Is increasing urbanicity associated with changes in breastfeeding duration in rural India? An analysis of cross-sectional household data from the Andhra Pradesh children and parents study.
Oakley, Laura;
Baker, Christopher P;
Addanki, Srivalli;
Gupta, Vipin;
Walia, Gagandeep Kaur;
Aggarwal, Aastha;
Bhogadi, Santhi;
Kulkarni, Bharati;
Wilson, Robin T;
Prabhakaran, Dorairaj;
+4 more...Ben-Shlomo, Yoav;
Davey Smith, George;
Radha Krishna, KV;
Kinra, Sanjay;
(2017)
Is increasing urbanicity associated with changes in breastfeeding duration in rural India? An analysis of cross-sectional household data from the Andhra Pradesh children and parents study.
BMJ open, 7 (9).
e016331-.
ISSN 2044-6055
DOI: https://doi.org/10.1136/bmjopen-2017-016331
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OBJECTIVE: To investigate whether village-level urbanicity and lower level socioeconomic factors are associated with breastfeeding practices in transitioning rural communities in India. SETTING: 29 villages in Ranga Reddy district, southern India between 2011 and 2014. PARTICIPANTS: 7848 children under 6 years identified via a cross-sectional household survey conducted as part of the Andhra Pradesh Children and Parents Study. OUTCOME MEASURES: Two key indicators of optimal breastfeeding: termination of exclusive breastfeeding before 6 months and discontinuation of breastfeeding by 24 months. Village urbanicity was classified as low, medium or high according to satellite assessed night-light intensity. RESULTS: Breastfeeding initiation was almost universal, and approximately two in three children were exclusively breastfed to 6 months and a similar proportion breastfed to 24 months. Using multilevel logistic regression, increasing urbanicity was associated with breastfeeding discontinuation before 24 months (medium urbanicity OR 1.45, 95% CI 0.71 to 2.96; high urbanicity OR 2.96, 95% CI 1.45 to 6.05) but not with early (<6 months) termination of exclusive breastfeeding. Increased maternal education was independently associated with both measures of suboptimal breastfeeding, and higher household socioeconomic position was associated with early termination of exclusive breastfeeding. CONCLUSION: In this transitional Indian rural community, early stage urbanicity was associated with a shorter duration of breastfeeding. Closer surveillance of changes in breastfeeding practices alongside appropriate intervention strategies are recommended for emerging economies.