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NEPAL

OUR FINDINGS: 

  • Almost all infants had a recent history of breastfeeding.

  • Among breastfed infants, the majority continued to receive breastmilk feeds (in conjunction with other feeds) well beyond two years of age.

  • Just over one-third of newborns were breastfed within the first hour of birth.

  • Only half of all breastfed infants were exclusively breastfed to six months of age.

  • The practice of offering non-breastmilk feeds is extremely common. Over 60% of newborns received either nothing or pre-lacteal feeds in the first hour of birth, while almost half of all of infants were given complementary feeds before the age of six months.

  • The rate of bottle-feeding in Nepal was extremely low.

  • Two-thirds of all infants 6–9 months of age were offered complementary feeds.

OUR RECOMMENDATIONS: 

  • Actively engage the health workforce in breastfeeding promotion and skill building programmes.

  • Develop community level initiatives to support appropriate IYCF among women who deliver at home.

  • Target urban dwelling women with higher education and wealth status to improve behaviours around exclusive breastfeeding.

  • Conduct further research to assess the quality and quantity of complementary foods including feeding patterns, dietary intake and the effect of these on growth.

Our work in Nepal highlighted a surprising phenomenon: mothers who had more contact with the health system appeared to be at greater risk of poor IYCF behaviours. This demonstrates an urgent need for breastfeeding promotion targeted at mothers with higher levels of contact with the health care system within the context of new and existing community breastfeeding promotion strategies to improve IYCF outcomes.