INFANT-FEEDING IN BOLIVIA - A CRITIQUE OF THE WORLD-HEALTH-ORGANIZATION INDICATORS APPLIED TO DEMOGRAPHIC AND HEALTH SURVEY DATA

Infant feeding is a multidimensional activity that can be described an d analysed in many different ways. The World Health Organization (WHO) has recently issued recommended indicators for assessing infant feedi ng practices. This paper presents these indicators and demonstrates th eir applications using the 1989 Demographic and Health Survey (DHS) da ta for Bolivia. The results indicate that, although most Bolivian infa nts are breastfed and two-thirds are breastfed for >1 year, supplement ary feeding practices deviate considerably from international recommen dations. Only 58% of infants <4 months old are receiving breastmilk al one (the 'exclusive breastfeeding rate') and a similarly low percentag e (54.7%) of 6-9 month olds are receiving the recommended combination of breast milk plus solid or semi-solid foods (the 'timely complementa ry feeding rate'). Furthermore, almost half of breastfed infants <12 m onths old are also receiving bottle feeds. The infant feeding practice s of city residents are least likely to conform to the infant feeding recommendations, while practices of mothers who have always lived in t he country are most likely to be similar to the WHO guidelines. Mother s who have moved to the city since the age of 12 are most likely to be giving their infants other milks in addition to breast milk and to be bottle feeding their infants. The WHO infant feeding indicators provi de a useful framework for quantifying infant feeding practices, and mo st of the indicators can readily be applied to DHS data. Nonetheless, improvements can be made in both the indicators themselves and the DHS questionnaire to improve reporting of internationally comparable infa nt feeding information.