The influence of a community-level breast-feeding promotion intervention programme on breast-feeding practices in Myanmar.

OBJECTIVE: Breast-feeding in the first 6 months of life is critical for ensuring both child health and well-being. Despite efforts to improve breast-feeding practices, recent studies have reported that Myanmar continues to have low rates of exclusive breast-feeding.Design/Setting/SubjectsA community-based breast-feeding promotion programme using trained community members was implemented for 1 year in hard-to-reach townships of Myanmar. The present study assessed the breast-feeding practices using a cross-sectional survey of 610 mothers of children under 2 years old: specifically, breast-feeding within 24 h, exclusive breast-feeding up to 6 months and breast-feeding duration.

RESULTS: Using Cox models for breast-feeding duration before 24 months, the hazard of breast-feeding cessation was lower in programme v. non-programme townships (hazard ratio (HR)=0·55; 95 % CI 0·32, 0·95). Mothers who worked as shop owners or ran a family business had lower hazard of breast-feeding cessation (HR=0·13, P<0·05) v. those who worked as supervisors, managers, self-employed and businesswomen. The hazard of breast-feeding cessation was higher in women in higher wealth quintiles v. those in the lowest quintile (lower quintile, HR=3·49, P<0·1; higher quintile, HR=3·50, P<0·1; highest quintile, HR=3·47, P<0·1).

CONCLUSIONS: The intervention did not affect exclusive breast-feeding practices or breast-feeding within the first 24 h. Potential reasons include existing high levels of early initiation of breast-feeding due to ongoing government-led maternal and child health activities, and social and traditional practices related to complementary feeding. Community-based breast-feeding programmes should continue to promote exclusive breast-feeding and develop strategies to support working mothers.