Breast-feeding performance index: a composite index to describe overall breast-feeding performance among infants under 6 months of age.

摘要

A composite index was developed to describe the overall breast feeding performance of infants <6 months of age, and, using this index, to identify the factors associated with poor breast feeding practices and the association between breast feeding and infant morbidity. The 2003 Demographic and Health Survey was a multi-stage cluster sample survey of 4320 households in Timor-Leste (East Timor) which covered 573 infants aged <6 months. Breast feeding Performance Index (BPI) was constructed by allocating 1 point for each of 7 infant feeding practices: first suckling within an h of birth; absence of prelacteals; non-use of feeding bottles; current breast-feeding; not receiving liquids; not receiving formula or other milk; and not receiving solids in the last 24 h. BPI was treated as the dependent variable in univariate and multivariate analyses to identify the factors associated with poor breast feeding. The exclusive breast feeding rate was 29.9%. The BPI (mean 4.4, s.d. 1.77) was categorised as low, average and high according to tertiles. Multivariate analysis indicated that infants from the richest households were 1.70 (95% confidence interval (CI) 1.04-2.77) times more likely to have low BPI than the poorest. Maternal body mass index <18.5 kgm-2 was predictive of poor breast feeding (odds ratio = 1.79; 95% CI 1.27-2.52). In the low BPI group, the incidence of diarrhoea (13.4%) and acute respiratory infections (20.7%) during the previous 2 wk was significantly higher than in the average (4.3 and 9.3%) and high BPI groups (4.6 and 5.5%). It is concluded that creating a composite index to assess the overall breast feeding performance among infants <6 months of age is feasible, and that BPI can be effectively used to identify target groups for breast feeding promotion interventions.