Consumption of breast milk, formula and other non-human milk by children aged under 2 years: analysis of eighty-six low- and middle-income countries

To investigate the prevalence and socio-economic inequalities in breast milk, breast milk substitutes (BMS) and other non-human milk consumption, by children under 2 years in low- and middle-income countries (LMIC). We analysed the prevalence of continued breast-feeding at 1 and 2 years and frequenc...

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Bibliographic Details
Published in:Public health nutrition 2022-03, Vol.25 (3), p.680-688
Main Authors: Neves, Paulo AR, Barros, Aluísio JD, Baker, Phillip, Piwoz, Ellen, Santos, Thiago M, Gatica-Domínguez, Giovanna, Vaz, Juliana S, Rollins, Nigel, Victora, Cesar G
Format: Article
Language:English
Subjects:
Age
Babies
Baby foods
Breast Feeding
Breast milk
Breastfeeding & lactation
Children
Children & youth
Consumption
Developing Countries
Diet
Feeding
Female
GDP
Gross Domestic Product
Health surveys
Households
Humans
Income
Income inequality
Indicators
Infant
Milk, Human
Nutritional Epidemiology
Poverty
Regression analysis
Research Paper
Socioeconomics
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Summary:To investigate the prevalence and socio-economic inequalities in breast milk, breast milk substitutes (BMS) and other non-human milk consumption, by children under 2 years in low- and middle-income countries (LMIC). We analysed the prevalence of continued breast-feeding at 1 and 2 years and frequency of formula and other non-human milk consumption by age in months. Indicators were estimated through 24-h dietary recall. Absolute and relative wealth indicators were used to describe within- and between-country socio-economic inequalities. Nationally representative surveys from 2010 onwards from eighty-six LMIC. 394 977 children aged under 2 years. Breast-feeding declined sharply as children became older in all LMIC, especially in upper-middle-income countries. BMS consumption peaked at 6 months of age in low/lower-middle-income countries and at around 12 months in upper-middle-income countries. Irrespective of country, BMS consumption was higher in children from wealthier families, and breast-feeding in children from poorer families. Multilevel linear regression analysis showed that BMS consumption was positively associated with absolute income, and breast-feeding negatively associated. Findings for other non-human milk consumption were less straightforward. Unmeasured factors at country level explained a substantial proportion of overall variability in BMS consumption and breast-feeding. Breast-feeding falls sharply as children become older, especially in wealthier families in upper-middle-income countries; this same group also consumes more BMS at any age. Country-level factors play an important role in explaining BMS consumption by all family wealth groups, suggesting that BMS marketing at national level might be partly responsible for the observed differences.
ISSN:1368-9800
1475-2727
DOI:10.1017/S1368980020004061