Dibley Michael J, Roy S K, Senarath Upul, Patel Archana, Tiwari Kalpana, Agho Kingsley E, Mihrshahi Seema
Sydney School of Public Health, University of Sydney, NSW, Australia.
Food Nutr Bull. 2010 Jun;31(2):366-75. doi: 10.1177/156482651003100224.
Information on infant and young child feeding is widely available in Demographic and Health Surveys and National Family Health Surveys for countries in South Asia; however, infant and young child feeding indicators from these surveys have not been compared between countries in the region.
To compare the key indicators of breastfeeding and complementary feeding and their determinants in children under 24 months of age between four South Asian countries.
We selected data sets from the Bangladesh Demographic and Health Survey 2004, the India National Family Health Survey (NFHS-03) 2005-06, the Nepal Demographic and Health Survey 2006, and the Sri Lanka 2000 Demographic and Health Survey. Infant feeding indicators were estimated according to the key World Health Organization indicators.
Exclusive breastfeeding rates were 42.5% in Bangladesh, 46.4% in India, and 53.1% in Nepal. The rate of full breastfeeding ranged between 60.6% and 73.9%. There were no factors consistently associated with the rate of no exclusive breastfeeding across countries. Utilization of health services (more antenatal clinic visits) was associated with higher rates of exclusive breastfeeding in India but lower rates in Nepal. Delivery at a health facility was a negative determinant of exclusive breastfeeding in India. Postnatal contacts by Public Health Midwives were a positive factor in Sri Lanka. A considerable proportion of infants under 6 months of age had been given plain water, juices, or other nonmilk liquids. The rate of timely first suckling ranged from 23.5% in India to 56.3% in Sri Lanka. Delivery by cesarean section was found to be a consistent negative factor that delayed initiation of breastfeeding. Nepal reported the lowest bottle-feeding rate of 3.5%. Socioeconomically privileged mothers were found to have higher bottlefeeding rates in most countries.
Infant and young child feeding practices in the South Asia region have not reached the expected levels that are required to achieve a substantial reduction in child mortality. The countries with lower rates of exclusive breastfeeding have a great potential to improve the rates by preventing infants from receiving water and water-based or other nonmilk liquids during the first 6 months of life.
在南亚各国的人口与健康调查及全国家庭健康调查中，可广泛获取婴幼儿喂养方面的信息；然而，该地区各国尚未对这些调查中的婴幼儿喂养指标进行比较。
比较四个南亚国家24个月以下儿童母乳喂养和辅食添加的关键指标及其决定因素。
我们选取了2004年孟加拉国人口与健康调查、2005 - 2006年印度全国家庭健康调查（NFHS - 03）、2006年尼泊尔人口与健康调查以及2000年斯里兰卡人口与健康调查的数据集。根据世界卫生组织的关键指标估算婴幼儿喂养指标。
孟加拉国的纯母乳喂养率为42.5%，印度为46.4%，尼泊尔为53.1%。完全母乳喂养率在60.6%至73.9%之间。各国中不存在与非纯母乳喂养率始终相关的因素。在印度，利用卫生服务（更多次产前诊所就诊）与较高的纯母乳喂养率相关，但在尼泊尔则与较低的纯母乳喂养率相关。在印度，在医疗机构分娩是纯母乳喂养的一个负面决定因素。在斯里兰卡，公共卫生助产士的产后接触是一个积极因素。相当大比例的6个月以下婴儿曾被喂过白开水、果汁或其他非奶类液体。及时首次吸吮率从印度的23.5%到斯里兰卡的56.3%不等。剖宫产被发现是延迟开始母乳喂养的一个始终存在的负面因素。尼泊尔报告的奶瓶喂养率最低，为3.5%。在大多数国家，社会经济地位较高的母亲奶瓶喂养率更高。
南亚地区的婴幼儿喂养做法尚未达到大幅降低儿童死亡率所需的预期水平。纯母乳喂养率较低的国家通过防止婴儿在出生后头6个月接受水、水性或其他非奶类液体，有很大的提高纯母乳喂养率的潜力。
