The Impact of Breastfeeding on Childhood Mortality in Kenya

Abstract

The study assessed the relationship between duration of breastfeeding and infant and child mortality. The study had three specific objectives. First, to estimate the mean durations of breastfeeding of children by various maternal background characteristics. Second, to determine the patterns of survival status of children by the duration of breastfeeding. Third, to determine the effect to breastfeeding in infant and child mortality when maternal. Environmental, socio-economic and socio-cultural factors are controlled } for. The study was based on data from the 1998 Kenya Demographic and Health survey (KDHS). A sub sample of 3531 births that occurred to women aged 15-49 years three years prior to the survey was used for analysis. Out of these births, 256 died between 0-3 years. The analytical framework developed by Mosley and Chen (1984) for child survival was adopted to guide the study. The variables selected for the study were duration of breastfeeding, maternal education mother work status, type of place of residence, ethnicity, parity, maternal age at birth, and type of place of delivery, presence of a toilet ~-.,.,. /latrine facility and source of drinking water. The quality of data used was assessed using internal checks by exammmg the age reporting of the study sample births and deaths as well as assessing age heaping for births, deaths and breastfeeding data. Incidence-prevalence method was used to calculate the mean durations of breastfeeding. The mean durations of breastfeeding gave the patterns and differentials ef breastfeeding by vanous maternal background characteristics. Childhood mortality differentials according to duration of breastfeeding are obtained by computing the interval risks of death using life table technique. Bivariate IV and Multivariate logistic regression models were run to determine the effect of breast feeding on infant and child mortality. Shorter durations of breastfeeding were associated with children borne to more educated, working younger, parity one, urban mothers. Children borne in health facilities were also associated with shorter durations of breastfeeding than those borne in non-health facilities. Interval risks of death revealed that the interval risk of death in infancy (0-11) months is higher for children breastfed for shorter periods (0-6 months) as compared to those breastfed for at least 7 months. However, children breastfed for more than 18 months had a higher risk of death was almost the same for all durations of breastfeeding. This implies ;that child mortality does not vary according to the months a child is breastfed. Bivariate logistic regression results indicated that maternal level of education, maternal work status, place of residence, maternal age at birth, place of delivery, source of drinking water, presence of toilet facility and ethnicity were statistically significant factors associated with the risk of infant and child death at 95% confidence level. Multivariate analysis established that duration of breastfeeding was only significant parameter estimates of duration of breastfeeding reduced insignificantly as other independent factors are controlled for.~Thus, the mechanism of causation of the effect of duration of breast feeding on childhood mortality is not clear. The study recommended that since the benefits of breastfeeding to the mother and child are numerous and therefore should be encouraged so as to increase the survival chances of children. This recommendation is not acceptable before 6 months of age. Efforts should also be made to achieve high standards of sanitation and health services. v Government should enhance policies that ensure universal access to clean water. Since breastfeeding turned out to be a slightly significant factor in determining infant and child health, mothers should be educated on alternative hygienic methods of infant and child feeding and also on nutritious foods that can be given to children with or instead of breast milk. NB. Exclusive breastfeeding is most important in the first 6 months and should start immediately after birth (30 minutes)