Breastfeeding Duration Is Associated With Growth Among Children Aged 0 to 23 Months; Analysis of the Zambia 2018 Demographic and Healthy Survey Data

Background: The World Health Organization recommends exclusive breastfeeding for the first 6 months and continued breastfeeding up to 24 months and beyond. Breastfeeding is beneficial for infant growth, development, and survival. Evidence on the association between breastfeeding duration and growth is not conclusive. The aim of the present study was to establish the association between breastfeeding duration and growth among infants and young children. MethodsThe study is based on data from the 2018 Zambia Demographic and Health Survey (ZDHS). The primary outcome for the study was height-for-age Z-score (HAZ). Association between HAZ and breastfeeding duration was assessed by using regression analysis. ResultsThe overall mean ± SD for HAZ was -1.24 ± 1.46 and the median (interquartile range) breastfeeding duration was 9 (4-14 months). After controlling for potential confounders, breastfeeding duration was inversely associated with HAZ (β=-0.07, p<0.001) and WHZ (β=-0.04, p<0.001). Path analysis demonstrated that the effect of breastfeeding duration is independent of child’s birth weight and maternal perceived birth size. Other determinants of HAZ were child’s weight and sex, while WHZ was predicted by maternal age, diarrhea episode and child’s birth weight. ConclusionBreastfeeding duration is negatively associated with both HAZ and WHZ among Zambian children. However, the magnitudes of the association are quite small to be of clinical significance. Thus, breastfeeding should continue to be promoted, protected and supported from birth up to two years and beyond.