Tohoku J. Exp. Med., 2018 September, 246

Inequality and Mother’s Age as Determinants of Breastfeeding Continuation in Bangladeshe

G.M. RABIUL ISLAM,1 ISAO IGARASHI1 and KOICHI KAWABUCHI1

1Department of Health Care Economics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

The World Health Organization recommends continuing breastfeeding up to 2 years of age or beyond for sound growth and development of children. In Bangladesh, continuation rates for breastfeeding have recently decreased and effective measures are required to counter this downward trend. Although recent years have seen economic development and reductions in poverty, Bangladesh still has the highest rate of child marriage worldwide. Thus, we aimed to clarify the factors influencing breastfeeding continuation, especially from the perspective of inequality and mother's age in Bangladesh, using data from the Bangladesh Demographic and Health Survey 2011. Event history analyses were performed during a 24-month follow-up period on 7,041 mothers with duration of breastfeeding as the outcome variable, with wealth index (an indicator for inequality) and mother's age used as the main explanatory variables. The results showed that poorer mothers were on the whole more likely to continue breastfeeding through 24 months after childbirth, and younger mothers were less likely to continue breastfeeding particularly past the first year. However, both younger and older mothers continued breastfeeding to the same extent within the first year after childbirth. Mother's age had time-varying effects on breastfeeding continuation, meaning that the effects on breastfeeding continuation were affected by the child's age. These findings imply that policymakers should be aware that efforts to reduce child marriage may increase the rate of breastfeeding continuation beyond the first year after childbirth. In contrast, efforts at poverty alleviation, aimed at preventing child marriage, may decrease the rate irrespective of the child's age.

Key words —— breastfeeding continuation; event history analysis; inequality; mother's age; time-varying by child's age

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Tohoku J. Exp. Med., 2018, 246, 15-25

Correspondence: Isao Igarashi, Department of Health Care Economics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.

e-mail: igarashi.hce@tmd.ac.jp