ArticleBMC public health2024
Measuring breastfeeding prevalence using demographic and health surveys.
Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Comparison of Lactation Information from Electronic Health Records with Survey Data Across Five US Health Systems.Epidemiology (Cambridge, Mass.) · 2026Article
- Exclusive breastfeeding practices and challenges in Nigeria, Sub-Saharan Africa: an integrative review.International breastfeeding journal · 2026Review
- Factors associated with exclusive breastfeeding practices among mothers in Mauritania: further analysis from 2019-2021 Mauritania demographic and health survey.BMC public health · 2026Article
- Breastfeeding Measurement - Considerations When Measuring Exclusive Breastfeeding.Journal of human lactation : official journal of International Lactation Consultant Association · 2025Article
- Trends and inequalities in exclusive breastfeeding among 0-5 month olds in Ghana from 1993 to 2022.Frontiers in public health · 2025Article
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1 author.
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Abstract
backgroundThis study aims to investigate the measurement of breastfeeding prevalence indicators using Demographic and Health Surveys (DHS) data, focusing on early initiation, exclusive breastfeeding, and continued breastfeeding indicators as reported by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) and on the discrepancies arising from small changes in their definition.
methodsTwo hundred sixty DHS samples from 78 countries were analyzed to re-calculate usual indicators reported by WHO and UNICEF: early initiation of breastfeeding (EIB), exclusive breastfeeding under 6 months (EBF), and continued breastfeeding between 1 and 2 years (CBF12 and CBF24). Additionally, alternative estimates of the same indicators, slightly changing their definition, were calculated to test their robustness.
resultsThe WHO and UNICEF indicators for early initiation (EIB) primarily capture cases where breastfeeding is initiated "immediately" after birth, omitting those initiated within 0 or 1 hour. This discrepancy leads to substantial underestimation of levels in some regions, particularly South Asia, and in trends. Furthermore, sizable discrepancies between exclusive breastfeeding (EBF) indicators arise from the inclusion or exclusion of plain water in the definition, with significant variations across regions, especially in West and Middle Africa. However, continued breastfeeding indicators showed consistency across definitions, proving them robust for international comparisons and time trend estimations.
conclusionThis study highlights the importance of understanding how breastfeeding indicators are defined and calculated using DHS data. Researchers should be cautious when using WHO and UNICEF indicators for early initiation and exclusive breastfeeding, as they may underestimate prevalence due to their narrow definition. Continued breastfeeding indicators, on the other hand, are less affected by small changes in definitions and provide reliable measures for cross-country comparisons and trend analyses. These findings underscore the need for standardized robust definitions and transparent reporting of breastfeeding indicators in global health assessments.
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