Exclusive breastfeeding up to six months: Are we getting the right figures?

Introduction: Exclusive breastfeeding (EBF) is recommended up to six months of age and is usually estimated by the 24-recall method which actually overestimates the real rate. EBF rate in Sri Lanka up to 4 months of age is 75% and up to 6 months of age is 51% according to data of the Sri Lanka Demographic & Health Survey 2006/07. Deuterium oxide dose-to-mother technique could be utilised for assessment of intake by babies of breastmilk as well as intake of water from sources other than breastmilk.

Objective: To determine the actual EBF rates at 3 and 6 months of age of infants in Sri Lanka using deuterium oxide dose-to-mother technique.

Method: Thirty healthy mother-infant dyads were followed up for a six month period from birth and breast milk intake was measured at 3 and 6 months using deuterium isotope analysis. Further, an interviewer administered questionnaire asked about the feeding history.

Results: The average milk intake at 3 months was 772±134 g.d^-1 (range 587-1057) and 800±174 g.d^-1 (range 500-1113) at 6 months (p=0.30). The non-milk oral intake at 3 months was 91±45 g.d^-1 (range -2-166) and 128±63 g.d^-1 (range 25-304) at 6 months (p=0.01). Breastfeeding practices revealed that only 40% (n=12) of mothers at 3 months and 30% (n=9) of mothers at 6 months were practising EBF. It confirmed that the EBF rate among study subjects was 50% at 3 months and 27% at 6 months, with the cut-off of 82.5 g.d^-1of non-milk oral intake. 

Conclusions: A decrease in EBF was noted between 3 and 6 months using deuterium oxide dose-to-mother technique. Further, the EBF rates in this study sample are much lower than the presently reported value for Sri Lanka using recall method.

Sri Lanka Journal of Child Health, 2018; 47(4): 311-315