Breastfeeding

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Model Inputs \(\rightarrow\) Family Planning Parameters \(\rightarrow\) Breastfeeding

Overview

Breastfeeding status and duration are simulated in the model after delivery, and are used to determine if women experience protective effects of lactational amenorrhea on risk of pregnancy.

Data

We obtained data compiled by UNICEF on ‘any breastfeeding’ for 131 countries,^[1] and ‘exclusive breastfeeding’ of infants 0-5 months for 134 countries.^[2] Globally, it is estimated that 42% of infants 0-5 months of age were exclusively breastfed in 2018, with variation by region.^[2]

Region	Exclusive Breastfeeding (%)
Eastern and Southern Africa	55
South Asia	54
Latin America and the Caribbean	38
North America	35
West and Central Africa	34
Eastern Europe and Central Asia	33
East Asia and the Pacific	30
Middle East and North Africa	30

Parameters

We estimated hierarchical logistic regression models for the probability of any breastfeeding, and of exclusive breastfeeding for infants 0-5 months based on the compiled UNICEF data. We also set priors for the probability of breastfeeding for 6 months (as opposed to 9 months, the maximum duration of LAM efficacy we model) conditional on any breastfeeding. We allowed the sampled parameters to vary by subgroup in the model.

Priors

Model Implementation

Breastfeeding status is simulated after live birth delivery in the model. Conditional on any breastfeeding, a status (exclusive/non-exclusive) and duration are assigned. We assume that women who breastfeed exclusively for any duration will then continue to breastfeed non-exclusively for an additional 3 months. If a breastfeeding child dies, we assume that the mother stops breastfeeding and no longer experiences any protective efficacy from LAM. (Note: If a mother had twins, then LAM protective efficacy continues if at least 1 breastfeeding child is still alive.)

References

United Nations Children’s Fund, Division of Data, Analysis, Planning and Monitoring (2019). Global UNICEF Global Databases: Infant and Young Child Feeding: Early initiation of breastfeeding, Ever Breastfed, New York, June 2019. Available at: https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding/
United Nations Children’s Fund, Division of Data, Analysis, Planning and Monitoring (2019). Global UNICEF Global Databases: Infant and Young Child Feeding: Exclusive breastfeeding, Predominant breastfeeding, New York, June 2019. Available at: https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding/

GMatH (Global Maternal Health) Model - Last updated: 28 November 2022

zward@hsph.harvard.edu