The World Health Organization estimated that about 800 000 infant deaths could be prevented annually by exclusively breastfeeding infants for the first 6 months of life. This study aimed to examine the prevalence of exclusive breastfeeding and its associated factors. A total of 192 mothers participated. The prevalence of exclusive breastfeeding practice in Trongsa district was 97% at 1 month, declining to 58% at 6 months. Mothers who returned to formal work were less likely to exclusively breastfeed than those who were farmers or housewives. The main reasons stated by the mothers for not exclusively breastfeeding were lack of the mother’s self-confidence that the child is getting enough breastmilk and mothers having to return to work, 59% and 22%, respectively. The rate of exclusive breastfeeding in Trongsa district of Bhutan is high, and every effort should be made to maintain and improve this rate.
World Health Organization. Global Strategy on Infant and Young Child Feeding. Geneva, Switzerland: World Health Organization; 2002.
2.
QasemWFentonTFrielJ.Age of introduction of first complementary feeding for infants: a systematic review. BMC Pediatr. 2015;15:107. doi:10.1186/s12887-015-0409-5.
3.
BinnsCWLeeMK.Exclusive breastfeeding for six months: the WHO six months recommendation in the Asia Pacific Region. Asia Pac J Clin Nutr. 2014;23:344-350. doi:10.6133/apjcn.2014.23.3.21.
4.
Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO collaborative study team on the role of breastfeeding on the prevention of infant mortality. Lancet. 2000;355:451-455.
5.
World Health Organization. Infant and Young Child Feeding, Model Chapter for Textbooks for Medical Students and Allied Health Professionals. Geneva, Switzerland: World Health Organization; 2009.
BlackREAllenLHBhuttaZA, et al; Maternal and child undernutrition study group. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371:243-260. doi:10.1016/S0140-6736(07)61690-0.
8.
American Academy of Pediatrics. Breastfeeding and the use of human milk. Pediatrics. 2012;129:e827-e841. doi:10.1542/peds.2011-3552.
9.
BinnsCLeeMLowWY.The long-term public health benefits of breastfeeding. Asia Pac J Public Health. 2016;28:7-14. doi:10.1177/1010539515624964.
10.
RaheemRABinnsCWChihHJ.Protective effects of breastfeeding against acute respiratory tract infections and diarrhoea: findings of a cohort study. J Paediatr Child Health. 2017;53:271-276. doi:10.1111/jpc.13480.
11.
VictoraCGBahlRBarrosAJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387:475-490. doi:10.1016/S0140-6736(15)01024-7.
12.
AlianmoghaddamNPhibbsSBennC.Reasons for stopping exclusive breastfeeding between three and six months: a qualitative study. J Pediatr Nurs. 2018;39:37-43. doi:10.1016/j.pedn.2018.01.007.
13.
BinnsCLeeASauerKHewittK.Reported breastfeeding rates in the Asia-Pacific Region. Curr Pediatr Rev. 2012;8:339-345.
14.
World Health Organization. Infant and Young Child Feeding: A Tool for Assessing National Practices, Policies and Programs. Geneva, Switzerland: World Health Organization; 2003.
15.
Ministry of Health. National Nutrition Survey: Nutrition Programme. Thimphu, Bhutan: Ministry of Health; 2015.
16.
Ministry of Health. National Health Survey Report. Thimphu, Bhutan: Ministry of Health; 2012.
17.
Population and Housing Census Bhutan. Population & Housing Census of Bhutan. Thimphu, Bhutan: Royal Government of Bhutan; 2005.
18.
World Health Organization. The Kingdom of Bhutan Health System Review. Vol 7. New Delhi, India: World Health Organization; 2017.
19.
Ministry of Health. National Health Policy. Thimphu, Bhutan: Ministry of Health; 2011.
20.
Ministry of Health. Annual Health Bulletin. Thimphu, Bhutan: Ministry of Health; 2017.
21.
Ministry of Health. Human Resource for Health Country Profile, Bhutan. Thimphu, Bhutan: Ministry of Health; 2014.
22.
National Statistics Bureau. Trongsa Dzongkhag, an Annual Report at a Glance. Thimphu, Bhutan: National Statistics Bureau; 2016.
23.
TsheringD.Situation Analysis of Dzongkhag Health Systems of Trongsa Dzongkhag. Trongsa, Bhutan: Dzongkhag Health Sector; 2015.
24.
World Health Organization. Indicators for Assessing Infant and Young Child Feeding Practices: Part 3, Country Profiles. Geneva, Switzerland: World Health Organization; 2010.
25.
TurnerRCMulvenonSWThomasSPBalkinRS.Computing indices of item congruence for test development validity assessments. Dutch J Educ Res. 1977:1-5.
26.
CampbellRKAguayoVKangY, et al. Infant and young child feeding practices and nutritional status in Bhutan [published online December 21, 2017]. Matern Child Nutr. doi:10.1111/mcn.12580.
27.
TangLBinnsCWLeeAHPanX.Low prevalence of breastfeeding initiation within the first hour of life in a rural area of Sichuan Province, China. Birth. 2013;40:134-142.
28.
KhanalVLeeAHKarkeeRBinnsCW.Prevalence and factors associated with prelacteal feeding in Western Nepal. Women Birth. 2016;29:12-17. doi:10.1016/j.wombi.2015.07.006.
29.
Ministry of Education. Operational Guideline for Non-Formal Education Program, Ministry of Education: Thimphu Bhutan. Thimphu, Bhutan: Royal Government of Bhutan; 2017.
30.
MgongoMMoshaMVUriyoJGMsuyaSEStray-PedersenB.Prevalence and predictors of exclusive breastfeeding among women in Kilimanjaro region, Northern Tanzania: a population based cross-sectional study. Int Breastfeed J. 2013;8:12. doi:10.1186/1746-4358-8-12.
31.
TanKL.Factors associated with exclusive breastfeeding among infants under six months of age in peninsular Malaysia. Int Breastfeed J. 2011;6:2.
32.
AdhikariMKhanalVKarkeeRGavidiaT.Factors associated with early initiation of breastfeeding among Nepalese mothers: further analysis of Nepal Demographic and Health Survey, 2011. Int Breastfeed J. 2014;9:21.
33.
TewabeTMandeshAGualuTAlemGMekuriaGZelekeH.Exclusive breastfeeding practice and associated factors among mothers in Motta town, East Gojjam zone, Amhara Regional State, Ethiopia, 2015: a cross-sectional study. Int Breastfeed J. 2017;12:12. doi:10.1186/s13006-017-0103-3.
34.
SeidAMYesufMEKoyeDN.Prevalence of exclusive breastfeeding practices and associated factors among mothers in Bahir Dar city, Northwest Ethiopia: a community based cross-sectional study. Int Breastfeed J. 2013;8:14. doi:10.1186/1746-4358-8-14.
35.
Jara-PalaciosMÁCornejoACPeláezGAVerdesotoJGalvisAA. Prevalence and determinants of exclusive breastfeeding among adolescent mothers from Quito, Ecuador : a cross-sectional study. Int Breastfeed J. 2015;10:33. doi:10.1186/s13006-015-0058-1.
