Correlates of breastfeeding and infant growth in Kenya

Thesis (Master's)--University of Washington, 2020The benefits of breast milk for infant nutrition are well established. Breastfeeding has been shown to reduce infant morbidity and promote optimal growth during infancy. However, the uptake of breastfeeding globally remains low. The objective of this study was to understand the factors that influence a mother’s decision to breastfeed, and how breastfeeding impacts infant growth. We used data from a cross sectional survey of mother-infant pairs attending week 6 and month 9 infant immunizations at 140 clinics across Kenya. Self-reported breastfeeding practices were collected by standardized questionnaire and infant weight, length, and mid-upper arm circumference were measured. Exclusive breastfeeding was the outcome at 6-week immunizations, while currently breastfeeding and exclusive breastfeeding during the first 6 months of life were outcomes at the 9-month visit. Infant growth was analyzed using weight and length measurements z-scores. Among 1,662 mothers at 6 week and 1,180 at 9-months, the breastfeeding prevalence was 100% and 93% respectively. In multivariable analysis, younger maternal age (<25 years) at 6-weeks postpartum was associated with a 4% (adjusted Prevalence Ratio (aPR)=0.96, 95% CI: 0.93, 0.99, p=0.02) lower prevalence of exclusive breastfeeding compared to older maternal age. HIV-infected mothers had a 5% higher prevalence of exclusive breastfeeding at 6-weeks postpartum (aPR=1.05, 95% CI: 1.01, 1.09, p=0.008) and a 27% higher prevalence (aPR=1.27, 95% CI: 1.17, 1.37, p