Exclusive breastfeeding up to six months: Are we getting the right figures?

Abstract

Introduction: Exclusive breastfeeding (EBF) is recommended up to six months of age and is usually estimated by the 24-recall method which actually overestimates the real rate. EBF rate in Sri Lanka up to 4 months of age is 75% and up to 6 months of age is 51% according to data of the Sri Lanka Demographic & Health Survey 2006/07. Deuterium oxide dose-to-mother technique could be utilised for assessment of intake by babies of breastmilk as well as intake of water from sources other than breastmilk. Objective: To determine the actual EBF rates at 3 and 6 months of age of infants in Sri Lanka using deuterium oxide dose-to-mother technique. Method: Thirty healthy mother-infant dyads were followed up for a six month period from birth and breast milk intake was measured at 3 and 6 months using deuterium isotope analysis. Further, an interviewer administered questionnaire asked about the feeding history. Results: The average milk intake at 3 months was 772±134 g/v (range 587-1057) and 800±174 g/day¹ (range 500-1113) at 6 months (p=0.30). The non-milk oral intake at 3 months was 91±45 g/day¹ (range -2-166) and 128±63 g/day¹ (range 25-304) at 6 months (p=0.01). Breastfeeding practices revealed that only 40% (n=12) of mothers at 3 months and 30% (n=9) of mothers at 6 months were practising EBF. It confirmed that the EBF rateamong study subjects was 50% at 3 months and 27% at 6 months, with the cut-off of 82.5 g/v of non-milk oral intake. Conclusions: A decrease in EBF was noted between 3 and 6 months using deuterium oxide dose-to-mother technique. Further, the EBF rates in this study sample are much lower than the presently reported value for Sri Lanka using recall method.