Calculating Exclusive Breastfeeding Rates: Comparing Dietary "24-Hour Recall" with Recall "Since Birth" Methods

Background: Calculating exclusive breastfeeding (EBF) rates based on the previous-day recall has been recommended by the World Health Organization to avoid the recall bias but it also may not accurately reflect the feeding pattern since birth and leads to overestimate of the proportion of exclusively breastfed infants. The objective of this study was to compare the (EBF) rates calculated by the 24-hour recall and since birth recall and their association with different sociodemographic and maternal data. Subjects and Methods: Prospective descriptive study in Mansoura District including 1,102 mother-infant dyad attending primary healthcare centers for vaccination. One thousand ninety-one and 1,029 were followed up at 4 and 6 months during a period from January to October 2015. Sociodemographic data, maternal, antenatal, birth, and some infant related data were collected through interview. Questions about EBF using the 24-hour recall and since birth recall definitions were asked. Results: This study shows consistent difference in breastfeeding pattern reported by 24-hour recall with recall since birth at all age intervals. At the age of 6 months 13.6% of infants were EBF as reported by 24-hour recall method versus 5.2% for recall since birth method. Different factors were associated with EBF practice reported using these different methods. Conclusions: The two recall methods describe the reality in different and incomplete ways. It is better to measure and report EBF rated using both methods so as to give a full picture of breastfeeding practice. And it is very important to distinguish between both methods and not to be used interchangeably with each other.