Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr 3:14:14.
doi: 10.1186/s13006-019-0208-y. eCollection 2019.

Determinants of infant breastfeeding practices in Nepal: a national study

Shiva Bhandari  1   2 , Andrew L Thorne-Lyman  3 , Binod Shrestha  1 , Sumanta Neupane  1 , Bareng Aletta Sanny Nonyane  3 , Swetha Manohar  3 , Rolf D W Klemm  3   4 , Keith P West Jr  3
Affiliations

Determinants of infant breastfeeding practices in Nepal: a national study

Shiva Bhandari et al. Int Breastfeed J. .

Abstract

Background: Optimal breastfeeding practices, reflected by early initiation and feeding of colostrum, avoidance of prelacteal feeds, and continued exclusivity or predominance of breastfeeding, are critical for assuring proper infant nutrition, growth and development.

Methods: We used data from a nationally representative survey in 21 district sites across the Mountains, Hills and Terai (southern plains) of Nepal in 2013. Determinants of early initiation of breastfeeding, feeding of colostrum, prelacteal feeding and predominant breastfeeding were explored in 1015 infants < 12 months of age. Prelacteal feeds were defined as food/drink other than breast milk given to newborns in first 3 days. Predominant breastfeeding was defined as a child < 6 months of age is mainly breastfed, not fed solid/semi-solid foods, infant formula or non-human milk, in the past 7 days. Adjusted prevalence ratios (APR) and 95% confidence intervals (CI) were estimated, using log Poisson regression models with robust variance for clustering.

Results: The prevalence of breastfeeding within an hour of birth, colostrum feeding, prelacteal feeding and predominant breastfeeding was 41.8, 83.5, 32.7 and 57.2% respectively. Compared to infants not fed prelacteal feeds, infants given prelacteal feeds were 51% less likely to be breastfed within the first hour of birth (APR 0.49; 95% CI 0.36, 0.66) and 55% less likely to be predominantly breastfed (APR 0.45; 95% CI 0.32, 0.62). Infants reported to have received colostrum were more likely to have begun breastfeeding within an hour of birth (APR 1.26; 95% CI 1.04, 1.54) compared to those who did not receive colostrum. Infants born to mothers ≥ 20 years of age were less likely than adolescent mothers to initiate breastfeeding within 1 hour of birth. Infants in the Terai were 10% less likely to have received colostrum (APR 0.90; 95% CI 0.83, 0.97) and 2.72 times more likely to have received prelacteal feeds (APR 2.72; 95% CI 1.67, 4.45) than those in the Mountains.

Conclusions: Most infants in Nepal receive colostrum but less than half initiate breastfeeding within an hour of birth and one-third are fed prelacteal feeds, which may negatively affect breastfeeding and health throughout early infancy.

Keywords: Breastfeeding; Colostrum; Infant; Nepal; Prelacteal feeding.

PubMed Disclaimer

Conflict of interest statement

The study was ethically approved by the by the Nepal Health Research Council (Reg. No.: 16/2013), an autonomous body, under the Ministry of Health, Government of Nepal, and the Institutional Review Board (IRB number: IRB00004937) at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Participants were briefed about the purpose of the study and participation was voluntary. If they agreed to be in the study, informed oral consent was obtained.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
PoSHAN Community Study districts, Nepal, 2013 (adapted with permission from [30])
See this image and copyright information in PMC

References

    1. WHO . Infant and Young Child feeding. Model chapter for textbooks for medical students and allied health professionals. Geneva: World Health Organization; 2009. - PubMed
    1. Lamichhane DK, Leem JH, Kim HC, Park MS, Lee JY, Moon SH, et al. Association of infant and young child feeding practices with undernutrition in children: evidence from the Nepal Demographic and Health Survey. Paediatr Int Child Health. 2016;36(4):260–9. - PubMed
    1. Mullany LC, Katz J, Li YM, Khatry SK, LeClerq SC, Darmstadt GL, et al. Breast-feeding patterns, time to initiation, and mortality risk among newborns in southern Nepal. J Nutr. 2008;138(3):599–603. doi: 10.1093/jn/138.3.599. - DOI - PMC - PubMed
    1. Garcia CR, Mullany LC, Rahmathullah L, Katz J, Thulasiraj RD, Sheeladevi S, et al. Breast-feeding initiation time and neonatal mortality risk among newborns in South India. J Perinatol. 2011;31(6):397–403. doi: 10.1038/jp.2010.138. - DOI - PubMed
    1. Rochat TJ, Houle B, Stein A, Coovadia H, Coutsoudis A, Desmond C, et al. Exclusive breastfeeding and cognition, executive function, and behavioural disorders in primary school-aged children in rural South Africa: a cohort analysis. PLoS Med. 2016;13(6):e1002044. doi: 10.1371/journal.pmed.1002044. - DOI - PMC - PubMed

Publication types