Breast-, complementary and bottle-feeding practices in Kenya: stagnant trends were experienced from 1998 to 2009

The pattern of infant and young child feeding that provides the most benefit includes being put to the breast within an hour of birth, exclusive breastfeeding for 6 months, continued breastfeeding along with complementary foods up to 2 years of age or beyond, and avoidance of any bottle-feeding. However, since there are no published data from Kenya regarding trends in these feeding practices, this research undertook time trend estimation of these feeding practices using the 1998, 2003, and 2008-2009 Kenya Demographic and Health Survey and also examined the multivariate relationships between sociodemographic factors and feeding practices with data from 2008 to 2009. Logistic regression was used to test the significance of trends and to analyze sociodemographic characteristics associated with feeding practices. There was a significant decline in early initiation of breastfeeding among children in Central and Western provinces and those residing in urban areas. Trends in exclusive breastfeeding showed significant improvement in most sociodemographic segments, whereas trends in complementary feeding and breastfeeding remained stable. Bottle-feeding significantly decreased among children aged 12 to 23 months, as well as those living in Coast, Eastern, and Rift Valley provinces. In the multivariate analysis, the province was significantly associated with feeding practices, after controlling for child's size, birth order, and parity. The stagnant (and in some cases worsening) trends in early initiation of breastfeeding and complementary feeding with breastfeeding paint a worrisome picture of breastfeeding practices in Kenya; therefore, efforts to promote the most beneficial feeding practices should be intensified

Child undernutrition in Kenya: trend analyses from 1993 to 2008-09

Background: Research on trends in child undernutrition in Kenya has been hindered by the challenges of changing criteria for classifying undernutrition, and an emphasis in the literature on international comparisons of countries’ situations. There has been little attention to within-country trend analyses. This paper presents child undernutrition trend analyses from 1993 to 2008–09, using the 2006 WHO criteria for undernutrition. The analyses are decomposed by child’s sex and age, and by maternal education level, household Wealth Index, and province, to reveal any departures from the overall national trends. Methods: The study uses the Kenya Demographic and Health Survey data collected from women aged 15–49 years and children aged 0–35 months in 1993, 1998, 2003 and 2008–09. Logistic regression was used to test trends. Results: The prevalence of wasting for boys and girls combined remained stable at the national level but declined significantly among girls aged 0–35 months (p < 0.05). While stunting prevalence remained stagnant generally, the trend for boys aged 0–35 months significantly decreased and that for girls aged 12–23 months significantly increased (p < 0.05). The pattern for underweight in most socio-demographic groups showed a decline. Conclusion: The national trends in childhood undernutrition in Kenya showed significant declines in underweight while trends in wasting and stunting were stagnant. Analyses disaggregated by demographic and socio-economic segments revealed some significant departures from these overall trends, some improving and some worsening. These findings support the importance of conducting trend analyses at detailed levels within countries, to inform the development of better-targeted childcare and feeding interventions