Comparison of infant-feeding practices in two health subdistricts with different baby-friendly status in Mpumalanga province

Objectives: The objective of the study was to compare the infant-feeding practices of two subdistricts with different baby-friendly status in Mpumalanga province, South Africa.Design: This was a cross-sectional, descriptive, observational study with an analytical component. Eighteen fieldworkers assisted with the data collection, utilising two sets of interviewer-administered questionnaires – one on socio-demographic information and the other on infantfeeding practices.Subjects: Mothers with infants from birth to six months old, attending postnatal care at public sector primary health care facilities in Emalahleni and Mbombela health subdistricts on the days of data collection were included. A total of 435 mother and infant pairs were included in the study.Outcome measures: Five infant-feeding indicators were used, namely the early initiation of breastfeeding, exclusive breastfeeding, exclusive replacement feeding and mixed feeding rates, as well as the age at which complementary food was introduced.Results: There was a significantly higher early initiation of breastfeeding (57% vs. 43%), exclusive breastfeeding rates (60% vs 48%), and a lower exclusive replacement feeding rate (18% vs. 33%) in Emalahleni subdistrict, where all the public sector maternity facilities are accredited as being baby friendly, compared to that in Mbombela subdistrict, where none of the public sector maternity facilities are baby friendly. The mixed feeding rate (19% vs. 15%) and the mean age of the introduction of complementary foods (50 days versus 35 days) did not differ significantly between the two subdistricts.Conclusion: Implementation of the Baby-Friendly Hospital Initiative (BFHI) in a health subdistrict was associated with more optimal infantfeeding practices in mothers with infants aged six months and younger. It is concluded that strengthening practices prescribed within the BFHI would improve infant-feeding practices at community level