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Background: Best practices in breastfeeding are often not followed despite appropriate levels of knowledge and positive attitudes regarding the benefits of human milk. For many reasons, some women do not initiate breastfeeding, suspend breastfeeding early, or initiate complementary feeding earlier than recommended. Usual measurement methods use large sample surveys at a national scale, which are not well suited for monitoring sub-national differences. Methods: In order to understand how local infant feeding practices could influence policy and promotion practices, this paper uses data pooling methodology to analyse breastfeeding patterns in different Ecuadorian settings: Cumbayá parish, located near Quito, the Ecuadorian capital; the city of Macas and rural surroundings in the Amazon basin province of Morona Santiago; and the province of Galapagos. Using a cross-sectional design, we compiled and analysed data derived from three surveys of mothers of infants between 0 and 59 months of age. The surveys were conducted independently between August 2017 and August 2018. While the surveys are representative of each respective setting, sampling designs and survey methods differ, but the same demographic information and data based on standard breastfeeding indicators established by WHO were collected. In order to account for differences in the different settings, the design effect of each survey was considered in the analysis. Results: Significant differences were found in breastfeeding practices, particularly between the suburban parish near Quito and Galapagos on one hand and urban and rural parts of Morona Santiago province, on the other. For instance, initiation of breastfeeding in the first hour after birth occurs in only 36.2 percent of cases in Cumbayá but in 75.4 percent of cases in urban Morona. Conclusions: Differences among population segments reflect specific opportunities and barriers to practices related to promoting optimal infant health and nutrition. Consequently, regional or local conditions that often are not apparent in national-level data should orient policies and promotion activities in specific populations. |
