Factors associated with exclusive breastfeeding practices in western Bhutan

  • Hari Prasad Pokhrel Senior Nutritionist, Samdrup Jongkhar Hospital, Ministry of Health, Bhutan.
  • Patcharanee Pavadhgul Department of Nutrition, Faculty of Public Health, Mahidol University, Thailand.
  • Suwat Srisorrachatr Department of Nutrition, Faculty of Public Health, Mahidol University, Thailand.
Keywords: Exclusive breastfeeding; Maternal and Child Health Clinics; Western Bhutan.


Introduction: Breastfeeding is widely accepted in Bhutan but there are wide range of practices, some of which are not in accordance with the recommendations of WHO. In 2015 the prevalence of exclusive breastfeeding under six months of age, in western region was only 33.8% while the national rate was 51.4%. This study aimed to identify the factors associated with exclusive breastfeeding practices in western Bhutan.

Methods: A cross-sectional study was conducted involving 220 mothers with children 6-12 months of age attending the Maternal and Child Health clinics of three hospitals in western Bhutan. Data collection was done by a face-to-face interview in April 2017. Chi-square test was used to assess the association and all the significant variables were included in the multivariate model adjusting for potential confounders.

Results: The prevalence of exclusive breastfeeding at six months was 35.9%. Multivariate logistic regression detected significant association of exclusive breastfeeding with parity
(ORadjusted 2.80; 95% CI 1.36-5.78), knowledge (ORadjusted 2.09; 95% CI 1.09-4.00), family income (ORadjusted 2.26; 95% CI 1.10- 4.65), early initiation of breastfeeding (ORadjusted 6.28; 95% CI 1.90-20.70), and care giver (ORadjusted 3.56; 95% CI 1.19-10.59). Mothers’ perception that the child feels thirsty was the most important reason to stop exclusive breastfeeding.

Conclusions: The study identified breastfeeding education as a definite measure to improve the rates of exclusive breastfeeding in western Bhutan. The study recommends to educate mothers that water is not required for the baby until six months of age and to include fathers in breastfeeding education sessions. The study also recommends to strengthen lactation management clinic.


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