A RURAL-URBAN COMPARISON OF BREASTFEEDING PATTERNS AND ANTHROPOMETRY OF INFANTS 3 – 6 MONTHS OLD ATTENDING PRIMARY HEALTH CARE CENTRES IN LAGOS STATE

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A RURAL-URBAN COMPARISON OF BREASTFEEDING PATTERNS AND ANTHROPOMETRY OF INFANTS 3 – 6 MONTHS OLD ATTENDING PRIMARY HEALTH CARE CENTRES IN LAGOS STATE

Abstract

Background: Despite several studies done regarding exclusive breastfeeding, the rates have
remained low both in developing and developed countries. Anthropometry amongst infants 3-
6 months of age has been understudied compared to any other paediatric age group despite its
benefits especially when it is done earlier in a childs life. This study aims to assess and compare
the breastfeeding patterns and anthropometric indices of infants 3-6 months old attending
Primary Health Care Centres in urban and rural Local Government Areas in Lagos State.
Methods: This was a comparative cross-sectional study using a multi-stage sampling
technique. Study participants were mother-infant pairs attending Primary Health Care Centers
in rural and urban Local Government Area in Lagos State. An adapted, pre-tested, semistructured
interviewer-administered questionnaire was used for data collection and the
anthropometric measurements taken according to WHO recommendations.
Data analysis was with Statistical Package for Social Sciences (IBM SPSS statistics) version
20 and WinPepi 11.30 software. Anthropometric scores were first entered into the WHO
Anthro version 3.2.2 software and z-scores generated for weight-for-age (WAZ), height-forage
(HAZ), weight-for-height (WHZ), BMI-for-age (BAZ), head circumference- for-age
(HCZ), mid-upper arm circumference (MUAUZ), triceps skinfold thickness(TSFZ) and
subscapular skinfold measurements(SSFZ) using the WHO Multicentre Growth Reference
Study (MGRS) as the standard.
Frequency tables were generated. Chi-Square tests were used to compare proportions; odds
ratio and confidence intervals were also computed. Multivariate Logistic regression was done
for significant associations. Associations or differences were considered significant if p≤ 0.05
or if the confidence interval did not cross one.
xiv
Results: Respondents in the rural area were more educated (p< 0.001) and lived in better
apartments (p<0.001). The exclusive breastfeeding rates were 52.0% in rural and 48.8% in
urban area. Respondents were similar in proportions for several variables including: timely
initiation of breastfeeding (30.8% and 24.4%), giving prelacteal feeds (16.4% and 16.3%),
child being fed on demand (88.6% and 86.4%) and baby’s’ thirst being the commonest reason
for not breastfeeding exclusively (81.6% and 75.0%) in rural and urban areas respectively.
After multivariate logistic regression, the predictors for EBF were: timely initiation of breast
feeding (delayed initiation OR 0.40, 95% CI 0.21-0.78), not delivering with a TBA (TBA
delivery OR 0.34, 95% CI 0.11-0.99) and exclusively breastfeeding a previous child (OR 6.84,
95% CI 2.25-20.78) amongst rural respondents while the predictors in the urban area were
shorter mothers work hours (long work hours OR 0.42, 95% CI 0.25-0.70) and exclusively
breastfeeding a previous child (OR 5.97, 95% CI 1.09-32.71).
Rural respondents had significantly better scores for WHZ, BAZ, HCZ and MUACZ than the
urban. The worst index was for wasting: 19.6% in rural and 34.0% in urban areas. Both areas
were found to have very high malnutrition levels.
Conclusion/Recommendations: Timely breastfeeding initiation and not delivering with a
TBA in the rural area only while, shorter work hours of the mothers in the urban area only were
predictors for EBF. Exclusively breastfeeding a previous child was a positive predictor for EBF
in both rural and urban areas. Some of the anthropometric measurements can serve as proxies
to one another. Targeted initiatives are needed to improve EBF, promptly identify and reduce
malnutrition in young infants. Primary Health Centres can adopt the use of other
anthropometric measurement particularly the use of MUAC where weight measurements are
not readily available or feasible.

A RURAL-URBAN COMPARISON OF BREASTFEEDING PATTERNS AND ANTHROPOMETRY OF INFANTS 3 – 6 MONTHS OLD ATTENDING PRIMARY HEALTH CARE CENTRES IN LAGOS STATE

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