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Breast-feeding in Egypt

Epidemiology Study Center, Bilbeis, Sharqiya, Egypt and Center for Infectious Diseases, University of Texas, Medical School and School of Public Health, Houston, Texas, USA

Randall R. Reves, MD, MSc

Epidemiology Study Center, Bilbeis, Sharqiya, Egypt and Center for Infectious Diseases, University of Texas, Medical School and School of Public Health, Houston, Texas, USA

Maged M. Radwan, MBBCh, MSc

Epidemiology Study Center, Bilbeis, Sharqiya, Egypt and Center for Infectious Diseases, University of Texas, Medical School and School of Public Health, Houston, Texas, USA

Salwa Amin Arafa, MBBCh

Epidemiology Study Center, Bilbeis, Sharqiya, Egypt and Center for Infectious Diseases, University of Texas, Medical School and School of Public Health, Houston, Texas, USA

Mostafa Habib, MBBCh, MD

Epidemiology Study Center, Bilbeis, Sharqiya, Egypt, Center for Infectious Diseases, University of Texas, Medical School and School of Public Health, Houston, Texas, USA

Herbert L. DuPont, MD

Epidemiology Study Center, Bilbeis, Sharqiya, Egypt, Center for Infectious Diseases, University of Texas, Medical School and School of Public Health, Houston, Texas, USA

Planning, implementation and evaluation of programmes to promote appropriate infant feeding practices require detailed, current information about these practices in the target populations. To estimate the prevalences and iden tify the correlates of overall breast-feeding and of exclusive breast-feeding in different age periods during infancy, a cohort of 152 apparently healthy neonates and their mothers were followed during October 1987 through April 1989 in rural Bilbeis, Sharqiya Governorate, Egypt. Feed ing data were collected through twice weekly home visits thus reducing the potential for bias in our findings due to respondent recall errors. The prevalence of overall breast feeding in the infants declined from 100% in age period 0- 11 weeks to 89% in age period 36-47 weeks. Mothers with previous living children were associated with significantly higher (odds ratio [OR]: 6.53, 95% confidence interval [CI]: 1.33-32.09) and ownership of refrigerators was asso ciated with significantly lower (OR: 0.18, 95% CI: 0.05- 0.67) overall breast-feeding prevalences in age periods 24-35 and 36-47 weeks, respectively. The prevalence of exclusive breast-feeding in breast-fed infants dropped from 20% in age period 0-11 weeks to 0% in age period 36-47 weeks. After multivariate adjustment, prelacteal feeding was significantly negatively (OR: 0.12, 95% CI: 0.04- 0.37) associated with exclusive breast-feeding in age period 0-11 weeks. Nearly 90% of Bilbeis infants were breast-fed at age 47 weeks, but the initiation of supplementation at 0-11 weeks in 80% of breast-fed infants is contrary to current recommendations. This indiscriminate initiation of early sup plementation in breast-fed infants should be discouraged and the impact of this practice on the quantity of breast milk consumed by these infants needs to be investigated. The reasons for earlier termination of breast-feeding by socio- economically better-off mothers and the reasons for not stopping the administration of prelacteally fed items, despite the start of breast-feeding, have to be identified for appropriate interventions.

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