, a significant decrease in overestimation of EBF was observed.

Conclusion: A significant overestimation was observed when single 24 h recall was used to estimate prevalence of EBF compared to seven days of 24 h recall. By increasing the observation days we can significantly decrease the degree of overestimation. Recall since birth presented estimates of EBF that is close to seven repeated 24 h recall. This suggests that a week recall could be an alternative indicator to single 24 h recall.

Keywords: 24 h recall; Accuracy; Exclusive breastfeeding; IYCF; Overestimation.

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Conflict of interest statement

Ethics approval and consent to participate

The study received ethical approval from the Research Ethical Committee of School of Public Health, Addis Ababa University. Then written informed consent was obtained from the participants, after the necessary explanation about the purpose, procedures, benefits, risks of the study. After getting informed consent from the respondents the right of the respondents to refuse answer for few or all of the questions was respected. All the interviews with the subjects were made with strict privacy.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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