Infant feeding practices in rural and urban areas of Kathmandu district in Nepal : a study

Abstract

Breast milk is an ideal food for infants, breast feeding is universal, easily initiated and carried out without effort by all mothers. Early initiation of breast feeding also brings closer bonding of mother and child. Breastfeeding is almost universal in Nepal with 98 percent of children being breastfed and the median duration of breast-feeding is 33 months. The mean duration of breastfeeding is 29 months (NDHS, 2001). The State of World’s Children Report (UNICEF, 2004) highlighted that in Nepal, breastfeeding was continued till 24 months among 92 percent of the mothers. In order to determine urban rural differences in infant feeding practices in Nepal, the present study was designed with the objectives of assess to the anthropometric profile, breast feeding practices, morbidity profile of infants 0-12 months of age in rural and urban areas of Kathmandu district. The study was longitudinal study with 200 mothers and infants followed up for a whole year from 10-15 days after birth. Infant feeding practices including breast feeding, complementary feeding, feeding during these etc were examined at 0, 3, 6, 9 and 12 months of age. Weight, length, head circumference, chest circumference and mid upper arm circumference were measured at birth after 10-15 days, 3, 6, 9 and 12 months. Using standard deviation and Z-score WAZ, HAZ and WHZ techniques were calculated by WHO 2006 standard. Both the urban and rural pregnant women were between 19-34 years of age. The number of younger aged women i.e. 19-26 years was found to be higher among the rural group. Mean age of urban pregnant women was 25.4 years and that of rural was 23.3 years respectively. Urban women were comparatively more educated than rural women 23 percent and 31 percent of the urban pregnant women were post graduates, and graduates respectively. Urban mothers (47%) was working outside the home. Whereas most of the rural women (80%) were housewives and only 20 percent were working in different sectors mainly in private service.Sample comprised of Brahmin, Chhetri, Newar, Janjati (indigenous people) and Dalit groups. All most all the deliveries were in the hospital only 4 deliveries were at home in rural areas. Most of the delivery cases were normal. Only four and nine were cesarean cases in urban and rural areas, respectively. Out of 200 births, 105 were girls and 95 boys. Initiation of breast feeding within an hour of birth found to be quite high (69.5%) in both urban and rural areas of Kathmandu district. The colostrum feeding practices among the mothers were 100 percent in both urban and rural areas. In case of caesarean delivery, glucose water was given to infant at the hospital. It seems that practices of antenatal check up services in both urban and rural areas helped to change the attitude of mothers towards prelacteal feeds. Among the 200 mothers, 28 percent of the urban mothers and 64 percent rural mothers reported exclusively breast feeding up to 6 months. Over 16.66 percent mothers of both urban and rural area were found giving formula milk to their infant as breast milk substitute. Sixty one percent of urban and 58 per cent of rural infants were receiving complementary food at age of 5-6 months respectively and 33 per cent urban infants and 39 per cent rural infants respectively were receiving complementary food by age at 6-7 months. Popular complementary food given to infant were jaulo, mashed rice/dal/vegs and home made flour and commercial (Sarbottam pitho) food respectively.