Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality

Felix A Ogbo; Kingsley Agho; Pascal Ogeleka; Sue Woolfenden; Andrew Page; John Eastwood; Global Child Health Research Interest Group

doi:10.1371/journal.pone.0171792

Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality

PLoS One. 2017 Feb 13;12(2):e0171792. doi: 10.1371/journal.pone.0171792. eCollection 2017.

Authors

Felix A Ogbo^{1

2}, Kingsley Agho³, Pascal Ogeleka⁴, Sue Woolfenden^{2

5

6}, Andrew Page^{1

2}, John Eastwood^{2

6

7

8

9}; Global Child Health Research Interest Group

Affiliations

¹ Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, New South Wales, Australia.
² Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia.
³ School of Science and Health, Western Sydney University, Campbelltown Campus, New South Wales, Australia.
⁴ Department of Public Health, College of Science, School of Public Health, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia.
⁵ Department of Community Child Health/Integrated Care, Sydney Children's Hospital Network, Randwick, New South Wales, Australia.
⁶ School of Women's and Children's Health, The University of New South Wales, Kensington, Sydney, New South Wales, Australia.
⁷ Menzies Centre for Health Policy, Charles Perkins Centre, School of Public Health, Sydney University, Sydney, New South Wales, Australia.
⁸ School of Public Health, Griffith University, Gold Coast, Queensland, Australia.
⁹ Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, New South Wales, Australia.

Abstract

Background: The impacts of optimal infant feeding practices on diarrhoea have been documented in some developing countries, but not in countries with high diarrhoea mortality as reported by the World Health Organisation/United Nations Children's Fund. We aimed to investigate the association between infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality.

Method: The study used the most recent Demographic and Health Survey datasets collected in nine sub-Saharan African countries with high diarrhoea mortality, namely: Burkina Faso (2010, N = 9,733); Demographic Republic of Congo (2013; N = 10,458); Ethiopia (2013, N = 7,251); Kenya (2014, N = 14,034); Mali (2013, N = 6,365); Niger (2013, N = 7,235); Nigeria (2013, N = 18,539); Tanzania (2010, N = 5,013); and Uganda (2010, N = 4,472). Multilevel logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between infant feeding practices and diarrhoea in these nine African countries.

Results: Diarrhoea prevalence was lower among children whose mothers practiced early initiation of breastfeeding, exclusive and predominant breastfeeding. Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with lower risk of diarrhoea (OR = 0.81; 95% confidence interval (CI): 0.77-0.85, P<0.001 and OR = 0.50; 95%CI: 0.43-0.57, respectively). In contrast, introduction of complementary foods (OR = 1.31; 95%CI: 1.14-1.50) and continued breastfeeding at one year (OR = 1.27; 95%CI: 1.05-1.55) were significantly associated with a higher risk of diarrhoea.

Conclusion: Early initiation of breastfeeding and exclusive breastfeeding are protective of diarrhoea in sub-Saharan African countries with high diarrhoea mortality. To reduce diarrhoea mortality and also achieve the health-related sustainable development goals in sub-Saharan African, an integrated, multi-agency strategic partnership within each country is needed to improve optimal infant feeding practices.

MeSH terms

Adolescent
Adult
Africa South of the Sahara / epidemiology
Bottle Feeding / statistics & numerical data*
Breast Feeding / statistics & numerical data*
Diarrhea / epidemiology*
Diarrhea / mortality
Female
Health Surveys / methods
Health Surveys / statistics & numerical data*
Humans
Infant
Infant Food*
Infant Mortality
Infant, Newborn
Logistic Models
Male
Mothers / statistics & numerical data
Multilevel Analysis
Prevalence
Young Adult

Grants and funding

This study received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.