Estimates of Exclusive Breastfeeding Rates among Mother—Infant Dyads in Quetzaltenango, Guatemala, Vary According to Interview Method and Time Frame

Abstract

Background The World Health Organization (WHO) recommends exclusive breastfeeding, defined as receiving only breastmilk, through the first 6 months of life to optimize survival, health, and development. Objective To assess exclusive and predominant breastfeeding rates, as defined by WHO, in a sample of Guatemalan infants using three dietary assessment methods. Methods Mothers of 156 infants (78 boys and 78 girls) in the 6th month of life, attending a public health center in Quetzaltenango, an urban area located in the Highlands of Guatemala, were recruited. A single face-to-face interview was performed to assess infant dietary intake using three methods: previous day dietary recall (as suggested by WHO), current feeding practices, and recall of feeding practices since birth. Results Based on the previous day dietary recall method, exclusive breastfeeding was reported by 87 (56%) of the mothers. Exclusive breastfeeding rates were much lower when estimated by current feeding practices questions (20%) and even lower when based on recall of feeding practices since birth (9%). The sum of exclusive and predominant breastfeeding (full breastfeeding) rates was 58%, 49%, and 31% based on previous day dietary recall, current feeding practices, and recall of feeding practices since birth, respectively. Conclusions The WHO method of dietary assessment, based solely on the previous day dietary recall, overestimates the exclusive breastfeeding rate compared with recall of feeding practices since birth. In our population sample, adherence to the WHO guidelines for feeding in the first semester of infancy was less than ideal and in need of strengthening.