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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Early cessation of breastfeeding amongst women in South Africa: an area needing urgent attention to improve child health
BMC Pediatrics, Volume 12, Article 105, Year 2012
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Description
Background: Breastfeeding is a critical component of interventions to reduce child mortality. Exclusive breastfeeding practice is extremely low in South Africa and there has been no improvement in this over the past ten years largely due to fears of HIV transmission. Early cessation of breastfeeding has been found to have negative effects on child morbidity and survival in several studies in Africa. This paper reports on determinants of early breastfeeding cessation among women in South Africa.Methods: This is a sub group analysis of a community-based cluster-randomized trial (PROMISE EBF) promoting exclusive breastfeeding in three South African sites (Paarl in the Western Cape Province, and Umlazi and Rietvlei in KwaZulu-Natal) between 2006 and 2008 (ClinicalTrials.gov no: NCT00397150). Infant feeding recall of 22 food and fluid items was collected at 3, 6, 12 and 24 weeks postpartum. Women's experiences of breast health problems were also collected at the same time points. 999 women who ever breastfed were included in the analysis. Univariable and multivariable logistic regression analysis adjusting for site, arm and cluster, was performed to determine predictors of stopping breastfeeding by 12 weeks postpartum.Results: By 12 weeks postpartum, 20% of HIV-negative women and 40% of HIV-positive women had stopped all breastfeeding. About a third of women introduced other fluids, most commonly formula milk, within the first 3 days after birth. Antenatal intention not to breastfeed and being undecided about how to feed were most strongly associated with stopping breastfeeding by 12 weeks (Adjusted odds ratio, AOR 5.6, 95% CI 3.4 - 9.5 and AOR 4.1, 95% CI 1.6 - 10.8, respectively). Also important was self-reported breast health problems associated with a 3-fold risk of stopping breastfeeding (AOR 3.1, 95%CI 1.7 - 5.7) and the mother having her own income doubled the risk of stopping breastfeeding (AOR 1.9, 95% CI 1.3 - 2.8).Conclusion: Early cessation of breastfeeding is common amongst both HIV-negative and positive women in South Africa. There is an urgent need to improve antenatal breastfeeding counselling taking into account the challenges faced by working women as well as early postnatal lactation support to prevent breast health problems. © 2012 Doherty et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Doherty, Tanya M.
South Africa, Tygerberg
South African Medical Research Council
South Africa, Bellville
University of the Western Cape
Sanders, David M.
South Africa, Bellville
University of the Western Cape
Jackson, Debra J.
South Africa, Bellville
University of the Western Cape
Swanevelder, Sonja A.
South Africa, Tygerberg
South African Medical Research Council
Lombard, Carl J.
South Africa, Tygerberg
South African Medical Research Council
Zembe-Mkabile, Wanga Z.
South Africa, Tygerberg
South African Medical Research Council
Chopra, Mickey
United States, New York
Unicef
Goga, Ameena Ebrahim
South Africa, Tygerberg
South African Medical Research Council
Colvin, Mark S.E.
South Africa, Durban
Maromi Health Research
Fadnes, Lars Thore
Norway, Bergen
Universitetet I Bergen
Engebretsen, Ingunn Marie Stadskleiv
Norway, Bergen
Universitetet I Bergen
Norway, Bergen
Haukeland Universitetssjukehus
Ekström, Eva Charlotte M.
Sweden, Uppsala
Uppsala Universitet
Tylleskär, Thorkild
Norway, Bergen
Universitetet I Bergen
van de Perre, Philippe
Unknown Affiliation
Ekström, Eva Charlotte
Unknown Affiliation
Méda, Nicolas Yelbomkan
Unknown Affiliation
Tumwine, James Kashugyera
Unknown Affiliation
Kankasa, Chipepo
Unknown Affiliation
Jackson, Debra
Unknown Affiliation
Statistics
Citations: 107
Authors: 19
Affiliations: 7
Identifiers
Doi:
10.1186/1471-2431-12-105
e-ISSN:
14712431
Research Areas
Food Security
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Case-Control Study
Study Approach
Quantitative
Study Locations
South Africa
Participants Gender
Female