Sociodemographic, health and pro-breast-feeding policies and programmes associated with breast-feeding duration in Latin American countries

Abstract

AbstractObjective:To describe the duration of breast-feeding between 1990 and 2013 and to estimate the association between breast-feeding duration and sociodemographic, health and pro-breast-feeding policies and programmes in Latin American countries.Design:This is a cross-sectional study with data from Demographic and Health Surveys programme conducted in Bolivia, Brazil, Colombia, Peru and the Dominican Republic between 1990 and 2013. The median duration of breast-feeding was estimated by survival analysis. Information on pro-breast-feeding policies and programmes was extracted from the World on Breastfeeding Trends Initiative (WBTi) tool. The association between the duration of breast-feeding and WBTi tool score was analysed by multilevel survival regression.Setting:Nationally representative cross-sectional survey from Bolivia, Brazil, Colombia, Peru and Dominican Republic.Participants:We included children under 24 months of age, totalling 17 318 children.Results:Breast-feeding duration showed a significant increase in all countries, except the Dominican Republic. Mothers with higher schooling level (HR = 1·66; 95 % CI 1·35, 2·04), higher income (HR = 1·58; 95 % CI 1·40, 1·77) and overweight (HR = 1·14; 95 % CI 1·05, 1·23) breastfed for a shorter time. Breast-feeding in the first hour of life (HR = 0·79; 95 % CI 0·74, 0·83) was associated with increase in the duration of breast-feeding. Regarding WBTi, Peru presented the lowest score and the Dominican Republic presented the highest score. WBTi score was inversely related to the duration of breast-feeding for this set of countries (HR = 1·07; 95 % CI 1·02, 1·12).Conclusions:Mothers with better socio-economic conditions and overweight breastfed for a shorter time. Breast-feeding in the first hour was associated with longer duration of breast-feeding. In this set of countries, higher scores from WBTi tool did not result in longer duration of breast-feeding.