Breastfeeding and complementary feeding practices in rural Malawi

To facilitate optimal growth of newborns, many countries have developed inf ant feeding recommendations, usually suggesting 4-6 mo of exclusive breastf eeding and then the gradual introduction of complementary foods. We prospec tively studied the changes in infant diets and predictors of adherence to n ational infant feeding recommendations in a cohort of 720 newborn babies in rural Malawi, Sub-Saharan Africa. Monthly interviews of the main guardians indicated that breast-feeding was universal for 18 mo. As most babies were given water or other supplemental foods soon after birth, the exclusive br eastfeeding rates were only 19%, 8%, 2% and 0% at ages 1, 2, 3 and 4 mo, re spectively. Complementary foods and family foods were introduced at median ages of 2.5 and 6.3 mo, i.e. much earlier than recommended. Better adherenc e to recommendations was associated with smaller number of children in the family, increased maternal education and some other socio-economic or envir onmental variables. Conclusion: Exclusive breastfeeding is uncommon and complementary foods wer e introduced early to newborns among these rural families. Education and fa mily planning may improve adherence to infant feeding recommendations and r educe the incidence of early childhood malnutrition in Malawi.