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Khanal et al. BMC Public Health 2013, 13:958 Page 5 of 13 http: !!!.bio"e#cent$al.co" 1%&1'2%58 13 958

(able 1 P$opo$tion )*+ of e clu-i e b$ea-tfee#ing in infant- 5 "onth- of age an# un#e$ b/ #e"og$aphic an#-ocioecono"ic cha$acte$i-tic-, epal 200 ) %82+ an# 2011 ) 22&+

acto$ 200 2011

(otal 4* 6B n 4*7

p

alue (otal 4* 6B n 4*7

p

alue

nfant - age )"onth-+;0.00

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1

; %

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102 )21.2+ 2

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>o$@ing )pai#+ &1 )1%.&+ 32 )51.%+ 19)8.%+ 12

) 5.0+

athe$ - occupation 0.003 0.&%

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Khanal et al. BMC Public Health 2013, 13:958 Page of 13 http: !!!.bio"e#cent$al.co" 1%&1'2%58 13 958

(able 1 P$opo$tion )*+ of e clu-i e b$ea-tfee#ing in infant- 5 "onth- of age an# un#e$ b/ #e"og$aphic an#-ocioecono"ic cha$acte$i-tic-, epal 200 ) %82+ an# 2011 ) 22&+ )Continue#+

>ealth in#e 0.015 0.310

Poo$e-t 138 )28. + 88 ) &.2+ 52 )22.8+ 39) 1.

&+

Poo$ 8)1&.

8+ %2)51.

2+ %5)20.

0+ 31) 5.

5+

Mi##le 9% )19.5+ %% )5%.3+ 58 )25.5+ 31)&&.

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8+ %%)19.

2+ 30) 9.

1+

iche-t &2)1%.

1+ 28)%0.

+ 28)12.

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1+7the p$opo$tion $ep$e-ent- the pe$centage afte$ a#Du-ting fo$ -tu#/ #e-ign an# -a"ple !eight. (hi- "a/ not be eEual to -i"ple calculation of p$opo$tion.

: the pe$centage in the cell- i - the $o! pe$centage of the each -ub g$oup-.

place of delivery were significantly associated with EBFwhen age of infant was excluded from the initial model ofTable 3. The infants whose mothers were from Hills

[a ! ".#$%& '() *+ ,-.%'$ //.-0/12 and Terai [a !3./'#& '() *+ ,/."3# 0.//#12& attended four or more45* visits [a ! 3.#/%& '() *+ ,/.3#( /%."#-12 and hadvaginal ,normal1 delivery [a ! "."%3& '() *+ ,/./03/$.(-"12 were more li6ely to be EBF. n the other handthe infants whose fathers were from pro fessionalclerical service and manual [a ! %.$"-& '() *+ ,%."/-/.%%12 and other occupation [a ! %.--/& '() *+ ,%.%"'%.'#012 were less li6ely to provided EBF. The infants withwealthier mothers were less li6ely to be provided withEBF. 7hile there was a significant change in factorsassociated with EBF in -%%$ exclud ing infant s age from-%// data ,Table "1 showed that there was no change inthe factors associated with EBF in -%// ,Table notshown1.

Change- in the $ate of e clu-i e b$ea-tfee#ing acco$#ingto infant - age, epal 200 an# 2011Table $ describes the gradual decline in the rate of EBFaccording to infant s age ,in months1 during the survey.The rate of EBF at less than one month of age was '%.$)in -%%$ and 0#.") in -%//. 5ot surprisingly the EBF ratedecreased as the age of infant increased and it declined to33./) in -%%$ and 33./) in -%// at five months. The

-%// EBF rate at age / - 3 " and ( months was higherthan that in -%%$& however there were no statisticallysignificant differences in EBF rates between -%%$ and-%// with the exception at " months [3-.%) *+ ,/'.'"0.%1 for -%%$& $(.() *+ ,"#./ 0'.$1 for -%//2. +t should

be noted that even when the demo graphic surveys in 5epal included a large household level sample it was nota large enough sample to ma6e comparisons within agestrata for EBF. The rate of EBF& therefore has a wide'() confidence interval showing variation due to thesmall number of observation in par ticular age strata. Forcomparison purpose the rates of EBF for each age groupwere calculated using the num ber of infants breastfed

exclusively.

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=i-cu--ion 5utrition in early childhood is essential not only for theimmediate health of the child but also for the long term

benefits. EBF confers protection against infectiousdiseases such as gastroenteritis and respiratory illness aswell as other chronic diseases in the long term [3/2 while

preventing up to /%) of all child deaths. Therefore 7Hand 85+*EF recommend exclusive breastfeeding for thefirst six months and continued breastfeeding thereafte r

[/ -2. To reach the 9illennium :evelopment ;oal targetsfor child survival 5epal needs to reduce infant mortalityfrom /%# per /%%% live births in /''% to 3" per /%%% live

births by -%/( [3-2. The infant mortality was "$ per /%%%live births in 5epal in -%// [//2. This reduction from "$to 3" ,in -%/(1 can in part be achieved through a greateradoption of the recommended breastfeeding practice.

+n this study only $$.3) in -%// and (3.-) in -%%$ ofinfants were EBF within % F( months. 7hile it is encouraging to note that there was a /3) increase in the rate ofEBF it is still significantly lower than the 7H < 85+*EFrecommended level of '%) [- /- /"2. 5everthe less the

EBF rate among G( months infants is higher in 5epalcompared to Bangladesh ,"$)1 +ndia ,"0)1 and =a6istan,(%)1 [332. 7hen examined for the age specific changesin the rate of EBF the data showed a rapid decline in theEBF around the age of four months which is similar to thefindings from +ndia [/02 and =a6istan [3"2. 4t the age offive months the rate of EBF in 5epal had dropped to33./) in -%//. ur findings suggest that achieving the7H

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Khanal et al. BMC Public Health 2013, 13:958 Page & of 13 http: !!!.bio"e#cent$al.co" 1%&1'2%58 13 958

(able 2 P$opo$tion )*+ of e clu-i e b$ea-tfee#ing in infant- 5 "onth- of age an# un#e$ b/ health $elate#cha$acte$i-tic-, epal 200 ) %82+ an# 2011 ) 22&+

acto$ 200 2011

(otal 4* 6B n 4* 7

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Pa$it/ 0.002 0.%22

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)30.%+ 58 )%1.3+80 )35.1+ 51

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22% )% . + 123 )5&.2+

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