Determinants and Effects of Exclusive Breastfeeding Among Infants at a Tertiary Care Center, Kerala

Abstract BACKGROUND: Exclusive breastfeeding (EBF) is the first fundamental right of the child. Globally less than half of the infants of the world are optimally breastfed. Suboptimal breastfeeding can lead to increased respiratory and gastrointestinal infections. This study was undertaken to assess the determinants and effects of EBF among infants at a tertiary care hospital in south India. METHODS: This cross-sectional study was done among infants at the pediatric unit of Believer’s Church Medical College Hospital, from October 2019 to April 2020, using a structured pretested questionnaire. RESULTS: 257 infants were included in the final analysis. 70.4% of babies were exclusively breastfed for the first 6 months, while 80.9% were breastfed within the first hour after birth. Among determinants of exclusive breastfeeding, unemployed mothers and mother’s without a professional qualification were more likely to continue exclusive breastfeeding for 6 months (OR 2.8 95% CI (1.6 – 4.9). and 2.7 95% CI (1.5 – 4.9). respectively). Antenatal counselling appeared to have some beneficial effect but the result was not statistically significant. We did not find significant increase in the number of infections or hospitalizations for respiratory or gastrointestinal infections among the formula fed babies. However, significantly lower number of breastfed babies had constipation (OR 0.4, 95% CI 0.2 – 0.9) when compared to formula fed babies. CONCLUSION: Significantly higher percentage of infants presenting to our hospital have been exclusively breastfed as compared to the state average. The major determinant of EBF was maternal education and employment and the main effect of EBF was a protection against constipation.