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The Influence of Infant Feeding Practices on Infant Mortality in Southern Africa

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Abstract

Objective To examine the adjusted and unadjusted effects of infant feeding practices on infant mortality in Southern Africa. Methods A merged dataset from the most recent Demographic and Health Surveys for Lesotho, Swaziland, Zambia and Zimbabwe was analysed using the Cox Proportional Hazard Model. A total number of 13,218 infants born in 5 years preceding all the surveys with information on infant feeding practices constituted the study population. Infant mortality was the outcome variable and infant feeding practices categorised into; no breastfeeding, partial breastfeeding and exclusive breastfeeding were the main explanatory variables. Maternal demographic and socio-economic characteristics and infants’ bio-demographic characteristics were also studied. Results Although, exclusive breastfeeding was quite low (12 %), exclusively breastfed infants exhibited a 97 % lower risk of dying during infancy compared to infants not breastfed in the region. Variations existed by country in the levels and patterns of both infant mortality and infant feeding practices. Mother’s country, highest level of education and marital status; child’s sex, birth weight and preceding birth interval were the significant predictors of infant mortality in Southern Africa. Conclusions Any form of breastfeeding whether exclusive or partial breastfeeding greatly reduces the risk of infant mortality with the greatest mortality reduction effect observed among exclusively breastfed infants in Southern Africa. To reduce the upsurge of infant mortality, there is the need to step up the effectiveness of child nutrition programmes that promote breastfeeding and put emphasis on exclusive breastfeeding of infants in the region.

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Acknowledgments

This paper is based on the first author’s Master of Arts research in Demography and Population Studies at the University of the Witwatersrand, Johannesburg, South Africa. Sincere gratitude to the William and Flora Hewlett Foundation, USA, through support to the interdisciplinary Demography and Population Studies Programme run through the Schools of Social Sciences and Public Health, University of the Witwatersrand, Johannesburg, South Africa, for the financial support.

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Authors and Affiliations

  1. Demography and Population Studies, University of the Witwatersrand, Johannesburg, South Africa

    Lungile F. Motsa & Clifford Odimegwu

  2. Epidemiology and Biostatistics Division, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa

    Latifat Ibisomi

Authors
  1. Lungile F. Motsa
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  2. Latifat Ibisomi
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  3. Clifford Odimegwu
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Corresponding author

Correspondence to Lungile F. Motsa.

Appendices

Appendix 1

Figures 1, 2, 3.

Fig. 1
figure 1

Kaplan Meier’s infant mortality curve (hazard function) in Southern Africa

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Fig. 2
figure 2

Percentage distribution of infant feeding practices by country

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Fig. 3
figure 3

Kaplan Meier’s infant mortality curves by infant feeding practices in Southern Africa

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Appendix 2

Kaplan–Meier’s infant mortality estimates by country.

figure a

Appendix 3

Kaplan–Meier’s infant mortality estimates by infant feeding practices (Lesotho, Swaziland, Zambia and Zimbabwe).

figure b

Appendix 4

Tables 1, 2, 3, 4.

Table 1 Definitions of explanatory variables used in the study
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Table 2 Levels of infant mortality (IMRs) by infant feeding practices in each country and the Southern African region
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Table 3 Levels of infant mortality (IMRs) by maternal and infants’ biodemographic characteristics
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Table 4 The unadjusted and adjusted hazard ratios (HR) of the association between infant feeding practices and other covariates on infant mortality in Southern Africa
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Motsa, L.F., Ibisomi, L. & Odimegwu, C. The Influence of Infant Feeding Practices on Infant Mortality in Southern Africa. Matern Child Health J 20, 2130–2141 (2016). https://doi.org/10.1007/s10995-016-2033-x

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  • DOI: https://doi.org/10.1007/s10995-016-2033-x

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