Breastfeeding intentions, patterns, and determinants in infants visiting hospitals in La Paz, Bolivia

BACKGROUND Recent ecological research from Latin America has shown that infant health could be promoted through exclusive breastfeeding in infants aged 0-3 months and partial breastfeeding throughout the remainder of infancy. METHODS In a cross-sectional study in 1995, the author interviewed 518 mothers with infants leq; 1 year in La Paz, Bolivia, to describe the breastfeeding pattern and its determinants including socio-economic, religious and ethnic background. RESULTS The rate of any breastfeeding remained above 85% during the first year. Exclusive breastfeeding rates fell from 89% at one week of age to 45% as early as one month of age, and then gradually declined to 20-25% in 6-month-old infants. The overall exclusive breastfeeding rate in infants < 4 months was 46% (n = 246). The use of prelacteal feeds (p < 0.0001, n = 436), not feeding the infant colostrum (p = 0.0008, n = 436), and Latin ethnicity (p = 0.0091, n = 436) were associated with a shorter duration of exclusive breastfeeding. Rural mothers were four times more likely to discard the colostrum than urban mothers (p = 0.0110, n = 501). Actual exclusive breastfeeding duration was shorter than what the mothers reported to be the ideal duration of exclusive breastfeeding for the infant. CONCLUSIONS The rate of exclusive breastfeeding in Bolivian infants fell rapidly during the first months of life. Avoidance of prelacteal feeding and use of colostrum were associated with improved breastfeeding patterns.