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It takes a village: An empirical analysis of how husbands, mothers-in-law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India.

ABSTRACT: Evidence on strategies to improve infant and young child feeding in India, a country that carries the world's largest burden of undernutrition, is limited. In the context of a programme evaluation in two districts in Uttar Pradesh, we sought to understand the multiple influences on breastfeeding practices and to model potential programme influence on improving breastfeeding. A cross-sectional survey was conducted among 1,838 recently delivered women, 1,194 husbands, and 1,353 mothers/mothers-in-law. We used bivariate and multivariable logistic regression models to examine the association between key determinants (maternal, household, community, and health services) and breastfeeding outcomes [early initiation of breastfeeding (EIBF)], prelacteal feed, and exclusive breastfeeding (EBF). We used population attributable risk analysis to estimate potential improvement in breastfeeding practices. Breastfeeding practices were suboptimal: EIBF (26.3%), EBF (54%), and prelacteal feeding (33%). EIBF was positively associated with maternal knowledge, counselling during pregnancy/delivery, and vaginal delivery at a health facility. Prelacteal feeds were less likely to be given when mothers had higher knowledge, beliefs and self-efficacy, delivered at health facility, and mothers/mothers-in-law had attended school. EBF was positively associated with maternal knowledge, beliefs and self-efficacy, parity, and socio-economic status. High maternal stress and domestic violence contributed to lower EBF. Under optimal programme implementation, we estimate EIBF can be improved by 25%, prelacteal feeding can be reduced by 25%, and EBF can be increased by 23%. A multifactorial approach, including maternal-, health service-, family-, and community-level interventions has the potential to lead to significant improvements in breastfeeding practices in Uttar Pradesh.

SUBMITTER: Young MF

PROVIDER: S-EPMC7083414 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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It takes a village: An empirical analysis of how husbands, mothers-in-law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India.

Young Melissa F MF Nguyen Phuong P Kachwaha Shivani S Tran Mai Lan L Ghosh Sebanti S Agrawal Rajeev R Escobar-Alegria Jessica J Menon Purnima P Avula Rasmi R

Maternal & child nutrition 20191126 2

Evidence on strategies to improve infant and young child feeding in India, a country that carries the world's largest burden of undernutrition, is limited. In the context of a programme evaluation in two districts in Uttar Pradesh, we sought to understand the multiple influences on breastfeeding practices and to model potential programme influence on improving breastfeeding. A cross-sectional survey was conducted among 1,838 recently delivered women, 1,194 husbands, and 1,353 mothers/mothers-in- ...[more]

PMID: 31773869

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Dataset Information

It takes a village: An empirical analysis of how husbands, mothers-in-law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India.

Publications

It takes a village: An empirical analysis of how husbands, mothers-in-law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India.

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