Infant and young child feeding practices and factors associated with early initiation of breastfeeding among ultra-poor slum mothers of Bangladesh

Background: Appropriate infant and young child feeding (IYCF) practices, including early initiation of breastfeeding (EIBF), are necessary for the optimal development of children and the reduction of child mortality and morbidity. There is a paucity of IYCF data from the ultra-poor children living in the slums of Bangladesh. Aim: To explore IYCF practices in slums in Bangladesh and identify factors associated with EIBF. 

Methods: We conducted a cross-sectional study and interviewed 682 ultra-poor mothers with 0–23-months-old children living in the slums of Dhaka and Saidpur. The interview questionnaire (adapted from Bangladesh Demographic Health Survey and World Health Organization tools) included sociodemographic, dietary, and healthcare utilization variables. We conducted a descriptive analysis to report the prevalence of IYCF practices. Multivariable logistic regression was performed to identify factors associated with EIBF. 

Results: About 99.3% of children were ever breastfed; 89.4% of women breastfed their newborns within an hour; 63.5% of 0–5-months-old children were exclusively breastfed; 78.2% of mothers fed their 6–8-months-olds solid, semisolid, or soft foods; and 34.2% of 0–23-months-olds were bottle fed. Secondary or higher maternal education (≥grade 6) (adjusted odds ratio [aOR] = 0.28, 95% confidence interval [CI] = 0.13–0.59, p = 0.001), previous history of two or more live births (aOR = 2.52, 95% CI = 1.38–4.61, p = 0.003), and cesarean delivery (aOR = 0.36, 95% CI = 0.18–0.69, p = 0.002) were significantly associated with EIBF. 

Conclusion: In the urban slums of Bangladesh, exclusive breastfeeding needs further improvement, and bottle feeding needs to be reduced. Moreover, special attention should be provided to the children delivered through C-sections as they are at greater risk of late initiation of breastfeeding.