ArticleBMJ open2019
Changes in rates of early exclusive breast feeding in South Africa from 2010 to 2013: data from three national surveys before and during implementation of a change in national breastfeeding policy.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 21 citations in OpenAlex.
- A randomized controlled, trial on effects of mobile phone text messaging in combination with motivational interviewing versus standard infant feeding counselling on breastfeeding and child health outcomes, among women living with HIV.International breastfeeding journal · 2025Trial
- Effect of Maternal Pregnancy Intention on Neonatal and Infant Healthcare Across the Continuum of Care in Ethiopia: A National Longitudinal Study Using Propensity Score Methods.Child: care, health and development · 2025Article
- Article
- Health facility users' knowledge, perceptions, and practices about infant feeding in the context of option B+ in South Africa: a qualitative study.International breastfeeding journal · 2022Article
- Infant feeding, growth monitoring and the double burden of malnutrition among children aged 6 months and their mothers in KwaZulu-Natal, South Africa.Maternal & child nutrition · 2022Article
- Lockdown-Associated Hunger May Be Affecting Breastfeeding: Findings from a Large SMS Survey in South Africa.International journal of environmental research and public health · 2021Article
- Breastfeeding inequities in South Africa: Can enforcement of the WHO Code help address them? - A systematic scoping review.International journal for equity in health · 2021Article
- Experiences of workplace breastfeeding in a provincial government setting: a qualitative exploratory study among managers and mothers in South Africa.International breastfeeding journal · 2020Article
- Reported infant feeding practices and contextual influences on breastfeeding: qualitative interviews with women registered to MomConnect in three South African provinces.International breastfeeding journal · 2020Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveBetween 1998 and 2009 reported exclusive breastfeeding (EBF) rates in South African infants, aged 0-6 months, ranged from 6.2% to 25.7%. In 2011, the National Minister of Health shifted policy to promote 'exclusive' breast feeding for all women in South Africa irrespective of HIV status (Tshwane Declaration of Support for Breastfeeding in South Africa). This analysis examines early EBF prior to and through implementation of the declaration.
settingData from the three South Africa national, cross-sectional, facility-based surveys, conducted in 2010, 2011-12 and 2012-13, were analysed. Primary health facilities (n=580) were randomly selected after a stratified multistage probability proportional-to-size sampling to provide valid national and provincial estimates.
participantsA national sample of all infants attending their 6 weeks vaccination at selected facilities. The number of caregiver-infant pairs enrolled were 10 182, 10 106 and 9120 in 2010, 2011-12, and 2012-13, respectively. PRIMARY OUTCOME MEASURE: Exclusive breast feeding as measured using structured 24 hours recall plus prior 7 days (8 days inclusive prior to day interview) and WHO definition.
resultsThe adjusted OR comparing EBF prevalence in 2011-12 and 2012-13 with 2010 were 2.08 and 5.51, respectively. Mothers with generally higher socioeconomic status, HIV-positive, unplanned pregnancy, primipara, postcaesarean delivery, resided in certain provinces and women who did not receive breastfeeding counselling had significantly lower odds of EBF.
conclusionWith what seemed to be an intransigently low EBF rate since 1998, South Africa saw an increase in early EBF for infants aged 4-8 weeks from 2010 to 2013, coinciding with a major national breastfeeding policy change. These increases were seen across all provinces and subgroups, suggesting a population-wide effect, rather than an increase in certain subgroups or locations. While these increases in EBF were significant, the 59.1% prevalence is still below desired levels of early EBF. Further improvements in EBF programmes are needed.
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